Am I over medicated?

[gracegirl78]

Hi folks! Hoping this is my last pregnancy related post as I'm nearly 35 weeks. Had bloods done Monday, results have been pretty much the same for last few months:

Tsh: 0.05 (0.27-4.2)

T4: 18.4 (10.5-22)

In fact, the t4 has dropped a bit since last month.

Anyhoo, I wasn't feeling too well, hot flushes and breathless, she immediately said (based on last month's tsh as t4 has never gone above range) to decrease my dose from 125/150 alternate to 125. This was on Monday.

I'm still feeling crap so I'm not sure if over medication was the problem, maybe its just late pregnancy.

Should I continue the lower dose or go back to what I was taking? I'll be back at Dr's in about 10 days so can discuss it further then.

This pregnancy has been so stressful in regards to dosing. I can't wait for it to be over!!

[Clutter]

Gracegirl, those results look good and don't indicate over medication or under medication. If you felt better on the high dose go back on it but I think it's most likely the advanced pregnancy causing breathlessness.

Hope all goes well and the labour isn't too difficult xx

[gracegirl78 in reply to Clutter]

Thanks clutter. I know pregnancy can skew them a bit so I wasn't sure. That t4 is after taking thyroxine too (I started always taking it before bloods for consistency) so I don't want it to go any lower. Problem is, she wanted to decrease me anyway. So I'm expected to....maybe I should drop to 125 for 2 days then 150 every 3rd. Won't be much of a change tho.

[haggisplant in reply to gracegirl78]

I had an awful time in pregnancy and found it really stressful. Those results are good, ideally you should be back down to pre preg dose near full term, though keep a close eye on it for some time afterwards. I've been wobbling post pregnancy.

It could have been my perception but I felt funny for a couple of weeks after every drop (was over medicated at 14 weeks as had been on TEVA and swapped, at 225. Slowly dropped from 20 weeks back down to 125 by around 36 weeks.)

Good luck with your birth! Xxx

[gracegirl78 in reply to haggisplant]

Thanks haggis,

My Dr hasn't mentioned dosing after birth yet, will ask her next visit. Sorry you had a tough time too, its been a non stop worry for me too. Its my 3rd baby but first since diagnosis and I haven't been able to enjoy it at all.

Its funny you mentioned your dose decreased after 20 weeks...were you under an endo? Wish I had been! My Dr is good but I've basically self increased based on symptoms then she's okayed it. I've not gone up since 23 weeks tho as I feel things settled after that. My pre preg dose was 100. Xx

[JenniferG]

Can I just check with the pregnant ladies on here if your doctor increased your dose or if you were seeing seeing a consultant . I'm 13 weeks pregnant and was told by my doctor to increase my dose as soon as I found out I was pregnant. It's now 8 weeks later and I'm wondering will my doctor manage my dosage, will it be a consultant or will as per usual it be me that has to chase and request blood tests.

How often have you had your bloods done throughout the pregnancy?

[Clutter in reply to JenniferG]

JenniferG, R4 Inside Health tomorrow 21.00 and repeated 15.30 Wed is discussing thyroid and pregnancy.

[Jackie]

HI Can I suggest you have an essential Free t3 test to see the full picture. Not easy to get or I use blue Horizon on line, but so important.

Best wishes,

Jackie

[haggisplant]

Hi I believe technically you're classed initially as high risk and so you are supposed to be referred to an obstetrician (I thought it would be an endo but no such luck) who you should meet at 12 week scan. To be honest he was as much use as a chocolate fire guard and a good dr can easily monitor as long as they are on top of things.

Midwives have woefully low awareness in my experience and as far as I can tell it's the first 12 weeks that need the closest monitoring. If you check the nice guidelines and print out it can help to point out to dr. However there really is no reason why you can't be referred to an obs sooner - though it may be 12 weeks anyway. I think it all happens at booking in apt at 8 weeks.

Some people do not need the rise - this is where it gets tricky. I attended a talk by an obs at the btf locally. A woman's thyroid naturally grows to accommodate the extra hormones baby needs. In ancient Egypt their pregnancy test was a cord round the neck - when it tightened it indicated pregnancy. So some women's thyroid may grow to accommodate the extra need even with supporting Levo doses, others like mine not.

My Tsh shot up very quickly. Next time I'd put it up 50 right away (currently on 175 though it may be a bit high) and I'd be bolshy enough to insist on tests every 2-3 weeks! And insist on t4 t3 (though this can be the labs issue. Drs and nurses must indicate clearly that you're pregnant and how many weeks on the blood work form. Infact, I actually had the bloods done at the hospital a couple of times) BUT the fact I was on the faulty Levo TEVA may have skewed results for me.

After around 24 weeks (iirc) baby has his own thyroid and so your own (normal thyroid) starts to shrink slowly hence the need to drop towards the end. Also, too much thyroxine can interfere with milk production. I had NO issues there, infact had too much, though I did start nipple stimulating a little in the final weeks, not sure if that helped or not!

The high risk thing was confusing; they kept changing their minds about that. I was In the end as needed an induction but I think I may have been ok to go to the midwife led bit if I'd started naturally.

I hope this helps?

All the best! Xxx

[haggisplant]

I did have quite regular tests, partly as things went awry so quickly and partly as I was so anxious about it. At one point it was every 2 weeks as I had to bring my meds down from 225 but was terrified to do so. (I'd been so upset by the rising Tsh and lost tests early on)

I do need to say my son is very healthy and very bright so even though Tsh wasn't the best early on there's been no issues! He had iugr but I think that was due to other factors, I had a small placenta (very healthy though) and a bad vomiting bug at 40 weeks which I think did affect him as he'd clearly lost weight in the womb. He packed it on quickly with my over supply though!

At the btf meeting the obs consultant did say it was really important to take iodine and vit d - pregnacare had the right amount though I think you could / should take more vit d, especially through the winter as your skin will not make any from nov onwards

X