Raised TSH 4 weeks pregnant

[Corndog]

Hello All

I'll try to keep this short.

I have had two miscarriages this year following a very easy and successful pregnancy with my daughter 3 years ago.

With both of this years losses we had seen heartbeats at 6/7 weeks to then go on and have missed miscarriages by 9 weeks.

I demanded blood tests for progesterone & thyroid functionafter the last loss and last month these came back at TSH 5.1 and low progesterone T4 was normal. She noted sub clinical hypothyroidism and told me to come back in 8 weeks! Following cycle ptogesterone was at 37.6 so I assumed good ovulation and aSunday of this week I found out I was pregnant! I immediately went in and demanded more tests on hormones and thyroids etc which today have come back with T4 at 9.3 and TSH at 6.7 progesterone normal but I'm not sure of levels, should I be worrying as much as I am?

I rang the doctors and demanded a follow up appointment to discuss my TSH level which I can only assume from all of my research is far too high?

I have an appointment for Monday, I will be 4.5 weeks preganant. Does anyone think I have a chance with this pregnancy? The thought of losing another is soul destroying and I need all the help and advice I can get

Thanks in advance

[humanbean]

If you read the NICE Clinical Knowledge Summaries women should be treated such that their TSH is kept in the low normal range so you need levothyroxine immediately.

Quote : "Aim for a TSH concentration in the low-normal range (0.4 mU/L to 2.0 mU/L) and an FT4 concentration in the upper reference range."

cks.nice.org.uk/hypothyroid...

On the link above, click on the blue tabs on the left hand side of the page and read all the bits relating to diagnosis and treatment for the newly pregnant. Print it out and take it to your doctor ASAP.

[Corndog in reply to humanbean]

Hello Human Bean

Thanks so much, I have lots of ammunition ready to take to the docs and have been doing research all week on this and have found the same info! I am convinced I need medicating, I just hope next week won't be too late!

Thanks

[humanbean in reply to Corndog]

Good luck with everything. Hope it goes well with the doctor. And well done on doing your homework.

[Hidden]

Hello Corndog,

I welcome you to our forum and am so sorry to hear of your previous miscarriages.

There is evidence of increased fatal loss, and psychomotor and IQ deficits, in infants born to mothers with undiagnosed or inadequately treated hypothyroidism (including subclinical hypothyroidism) [Casey et al, 2005].

Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and oestrogen cause increased thyroid hormone levels in the blood. Made by the placenta, hCG is similar to TSH and mildly stimulates the thyroid to produce more thyroid hormone. Increased oestrogen produces higher levels of thyroid-binding globulin, also known as thyroxine-binding globulin, a protein that transports thyroid hormone in the blood.

Normal thyroid hormone level is critical to normal development of the baby’s brain and nervous system. During the first trimester, the fetus depends on the mother’s supply of thyroid hormone, which comes through the placenta. At around 12 weeks, the baby’s thyroid begins to function on its own.

Thyroid Stimulating Hormone (TSH) should be kept LOW in all woman who are pregnant whether already medicating on thyroid hormone replacement or newly diagnosed whilst waiting for referral to a specialist.

Your GP should follow local specialist advice regarding the dose, as experts recommend different starting doses (varying from 25 micrograms to 100 micrograms to be taken each morning).

TSH & T4 levels should be monitored every four weeks and your Levo dose titrated during the first trimester, and then at 16 & 28 weeks of gestation.

TSH should be kept in the low-normal range (0.4–2.0 mU/L) and an FT4 concentration in the upper reference range.

These recommendations are based on information from a consensus guideline produced by the Association for Clinical Biochemistry, the British Thyroid Association, and the British Thyroid Foundation [BTA et al, 2006]; expert opinion in a guideline produced by the Endocrine Society [Abalovich et al, 2007]; expert opinion in a learning module [Edwards and Vanderpump, 2007]; and the opinion of CKS expert reviewers. Some of the evidence to support these recommendations is based on observational studies.

The recommendations on monitoring of thyroid function (TSH and FT4 levels) are based on expert opinion in guidelines [BTA et al, 2006].

I suggest you discuss this your GP ASAP and wish you all well.

Flower

cks.nice.org.uk/hypothyroid...

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Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

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[Corndog in reply to Hidden]

Thanks for all of the information! I do feel really prepared to go to the doctor fully armed and have insisted they did these tests from the moment I found out I was pregnant...I'm so glad I did!

I am praying my levels are not so high that they will have any long term damage or devastating consequences if the doctors are able to prescribe medication next week, I really don't want this to take too long!

[Gismo333]

Hi my daughter is hypothyroid but being treated. She miscarried several times and it wasn't until she started on progesterone cream that she stopped miscarrying. She chose the paraben free cream. It worked a treat. Your TSH is a little high and the T4 a little low. Her private doctor told her that during pregnancy he likes the T4 to be around 18.

I would say to your doctor that you would like to take some progesterone cream to ensure you don't miscarry. You can get this yourself and it's easy to use. Progesterone levels go sky high once pregnancy advances but it's in the early stages that progesterone is needed and if you have a history of miscarriage the cream should really help.

[Corndog in reply to Gismo333]

Thanks so much Gismo

I have too been researching progesterone and feel that supplementing this would help things! I have tried to discuss progesterone cream with GP but they seemed uninterested? I will push again on Monday

Thanks

[denvajade]

Wishing you all the best.

[Corndog]

Doctor prescribed 50mg so I just have to sit and hope now!