NHS endocrinology care during pregnancy

Hello, just wondered if anyone had any experience of NHS endocrinology care during pregnancy?

I'm 12 wks pregnant this week after a long and difficult journey due to Hashimoto's. (So am understandably a little on the anxious side!) I've had two private blood tests and one NHS test during first trimester and adjusted meds accordingly. I take 100mcg/125mcg Levo on alternate days. My latest test shows that TSH is sitting a little below ref range at 0.16 (0.27-4.2) T4 is 21.9 (12.0-22.0). My private endo told me that i should aim to be in the 0.3-2.0 part of the normal range.

- my Gp is concerned but I feel ok, what do you think? Is there any danger of being a little low on TSH if T4 is ok?

My initial diagnosis and care until things were under control was under a private endo after appalling treatment and mis-diagnoses from an NHS GP. But I've since found a good GP and have been looked after by her since earlier this year.

Now that I am pregnant she has referred me to a combined antenatal-endocrine clinic at my local NHS hospital (in London) but I haven't got an appointment yet and called today only to be almost laughed at for expecting I would get an appointment so soon.

-have any of you been looked after by an NHS endo during pregnancy and how often/in which trimester did you have appointments? I would have thought they would be geared up better for this as surely the first trimester is most important when you have thyroid issues. I couldn't have known 6 months ago that I would be pregnant and would need this appointment!

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  • Shamrock16,

    High TSH can be a problem but TSH 0.16 is very mildly below range and unlikely to be problematic. The foetus has it's own thyroid gland at 12 weeks so will be independent of maternal hormone levels now.

    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...

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