Lab Results 17 weeks pregnant taking levo only

[Cavalli13]

Hello Everyone,

This morning I picked my blood results taking 62.50 mcg of T4 only since my last increased and the results are as follow..

TSH 3.3 uU/ml (0.4-4.5)

Free T4 1.24 ng/dl (0.85-1.8)

No Free T3 labs done, but I guess they are low too, so I asked my gp to increased to 75mcg but she said that the results are fine so she didnt allow me to increase my meds now.

I am not feeling ok, I know that T4 is not the treatment for me but at the moment I need to take something for the health of my baby, so I am thinking to increase my dose to 75 mcg and re test next month again by myself.

I am tired all the time, I am having headaches, and my mood is intolerable, but I guess is not all about my thyroid I guess my pregnancy hormones are involved too..

My ferritin is ok is around 70 and I am taking b12 and a pregnancy multivitamin too,

Should I increase my dose to 75mcg or stay like I am?

Many thanks for all your help

[Clutter]

Cavalli,

Increase your dose to 75mcg but ask for it to be increased to 87.5mcg and have a follow up thyroid test in 6 weeks. Your foetus will have stopped being dependent on maternal thyroid hormone at around 12 weeks but TSH rising increases the risks of miscarriage and developing post partum psychosis.

Show your GP the statement below from the Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee

13. The serum TSH reference range in pregnancy is 0·4–2·5 mU/l in the first trimester and 0·4–3·0 mU/l in the second and third trimesters or should be based on the trimester-specific reference range for the population if available. These reference ranges should be achieved where possible with appropriate doses of L-T4 preconception and most importantly in the first trimester (1/++0). L-T4/L-T3 combination therapy is not recommended in pregnancy (1/+00).

onlinelibrary.wiley.com/doi...

[Cavalli13 in reply to Clutter]

Hi Clutter

Many thanks for your reply.

I am scared about the post partum psychosis, I have read other people experiences and its pretty scared.

I will increase one week 75mcg and then next week 87.5 mcg until 6 weeks I will do my own blood work.

I am really worried that this could have affected my baby, on the 27th February I will have my second scan in where they will check all her or his organs so I am praying all day that the baby is ok, and my thyroid has not affected him or her.

Many thanks again

I will keep posting

[Clutter in reply to Cavalli13]

Cavalli,

Baby has had its own independent thyroid since 12 weeks so should be fine. I would increase to 87.5mcg now if you have enough Levothyroxine.

[Cavalli13 in reply to Clutter]

Hi Clutter

Ok I will do it and I will retest in 6 week, if I will notice any hyper sign I will reduce to 75 mcg.

Many thanks!

[eeng]

Your doctor clearly doesn't realise that TSH in pregnancy is supposed to be kept below 2. The British Thyroid foundation website says "The recommendation is that before and during pregnancy thyroid function tests are regulated such that serum TSH is kept in the lower half of the normal range (<2.5 mIU/l before and <2.0 during pregnancy). This may require a dose adjustment in your levothyroxine".

Having said that, don't be too alarmed. It is the first 12 weeks that are the most important, and you are past that stage now. I think you should raise your dose to 75mcg a day (that's only a tiny increase).

[Cavalli13 in reply to eeng]

I think she is worried that I will be hyper if I increase my dose, but I explained to her that I am having I guess hypo symptons, like headhaches, tiredness, and low mood but she didnt care about it, she was really cutting on it.

The problem is I will need more pills beacuse I am prescribed only 50mcg so finally I will let her knows that I need 75 mcg or more in my pregnancy, if she will not prescribed it I will ask for a complaint or I will change my doctor.

[silverfox7]

Have you mentioned this to your midwife? They should be taking over your thyroid care at this time and monitoring you frequently.

[Cavalli13]

In Spain we have only two appointments with your midwife until you will give birth, the first trimestrer and then two days before the birth, anyway many thanks for the idea, I will try to call her now and see If I will be able to speak with her today, Many thanks!

I would like to thanks all you guys , last night I started taking the extra levo, the thing is that my mood is so low, and I am angry all the time...I dont know if is the pregnancy or my thyroid doing this..Anyway I will wait until the extra levo will do the thing.

I will keep posting Many thanks!

[Cavalli13]

Hi, I have just called my midwife and she said that if the gp considered that the results were fine she can´t prescribed me anything or do anything, I explained to her the thyroid recommendations, but she did not care about it, so the only thing I have is to do it by myself and retest in 6 weeks.

Hopefully I have this kind forum that probably will help me at any time!