On Miscarriages and Thyroids and Disease With Weird Names

Happy Wednesday!

The air here is chilly and we have snow in the forecast for the second day in a row. Nothing materialized yesterday and I'm crossing my fingers that today is the same. It's October for Pete's sake!

Anyway, it's been awhile since I talked at all about our miscarriages and I thought today I would give an update on what we've found out and what things will probably look like going forward.

For those that are new here, let me give you a brief history. I have had two perfectly normal, uncomplicated pregnancies, labors and deliveries. Two perfectly healthy little girls, born two years apart, now ages five and three.

I have never been someone who struggled with weight and during both pregnancies I gained only 20 and 22 pounds consecutively. This wasn't intentional - I hardly exercised and I didn't eat any sort of special diet, I was just lucky enough to have the genetics that made me that way. I also lost the weight almost immediately after both pregnancies - again, without any sort of diet or exercise. I'm not saying this to brag, because I had absolutely nothing to do with it! I'm just giving you a little context.

About six months after having Sophia, I noticed that I was starting to gain weight. Not a ton, but it was strange to me because I hadn't made any changes in my diet. I'm not a health nut but I wasn't binging on junk food either. I figured it was just a part of getting older and that I was going to need to start being a little more diligent about eating right and exercising regularly. Dave and I began a super intense diet and exercise program (P90X). But despite all of that, my weight continued to rise. (And OF COURSE, Dave was losing weight and looking great! *sigh*)

I was also tired - but what mother of a nursing infant and a toddler isn't?!? I didn't really connect any of these symptoms. I just figured it was all part of getting older.

A little over two and a half years after Sophia was born two things happened: we decided we were ready for another baby and I went in for my yearly OB/GYN appointment. I mentioned to my doctor that I had been having irregular periods - sometimes it would be six weeks and sometimes only three. I have always been able to set my watch by my cycle so I knew something was probably off. She decide to run some blood work and test me for a few things, one of them being hypothyroidism. And sure enough, the results came back showing that the levels of my Thyroid Stimulating Hormone (TSH) were elevated, meaning I had an under active thyroid.

Suddenly all of those seemingly disconnected symptoms made sense. My doctor started me on a thyroid replacement hormone and we began the process of figuring out how to get my levels normal.

About a month later we found out we were expecting. We were shocked that it had happened so quickly but excited and I immediately called my doctor to see what needed to be done. I knew the thyroid was important in early pregnancy but I didn't really know why. She assured me that we would continue to check my levels and everything should be fine. 

Just four weeks later, I walked out of the doctors office with the heartbreaking news that the baby had died. Our first miscarriage.

I was shocked. I knew other women had struggled with this, but not me. My doctor assured me it was normal (and it is) and that it had nothing to do with my thyroid (which I didn't realize until later wasn't true). These things just happen sometimes. You can try again and things will be better.

We grieved and we continued to treat my thyroid and after about 5 months we decided we were ready to try again. About the same time, I went in for a check of my thyroid levels. They had been stable but my doctor wanted to continue to monitor them to be sure we had them in the right place. I got a phone call from the nurse after the appointment letting me know that my thyroid hormone was high, but curiously, so was my progesterone? Where was I in my cycle? And I realized...I was late. Two tests confirmed the happy news - we were pregnant again!

And again, a month later we listened in vain for the sound of a heart that was no longer beating, our second miscarriage.

It is difficult to describe what that news did to my heart. It crushed my fragile hope that the first miscarriage was really just a fluke. Suddenly, this wasn't just one isolated incident. It was two consecutive almost identical miscarriages. Though my doctor did admit that it was a little unusual, she still did not believe it could have stemmed from my thyroid issues. I was not convinced.

On the recommendation of a friend, I made an appointment to see an endocrinologist who specializes in thyroid and diabetes. She gave me a full explanation of the thyroid and how it functions, (complete with diagrams!) something I had never gotten from my OB. She also explained to me that though my doctor had been keeping my TSH levels in the "normal" range, she had not had them within the recommended guidelines for a pregnant woman.

In other words, my levels were not where they should have been. Additionally, she explained, some women who have hypothyroidism develop problems because they have developed an autoimmune disease called Hashimoto's.

This is a disease of the immune system in which your body views your thyroid as a foreign object and begins attacking it. Essentially, you lose pieces of your thyroid that will never be recovered. The problem is, those same antibodies that are attacking your thyroid may then move on to attack other tissues in your body, like your pancreas, your stomach, or, in the case of a pregnant woman, your developing baby.

After having some blood work done, the endocrinologist confirmed that those antibodies were present and were very likely the cause of my miscarriages.

So this is where we are today. As relieved as I am to know the cause of the miscarriages, there is a terrible feeling that comes with knowing that your body, the place that is supposed to be a gentle environment that nourishes your developing baby has instead become a hostile one that attacks it. Essentially my own body killed my babies. And though I know I had nothing to do with it, it's still an awful thought.

The good news is that there is hope. My endocrinologist believes that by keeping my hormone levels in the appropriate range for a pregnant woman, we will keep the antibodies away and thus still be able to have a healthy pregnancy. Since finding out the news of my diagnosis I have scoured the Internet reading countless stories of women with Hashimoto's who have been able to carry a baby to full term.

The bad news is, because of my diagnosis, every pregnancy I have will now be considered high risk. In a normal pregnancy the risk of miscarriage almost disappears at 12 weeks. With Hashimoto's, I will be at risk for miscarriage/stillbirth up to 32 weeks. We will have to constantly monitor my thyroid levels and make adjustments as needed. And while there is a chance that I will be able to have more children, there is also a chance that I may never be able to carry another baby to term.

I will be honest, that's hard for me to think about. I know we still have a long ways to go and I haven't resigned myself to the possibility yet at all. We will keep trying and we will keep trusting that if God wants us to have more children, He will make it happen in His time and His way. But I also have come to the understanding that birth control and the idea that we can actually decide how many children we are going to have and when is something of a misconception. We only have the amount of control over it that God allows us to have. He is sovereign. He knows. And I trust that He is good whether we are able to have 12 more children or whether we have none.

I hope that in sharing my story, I might be able to help other women who could be struggling with some of the same issues and not even realize it. If I had just listened to my OB and had never gotten a second opinion, I wouldn't know what I do today. I don't fault her - she was acting on the information she had and I hope that her experience with me helped her in knowing how to help future hypothyroid patients. She is an extremely kind and loving doctor who genuinely cares for her patients and I hold no resentment towards her. 

 

But I do hope that perhaps someone might be helped by reading my experience. If you are having problems with your thyroid, I recommend you get to a good endocrinologist right away, and if you have second thoughts about what your doctor is telling you, don't hesitate to get opinions from other qualified medical professionals either!

Whew, that was a lot of words! Hope it was helpful!