Untreated hypothyroidism in first trimester pregnancy?

[babyvee]

hi im new to thus site. i was recently diagnosed with hypothyroidism at 12 weeks pregnant with a TSH level of 15 however ive been feeling all the symptoms for more than a month now but i didnt get to do my blood work early enough in the pregnancy!! i totally regret it. ive had total thyroidectomy 6 years ago and have been on 75mcg levothyroxine. my GP recently increased it to 100 mcg. im worried i had affected my babys developmental growth! hope to hear some advice! #hypothyroidism #pregnancy

[Clutter]

Babyvee,

Your GP should have increased Levothyroxine to 125mcg at least to raise FT4 and bring down TSH ASAP.

TSH should be in the low-normal range 0.4 - 2.5 during the first trimester. When pregnancy is confirmed dose is usually increased by 25-50mcg to ensure good foetal development. NICE also recommends that hypothyroid women planning pregnancy should be referred to endocrinology. 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...

According the ATA First Trimester TSH levels between 2.5 and 5.0 are associated with increased pregnancy loss

[jimh111 in reply to Clutter]

Please note that an elevated TSH early in pregnancy is associated with an increased RELATIVE risk, as the incidence of problems is small the actual ABSOLUTE risk is also small. So, your levothyroxine dose should be increased and there is an increased risk to your baby but this is still small and you shouldn't be unduly alarmed.

[Saggyuk in reply to jimh111]

I'm sorry to disagree but no risk is acceptable when it comes to your baby plus the poster doesn't have a thyroid so nothing compensating the thyroid meds she's on and is already nearly three months pregnant so I do think it should be asap. The doc knew at five weeks and has been too slow to deal with this

[jimh111 in reply to Saggyuk]

I agree an increase should start immediately. However, the risk is small and it is very wrong to cause unnecessary distress. The absolute risk is small, action should be taken straight away to minimise even this small risk

[Saggyuk in reply to jimh111]

Yes, apologies, having reread through, I meant more in line of doc needs to resolve asap and needs to be pushed quickly and no excuse for doc and had slightly misread your message - sorry

[jimh111 in reply to Saggyuk]

No problem! Babyvee could just double up her levothyroxine for two or thee days and then continue on an extra 25 mcg until she can sort her GP out.

[babyvee in reply to Clutter]

i am thinking about taking two of my 75mcg tablets daily and going against my GP's advice of taking 100 mcg daily. i asked to be referred to an endocrinologist however he insisted referring me to see an OB right away as this deals with pregnancy? thank you for the link however im in canada and jt stated that the link only works in Great britain

[Saggyuk in reply to babyvee]

As already mentioned, 125 would be the norm if on 75mcg beforehand but can't advise further than that as no idea whether you were adequately medicated beforehand. What were your levels before pregnancy?

[babyvee in reply to Saggyuk]

hi saggyuk. my GP said 2.5 but last blood work was done march 2017

[Boon79]

While we are all going through a horrid time on this site, many of us are not doctors or specialists. I would increase your dosage with caution and work with your gp until you feel as 'normal' as possible. I was borderline Hypo during my pregnancy and didn't take any medication. Whilst I had a beautiful and healthy little girl, she has been diagnosed with moderate to severe adhd, and is about to be medicated. I honestly believe that this is due to Hypothyroidism. A wonderful gp I had a few years after giving birth tested me when symptoms steadily got worse and I had become severely Hypo and very ill. He worked on how I felt rather than the test results. We gently increased the dosage by 25mcg at a time. Good luck and here's to a care free pregnancy x

[Clutter in reply to Boon79]

Boon79,

This is a patient to patient forum and no one, including the Admin team, on this community should be assumed to have medical training of any sort.

healthunlocked.com/thyroidu...

[Boon79 in reply to Clutter]

Which is why I stated that fact above. Somebody suggesting that a pregnant woman doubles her dose is dangerous and could be very harmful to her unborn child.

[moniacho]

Hi babyvee, I just wanted to share my experience with being hypo and pregnancy. I was hypo for 17 years and on 125 levothyroxine when I got pregnant. As soon as I knew I was pregnant I discussed increasing my levo with GP (when I was first diagnosed as a teen, I was warned that when I get pregnant my dose will have to be increased). My GP said no need, because my last bloods before pregnancy were fine. At next bloods when I was about 3months pregnant my TSH jumped to 4 or 5 and it was always suppressed at around 0.05. I was called to come to GP surgery as soon as possible and my levo was increased by 25 to 150. With that small increase the TSH went back to suppressed level. My boy is now 18months old, healthy happy baby and developing just fine. I wanted my experience to highlight few points: (1) doctors should know that in pregnancy the thyroid levels have to be checked regularly and more likely than not they will have to be increased, (2) even if at the start of pregnancy your levels were too low, it doesnt mean that your baby suffered. I would hope that our bodies are smart enough that in pregnancy the nutrients are directed primarly to growing baby, (3) Increase by 25 was enough for me. Obviously your bloods will have to be checked soon to see if you need any further increase, but I definetely wouldnt suddenly double your dose to 150 (2 tablets). (4) I understand you are upset and worried, I was too, but stress is also not good for your baby, so try not to panic. Wait a bit on the increased dose and then push GP to test again.

I am not medically trained, just another hypo mum.

I wish you helthy pregnancy and a healthy and happy baby. X

[thyroidx100]

Take care of your self and be strong.

[CorAC]

Hello, I’m just wondering what your outcome was please if you’re willing to share? I’m in a similar position. Thanks