Pregnancy, breastfeeding and HPTH
Blaithin O'Donnell is an HPTH UK member and became Hypoparathyroid following surgery for thyroid cancer in April 2002. Here she describes her experiences of two successful pregnancies and births in London and Dublin.
I'm lucky in that I'm pretty stable with my HPTH, and only had crashes when I was first diagnosed in 2002 following surgery for Thyroid Cancer. I do get pins and needles every day, but I've just gotten used to it and minor cramps but if I move about I can usually get rid of them, and then I usually remember that I've forgotten a Sandocal. I'm currently taking Sandocal 400 (2 twice a day) and Alfacalcidol (Alpha D)(1mcg six days a week and 2mcg once a week.
My husband and I had a baby daughter London in July 2004 ago and I had excellent care in pregnancy with an woman obstetrician Dr Girling in West Middlesexhospital, Isleworth, who takes a special interest in endocrinology in pregnancy. I had blood tests every 3-4 weeks to check my levels, which were quite stable actually. I had to increase to 6 Sandocal a day, but no other major problems with the pregnancy. Dr Girling even pre prescribed IV Calcium if it needed to be administered if I had continual vomiting in labour which would cause my levels to crash.
We moved from London to Dublin May 2005.
I was breastfeeding for 1 year after Roisin was born at the higher Sandocal levels, without problems and 2 months after ceasing breastfeeding I was put back down to 4 a day. The first week from 6 to 4 was not nice, (more cramps and pins and needles than normal) but I stabilised then, and I'm back to my pre pregnancy levels now.
There has been no proper research done on Alfacalcidol whilst breastfeeding.There was a worry that the baby might become Hypercalcemic, as studies showed in rats that it can transfer through into breastmilk, but 2 weeks after I started feeding Roisin she had a blood test which showed her calcium levels to be normal, so I'm proof that it is possible. None of the medical staff had come across a breastfeeding woman on Alfacalcidol before, and I was a guinea pig, but I was adamant I wanted to feed her myself. Now there is some data to spread around!
I'd love in the future If I could cease taking the Sandocal as it is such a pain to dissolve and I'm always leaving it dissolving and then forget to take it and come back to a glass with solidified calcium up the glass! Also it is awkward when travelling and when you're out and about
I'm planning a 2nd pregnancy in 2007 so my blood tests will have to become monthly instead of 6 monthly during any pregnancy. On my last pregnancy I found there was very little research done into Pregnancy and breastfeeding with HPTH and so we had to make up the rules as we went along. If there is ever any survey about Pregnancy with HPTH I would be a willing participant!
Update June 2007 - 2nd baby
I am attending the Rotunda maternity hospital in Dublin and went for my first appt at the endocrine clinic there about 3 weeks ago. The first doc I saw there hadn't a clue! "So you have an overactive thyroid then is it?" he said.
"Well, no, I have no thyroid and no parathyroids" I said, at which point he looked panicked! I asked him to just take down exactly what I said and gave him a complete case history and then asked him to take it next door to the senior consultant Maria Byrne who came in straight away with a big grin and a look of "Ooh good, something different then Diabetic women today!". She is very matter of fact which suits me fine and could see I knew my HPTH inside out so didn't patronise me.
I've read the USA Newsletter pregnancy article and have been thinking that I have been lucky in my last and this pregnancy that I did not have bad morning sickness or my calcium levels would have been all over the place.
In fact the HPTH symptoms such as pins and needles aren't as bad during my pregnancies as normal (not that they are very bad usually, but I can sit in my old cross legged position for 10 minutes now,without cramping which is a treat!)
Dr Karim Meeran was my Endo in Charing Cross Hospital in London. A real gentleman.
Dr Donal O'Shea is my Endo in St. Vincent's hospital in Dublin (but visits other hospitals too) I'd recommend them to forum members if you want to include them.
Blaithin O'Donnell: Dublin
NOTE: Blaithin had her 2nd baby in Dec 2007 and all are doing well!