Six years ago we started trying for a baby after a year I fell pregnant but unfortunately had a miscarriage at six weeks. We continued trying and although had lots of investigations for un diagnosed infertility no problem could be identified after months of medication & injections nothing happened. Last year I was diagnosed with hypothyroidism and in the last few months had actually started to feel more like my old self. Then wow I fell pregnant we were over the moon, I read everything I could and asked questions on here and from the feedback I received I asked my GP to increase my levothyroxin, my TSH was 3.17 which is higher than its been for a while. My GP was happy with my levels and refused this but I rang back to challenge this giving the surgery the information I had and again requested it be increased. This was again declined. Getting to eight weeks I actually started to relax and was feeling really well, I booked in with the Midwife explained my concerns about my levels and was told I would be under the consultant who would keep a close eye on my levels. Unfortunately I had a miscarriage a few days ago. We are totally devastated and while I can't say for sure that my thyroid problems have had an impact on this or have ultimately caused this, I can't help feeling like if they had have increased my medication I might not be in the black hole of grief that I'm in.
My husband, family & friends are all being amazing they are all so supportive. I haven't been to see my GP yet as I'm not sure I will be able to speak calmly enough to express myself! What do you say to someone who didn't listen to you!
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I'm so sorry to hear about your devastating news and that your doctor is not being helpful.
I can't say for sure, but increasing your thyroxine may have helped.
Dr Toft, former chair of the British Thyroid Association, states that for anyone on thyroxine their TSH should be below 1 and their T4 at the top of the range for them to feel well. He states this in his book "Understanding Thyroid Disorders". I'm not sure what he says specifically about pregnancy though.
It is also fairly common knowledge (or at least it should be!) that women who are pregnant often require a slight increase in their thyroxine. Naturally you would produce more thyroid hormone anyway when pregnant, which is why you tend to feel a little warmer than usual. Obviously if your thyroid doesn't work, then this equates to a small increase in dose.
Many gynaecologists treating people for fertility problems with borderline hypothyroidism, try to get their patients TSH below 2 before conception to increase the chances. Chances of conception and going to term are greatly increased if your TSH is good. If it is near the top of the range, like yours is, this is less likely for some people.
Clearly from your TSH, you are under-replaced and could do with an increase in thyroxine.
Please ask for a referral to an endocrinologist or gynaecologist, or see a different GP if yours is refusing to provide adequate treatment.
I wish you all the best for the future. Hopefully once your medication is sorted out things will turn out much better.
If you have any further questions about pregnancy and thyroid please do ask and we will do our best to help.
Here is an article in an endocrinology journal that categorically states that women with a TSH in the upper half of the range (like yours) are more likely to suffer miscarriages.
I am truly sorry to hear your news, it's devastating and have been there myself x it is hard to know what causes miscarriage but with hypoT the risks are increased. It is most important to access midwife n GP care ASAP as soon as pregnancy is confirmed and that a referral is sent to both obstetric and endo teams who should work together to maximise the health of you and your baby . In pregnancy thyroxine needs to be increased to compensate for the additional requirements of the baby as it grows. I ' think' it's 25mcg more than you are on. You said what ur TSH is now but what have all ur levels with ranges been like?? Post them up so folks can comment. What dose are you on and do you feel well? If not you may well need a bigger increase...the problem being ... Like we all have is the dreaded 'normal' levels do your fight may well continue unless the endo is any good so you need to find strength to fight your corner. If I can help more please ask... I don't claim to know loads but can guide you in helping to achieve a healthy pregnancy. Don't forget ur folic acid x x good luck x x
This is what Dr Toft says in his online Pulse article. If you want a copy of the whole article email louise.warvill@thyroiduk.org.
10 And what about hypothyroidism in pregnant women?
Untreated maternal hypothyroidism results in neuropsychological damage to the offspring. Patients with hypothyroidism who become pregnant need to have the dose of levothyroxine increased on average by 50µg daily in order to maintain normal serum TSH concentrations.
The advice to patients with established hypothyroidism is that they should increase their dose of levothyroxine by 25µg daily as soon as pregnancy is confirmed and make an appointment for thyroid function tests to be measured some two weeks later. The aim is to achieve a free T4 concentration of 16-20pmol/l.
Further measurement of serum free T4 and TSH should be made six weeks later and again in the middle of the second and third trimesters.
The pre-pregnancy dose of levothyroxine can be restored four weeks after delivery by which time the increased concentrations of thyroxine binding globulin will have returned to normal. It’s not clear whether this meticulous care is necessary and it may well be that any thyroxine therapy in the hypothyroid mother will allow normal foetal development
Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum were updated in 2011. They recommend the following trimester-specific reference ranges for TSH in pregnancy:1
I'm so sorry to hear your sad news. I too had two miscarriages and was devastated each time. However, I did go on to have two healthy pregnancies afterwards and am lucky enough to have two healthy daughters now. There is some excellent advice above to which I can't add anything, but I just wanted to send you a big hug and hope things work out for you. Clare ((())) xxxx
I feel so sad for you. I really don't think that I could continue to see this GP. It is so important to increase your thyroid meds when pregnant, how can this GP not know this?!
So pleased that your family and friends are there for you. I send you my best wishes too.
I was lucky enough to find a good gp so as soon as I found out I was expecting she done my bloody again. I've had them done every 6 weeks and my dose has been increased. Pre pregnancy I was on 200 now on 250. In the last week a few of my symptoms have appeard so waiting for results to come back from the lab. She told me to expect my dose to nearly double by the time the baby is born. Could be time for you to find a new gp or ask the practice manager to put on your notes not to see that doctor anymore. I hope you manage to get everything sorted xx
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