Hypothyroidism.... Help :( :UPDATE PG 6:

[LeighAnne]

What a sigh of relief!!! Congrats Krippy!!! Hug him for us!

 

[aimee-lou]

Hi ladies,

Just wanted to update - I am 11 and a bit weeks PG again lol. I went for my routine blood test earlier this week and I've been called in urgently to see the GP tomorrow morning as a result. I don't think I've done anything wrong. I feel fine, my dose got put up to 150mcg when I was just over 6 weeks as expected (and as happened with Eddy). I am worried now though that it's going to be bad news. I'm normally the optimistic one as you know, but now I'm worried - what if I've done damage to my baby. I know the main thing is developmental problems....I'm so worried now that I've caused my baby to have learning difficulties.

It could also just be a minor adjustment to my dose, or to have a go at me about my anti-d's.

 

[essie0828]

Hi ladies!
Its great to see all these positive stories. Its been a baby boom up in here. Dh and I are back at it, sorta. Waiting to get bloods drawn and stuff before "trying" but the implant is out I think I'm probably nuts for wanting another but we wanna try for that boy or another gorgeous girl. God help us when they are in high school and college at the same time....

 

[aimee-lou]

Hi ladies,

Just wanted to update - I am 11 and a bit weeks PG again lol. I went for my routine blood test earlier this week and I've been called in urgently to see the GP tomorrow morning as a result. I don't think I've done anything wrong. I feel fine, my dose got put up to 150mcg when I was just over 6 weeks as expected (and as happened with Eddy). I am worried now though that it's going to be bad news. I'm normally the optimistic one as you know, but now I'm worried - what if I've done damage to my baby. I know the main thing is developmental problems....I'm so worried now that I've caused my baby to have learning difficulties.

It could also just be a minor adjustment to my dose, or to have a go at me about my anti-d's.

Sometimes I really do hate my Drs! They put me through all that stress, just for a 25mcg increase that's required because my TSH is slightly elevated. I traipsed there in the snow, after leaving my littley with the CM for the first time ever and came away with nothing more than a new prescription. Arghh! Oh well......at least I can stop worrying, and I now have more levo than a pharmacy! lol

 

[Proserpina]

Last week, I had some bloodwork done. When I requested a beta HCG quantity test, my doctor also put in orders for a CBC, TSH, and Free T4. The beta HCG quantity came in at 138 (which is within normal range for 4-5 weeks pregnant) while the CBC was also normal on all counts. The Free T4 also came in normal at 1.06 (lab range: 0.61-1.81), but my TSH was a whopping 12.573.

I had an ultrasound on my thyroid last August 2012, which found “Diffusely heterogeneous and nodular echotexture is present consistent with Hashimoto’s Thyroiditis.” My TSH was also tested in September 2012 and found to be 7.595, which is high, but my Free T4 was still normal then (1.03), so the doctor said I didn’t need treatment and that was the last I heard of it.

I’m awaiting the results of a Free T3 now to find out if the problem is that my thyroid isn’t converting T4 to T3, but assuming that comes back normal, what I have is apparently called “sub-clinical hypothyroidism.” Apparently it’s recommended that even sub-clinical hypothyroidism be treated in pregnant women, as women with thyroid disease are at a greater risk of miscarriage, gestational complications, and giving birth to babies with birth defects.

I’m just trying to tell myself to calm down, that there’s nothing I can do at this point, that I just have to wait for my doctor to get back to me on what kind of thyroid medications he wants to put me on and at what dosage. I’m a bit miffed that he didn’t try to treat my sub-clinical hypothyroidism sooner than this, given that he knew I was trying to get pregnant. I’m just hoping and praying that sub-clinical hypothyroidism doesn’t pose as much of a threat to pregnant women as full-blown hypothyroidism. But then again, if my Free T3 comes back low, then I’m not really sub-clinical to begin with—although it would be good to be able to pinpoint what exactly is causing my distressingly high TSH levels.

Any advice or reassurance for me? I am a little freaked out.

 

[Hope39]

Proserpina - your doc should have treated you back in September because your TSH was out of range then. I started treatment when my tsh was 9.27. Mine came down to 1.3 after taking thyroxine for a few months but it then went up into the 40's.

Your tsh needs to be ideally between 1-2 for fertility.

Mine took 8 months to stabilise and sadly I could not try within that time due to chance of mc again.

Have you had thyroid antibodies tested?

 

[Hope39]

Are you on thyroxine already? Don't take a high dose immediately, we'll your doc should know this, I started on 25mg and had monthly tests, it increased by 25mg each month, towards the end we upped the dose more to get it sorted, I am now on 200mg

Xx

 

[Proserpina]

Your tsh needs to be ideally between 1-2 for fertility.

So I've heard. Unfortunately, won't help me w/ this pregnancy. In my favor, I don't have any kind of history of miscarriages, and both times that I've been pregnant, I conceived within 1-2 cycles of coming off a hormonal form of birth control (pills with DD seven+ years ago, Mirena removed in late November w/ this pregnancy).

Have you had thyroid antibodies tested?

No.

 

[Proserpina]

Are you on thyroxine already?

No. Spoke w/ doc on phone on Tuesday. He said he was going to check on what kind of dosage to put me on & call me back.

 

[Hope39]

You need to start thyroxine asap, maybe start on 25 or 50 and test tsh month later. If they start you on higher dose than 50 and you get heart palpitations cut the dose back

Quite dangerous to start on a high dose

Best of luck

Xx

P.s the thyroid antibody test I had confirm I have auto immune thyroid disease, antibody attack my thyroid making me hypothyroid

 

[Proserpina]

Okay, called the doctor's office again and left a message for him. They said he would be back in the office on Monday, so hopefully he will call me back then. I will raise the subject of starting me on a low dose of Synthroid and doing a thyroid antibodies screen when he calls me back. (That is, assuming my Free T3 screen hasn't come back low. If the Free T3 is low, then I imagine it's Cytomel that I need to be on.)

If anyone else has any advice, feel free to weigh in.

 

[Proserpina]

Amazingly, the doctor called me back today. He's put in for me to start 50 mcg of levothyroxine daily; gonna pick up the prescription today and start it tomorrow morning. I'll watch carefully for signs of hyperthyroidism. I have my first prenatal check-up with him in two weeks two days, and I'm sure we'll go over it more then. He wants to re-test my blood and see how I'm doing in six weeks.

 

[aimee-lou]

Amazingly, the doctor called me back today. He's put in for me to start 50 mcg of levothyroxine daily; gonna pick up the prescription today and start it tomorrow morning. I'll watch carefully for signs of hyperthyroidism. I have my first prenatal check-up with him in two weeks two days, and I'm sure we'll go over it more then. He wants to re-test my blood and see how I'm doing in six weeks.

Excellent news! With pregnancy my dr's have always said that it's better in the early stages to be a bit over than a bit under, so it's good that he's gotten back to you. with 50mcg you shouldn't feel too many effects. My MIL once accidentally took 100mcg of my levo (looked exactly the same as one of her meds that she takes) and she said she felt faint, drunk and bit 'flighty'. Needless to say I was more careful where I left my tabs after that lol.

 

[Proserpina]

I spent some time Googling up some information on sub-clinical hypothyroidism (SCH) and pregnancy today. It seems like there is a lot of debate among physicians on whether it needs to be treated or not. Some studies have suggested that SCH does increase the risk for adverse outcomes in pregnancy (though not nearly as much as overt hypothyroidism) and some have found that it doesn't. This article sums it up pretty well:

Experts agree that overt hypothyroidism should be treated for both maternal and fetal benefit, but whether SCH should be treated is less certain. Although the risks for pregnancy complications and fetal neurologic damage are far from clear, available evidence suggests a possible risk for adverse outcomes. Levothyroxine treatment is relatively cheap, safe, widely available, and well tolerated; however, the 2 prospective interventional trials (ie, Negro and colleagues and CATS) had negative primary outcomes. This leaves the clinician who diagnoses SCH in a difficult position. ACOG recommends against "screening and treating" SCH in pregnancy, but does not directly address the situation if it is found incidentally or by means of risk factors. Other endocrine organizations, such as the Endocrine Society, and the American Association of Clinical Endocrinologists, do recommend treating SCH in pregnancy. Given the lack of clear guidance from the literature, it is reasonable to leave the treatment decision up to the individual physician and patient.

...

Physicians should exercise caution when interpreting maternal FT4 levels. Method and trimester-specific reference ranges should be used when available. Although some studies have found an association between SCH and pregnancy complications, including increases in abruption, preterm delivery, and pregnancy loss, others have not. Nevertheless, theoretical concern surrounds SCH and the risk for neurologic impairment in the fetus. More studies are needed to confirm and define this risk.

If SCH is diagnosed either by symptoms or by risk factors, insufficient evidence exists either for or against a recommendation for treatment with a low dose of levothyroxine. Universal screening of all pregnant women for hypothyroidism, overt or subclinical, is not currently recommended.

I'm glad that we're treating with a low dose of levothyroxine given how much my TSH has risen in 4 months, but now I can understand why my doctor chose not to treat before I got pregnant, and knowing that my risk of adverse outcomes in pregnancy are much lower than it would be if I had overt hypothyroidism puts my mind at ease.

 

[aimee-lou]

Yes definitely a good thing to treat you - the levels are much more strict in pregnancy in an attempt to counteract any adverse effects. it's good that your Dr has been pro-active.

 

[Vinesha]

Hello ladies i m new here can I join

Me 25 dh 32 i have recently diagnosed with pcos and hyperthyroidism t4 levels are 14 ...I am not getting af at all it's been 3 months , just started accupunture hope it works will i be able to conceive

Baby dust to all

 

[Courtney917]

Had 4 miscarriages before being diagnosed with hypothyroidism. I was put on synthroid when I was 4 weeks pregnant. It had to be increased from 50-112 mcg but so far so good with the pregnancy. Have any of you ladies experienced any issues with your progesterone levels? Mine were low at the beginning so I had to be put on 400 mg of suppositories. We want to TTC again after this LO is born but I am so afraid I will experience losses again .

 

[Hope39]

Vinesha - have you tried metformin for your PCOS? Xx

 

[Hope39]

Courtney

I haven't had mine tested but take 400mg twice a day when pregnant

There is no reason why you can't ttc soon after, just make sure your thyroid is right and you take progesterone

Xx

 

[essie0828]

Prosperina

Have you got your t3's back yet darlin??? I may have a little insight as to why your tsh is 12 something. If your t4 levels are normal, t4 is the most usable form of thyroid hormone and it's produced in your thyroid by binding another molecule to t3. So basically what's happening is your CNS/pituitary gland is having to over stimulate your damaged thyroid gland to keep up a normal production of t4. Your thyroid is working fairly well....it just needs a tiny boost to tell your pituitary to chill out on the thyroid stimulating hormone. The extra tax on your body from being pregnant can cause this sometimes. The fact that your t4 was normal is a really good thing for your baby. I agree with your doc s long as your t3 is normal.

I take 200mcg levo and my Fetal Medicine Specialist wants my tsh around 4 to 5 in pregnancy. That's considered a bit high but he has found that if my pituitary kicks in some and he supplements me with 200mcg that my t4's stay in range of what he wants for a baby till 13-15weeks gestation. After then they have their own thyroid Good luck dear. I'm being a bit vague but if you have any questions just ask. I can either explain it better or point you tosome articles that will.