Pregnancy and Hypothyroid

[Rhsana]

Well. It's confirmed. I am indeed pregnant. My partner is concerned that this will make me 'ill again', I have been feeling better in recent months and he is worried the pregnancy will cause a relapse of a sort. Also I have been told that being hypo we are at high risk of miscarrying. I guess I am just looking for a little advice from any of you wonderful HUers who have been through it all. R xx

[bluebug]

There is a thread just above your post by Hidden who is also pregnant - maybe you should PM her for advice plus join those other groups you were advised to yesterday.

[Rhsana in reply to bluebug]

Thanks bluebug xx

[Katoir in reply to bluebug]

Just seen these . Many thanks .

[Hidden]

Hi, you are welcome to inbox me for a chat. Congratulations! As long as you get your levels to top end of the range at the beginning of pregnancy and your tsh down you will be OK x

[bluebug in reply to Hidden]

Thanks

[Clutter]

Congratulations, Rhsana.

BTA advises TSH of pregnant women should be in the low-normal range 0.4 - 2.5 during the first trimester with FT4 in the upper range. Levothyroxine dose is usually increased by 25-50mcg when pregnancy is confirmed.

british-thyroid-association...

[Rhsana in reply to Clutter]

Thanks Clutter . I can't tolerate levo, so that is somewhat worrying. I am going to try to go back on NDT for the duration of the pregnancy (if it turns out to be viable) but I am confused to what dose to go on as I am on 50mcg of T3 do I just switch to the 'equivalant' of that on NDT?

[Clutter in reply to Rhsana]

Rhsana,

50mcg T3 is equivalent to 2 grains NDT but it will take 7-10 days for the T4 to be absorbed and build up so you may need to continue taking 50mcg for a few days.

[Rhsana in reply to Clutter]

Clutter,

Perfect, thank you! Now this may be a silly question but... as my body will need to convert the T4 to T3 (in the liver and gut) And as I have shown not to be that great at converting at the moment, could this put more strain on the body and actually be harmful to the pregnancy?

[Clutter in reply to Rhsana]

Rhsana,

As you are taking T3 direct in Liothyronine or NDT that will over come any conversion issues you have.

[Rhsana in reply to Clutter]

So the T4 would be needed predominantly for the pregnancy then?

[Clutter in reply to Rhsana]

Rhsana,

I don't think so. The T4 will convert to T3.

[Rhsana in reply to Clutter]

Then I am so confused, why the need for T4 at all?

[Clutter in reply to Rhsana]

Rhsana,

tiredthyroid.com/blog/2013/...

[Rhsana in reply to Clutter]

Thank you Clutter , so that would indeed imply that the T4 is being used directly for the fetus' brain development and not to be converted to T3 for the mother.

"Pregnant women on thyroid medication occasionally appear on thyroid internet forums and ask what they should do. Is it ok to stay on the T3-only protocol, to take 12.5 mg iodine, or 1.5 grain desiccated thyroid? According to my research, the answer is no, because the baby’s brain development is highly dependent on adequate amounts of T4, not T3"

[Clutter in reply to Rhsana]

Rhsana,

It doesn't mean that T4 for conversion isn't required or happening for the mother too.

[Rhsana in reply to Clutter]

Clutter,

Ok, I am just not sure why that conversion would be necessary for the mother during pregnancy?

[Clutter in reply to Rhsana]

Rhsana,

If you are taking T4 it will convert to T3 whether you are pregnant or not. It's what T4 does.

[Rhsana in reply to Clutter]

Unless of course you have conversion problems, which I do.

[lovesjennypackham in reply to Clutter]

Hi when you say top end of range for t4, do you know what this is? My t4 has ranged from 13-15, and I keep having miscarriages.

[Clutter in reply to lovesjennypackham]

Lovesjennypackham,

I'm sorry for your losses.

If your T4 range is 12-22 the upper range would be >18.

What level is your TSH?

[lovesjennypackham in reply to Clutter]

My levels have never been above 15. Four losses in two years. In despair with it all!

[Clutter in reply to lovesjennypackham]

Lovesjennypackham,

T4 15 is very probably fine. 'Upper range' is a target, it doesn't mean that lower than that is causing miscarriage.

TSH of pregnant women needs to be 0.4 - 2.5 because higher levels increases the risks of miscarriage.

[hachiko in reply to Clutter]

(out of curiosity: TSH; can it be lower than that?)

[Clutter in reply to hachiko]

Hachiko,

As far as I'm aware it is high TSH which is a problem, not low TSH.

[hachiko in reply to Clutter]

Gotcha, thanks!

[lovesjennypackham in reply to Clutter]

Last time is was 0... Thank you

[Clutter in reply to lovesjennypackham]

lovesjennypackham,

I doubt TSH 0 with FT4 13-15 is why you've had miscarriages. Have thyroid antibodies been tested? High antibodies do increase the risk of miscarriage.

[lovesjennypackham in reply to Clutter]

No that's not been mentioned... Is that something my GP could organise? Is it just a blood test? Sorry that should have read 1 for TSH

[Clutter in reply to lovesjennypackham]

lovesjennypackham,

TSH 1.0 is good. Thyroid Peroxidase antibody testing is a blood test which your GP can order. If positive, it means you have autoimmune thyroiditis (Hashimoto's) which eventually causes 90% of hypothyroidism. Having high thyroid antibodies increases the risk of miscarriage.

[lovesjennypackham in reply to Clutter]

Thank you for your help. Is that possible then with normal T4 levels? How do the symptoms manifest?

[Clutter in reply to lovesjennypackham]

lovesjennypackham,

Hashimoto's with normal thyroid levels is known as euthyroid Hashimoto's. I had hyper symptoms for months then started swinging between hyper and hypo but doctors told me symptoms were non-thyroidal because I was euthyroid. thyroiduk.org.uk/tuk/resear...

[Katoir]

Congratulations Rhsana

I'm hoping to get pregnant and on NDT

How about you ?

Sorry you've had no experiences shared .

[Rhsana in reply to Katoir]

Hi Katoir , thank you! It was actually completely unexpected as I was told I was not ovulating and had too low progesterone levels. I have been on T3 only for about 6 weeks now, but due to the advice on here I am going to go back on NDT as well. I have an appointment on Monday so hopefully I will know more about the 'plan' moving forward after that. Its very early days (4 weeks) so its also very likely that I misscary as I have read that this is very common for us. Have you have a hypo pregnancy before? R xx

[Katoir in reply to Rhsana]

Hi

I have a little girl of 6 Pre hypo issues and have been doing all I can to prepare for a pregnancy .

I miscarried twice before I knew I had thyroid issue and have been trying to 'optimise' ever since as I'm worried about it happening again .

My latest readings show my ft4 at lower end of range , ft3 upper with suppressed TSH so I'm stable but unsure if that's ok for pregnancy as with Levo ft4 needs to be at least mid range .

I've never tried Levo and wondering about switching just for pregnancy to minimise stress but seems risky as I'm so well on ndt .

Keep me posted .. interested about the plan and how receptive they all are .

Hope this works out for you - sure you're anxious xxx

[Rhsana in reply to Katoir]

Katoir , I Pm'd you xx

[Katoir]

Ok - will have a read and respond a bit later . ( on school run )

Happy to share experiences .

Miscarriages before I started medicating ... tbc x

[cbrennan]

Huge congrats!

I'm hypo too and my 2nd pregnancy was approved by both my GP and endocrinologist. My endo told me to ring her as soon as I knew I was pregnant. I was advised to increase my dosage by 25mg (from 75 to 100) and stayed on that throughout the pregnancy.

Obviously please do not do this without being told by your doctors.

Please get seen early.

Prior to being diagnosed with hypo I had a miscarriage and it also took me a long time to conceive. I believe this was as a result of undiagnosed thyroid problems

Best of luck and huge congrats!

[Hidden]

I am 32 weeks pregnant now and she is being delivered in 6 weeks and done it all on my own with NDT as my local doctors and hospital also are really rubbish with thyroid issues and left me to rot. Had 7 miscarriages, never looked into and total refusal to test my thyroid or accept private results. Don't panic as stress is bad for your pregnancy. The one bonus is you know what to do early. I didn't for years whilst my thyroid was declining. Just work on getting your levels top end of the range and tsh down under 1 that's the main thing. Anything lower than mid range can cause problems. Oh and this is my 4th and last haha x

[HowNowWhatNow]

Congratulations!

My local GP was sub par when it came to pregnancy and in general over thyroid stuff. I was told to reduce my thyroxine dosage when I told her I was expecting. I have no endo supervision.

Thinking this odd I went away and read the NICE guidelines and increased it by 25 % - as per guidelines - and told the midwife that was what I was doing. She agreed. My TSH was then stable throughout the pregnancy and the baby is healthy and I had no scares along the way. I have no issues with Levo so can't help on that point. Hope this helps.

[Rhsana]

Thank you all so much! It is very heart warming to hear, despite a lot of bad guidance, there has been some good out there and that you all had healthy pregnancies. R xxxxxxx

[EllenFrances]

The higher estrogen will lower your thyroid Make stir tonstay as stree free as possible. Congratulations 🎈