In a message dated 5/31/2002 3:51:42 PM US Eastern Standard Time,
[log in to unmask] writes:


> I then miscarried on March 30th. I was approx 10 weeks
> pregnant. >>>

My sincere condolence for your pain and the pain of every other women who
suffered similar losses. My mother had 4 miscarriages, one for each live
birth. Her first cousin had a goiter removed, and my mother died at 48
because it never occurred to anyone that the miscarriages, the rapid weight
gain of 60-70 pounds (while living mostly on black coffee and Pall Mall
cigarettes), the depression, and hair loss were all related to Mom's
undiagnosed and untreated hypothyroidism.

In the 50s, it was well known by Gynecologists and family docs that many
times, taking thyroid could prevent miscarriages. Dr. Arem, in "The Thyroid
Solution," has a good description of the problems of infertility and
miscarriage associated with even minor disorders. A women's need for thyroid
hormones increases during pregnancy, and I have worked with pregnant women
who eventually needed DOUBLE the amount of thyroid medication before the
pregnancy came to a happy end.  <<<<

>
> I have been unable to conceive for the past two cycles. I fell pregnant
> after
> only one month with my first child and also with the pregnancy earlier this
> year. My endo refuses to let me increase my T3 back to 20mcg. I am
> suffering
> from numb fingers and toes, pins & needles all up my arms, I am unable to
> type very well (my husband has typed this for me) and therefore have been
> unable to work since the beginning of March.I am having a recurrence of the
> kidney pains I haad before I got pregnant with my last child, which wake me
> up during the night. I have also gained 10lbs which I know part of which
> may
> be due to confused hormones.  >>>
>
> Too often, patients who know better will listen to docs who do not. It
> sounds like you already realize that your current doc may not be so good
> for your health, or fertility. Your observation on the improved fertility
> with adequate thyroid replacement is correct. I have literally lost count
> of the number of women who have gotten pregnant shortly after getting
> enough thyroid replacement.
>
> Dr. Arem quoted a study that found that about 25% of women referred to
> Infertility clinics have hypothyroidism (and he probably counts high TSH
> patients only) <<<

>
> I am tempted to cancel visits to my endo and just take 20mcg T3 (I am
> sneaking 15mcg at the moment which she is very unhappy about but without it
> I
> would not be able to get out of bed) but I would be very nervous of being
> pregnant and not having blood tests every month. I cannot swap doctors, so
> what should I do?  >>>>
>
> What would you do if your doctor was a serial killer, and you "could not
> swap doctors?"

(Here comes my mantra.) Thyroid status is a diagnosis, NOT a blood test. The
> clinical lab is unable to replace clinical acumen. And 85% of a diagnosis is
> the History. (What has been happening to your patient before she came to
> the office?) The Exam is about 10%, and your labs are worth, on the average
> 5%.
>
> Being hypothyroid and pregnant is a very dangerous combination. In addition
> to infertility that hypothyroidism causes, miscarriages at all stages of
> pregnancy, birth defects, mental retardation, problems with maintaining
> health during pregnancy, delivery difficulties, and post partum depression
> are all more common in the hypothyroid, pregnant patient.

> When one evaluates all the risks involved, a serial killer who was NOT a doc
> would be a lot less dangerous. <<<

> Any advice would be gratefully received as you can appreciate the stress
> this
> situation is creating in our marriage. >>>>

Please, get to someone who will treat your thyroid condition better than how
you have been treated. You deserve a trained health care worker to help
manage the thyroid problem. I think that it is painfully obvious that your
doc leaves much to be desired.

A prayer that you get what you need to get well.

Doc Don

>
>
>


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