Last post of my pregnancy update was at 30.79 weeks pregnant and a lot has actually happened since then.
My goal throughout pregnancy was to update as often as possible with the intention of doing a post at least once a week. However, with everything that I am working on (school, cookbook, recipe, pregnancy, etc.) I haven’t found enough time to do a post as often as I’d like. Take for example, my last post of pregnancy update about 4 weeks ago. At first I was a little hard on myself and then I realized that this is just the way it’s going to have to be and I have to be okay with that. I’m working on blogging more and I continue to do what I can when I have time and quite frankly that IS good enough. No matter what the opinions swirling around in my head have to say.
The past 4 weeks have been extremely eventful and hard. If you don’t already know, I am currently going to school for my MNT (Master Nutritional Therapist) and I take my education very seriously. I also take my family’s health very seriously as well. Over the past few months I’ve been helping my husband fight the yeast overgrowth in his body and if anyone is addressing leaky gut or Gaps or is following a real Anti-Candida protocol they know that it’s fairly challenging. Luckily over the past few years we’ve eaten fairly strict and have found by listening to our bodies that narrowing our diet based on our ‘symptoms’ through an almost deduction diet is really what got us in ‘tune’ with our body. Doing this, allowed for the transition into something as strict as an Anti-candida diet as an almost ‘natural’ next step process. If you’d like to read more about that in another blog post I wrote click: Anti-Candida ‘Diet’.
Back to the pregnancy update…
The past few weeks I’ve been working on my own health as well. While I am eating mainly the anti-candida diet, I am also including some fruit in my diet for the baby. I don’t need a lot of sugar and usually eat an apple or 1/2 grapefruit each day. I personally feel that this diet is a very good foundation diet to keep my body running optimally and deliver nutrients to my daughter efficiently and effectively. Plus, I really don’t have the energy to make 2 separate meals for dinner when there really isn’t any reason. Of course I eat healthier now than I did before I was pregnant. Which actually played a significant role in helping with my analysis of my body the past few weeks.
If you’ve been following my blog or know me personally, you’ll know that I was told I had PCOS several years ago prior to being pregnant. With that comes a lot of useful knowledge about my body. For example, how my body handles sugar (insulin resistance) and how the thyroid functions (hormone response). There is a negative aspect to PCOS where the label puts people in a box. The box is: you have to take thyroid medication, you have to take metformin, you have to take PCOS supplements to help with hormone regulation. With this prescription also comes the added bonus of being told that I will not be able to conceive (without extreme effort and very unlikely circumstances) which is obviously incorrect.
While I do believe there are some benefits of being ‘diagnosed’ with certain conditions I don’t believe that it’s the end-all be-all of who you are. Please read my blog post where I go into depth about PCOS and understanding the thyroid connection in the post: PCOS and the Thyroid Connection.
I’ve spent a lot of time learning about how the thyroid works and how a proper diet and exercise can really help bring the thyroid into normal levels. However, all of that practically goes out the window when you are pregnant.
During my pregnancy my thyroid (TSH) was doing this rollercoaster ride of 3.94 (week 10) to 3.09 (week 17) back up to 3.78 (week 24). I’ve been supporting my thyroid with different supplements starting week 24 when it went back up with both Thyrocsin and liquid Chromium. Thyrocsin has supportive supplements that help with the thyroid by aiding in the conversion of T4 to T3 as well as helping support hormone balance (with ashwagandha, iodine, and L-tyrosine) and the Chromium helps with insulin response (managing glucose levels) which work with the adrenal glands (part of the thyroid). In addition to this I’ve monitored my glucose levels by doing a blood glucose test (at home) where I test my blood sugar levels before I eat and after (2 hours) I eat each meal. I did this for a week straight and continued the same diet protocol that I have been for the past 2 months. My blood sugar was great and my insulin response is fantastic. I’m very happy with that aspect of my health.
During the last visit with my N.D. I decided to do a full blood work test. Not a common test to do, especially during pregnancy, but being a researcher I was interested in what my blood tests came back regarding Uric Acid, BUN, Creatinine, Calcium, Chloride, Bilirubin, LDH, AST, ALT, GGT, Cholesterol, WBC, RBC, Platelets, B12, etc. These are the things I’m studying in school so why not know my own numbers for a better complete understanding of how the body works. I also asked him to do my TSH again but he wasn’t sure that was necessary and indicated that the insurance company may ‘flag’ him if he tries to do the TSH again without reason. (Besides the obvious factor that I am pregnant and this is something that should be monitored.)
When I got my results back a lot of the numbers ranged from ideal to excellent, however there was one set of numbers which was extremely high for what was considered ‘normal range’ and that was the AST and ALT. Remember, this is not a common test to preform during pregnancy and most people haven’t had this test done unless they have a reason. When the numbers for AST and ALT came back high and I’m talking the AST norm is 0-40 IU/L and mine came back 146 IU/L with the ALT (norm 0-32 IU/L) at 250. Those are both alarmingly high and for me this caused concern. Although, my N.D. didn’t seem too concerned with the numbers being high because the LDH and the GGT came back low (normal) and said that he would check with the lab to see if this was ‘normal’ for pregnancy. I was definitely ‘alarmed’ when I got off the phone with him. The ALT and AST are liver enzymes and they reflect the ‘function’ of the liver. I was very confused at why he was OK with the numbers being as high as they were. Maybe I didn’t have anything to worry about and maybe I did, but I’m not the type of person that sits on things. My brain is a highly analytical brain and problem solving is a natural skill that I can’t seem to quiet. I called back a few days later (Thursday) to check back on my iodine levels and to find out what he heard back from the lab regarding the ALT and AST tests. The iodine levels came back normal but he hadn’t checked with the lab yet on the numbers. Now, my idle thoughts were starting to not be idle. I had an appointment with the midwives on Tuesday the following week and I wanted to know what was going on with my liver. One thing that I had been experiencing this whole time and I did bring it up to my N.D. when I had my blood drawn were 2 things. First, my leg cramps at night were horrible and second, my legs itched really bad. My question was, did they go hand-in-hand? What I ended up doing was making an electrolyte water with magnesium calm to help with the cramps, which helped significantly however, the itching pursued.
I started to research a ton about liver enzymes AST and ALT being high and was not coming to any ‘normal’ conclusions for pregnancy. Because I know that the TSH was high and my T3 and T4 were ‘normal’ my thoughts about the liver enzymes became increasing persistent that something wasn’t right. Especially this, my mother also experienced extreme itchiness when she was pregnant and my grandmother died of liver failure. These are great factors to keep in mind when thinking about my current condition and understanding of my own genetic background revolving around liver functioning.
By the time I had arrived at my midwives I was armed with my blood lab work and knowledge about my concerns. There were several things that this could be and none of them aligned with pregnancy necessarily but disease of the liver itself. Cholestasis of the liver, fatty liver, abuse to the liver, and liver tumor. All of them pointed to the fact that there was something wrong with the liver but nothing stated anything about the thyroid connection. I sat down with the midwives and said “I had blood work done with my N.D. and my AST and ALT came back high. I’m experiencing itching of the legs but not the palms or feet. I don’t have jaundice and there are no rashes. I’d like to do a bile acid test and retest my liver enzymes” and they wondered why my doctor had these tests run. I said, I asked him to. Surprised they looked at me and said “why?” and I said “because I have speculation that there is something effecting my thyroid (TSH) levels and that they are going up and down and while that may be considered ‘normal’ during pregnancy they aren’t within ‘normal’ range and because I am not taking a thyroid supplement I need to understand in totality how my body is preforming.” They knew I was a nutritional therapist but I don’t think they understood that I was a scientist disguised as a nutritional therapist. 🙂
They were aware of implications of AST and ALT being high and agreed that the test needed to be re-run again. There are many things that can throw off the AST and ALT so it’s always good to double check. On top of that they ran my TSH again (thankfully) and agreed that it’s something that should be checked often. They also asked me to do a fasting bile acid test (from my research this was a great indicator of the health of the liver) and I promptly agreed!
The results came back the following week, Monday. Now, 2 weeks since my N.D. said he would get back to me regarding the AST and ALT from the lab. The midwife on the phone says “The thyroid level came back at 3.07” (a great number considering it had gone up previously and this told me that my supplements were helping) “the liver enzymes AST and ALT came back high but lower than what they were previously” (a neutral) “the bile acid did come back high though with the normal being up to 10 present in the blood and yours is a 28”. My heart sank.
I said “what does this mean?” because to me from research this meant a type of cholestasis of the liver, but that didn’t make sense. I hadn’t experienced these symptoms prior to being pregnant.. no itchiness or other indicators..
she replied “This means you carry a rare genetic factor called Intrahepatic Cholestasis of Pregnancy (ICP)” again my heart sank, because this meant that I would most likely not be able to have the baby at the birth center through ‘natural’ means.
To confirm I said “So, I won’t be able to have the baby with you then?”
“Unfortunately, I wouldn’t recommend that, the risks are too high” She wanted to talk to me in person but she knew the kind of person I was and that I would want to know as soon as she knew. She also knew that I’d want to research it (which is absolutely correct). She asked me to set up a time with her that week (Wednesday) to go over any questions and by the time I saw her on Wednesday I had a lot of questions. What does this all mean?
After a couple days of depression I started to pick myself up again. My family and friends were extremely supportive and encouraging. It means I’ll have to be induced into pregnancy at 37/38 weeks depending on the provider-but I would really prefer that it be at 38 weeks so that my body is more ready to have a baby vaginally and so my doula could be there (as she is currently in Australia). I’m finding ways to turn things around, turn it into a positive thing. I did much of the foot work to put myself into the position of finding this condition. If you’ve ever known anyone who had ICP or who has gone through results of ICP you’ll probably know that most of the time it goes without being noticed up until the baby is born. At this time there is a very high possibility that the bile acid will cross the placenta touch the umbilical cord (which is incredibly vital for lung development) and can cause high risk for fetal distress, meconium staining, spontaneous preterm labor, respiratory distress and stillbirth. It’s not something that is taken lightly. There isn’t enough information on ICP and I’m currently working on a thesis that revolves around identifying precursors of ICP. I want to thank everyone who has taken the time to be supportive to me, you all have been such a blessing in my life and one that I’m very thankful for. If you have ICP, there are some great sites that help with information for ICP such as:
If you have any questions or are dealing with ICP yourself please feel free to contact me directly at my personal email: firstname.lastname@example.org and I’d love to help in any way that I can.
Disclaimer: This is not a medical reference for you to use should you have ICP, hypothyroidism or PCOS during pregnancy nor is it intended to treat, diagnose, or cure any of the diseases/genetic factors discussed in the topics (above) as I’m simply sharing with you my personal story. Everyone should always talk to their doctor before attempting to take any supplements or modify their diet.