Pregnancy After Thyroid Cancer

My Quest For Information
I agonized over whether it was a good idea to have a 2nd child after having thyroid cancer.  It seemed that each doctor I talked to had a different opinion and the people on my online support groups had more.  I was told by some that the hormones from the pregnancy could make the cancer grow.  I was told by others that they were just fine and so were their children.  There is very little scientific research to back up any of these assertions.  I did find that there was some concern over the quality of the eggs due to the RAI being eliminated from the bladder and the ovaries being in close proximity to it.  Since I had been treated with RAI two times this was of concern to me (100 mCi's and 150 mCi's).

I was told that once my Tg got to below 5 and 9 mos had passed since my last RAI treatment it was OK to consider getting pregnant.  I was told that I may not ever get pregnant or that it may take a long time.  I had my 2nd RAI on 1/19/01 and on 9/06/01 my Tg was 4.9 so my doctor said it was OK for me to try to get pregnant.  I got pregnant the following weekend.  We were shocked!

Things I Learned That You Should Do Before Pregnancy
If I had it to do it again I would do things very differently.  In the 2 1/2 years between pregnancies I would have focused on detoxing, adrenal support, balancing my hormones and increasing nutritional levels.
DETOXING - Detoxing what you might say?  There are many things to be concerned with that will affect our children's health that they are exposed to in the womb.  The first thing to consider is fluoride.  Fluoride is a toxic halide that is in most city drinking water systems.  It is a thyroid inhibitor - being a component used in drugs to control hyperthyroidism (Graves) disease.  I would put a full house water filtration system in (with reverse osmosis) to protect from all the chemicals in the water.  Chlorine is also another issue because it is absorbed through the skin and breathed in through the steam.  I put this system in my home in 2007 from Water Resources International and I have been very pleased.

MERCURY - The next thing you should be concerned with is mercury.  Where do you get that? There is much talk about a pregnant mother not eating fish that may be poisoned with it but what about your mouth?  Do you have mercury amalgam fillings in your teeth?  If you do then you are constantly being bombarded with mercury.  When you drink hot liquids, brush your teeth or chew.  It is released into your system.  This crosses the placenta and is a known neurotoxin.  I had 11 fillings removed from my mouth - unfortunately not until after my 3rd failed RAI.  After removal many, like me, use chelators to get the mercury out of the tissues.  Please make sure that if you decide to do this that you read Hal Huggins books on the proper / safe removal protocol and / or find a knowledgeable biological dentist.  
BROMIDE - Thirdly, Bromide is a very toxic halide.  It is found in our breads, sports drinks, cars, computers, cell phones, and more.  It is used as a flame retardant in clothing, mattresses and carpeting.  It is a thyroid inhibitor.  It sits on the iodine receptors blocking absorption until it is knocked off and moved out of the body.  You need to supply enough iodine to do this.  I am constantly asked how much is needed.  There is not one magic formula unfortunately as each person is biochemically different.  Bromide does cross the placenta and is very toxic.  So beginning to remove all this before you get pregnant will help the baby.  Bromide also passes through to the breast milk.  The reason I would detox this is that iodine is needed by the baby for proper neurological development.  Supplementing with iodine in pregnancy is a good thing to do.  However, if you have not worked on detoxing prior to your pregnancy it would be very dangerous to take in the larger amounts of iodine because bromide would be released.  A dose of 12.5 mgs and below of Lugol's formula has been considered to be safe to take during pregnancy.  You can have your doctor check bromide serum levels to determine your toxic load or do the Iodine Loading test available through Hakala Labs with the Bromide toxicity level test.
ADRENAL FATIGUE - If you have had your thyroid removed, are being treated with synthetic thyroid hormones, had RAI or any combination of them you will need to check your adrenals.  The adrenal glands are located on top of each kidney.  They supply not only adrenaline and cortisol but sex hormones.  When the body has undergone enormous stress or has been under treated as occurs with T4 only synthetic medications they become fatigued.  Morning sickness has been tied to adrenal fatigue.  With my second child the nausea was so bad that my doctor had to place me on medication to keep me from vomitting day and night.  Support for the adrenal glands include, Vitamin C, B-Complex vitamins and unrefined salt plus magnesium.  Try to supplement or include a diet rich in these nutrients.  You can test adrenal sufficiency by doing a 4x Cortisol test.  These tests can be ordered by the individual without a doctor at Canary Club.  If you are struggling to get pregnant after thyroid cancer treatment then this test may also help you to identify the issue.

You Are Pregnant - Now What?


I found this time of my life the most difficult.  While worrying about possible issues with my own health I also had to worry about the potential health of my unborn child.  

Thyroid Medication
Most doctors don't really understand how to properly dose the thyroidless patient during pregnancy.  Most thyroid cancer patients are on synthetic T4 only medication which just doesn't work well.  Many hypothyroid symptoms still remain that could be eliminated with desiccated thyroid (such as Nature-thyroid or Armour Thyroid).  I would recommend investigating a change to this medication before becoming pregnant to allow for the proper level of dosing to be obtained.  The fetus has one of two places to obtain thyroid hormones.  The first being from the mother.  But if the mother isn't getting what she needs then the baby will be left deficient.  The fetus is able to synthesize its own thyroid hormones at approximately 10-12 weeks gestation.  Therefore it is very important that the doctor check your thyroid hormones during pregnancy.  These tests should include not only TSH but Free T3 and Free T4 which are the unbound proteins that are available for usage.  There is substantial transfer of thyroid hormones through the placenta.   The placenta contains deiodinases that convert T4 to T3.  Low thyroid levels can contribute to mental retardation and under developed thyroids.  

IODINE
Sufficient iodine is important for both mother and child.  A fetus that does not get enough iodine while in the womb can result in a child with creatinism, mental retardation and deaf-mutism.  The fetus will take what it needs so if not enough iodine is supplied for both mother and child, the mother will suffer first.  This is what I believe happened to me.  After delivery my neck was swollen with a goiter which is a key indicator of iodine deficiency.  I was told to avoid iodine due to a shell fish allergy.  This I believe was the final nail in the coffin which ensured that I would get thyroid cancer.  My deficiency continued until I began to supplement with Iodoral 4 years after the birth of my last child.  Both of my children are hypothyroid and I attribute this in part to the lack of iodine in my diet.  



Scientific References:
  • Glinoer D: The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 18:404, 1997.
  • Haddow JE, Palomaki GE, Allan WC, et al: Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. New Eng J Med 341:549-555, 1999.
  • Oppenheimer JH, Schwartz HL: Molecular basis of thyroid hormone-dependent brain development. Endocr Rev 18:462-475, 1997.
  • Xue-Yi C, Xin-Min J, Zhi-Hong D, et al: Timing of vulnerability of the brain to iodine deficiency in endemic cretinism. New Eng J Med 221:1739-1744, 1994.

Watch Your Children

As the mom of two hypothyroid children I know how important it is to make sure that your children are cared for.  Hypothyroid mothers have children that are at higher risk for hypothyroidism. If your child is always cold on warm days, wants to lay down all the time, intolerant to change, seems less active than other children or is hyper-active have them checked.  If your child has issues with  staying dry at night.  Check for hypothyroidism.  If they develop issues with eating or complain of a stomach ache.  It could be constipation due to low thyroid.  If your child cannot concentrate and the school suggests ADD/ADHD medication.  Please consider checking the thyroid.  We have had great success with Nature-throid, Omega 3 Fish oils, selenium, iodine, iron, zinc, magnesium and probiotics to help our children heal.