Hypothyroid and pregnant

[Abbie2302]

Hi I am 25 years old and pregnant. I was diagnosed hypothyroid before the pregnancy was confirmed and started on 25mcg levothyroxine due to my slight weight at the time of 45kg. My TSH is currently 7.10 (0.2 - 4.2) Free T4 12.2 (12 - 22) Free T3 3.7 (3.1 - 6.8) TPO antibody 385 (<34) TG antibody 269.5 (<115)

Does this mean my baby will now be at risk of developing problems? Also have symptoms of tiredness, muscle cramps and bone pain, feeling low, hands and feet being cold. Thank you.

[SeasideSusie Remembering]

Abbie2302 There are 'Related Posts' to the right or below (depending on your device) about hypo and pregnancy which you can check out. I believe TSH should be about 2 or below and I think Levo is usually increased as well.

Also checkout the links about thyroid and pregnancy on ThyroidUK's main website thyroiduk.org.uk/tuk/about_...

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TSH 7.10 (0.2 - 4.2)

Free T4 12.2 (12 - 22)

Free T3 3.7 (3.1 - 6.8)

You are currently very undermedicated. Pregnancy aside, the aim of a hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their reference ranges if that is where you feel well. You need an immediate increase in your Levo with regular tests and further increases every 6 weeks until you feel well and your symptoms abate.

When booking blood tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. Do this every time and you will be able to compare results accurately.

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TPO antibody 385 (<34)

TG antibody 269.5 (<115)

Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results and you may find you swing from hypo to hyper and back again. Adjustment to dose of Levo might be needed if this happens.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

Gluten/thyroid connection: chriskresser.com/the-gluten...

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Some of your symptoms can be indicative of low nutrient levels. If not already tested, ask your GP to test

Vit D

B12

Folate

Ferritin

If already done, please post results with reference ranges for comment.

[Clutter]

Abbie2302,

Your doctor should be dosing according to your blood levels not your weight. You are undermedicated and the risk of miscarriage increases when TSH is >3.0. Your GP should increase dose by 50mcg immediately and retest in 4-6 weeks to check TSH is in the low-normal range 0.4 - 2.5 and increase further if necessary. Your TSH is probably so high because the foetus is stealing your thyroid hormone until s/he develops his/her thyroid at 12 weeks.

NICE recommends hypothyroid women who become pregnant should be referred to endocrinology.

Pregnant

Check TFTs immediately once pregnancy is confirmed.

Discuss urgently with an endocrinologist regarding initiation of, or changes to, dosage of LT4 and TFT monitoring while waiting for review — trimester-specific TFT reference ranges may vary locally.

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

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...

[silverfox7]

Your doctor should have told you to return after 6 weeks for more bloods and your results will most likely show you need to increase again. Make sure he does that and I hope he has referred you to a hospital for your pregnancy and that they are monitoring you carefully. If this is t happening please say something

[Abbie2302 in reply to silverfox7]

Thanks no I haven't had a referral.

[mistydog in reply to Abbie2302]

You should ring tomorrow and ask for one and insist that it is urgent since you are already pregnant. You should also get a new blood test asap (first thing in the morning, no caffeine or food), and an increase in your levothyroxine. I cannot stress this highly enough, you are at high risk of miscarriage until your thyroid is under control.