Celiac Disease and Other Autoimmune Conditions
September 12, 2012
Autoimmune Disease and Parabens
September 14, 2012

Graves’ Disease and Pregnancy

How common is Graves’ and what are some risks for pregnancy?

Graves’ disease, a common autoimmune condition that causes the thyroid to overproduce thyroid hormone and thereby speed up the body’s metabolism (called hyperthyroidism), can have a negative impact on both fertility and pregnancy.  As such, it is especially important for women who are pursuing pregnancy to receive a prompt diagnosis and effective treatment.

Overall, about 2% of the female population has Graves’ disease and of these, many are diagnosed in pregnancy (1/1,500 pregnant women will get Graves’).  Prior to pregnancy, Graves’ can affect fertility by causing irregular menstrual cycles.   There is also some research that indicates the antibodies (i.e., immune attack cells) circulating in autoimmune women’s bodies reduce both conception and response to fertility treatments.

In pregnancy, Graves’ can lead to miscarriage, premature birth, eclampsia (hypertension of pregnancy), and ‘small for gestational age’ (SGA) babies.  While you may feel overwhelmed and concerned about the health of your growing or planned baby with this diagnosis, try to take a deep breath and find comfort in the fact that that thyroid conditions are extremely common and obstetricians, midwives, endocrinologists and alternative health practitioners deal with them all the time.   Also, you will feel, physically, much better when your thyroid hormones get sorted out and feeling better will help you cope with the sorrow you may have over your diagnosis.

There are several proven-effective treatment options to discuss with an endocrinologist, and as many unproven and unresearched management programs from alternative health providers.  The links below provide additional information of diagnosis and treatment of Graves’ disease:

What are some considerations for planning to become pregnant if I have Graves’ disease?

Before becoming pregnant, you must try to get your thyroid hormones into a normal range and stabilized (it often takes a few months of treatment before everything gets into range).  Generally, endocrinologists try to get control of the overactive thyroid and then keep the TSH (thyroid stimulating hormone level) between 1-2 mIU/L.  Your T3 and T4 levels will also be monitored once you’re pregnant, as pregnancy will independently affect thyroid hormone levels.

And don’t forget your folic acid while you’re planning for pregnancy – you should be on a prenatal vitamin for at least three months before you get pregnant!

Will I still be able to take my medicine while pregnant?

Absolutely.  You should never stop a medication without consulting your provider.  After radioactive iodine or surgical treatment, you will become hypothyroid (i.e., have an underactive gland) and your medication is supplemental thyroid hormone.  If you choose to treat the Graves’ with medication, propylthiouracil, (PTU) is generally the preferred and more widely used option.

What is the likelihood of passing on a thyroid condition to my child(ren)?

If the Graves’ goes unmanaged during pregnancy, there is a risk the baby will be born with hyperthyroidism (this is very rare).  Overall, any family member of a person with autoimmune disease has a higher likelihood of developing the same or another autoimmune disease, so your child does have an increased risk (the exact risk is unclear).  However, while we don’t entirely understand autoimmunity, we do know that genetics alone do not explain its onset and there are likely several environmental factors that play a role.

Is there anything complementary/alternative approach that I can take to help my body adjust to pregnancy while managing my hyperthyroid symptoms, especially if they change while I am pregnant?

Alternative health encompasses a huge array of therapies including Ayurveda, Chinese Medicine, Herbalism, Acupuncture and Homeopathy, to name just a few.  All of these schools offer a variety of treatments for thyroid conditions, though none of these treatments has undergone testing by conventional medical standards or been proved to work (and there’s even less information regarding their use in pregnancy).

Some common treatments include: Bugleweed (Lycopus virginica), Gypsywort (Lycopus europaeus), Lemon balm (Melissa officinalis), Stephania root (Stephania tetranda), and Motherwort (Leonurus cardica).

Questions for your doctor:

  • When can I expect to feel better?
  • Should I have a consultation with a “high risk” obstetrician (called Maternal-Fetal Medicine) if my hormone levels are abnormal in pregnancy?
  • Are there any concerns about breastfeeding with these medications?
  • Should I be screened for other common autoimmune diseases?



About the Author
Kathi Kuntz, RN, MSN holds a Bachelor’s and a Master’s Degree in Nursing from the University of Pennsylvania. Her specialization is in the healthcare of women and her graduate research thesis was on autoimmune disease in pregnancy. She has over ten years of clinical practice experience. Currently, Kathi is on an adventure living and traveling with her husband and two young sons in Australia.

This blog post was originally published by AutoimmuneMom.com, written by Kathi Kuntz, RN, MSN, and first published on Sep 13, 2012.

This post contains the opinions of the author. AARDA is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. AARDA does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.


  1. Suzanne says:

    I am 26 years old and had a total thyroidectomy one month to date ago. Me and my husband would love to start having children.
    1. Is there a high risk that something will be wrong with my baby or he/she will be harmed?
    2. Am I high risk?
    3. If I am overall healthy will it be hard to get preggers?

    • Katie Cleary says:

      Hi Suzanne, these are great questions for your Ob and I recommend you find one who has experience with fertility and autoimmune, know that can be a tall order but that is my first thought. There are some risks that are higher than in the general population but you have your age going for you, so that will help. Here is another post that talks about other risks in those with Hashi and although you do not have Hashis, the post might be good as I believe some of this may apply since you are now in a hypothyroid state with no thyroid. Correct me if I am wrong on that! Good luck and keep us posted!! We are pulling for you! Take care, Katie

  2. Lucy says:

    im not sure when I had Graves’ disease but my son has a arachnid cyst could this have happened because of the Graves’ disease?

    • Madi says:

      I just wanted to say I’m an 17 an i was dignosed with graves in 2010 overs had it a while an over a few years I started to develop 3 archnoied cyst In the center of my brain I went to a neurologist an had test done they said they shouldn’t cause any problems an they think the reason these formed is that most women’ who have graves an have a child they’re baby’s brain doesn’t alawyas develop all the excess tissue an all an to fill in that space cyst come about but these cyst are nothing more than little fluid filled sacks that shouldn’t cause issues at all! That’s what i learned over these years of doctors visits so don’t be to worried

  3. Natasha says:

    I know this post is a few years old but I have a question if anyone is still answering posts…

    I was diagnosed with endometriosis in July 2014 and had surgery for removal in May 2015. This seemed to clear up my symptoms. Then…

    I was diagnosed in July 2015 with both Graves and Hashimotos. My endocrinologist put me on methimazole 10mg every other day and kept me on it until July 2016, due to my explaining that my husband and I wanted to try to get pregnant. I was put on a PTU 6 days a week at 50 mg. We conceived Sept 2016, but lost our angel around 10 weeks – baby had a heartbeat of 160 and was measuring correctly at 8 weeks, but failed to be at size or have a heartbeat at our 11 week appt.

    I am looking for any alternatives to the treatment for my Graves (my dr has not even started the treatment for Hashimotos yet) to allow me to still conceive and have a healthy pregnancy and baby. I am aware of surgery and iodine treatments, and I would really like to avoid having to do either, but I feel like I am running out of options.

    Any ideas or help?

    Thank you!

    • Natascha says:

      Hi Natasha,

      I came across your question and given your name I had to answer 😉

      First of all, I am sorry to hear about your little one.

      And I just want to share my story which may be helpful. After the birth of my first daughter in 2014, I started suffering from a long list of symptoms and was ultimately diagnosed with Graves Disease. Since the conventional treatments did not appeal to me (my endocrinologist preferred RAI), I had a wish for a second child, and the fact that the treatments don’t address the underlying problems (it’s an autoimmune system – the thyroid is merely a victim), I knew there had to be a different solution. I finally found my way to a functional medicine doctor. She helped me make some big lifestyle interventions and I felt so much better in weeks and my antibodies dropped fast over a couple of months. Four months later I was in remission and now I have a second daughter, fully grown on my own thyroid (no medications). To give you a resource: Dr Amy Myers in Austin is a functional medicine doctor. They look for underlying causes and suggest lifestyle interventions where necessary (you have to do the work!) http://www.amymyersmd.com
      That’s not my doctor, but this one had her thyroid ablated and still feels sorry about it. But all functional medicine practitioners should be able to help you.
      To conclude, for me, working on underlying root causes, such as food sensitivities, parasites and more has done so much for my health. I now feel better than I did in my teenage years and 20’s! A lot of other smaller complaints have disappeared as well. And what I know now helps me keep my children in good health as well!

      I hope this helps.

      • Marie says:

        Dear Natasha,

        I am in the same boat today. I have antibodies for both Graves and Hashimotos. Doctor has not started my treatment yet due to fluctuating levels of TSH, but has told me to hold off pregnancy.
        I was probably hyothyroid for years, but only got it tested 6 months back due to severe symptoms. TSH was 101 during this test. My blood work was repeated a few weeks later, the TSH levels had dropped from 101 to 7 this time, but still hypothyroid. But this time, my doctor put me on Levothyroxine (artificial T4). Well 3 weeks later due to different symptoms I got my blood work done, and this time I was hyperthyroid. All of this happened within2 – 2.5 months.
        I stopped taking medicine immediately, and now, fast forward 3 months later, haven’t been on any medicine, still hyperthyroid, have active antibodies for both Graves and Hashi.
        I want to have a child but loosing hope with my condition
        I am only here to learn if you had any success in improving your health.
        If anyone else had luck in improving their health from Graves and Hashi and bearing a healthy child, please do share your story. I just need some hope that I can be a mother too.

  4. Tori B. says:

    For my situation…I was diagnosed a couple years ago with Grave’s disease and my thyroid levels have been within normal range for the last 1.5 years. I am now 25. I will be getting married in the next couple years and would like to start thinking about how this will impact my ability to have children. I am currently on Methimazole, once daily. I have heard that this medication can cause difficulty with pregnancy and even be fatal to the fetus. What are you recommendations for being on Methimazole and hoping to have children one day?
    Thanks for your thoughts!
    *I know you are not my doctor and I will definitely be consulting her before moving forward with having children, but I’m just looking for other opinions.*

    -Tori B.

  5. Kiah Kinard says:

    Hi there!

    I have Graves’ disease and got diagnosed in March, my levels are all balanced out and I’m feeling so much better I have an amazing doctor who’s been there every step of the way. But now, I think I may be pregnant! I have been taking tests, but I’m not getting a positive result although I feel pregnant. (I’m would be a second time mom.) all pregnancy symptoms are there, plus some I’ve never gotten with my first. Am I testing too soon? Or is the Graves’ disease giving me hard time to get a positive result?

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