Thyroid, P-PROM and Miscarriage

Please help.

I had radioactive iodine treatment to correct Graves Disease in 2011 and have since been on Levothyroxine for hypothyroidism.

I had my first child in 2015 and he was born 6 weeks prematurely following preterm premature rupture of membranes (P-PROM). Thankfully after two weeks in special care we were able to bring him home and he is now well.

Unfortunately three weeks ago, at 16 weeks pregnant, I experienced P-PROM again and we lost our beautiful baby girl. In January my TSH was measured at 8.63 and my Levothyroxine was therefore increased from 100mcg to 150mcg however I fear that this was too little too late.

I have not had my T3 or T4 measured for a very long time but am due to see an Endocrinologist in April. I want to go to this appointment with as much information as possible so that they can't fob me off.

Has anybody got any experience/knowledge of hypothyroidism, P-PROM and/or miscarriage and can help shed some light on this for me?

I can't go through this again. :'(

4 Replies

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  • I am not medically qualified but my opinion is that people with no gland at all should either be given NDT or T3 added to levothyroxine.

    I am so sorry you lost your little baby girl and it is quite usual for miscarriages to happen when not on an optimum of hormones and you were certainly not with a TSH so high.

    It would seem to me you have been neglected as your dose was far too low. The aim of TSH is to be 1 or lower not somewhere in range as most doctors believe.

    I shall give you a link to another site which was started by a woman who lost her baby too. It is in the USA. I shall also give you another couple of links.

    Our Free T4 and Free T3's should be towards the upper part of the range but they seem never to be measured. A TSH cannot tell what is best for us as it is from the Pituitary Gland.

    hypothyroidmom.com/infertil...

    web.archive.org/web/2010103...

    The doctor who did the last link would never prescribe levothyroxine. It was either Natural Dessicated Thyroid Hormones which contain all of the hormones we don't have if hypo. Or T3 for thyroid resistant patients. Those who have clinical symptoms but TSH isn't sufficient for diagnosing.

    Levothyroxine is inactive, it has to convert to T3 and may not do so efficiently if we are kept on too low a dose or just cannot convert for some reason.

    T3 (liothyronine) is the only Active thyroid hormone required in our billions of receptor cells. It runs our whole metabolism.

    One again, I'm sorry and it's all due to the ignorance and advice from the Associations, I believe.

  • emma_marie,

    I'm very sorry for your loss.

    High TSH increases the risks of miscarriage and pre-term birth which is why it is recommended that the TSH of women planning conception and newly pregnant should be in the low-normal 0.4 - 2.5 range. Levothyroxine dose is usually increased by 25-50mcg when pregnancy is confirmed to ensure good foetal development.

    onlinelibrary.wiley.com/doi...

  • I am very sorry for your loss.

    I am on my 4th pregnancy with an underactive thyroid. My 1st was born at 32wks (my waters broke at 31wks.) and after a 21 day stay in neo natal, is now a healthy 3yr old. My 2nd was full term & healthy. Sometime after my 2nd baby, I found that I was under medicated, and didn't how long I had been under medicated for. (Perhaps throughout both my pregnancies?) I then got educated and optimally medicated before I tried for a 3rd baby.My 3rd pregnancy ended in miscarriage at 9wks, but it is unlikely this was due to my thyroid as all my no's were optimal-just one of those things. I am currently 13wks pregnant. (I should mention as well, that I have Gestational Diabetes in all my pregnancies as well as an under active thyroid.)

    The info below should hopefully help you as much as it did me. Sorry for the @cut and paste" answer, but there is so much info, it's the only way to do it!

    I take NDT (a mix of T4 and T3.)

    Check out the website, hyperthyroidmom.com. It has lots of great articles, (I have included some thyroid/pregnancy articles at the bottom) and advice you can take to your GP. (You GP will know very little about the thyroid in pregnancy, so it is very important for you to get as knowledgeable as you can. If you are lucky, you will have one like mine, who is very open minded and willing to read the articles and go with my suggestions.) Buy the book she wrote on pregnancy-it’s amazing! “Your Healthy Pregnancy with Thyroid Disease”, by Dana Trentini & Mary Shoman.

    If you planning a baby, get "optimal" before you start trying. When you find out that you are pregnant, then increase your Levo/thyroxinne (T4) by 30% . The demand increases as soon as 4-6 wks into pregnancy and we are trying to avoid miss carriage. Then go to your GP and let them know you need blood tests every 4weeks until 20weeks. The results of these tests, will likely show that you need further increases. (Don’t increase without the blood tests to tell you how much you need.) Your blood tests need to include T3 results. If your GP won’t do this, get private testing done through “Blue Horizon.” As always, get copies of all your blood tests, and post on here for advice. Do not accept your GP telling you that you are “normal” or “within range” as very few of them know what is healthy for pregnancy. At 20 wks, the demands usually plateau and you will need tests/increases less often. (The book tells you how often.)

    If like me, you take NDT (T4 and T3) rather than Levo/thyroxine (T4) then the instructions for increasing are not as straight forward, but can and must be done. To get advice, I emailed Lyn Mynott who began Thyroiduk: enquiries@thyroiduk.org. I put “Pregnancy Guidelines” in the subject line and she asked a doctor for me. He advised that I follow the instructions for increasing levo, but that I shouldn’t increase T3 at the same rate as increasing T4. (This was easy for me, because I take NDT plus extra T3.) You will read some articles saying that you shouldn’t take T3 in pregnancy as it crosses the placenta and some saying its fine-you will need to do your own research.)

    The book I mentioned above, gives this advice about the TSH levels you need to have to have a healthy pregnancy. This is really helpful to take to your doctor.

    First trimester: less than 2.5 with a range of 0.1-2.5

    Second trimester: 0.2-3.0

    Third trimester: 0.3-3.0.

    TSH should be monitored every 4 weeks during the first 20 weeks of gestation, then once again between 26 and 32 weeks

    If you are on NDT (Ie. Taking T3, your TSH should will be almost 0 with a low T4 in pregnancy (and non pregnancy)

    Keep an eye on your B12 levels, as pregnancy places a high demand on these and people with an underactive thyroid are usually deficient to begin with. (You can’t overdose on B12, anything you don’t need you will pee out. A bit of a waste of money, but not dangerous!)

    Some articles, you may like to read:

    thyroid.org/professionals/e...

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

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

    hypothyroidmom.com/what-eve...

    dl.dropboxusercontent.com/u...

    thyroiduk.org.uk/tuk/about_...

    thyroid-info.com/articles/p...

    healthunlocked.com/thyroidu...

    2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum

    online.liebertpub.com/doi/p...

  • Thank you for so much information. I will sit and go through it all before my appointment for sure...really appreciate it.

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