Jessica Florio and her husband

How I Managed the Stress of Graves' Disease During Pregnancy

So much of pregnancy is focused on the health of the growing baby, it can be easy to lose sight of the fact that the health of the person carrying them is just as important. The two are inextricably linked. This becomes even more apparent if, like me, the mother is dealing with a chronic illness. Throughout my pregnancy, I had the delicate task of treating my thyroid disease while keeping the wellbeing of my baby in mind. 

In October 2016 I was diagnosed with Graves’ Disease, an autoimmune disorder that causes hyperthyroidism. In the time leading up to my diagnosis, I suffered from dizziness, heart palpitations, diarrhea, anxiety, weight loss, fatigue, tremors, and reactive hypoglycemia. Everything in my body felt like it was running at high speed due to the sharp increase in my metabolism.

It took eight months to figure out what was going on. I went to multiple doctors and had dozens of different tests done with no luck—my thyroid levels looked completely normal, as did the rest of my bloodwork. One day I was back at the cardiologist to try to address the heart palpitations, and she decided on a hunch to check my thyroid levels again. This time, it was clear to her that I had Graves' Disease. No one has been able to explain to me why this happened. I am just thankful that eventually, my body did decide to finally let everyone know what was going on before things got even worse. 

One of the most heartbreaking things I was told after my diagnosis was that any future pregnancy could end up with several complications. I would automatically be considered high-risk. Unmanaged Graves' Disease during gestation can cause pregnancy loss, low birth weight, fetal growth restriction, preeclampsia, cardiac issues for both parent and baby, and the presence of a goiter. While the chances are very slim (1 to 5%), I worried for the health of any future children.

There are three ways to treat Graves' Disease so it becomes manageable: antithyroid medication, removal of the thyroid, or radioactive iodine therapy. I chose to go the route of medication, as it is the least invasive option. However, there is a small chance of some antithyroid medications causing birth defects.

The medication I had been taking for the past few years (methimazole) carried that risk. The standard protocol is to switch to another medication (propylthiouracil) that is potentially much less harmful to the baby. A side effect of propylthiouracil, however, is possible liver damage. In other words, there was no easy choice. But at the end of the day, I knew no matter what that I would always choose what was best for my child, and decided to switch my medications. He came first.

Every four to six weeks, my blood was drawn and I was given an ultrasound to monitor my baby's growth. The blood work was to make sure my medication was working, my liver was healthy, and my thyroid levels remained in the normal range. The frequent ultrasounds made sure that the baby was growing at a normal rate, and wasn’t developing a goiter or other defects.

I tried to reframe my thinking—I was grateful that the frequent trips to the doctor gave me more chances to 'see' my baby.

If I was feeling particularly squirmish about the needle that day, I'd make small talk with the nurse as a distraction. And I tried to reframe my thinking—I was grateful that the frequent trips to the doctor gave me more chances to "see" my baby.

During all of this testing, I struggled with feelings of anxiety and guilt. I was so nervous that my body wouldn’t be able to produce a healthy child. Was having a baby while dealing with a disease that could affect them the right thing to do? Was I being selfish? Could I forgive myself if something bad happened? At times it was stressful and overwhelming, but I tried my best not to let those feelings take over—stress is prime fuel for an autoimmune disease!

In order to keep my mind at ease, I only focused on the end results and staying present in the moment, and not the "what if’s." When worrying about future results, I would remind myself of all of the things I knew were true in that very moment: I am healthy, my baby is healthy, everything is fine. And until I knew otherwise, that what the mantra. Thankfully it was until the very end.

Each time the results came back normal, a little weight dropped off of my shoulders. And then I would do my best not to think about it again until the next results came back.

With this mindset, frequent appointments and check-ins became easier. Each time the results came back normal, a little weight dropped off of my shoulders. And then I would do my best not to think about it again until the next results came back. I focused on keeping my stress to a minimum and sending all the good vibes down to my belly.

Of course, this wasn't always so simple. Anxiety often has a way of creeping in wherever it can find a crack. If I couldn't pull myself back from feeling overwhelmed I found talking to my husband or a trusted friend was a great way to get out of my head. It could be a few quick texts while waiting for an appointment to start, or a long conversation later on in the day. It could be talking through the issue, or distracting myself with laughter. Either way, connecting with a confidant was a sure way to get me feeling better.

Another key part of this process was open communication with doctors that I trusted wholeheartedly. With my new medication, for example, I remember being very scared of the side effects for both me and the baby. But talking through questions and concerns thoroughly with my endocrinologist and obstetrician helped tamp down my fears.

If I had any questions about test results or what I was feeling, I asked my doctor right away, no matter how insignificant it seemed. It was important to not be afraid to ask all the questions I needed to and advocate for myself when necessary. It was sometimes hard to remember what I wanted to ask. So between prenatal appointments, I always wrote down any non-urgent questions that came to mind. When the next appointment came around, I felt so relieved to be prepared, which made it easier to get my thoughts out. Everything I wanted to ask was right there in front of me.

Managing a chronic illness during pregnancy and the stress that comes along with it can be so tough on parents-to-be—especially first-timers. I would not have been able to go through it all without staying present, finding a mantra, leaning on others when needed, and talking my questions through with medical professionals.

Finding what works for you may take some trial and error, but remind yourself not to worry about things you can’t control, and focus on what you can control—sending loving and positive feelings to your baby, and taking care of your mental and physical health. It may take a few tricks to get through what can be an anxiety-ridden time, but the experience will be better for both mom and baby overall.

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4 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The National Institute of Diabetes and Digestive and Kidney Diseases. Graves' Disease.

  2. Nguyen CT, Sasso EB, Barton L, Mestman JH. Graves’ hyperthyroidism in pregnancy: a clinical reviewClin Diabetes Endocrinol. 2018;4:4. doi:10.1186/s40842-018-0054-7.

  3. Song R, Lin H, Chen Y, Zhang X, Feng W. Effects of methimazole and propylthiouracil exposure during pregnancy on the risk of neonatal congenital malformations: A meta-analysisPLoS One. 2017;12(7):e0180108. doi: 10.1371/journal.pone.0180108

  4. Wu DB, Chen EQ, Bai L, Tang H. Propylthiouracil-induced liver failure and artificial liver support systems: a case report and review of the literatureTher Clin Risk Manag. 2017;13:65-68. doi:10.2147/TCRM.S122611.

By Jessica Florio
Jessica Florio is a blogger and freelance writer as well as a stay-at-home mom.