Hello, I'm 16weeks pregnant (hypothyroid) feeling anxious, tired, headaches, constipated and have twitches in my left eye what do I do?

[emcbutterfly]

I saw the endo team at the hospital two weeks ago, the specialist increased my dosage from 75mcg to 100mcg. I consulted my midwife and she thinks I should reduce my dosage but speak with my GP. I'm concerned that this is the wrong thing to do. What if I need more?

[Hidden]

Hello emcbutterfly, I don't want to scare you but I lost a baby at 17 weeks into my pregnancy,a horrofic experience! I've been hypo for years, my docs wouldn't increase my dose but I've read alot and been watching this forum since then and it's clear your thyroid plays a big part in pregnancy aswell! Take it as easy as you can and get as much advice as you can. Trust all goes well.

[Hidden]

Have you got any blood test results you could post? It might help people to comment on your dosage. I'm not hypo but I would have thought it would be better to take the Endo's advise rather than the midwife?

Now onto the twitching left eye - this is a symptom of B12 deficiency, I get it all the time. I imagine you have been taking folic acid through your pregnancy, but no B12? Both folic acid deficiency and B12 deficiency can cause macrocytosis, which is enlarged red blood cells. When you take folic acid, this will normalise your blood, and thus mask a B12 deficiency if you have one. So you really need to ask them to do a serum B12 test as soon as possible. Anything low normal can be problematic, so it is important to get a copy of the results. People with thyroid disease are often low in B12 already, and being pregnant will put an even greater demand on your stores.

Lots more info here:

b12deficiency.info/index.html

[Starfish123]

Hi,

Congratulations on your pregnancy. Unfortunate you are suffering though. Re the increase in dose, this is what should happen as per guidelines for thyroid and pregnancy so do follow that. You need to keep your TSH below 2.5 during pregnancy as above can cause miscarriage.

Hopefully with the increased dose some/all of the symptoms should disappear. I would check if you can supplement with magnesium for the headaches, I don't know if will cause any problem myself so please do check. I had persistent headaches in 3 of my 4 pregnancies, and it was awful, no painkillers nothing, so I know it's not nice but it did easy later on.

The twitch does sound like low b12 as stated above, but again check with dr it's safe to take, if in doubt products such as pregnacare( I think that's what it's called) are safe for pregnancy.

Hope it helps

[Hidden in reply to Starfish123]

I just wanted to clarify that I wasn't suggesting supplementing, I was suggesting testing for B12 deficiency. If you take supplements now you will skew the results of any blood tests. For the record, B12 is safe at any dose, it is water soluble and any excess is excreted in urine.

H x

[emcbutterfly]

My last blood test results Aug 12th - TSH 2.7 mU/L 0.30 - 6.00 free T4 16.0 pmol/L 10.0 - 22.0

Is this any help? Thanks for b12 advice I'm taking pregnacare vitamins which I think contains B12. Do I need more?

[Hidden in reply to emcbutterfly]

See my comment above, you need to get it tested first. If your levels are very low your doctor would put you on B12 injections, and should do further tests for Pernicious Anaemia (which studies show is present in 40% hypo patients). Your doctor might tell you you're normal when you're not, the range is set way too low. So it's important to get a copy of the result.

I would imagine there's a miniscule amount of B12 in pregnacare, in fact just looked it up it's 6ug, which is equivalent to 6mcg. For comparison, a hydroxoB12 injection is 1mg (1000mcg), and people taking methylB12 sublinguals are usually on a dose of 1000mcg or more a day.

So, in summary, ask for the test. H x

[nobodysdriving in reply to Hidden]

I second what hampster says

[Duchy82]

Headaches tiredness and constipation are all symptoms of early pregnancy or hypothyroidism on those alone i wouldnt lower my dose of thyroxine if i were in your situation the anxiety and twitcy eye could just be justified because you are worried about your baby or like hamster said add some b12 to your supplementing routine by the way anxiety can also be a symptom of hypo. if your really worried i would at least discuss it with your endo but i wouldnt lower your dose your baby is using that thyroxine too

[shaws Administrator]

Do not do as suggested by the midwife. The Endocrinologist is the one to advise.

This is a link:-

thyroiduk.org.uk/tuk/news_a...

This is an extract from an article by Dr Toft:-

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.

Dr Tony Toft is consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, and a former president of the Royal College of Physicians of Edinburgh and of the British Thyroid Association

[emcbutterfly]

Thank you all for your responses just seen Dr and getting tested for calcium and B12 as well as latest thyroid results best, Elaine

[nobodysdriving in reply to emcbutterfly]

good, well done. As for the thyroxine, only accept the endo's guidance as to reduce or increase, as they increased your dose this is probably the right thing to have been done, if you have any doubts ask them, you can always ring the secretary and leave an 'urgent message' (ie which means they should ring you back within a day or so).

[ejh1]

Hi. Just to reassure you, I've had 2 very lovely little (well, actually very big!) girls while hypothyroid and B12 deficient, and they are absolutely fine. The thyroxine increase is correct. I felt absolutely dreadful throughout both though....!!!

[Thyroidseb]

Hi, I have been hypo since i was 23 after the birth of my daughter. She is now 13 and I also have a 3yr old little boy. My thyroxine went up from 200 to 250 when I was pregnant no problems. I was consultant led with my care, and saw my consultant regularly during the pregnancy. 2 weeks before I was due my consultant noticed I was swollen and suffering carpol tunnel and they arranged a date to induce me two days before I was due. They didn't want me to go over. I was tired throughout my pregnancy but probably no more than normal. Try not to worry, insist on having consultant led care and take your medication. Listen to your body and follow your gut! Congratulations and good luck xxxx

[emcbutterfly]

Hello again to you all I really do appreciate your responses it helps to get a better insight to this illness that can have such an impact on your well being. My latest results are as follows: serum folate > 20.0 B12 398 TSH 1.6 Free T4 13.3, I didn't take my levo until after the test. I am feeling a lot better the twitching and anxiety has stopped. I also have a bit more energy thankfully. Could it have been the bodies reaction to my dosage increase and now I've adjusted? Thanks again Elaine