Recurrent miscarriages : Hi guys hope you can... - Thyroid UK

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Recurrent miscarriages

Beepi
Beepi
19 Replies

Hi guys hope you can help.

I am going through my 3rd miscarriage all at 8 weeks the HB stops.

My TSH level has been 0.63-1 (optimal) and been stable for 2 years.

Should I have taken 25mg levothyroxine when I found out i was pregnant? I thought not to as my TSH was optimal?

Now I'm thinking i should of taken the extra 25mg as soon as i found out I'm pregnant and wouldnt of not caused all my miscarriage :(

19 Replies
oldestnewest
boxesandplanes

So sorry for your losses beepi.

I'm afraid I don't have any answers. I've had 2 late miscarriages at 18 and 17 weeks. The only difference from when I had my 2 successful pregnancies was being on levothyroxine at all.

I've been through all sorts of scans and tests and no problems found. Apart from low ferritin.

It was suggested by gynaecologist I take progesterone and warfarin when pregnant to support the pregnancy, didn't think it would help because this is usually helpful in those who have had losses prior to 14 weeks. So maybe this could help you? Do you have a gynae?

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Ellyblue

Hello Beepi. I’m so sorry to hear about your miscarriages. My daughter had 5 after having a successful pregnancy with my granddaughter. After every test available she was told there was no reason, we consulted our herbalist who said she was very low on magnesium and that it was impossible to support a pregnancy in that case. She took an over the counter magnesium supplement, she said it would take three months to work, and her third cycle after she started the supplement she got pregnant with my beautiful grandson.

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radd

Beepi,

I am so sorry for all your sad losses. 😔

"There is evidence of increased fetal loss, and psychomotor and IQ deficits in infants born to mothers with undiagnosed or inadequately treated hypothyroidism".[Casey et al, 2005].

During the first trimester not only will your baby depend on your supply of thyroid hormone (as does not have his own until about 12 weeks) but your oestrogen levels will raise, encouraging TBG (thyroid binding globulin) to correspondingly raise and this binds to thyroid hormones, disabling a proportion.

So yes, it is usual to increase Levothyroxine dose, initially by 25-50 mcg & some even require weekly 25mcg dose increases in the early stages. Re blood results, many GP's will keep dosing Levo as per usual protocol as do not realise that you are not waiting for the total cell saturation that the usual recommended six week blood test determines but an immediate TSH blood serum level of low-normal range (0.4–2.0 mU/L) and an FT4 concentration in the upper reference range that must be retained, as stated by NICE. Your pituitary gland (if working) will be quickly responding by producing more TSH (thyroid stimulating hormone) in an effort to increase your FT3/FT4 and it is this TSH level that is your guide to establishing your Levo dose whilst pregnant.

“Women with known thyroid dysfunction who are taking levothyroxine may need the dose increased by 30–50% from as early as 4–6 weeks gestation” .. [De Groom et al, 2012).

If your doctor doesn't know all this, print off the NICE guidelines and ask to be referred to a specialist as NICE also states that your doctor must discuss urgently with an endocrinologist regarding initiation of or changes to dosage of Levo while waiting for a review.

Blood tests should be performed every four weeks during the first trimester, then 16 and 28 weeks of gestation, or more frequent if needed.

An excellent read is "Your Healthy Pregnancy with Thyroid Disease" by Dana Trentini & Mary Shomon.

.

NICE guidelines

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

.

Edit : Bloods should be performed after each Levo dose raise, so possibly even weekly for the first few weeks until TSH remains low.

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HashiFedUp

You should have medical advice before changing your doses. I had undiagnosed Hastimotos while pregnant, measured small all through pregnancy (no one bothered to check my thyroid), had a 5lb baby (no one checked my thyroid) - three years later after three years of exhaustion with a baby then toddler I was diagnosed. It’s really good that you’ve already been diagnosed already pre baby and you should be under a consultant ped. All the way thru and they should liaise with your Endo re treatment. You should get your bloods checked regularly too. My son is now healthy and happy. You’ll get there. Good luck x

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Elmira0708

It might help to check your levels of Vitamin d3, b12 and magnesium. All often low in hashimotos patients and vital for a healthy pregnancy. Good luck x

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Summer64

So sorry about your miscarriages. I had two early ones and threatened ones with both my babies that made it. I didn't know I had a thyroid problem then and maybe didn't but much later I was found to have Sjogren's Syndrome and that apparently predisposes you to miscarriages. Not sure they can do anything to stop it though but might be worth getting checked out. Good luck with future pregnancies.

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molliemdz
molliemdz
in reply to Summer64

Yes! My friend who led me to my functional docs had Sjogrens and POTS! She ended up having IVF for her two babies, but all of that was before discovering she had sjogren’s. Maybe the issue was there even before, when she was trying to get pregnant.

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molliemdz
molliemdz
in reply to molliemdz

And apparently all autoimmune illnesses predispose you to MC.

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molliemdz

In my experience, taking T4 did not prevent my miscarriages. I had four in under two years (all early, before 8 weeks). I had been treated for underactive thyroid for years before the MCs began (and I already had one child while taking T4, but the 1st pregnancy may have set off a new attack of thyroiditis, which may have contributed to later inability to sustain a pregnancy). If you have hashimoto’s or any other autoimmune illness, you are likely in a state of chronic inflammation. This state makes it almost impossible to maintain a pregnancy because the body recognises that it is under attack and/or has limited vital resources. Something in the immune system effectively signals the body to eject the pregnancy.

The good news in my case was that once I investigated the causes of the autoimmune situation and focused on healing leaky gut, etc, I was pregnant within six months, the pregnancy survived, and my little boy is now almost five (so there is hope). But you need to find a good functional medicine doctor and/or reproductive endocrinologist. I saw a FM doctor and endocrinologist duo in London, but I don’t know any docs in any other geography.

To give a bit more background as to what I went through before ending up down the functional medicine path:

At that time (2011-ish) you had to have 3 consecutive MCs before you could be referred to anyone for investigation.

After my 1st MC, I made a case for and got a referral to an endocrinologist. He gave me rather generic advice about keeping my TSH below a certain level.

A month/ 6 weeks later I had MC #2. I went to see an OB-GYN privately (a rather famous one, it turned out later, as he ended up being on the team that delivered the royal babies). He did some blood tests etc and some advice of a couple things to try (aspirin for one issue and progesterone for another, taken during different parts of the pregnancy, for different durations, and for different reasons. Neither helped prevent MCs 3 & 4).

After MC 3 I was eligible for referral to the Recurrent MC Clinic in St Mary’s Paddington. This is the top RMC clinic in the U.K. (& some might say, the world). They couldn’t find a reason for my MCs either. They repeated all of the tests that the OBGYN had done plus a few others, and still weren’t able to prevent MC #4. But they did give me some good advice on various things for when I did eventually get pregnant w/ #5, and were fantastic in the early stage of that pregnancy, so I am immensely grateful to them.

However, a friend at that time was going through her own nightmare while trying to get a correct diagnosis for what (we didn’t know at the time but) turned out to be another autoimmune illness. She mentioned this clinic where the doctors specialised in “difficult cases”. So I went, and they convinced me that I had IBS, put me on an elimination diet (did a bunch of testing in the meantime to investigate and rule out stuff), and in the end, with their guidance, I healed without pharmaceuticals (except for the T4, that is) but with dramatic lifestyle changes. It really has to be worth it to you to go to any lengths, though, because you have to go “whole hog” (as we say in the southern US) & comply 100%. If you sort of comply, or comply 80%, you’re just wasting time and money.

But again, the good news is that you likely can fix what’s going wrong. Good luck and PM me if you need support! (Big hugs to you and family for the MCs you’ve had...)

Mollie

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molliemdz
molliemdz
in reply to molliemdz

Clarification: T4 did not prevent my MCs from happening, BUT it was still critical to have a good supply of T4 and have it rechecked frequently throughout the pregnancies for all the very critical reasons mentioned above by “radd”.

Your dose may or may not change during your pregnancy, though. My thyroid function (TFT) was rechecked frequently during all my pregnancies, but during the surviving pregnancies, doses never increased from my pre-pregnant levels. It just depends on your body (or on the limitations of our tests?).

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Beepi
Beepi
in reply to molliemdz

Oh thank you Molliemdz, I do have hashimoto as my antibodies are high around the 500 mark.

I am seeing a private gynecologists on Tuesday, hoping she will help me.

Do you think I may need to be on injections steroids and baby asprin? My GP said I may need this as I have high antibodies?

My NHS endocrinologist who I saw before I got pregnant didnt say much about my antibodies, he said I'm fine as my TSH was 1 so gave me the go ahead to try for baby.

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molliemdz
molliemdz
in reply to Beepi

In my experience a standard gynaecologist won’t know much about the effects of autoimmune illness on pregnancy. A standard endocrinologist might be slightly more clued up, but still often not. Most endos spend most of their training on diabetes and not so much on thyroid. A reproductive endocrinologist might be better informed, but will still be looking at your situation with an “allopathic” lens (how can we treat this with pharmaceuticals, surgery, or medical devices — all the standard things in a doctor’s toolkit).

I’m afraid I don’t know much about the long term effect steroids will have, but I am pretty sure it’s like sticking a plaster on — might help on the surface/ in the short term to get antibodies down but won’t address the root cause. Functional docs focus on finding root causes and helping you correct what started them. True healing takes longer than a quick-result allopathic treatment. My guess is that most gynes, GPs and endos will give you advice that contradicts what a functional medicine practitioner might advise. But you have to be careful in choosing a FMP, as well. If you choose to see one, make sure you know what you are getting. There are some people who are licensed physicians and have an additional functional medicine qualification. Others may have some other licensure, like chiropractic / osteopathic or ND (doctor of naturopathy) plus functional medicine. And others have studied functional nutrition. Herbalists, acupuncturists, Chinese medicine practitioners etc might also have some useful advice (but might lack the ability to arrange functional labwork). All might be able to help, but consider their qualifications and background (someone with a track record of helping people like you/ us would be ideal!). I am not promoting one type of healer or another, just sharing my personal experiences. It might take some trial and error to find the right person.

Also, these approaches take some time (6-18 months for functional healing) and almost always involve changing your diet and lifestyle. Stress reduction will also play a big part. Xx

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Redditch

Hi

I went to the annual conference last week and there were two presenters talking about pregnancy and thyroid.

Both said that if you are trying to get pregnant or pregnant you need to up your medication three months before to prevent miscarriages. They have done a study in Cardiff. Depending on where you live you could have been referred to the Diabetic clinic for pregnancy... ask your midwife or the midwifery service what's available in your area, and speak to your GP.

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mardiray

Please really look into your B12 and folate. Low B12 can cause these problems, and this and a Thyroid problem can go together.

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Itileguy

I always had miscarriages at 8 - 12 weeks also

That is when the embryo starts to attach to the uterus

My doctor started my next pregnancy with progesterone injections and I had two healthy pregnancy

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la-plage

Your TSH shoud be under 2.5 even while trying to conceive.

ncbi.nlm.nih.gov/pubmed/204...

The study shows that you need on average two extra tablets a week from week 4 so basically as soon as you miss your first periods and have a positive.

Please note that it is NOT an increase of 25mcg to start with and take it from there!!!

IT IS TWO EXTRA TABLETS A WEEK (ABOUT 30%) OF THE DOSE YOU TAKE.

And it has to be increased straight away. So your GP and endo need to understand that you cannot wait to see them at a later appointment to get a blood test and then an increase as it can be too late by then.

Print the study and show them. In my experience, most doctors do not keep up with the latest studies, even when they are 10 years old!

And it is obviously an average so it needs to be assessed by blood tests very regularly at first (every few weeks in the first trimester with ideally one blood tests week 4 or 5 so you know where you stand, then 2-3 weeks later, etc) because you might need to adjust your dose very quickly (unlike the way you probably had your increases after a diagnosis - which is usually every 4 to 6 weeks).

Other studies suggest that the increase can be as high as 50% and sometimes some hypothyroid mums need no increase at all but it is much rarer. The study:

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

A great book to help you on the subject:

Dana Trentini, Your Healthy Pregnancy with Thyroid Disease.

If you have Hashimoto's thyroiditis, do check that your antibodies are not too high - which you might already know.

All my best wishes, xxx

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Micky7

Did you have checked for Mthfr gene mutation?

I have this mutation in my blood, like millions of people; can induce miscariages.

After an 8 week miscariage, doctor asked for blood analisys, i was positive on Mthfr and i took baby aspirin util i was having 31 weeks pregnancy.

I have a toddler of 2 1/2 y old.

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Beepi

Thank you for all your responses.

My endocrinologist is crap as he said everyone with underactive thyroid has high antibodies, dont believe him now!

All my vitamins are brilliant and have been for over a year.

My blood test for anticardioliphin has come back as positive and will have to test again in 6 weeks.

I generally do feel it's something to do with my blood as my hands feet scalp goes numb and has been for past 3 years. Gritty eyes, dried mouth, hair loss, feeling extremely exhausted to point it's an effort getting ready!

I hope they so find something as I'm so fed up with this. Xx

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