Subclinical hypothyroidism treatment in pregnancy- bad reaction to levothyroxine

[Runninggirl12]

I would be very grateful for any advice anyone can provide.

I have been advised by specialists in fertility & miscarriage that I should be treated with levothyroxine to obtain a healthy pregnancy.

It’s a long convoluted story but this is based on 2 miscarriages, a complicated pregnancy, tsh levels between 2.6-5 & positive tpo antibodies. I have also definitely suffered from flair ups of some symptoms of hypothyroidism throughout my life which improved massively when I switched to a gluten free diet several years ago.

I initially started on 50 mcg of atavis levothyroxine but had to stop after a week as couldn’t function due to the side effects. I then switched to Wockhardt 25 mcg which seemed ok at first but after 2 weeks I was developed a bleeding ulcer & severe chest pain so stopped immediately (unbeknown to me I became pregnant while on this dosage but ultimately lost this pregnancy which didn’t develop properly after about 5 1/2 weeks).

I am petrified of a repeat of the above scenario & dont feel I could contemplate attempting another pregnancy without finding a brand of thyroxine that I can tolerate (as I have been advised that if I can’t maintain my tsh under 2.5 I have an increased risk of miscarriage/development issues in my pregnancy).

I am presuming like others I am reacting to the binders in the levothyroxine brands - although the inactive ingredients in Wockhardt appear to be in all other brands available in the Uk - has anyone else reacted to Actavis & Wockhardt but found another brand that worked for them?? Is the liquid formulation of levothyroxine worth trying?? Has anyone found that they have eventually adapted to the brands & the side effects have stopped??

Any help would be appreciated.

TIA

[SlowDragon Administrator]

Sorry to hear you are struggling to find Levothyroxine that suits you and for miscarriage as result

Have you had vitamin D, folate, ferritin and B12 tested? If these are too low this can be one reason you struggle to use thyroid hormones

Add results and ranges if you have them

The fact you benefit from Gluten free diet confirms your gut is affected. Low vitamins are often a result especially with Hashimoto's (high antibodies)

What supplements do you take, if any?

Are you also lactose intolerant?

Teva brand is the only lactose free Levothyroxine tablets. There is Levo liquid, but it's expensive so NHS reluctant to prescribe

Perhaps you should be referred to endocrinologist to asses your adrenals

Or you could do private cortisol saliva test. More comprehensive than NHS test anyway

[Runninggirl12 in reply to SlowDragon]

Thanks you so much for your response. I am new to all this & have been very scared by my experiences so far.

I have never had my vitamin levels tested but have started on 2000iu of vit D & 5000mcg of folic acid daily. I also take a prenatal multi vitamin.

I have never had issues with Lactose. I have actually been recently provided with Teva Levothyroxine to try however in light of the very negative responses that people have posted about this brand I have been very reluctant to start this.

I am going to see an Endocrinologist privately next week & will definitely raise these points & query what further testing could be done.

[SlowDragon Administrator in reply to Runninggirl12]

You really should have vitamin levels tested first before starting supplements

Ask GP to test ASAP or get private testing

As you have gluten intolerance low vitamins are likely

For example if B12 is low, starting folic acid before B12 can exacerbate/mask low B12

ncbi.nlm.nih.gov/pubmed/179...

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

[Runninggirl12]

Thanks

The supplements were prescribed with an aim to minimise risk in any future pregnancy as opposed to any potential deficiency. I will look into getting vitamin levels checked.

I am confused though- I don’t really understand however how a vitamin deficiency would cause my reaction to the levothyroxine??

[Angel_of_the_North in reply to Runninggirl12]

If your vitamin levels are low, you can't convert the T4 (levo) into T3 - the active hormone.

[Runninggirl12 in reply to Angel_of_the_North]

Thanks - I will see if my GP can do this or will pay for private testing