TSH too dangerously high to start family?

[Ariemai6]

I have been taking levothyroxine for ten years since my late teens.

In August a blood test carried out through medichecks revealed my TSH was 1.78 (range 0.27-4.2)

T4 was 21.6 range 12-22) and

T3 was 4.21 (range 3.10-6.80)

In late August I started to take levothyroxine at night instead of in the morning and decided to try a gluten free diet for a trial period.

My bloods were tested by GP in November and TSH was 1.77, whilst T4 was slightly out of range at 24.

The GP then reduced my levothyroxine from 100 daily to alternated doses of 100 mcg and 50 mcg every other day.

In December I stopped the gluten free diet as I was finding no noticeable health benefits and found it difficult to maintain.

I then had my bloods taken again in April- TSH had now risen to 6.14 and T4 dropped to 19.6.

My doctor inexplicably has said they are happy with this result as my T4 is in range. I am very concerned about this rise in TSH as I was planning on starting a family and this has been put on hold, I don’t want to risk the health of any children I might conceive as TSH should be well controlled in pregnancy.

My question is should I push the doctor to increase my levothyroxine again to bring my TSH down or should I wait to see if it balances out over time as I may have unintentionally put my body through too many changes? I’m feeling like I need to express my concerns about pregnancy to my doctor and request a referral as l’m not confident they are equipped to guide me through safely.

Any advice would be appreciated as I’m puzzled as to the best approach to take.

[SlowDragon Administrator]

It was far to big a drop to reduce to 50/100 alternate days. It needs FINE adjustment

You are now under medicated

[greygoose]

Your doctor doesn't understand the importance of the FT3. If you felt well with your FT4 slightly over-range, it was because you needed it like that to get enough T3. And it really didn't matter. Reducing your dose so stupidly and drastically, your FT3 has now fallen very low, causing your TSH to shoot up. And, I very much doubt it will sort itself out, by itself. You need to go back to your original dose. But, even at that dose, your TSH was a tad high, you weren't euthyroid! But it was low enough for you to conceive. Now, you probably won't even conceive, I'm afraid.

[Suzannah1985]

Hi,

I am hypothyroid and undergoing fertility treatment (not solely due to thyroid issues, although they are a complication as I have hashimoto’s too). My clinic advise that TSH should be below 2.5 and they won’t treat until it is.

I would suggest speaking to your doctors as the thyroid can have a significant impact on TTC and sustaining a pregnancy.

Good luck xx

[Angel_of_the_North]

your earlier results were much better. For a successful pregnancy, TSH needs to be under 2. I wouldn't even try with such a high TSH as a miscarriage is heartbreaking. I think you need to see another GP and mention that you are wanting to get pregnant.

[Ariemai6]

Thanks everybody for your advice, much appreciated I’m going to my doctors now with confidence that I’m right and my dosage needs increasing, means I won’t leave without a fight! So disappointed with this situation as I was looking forward to trying for a family and now I have to wait until my TSH goes down (by a lot!).

Really peeved as not only did my doctor bring me down unnecessarily, but by too much at once, failed to call me back for five months for further checks and then dismissed my concerns via his secretary. Kicking myself that I agreed to the change in dosage and forgot to push for more blood checks before it got so bad!

[kiefer in reply to Ariemai6]

I believe that there are medical protocols for women with hypothyroidism who decide to become pregnant. Here is a link to a recent article that you might want to take to your "new" doctor as I doubt you can educate the current one. They really seem to hate it when patients bring in their favorite book, but an actual article published in the Indian Journal of Endocrinological Metabolism might not be flipped right back in your face.

ncbi.nlm.nih.gov/pmc/articl...

TREATMENT

"Serum free T4 and TSH levels should be measured 1 month after the initiation of treatment. The thyroxine dose should be titrated to reach a serum TSH value less than 2.5 mIU/liter, while maintaining free T4 levels in the high normal range. Women should be followed up every 4–6 weeks with free T4 and TSH value, till delivery, to facilitate periodic adjustment of LT4 supplementation. If hypothyroidism has not been diagnosed until the end of the first trimester, offspring may display impairment in final intellectual and cognitive abilities, thus underscoring the importance of early diagnosis and treatment."

[Ariemai6 in reply to kiefer]

Thank you very much for this article Kiefer, it’s very informative. I like to be as educated on these things as possible as GP’s don’t have a clue!

Pregnancy is risky enough as it is, but there’s so much else to worry about when you suffer from hypothyroidism!

I’ve been so careful to address any vitamin deficiencies this last six months in preparation, forgot all about my thyroid test! Very unlike me, now a long road back for me I’m afraid.