Breastfeeding

Thyroid and milk supply

I just came across this interesting article that talks about how poor milk production in women with a history of thyroid dysfunction is likely related to low blood levels of thyroid hormone. 

I had Graves Disease that was treated with radioactive iodine. So my hyperactive thyroid is now a hypoactive thyroid. I see an endocrinologist frequently and she's already increased my medication, Synthroid, twice so far in pregnancy (from 125 to 200; then 200 6x a week, 300 1x a week). Obviously I'll ask her about this at my next appointment. I just saw her recently, so my next appt isn't into January. But I wanted to ask you ladies a few questions:

1. Do your doctor need to adjust your medication AFTER birth?

2. How soon after birth did you have your blood tested for thyroid levels and/or see your endocrinologist?

3. What did I need to be aware of immediately after birth?

I've had my TSH levels get really out of whack twice. The first time was after the radioactive iodine before I was on Synthroid. My TSH got into the 30. I felt awful. I would shiver in any air conditioned setting even though it was the end of July. I was in Vegas on vacation and I had to go outside the casino to warm up.  I also got light headed and dizzy every time I stood up. The last time my TSH got out of whack was when I first got pregnant. My endo didn't see me until I was 8 weeks along and my TSH skyrocketed to 21. Same cold intolerance as before plus my pulse was super low (like 62 and I'm not a marathon runner!!). So I just gave my DH a heads up to pay attention to those symptoms for me after birth. I think I'll be a little tired and I'll need someone else to help watch out for me. :) 

Any other advice? 

Re: Thyroid and milk supply

  • I am hypothyroid.  I had no changes during pregnancy.  I was tested at about 8 weeks pp and was diagnosed hyperthyroid.  So I took my 50mg Synthroid and alternated with 25mg every other day (50 one day and 25 the next.)  At about 4 months pp I was diagnosed with post partum depression and anxiety.  So, my provider checked my thyroid again and my TSH was18! So they upped my Synthroid again, alternating between 50 and 75 mg.  I am so glad they rechecked as I was having symptoms that I just attributed to post-partum...anxiety, depression, low milk supply, tiredness, weight gain.  I am still on meds for my PPD but I feel better in many ways...less tired, not as anxious, and back in all my pre-pregnancy clothes! 

     

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  • I'm hypo and went from 50 mcg to 137 mcg synthroid during pregnancy. I'm still at 137. I was checked about a month pp and 6 months pp. It's not really a big deal unless you have symptoms. Make sure your pedi knows so they can check LO. They do an extra test on them if I remember right. He was fine.
  • I have Hashimoto's (hypo)

    1. During pregnancy I went from 25 mcg to 75mcg. I went to no medicine after birth to being on a weird schedule of 50mcg some days and 25mcg others (this is my current schedule but I need to be tested next week again).

    2. I believe I was first checked after babies 2 week appt. and again at 8 weeks.

    3. Just listen to your body. You are probably able to tell best when your thyroid is out of whack and when you are run down from taking care of lo. I knew my thyroid was out of whack about a month after I went off of all thyroid medicine because I was more tired and was constantly cold.

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  • I'm hypothyroid and my medication was not changed during pregnancy (I'm on 50mcg Synthroid).  My TSH will be checked at my 6 week appointment.

    I'm paying very careful attention to my body, but so far haven't had any of my typical "TSH out of whack" signs.  

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  • Same situation here- Graves treated with radioactive iodine.  My levels are always wonky throughout pregnancy.  Up and down the whole time.  Then after DS was born, they reduced my medication level to what it was pre-pregnancy soon after birth.  I don't think it was immediate, but within a couple weeks.  Then I had my levels checked again around the 6 week mark and I think she adjusted it once more and I stayed put at that dose for a long time.  After I weaned, they had to adjust me once again.  Just plan to get your levels checked every 3-6 mos or more often if you start feeling off.  As for milk production, I was worried about this too, but really it was never much of an issue.  For me, my supply issues were always related to stress so whatever you do, don't stress about your thyroid levels!  Just do what your Dr says and you'll be fine.  Really, the way that my OB has explained it to me is that during pregnancy, baby will take what he/she needs first and leave you feeling like crap.  Similar situation with BF- your body knows what to do and it would have to be really high/low for a long time for it impact your supply.  Also, don't be surprised if your baby fails their newborn thyroid screen.  It's VERY common and they will just repeat the test a couple weeks later and everything will probably be totally normal. 

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  • image mertense:

    I have Hashimoto's (hypo)

    1. During pregnancy I went from 25 mcg to 75mcg. I went to no medicine after birth to being on a weird schedule of 50mcg some days and 25mcg others (this is my current schedule but I need to be tested next week again).

     

    How do you know how much to take every day?  Synthroid dosage changes take 2 weeks to make a difference.  

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