Two miscarriages, Hashimotos, TSH normal

[Mama196]

Hi, I’m looking for some advice about private testing.

I’ve had two miscarriages in the last 9 months. I already have a son (aged 2.5) conceived when my hypothyroidism was subclinical and was on 25mg-50mg in pregnancy. since then I’ve had to increase dose and am on 100mg levothyroxine daily.

My TSH was at 3.0 in last pregnancy at 5 weeks. Increased dose by 25mg at 5weeks. Miscarriage was at 8 weeks and scan showed development of only 8 weeks and no embryo, only a gestational sac.

Previous miscarriage was missed, revealed no heartbeat at 12week scan and development of only 8weeks. No increase in dose until 8weeks on advice of GP receptionist who said meds would be reviewed at 8 weeks midwife appointment- I will never forgive myself for not questioning this advice!! All tests showed TSH in range but I only had one just prior to conception and then at 10 weeks when it was too late anyway.

I just feel in a real muddle. I’m being told by the GP that two miscarriages are common and it’s likely unrelated to the Hashimotos but my heart and head are screaming that I don’t trust the GP and their testing. They say it’s up to lab if they agree to test T4.

Can anyone help? Should I go for private tests or will it make me more confused? Plus the fee is £250 just for initial consultation never mind the tests and follow up! I’m worried I wouldn’t be able to interpret cheaper results like MediCheck without consultant to give overview.

I’m so worried about it happening again and am torn between trying again ASAP and risking further miscarriage (but after which I’d be eligible for NHS recurrent miscarriage testing) and delaying to take private tests. I just wish somebody could tell me what to do!! I am so anxious about it all.

Any advice welcomed, thank you!

[silverfox7]

We have seen, over time, several sad postings of miscarriages and uninformed GP's and even worse lack of empathy. I had my family before I was diagnosed thankfully but if I had my time over again and knowing what I now know I would insist on being tested before actively hoping for a baby and insist that my TSH is no higher than 2. I know most of us feel better when it's around 1 or even lower so I don't think that's too much to ask and be treated for. Some of us may want to start a family a little later as well and could easily run out of time if any sort of delay. Some don't want to risk losing another so again that seems a bit unfair not to check things out first.

[Mama196 in reply to silverfox7]

Thank you. I am a bit new to this idea that maybe GPs don’t know best when it comes to thyroid levels as previously in between having my son and trying again I just went with their advice and felt ok. I will do some private testing I think.

[Angel_of_the_North]

Well, NHS guidelines say that TSH should be under 2.5 (might even be 2) for a successful pregnancy so you could ask your GP why s/he thinks those guidelines don't apply.

[Mama196 in reply to Angel_of_the_North]

Thanks, they’re happy to try to keep TSH under 2.5, I’m just not clear if they should be testing other thyroid factors- T3, T4, FT4 etc

[Angel_of_the_North in reply to Mama196]

They probably should, but as it is not in the guidelines they do not have to. You said that your TSH was 3 last time so they don't seem to have been taking any notice of guidelines

[Mama196 in reply to Angel_of_the_North]

Thanks, they are aware of the guidelines but only increased my thyroxine dose by 25mcg at 4 weeks pregnant when I think it should’ve been by 50mcg (recommendation just says 25- 50mcg).

It seems hard to get the balance right and too much thyroxine is also not good in pregnancy. They’ll increase by 50mcg if we manage to conceive again.

[Harper]

Hi perhaps your doctor is right I’ve had two children, a long time ago now. I was on 200 mcg at the time and never miscarried.

I know some women have trouble conceiving and some can’t get pregnant. So there may be other reasons. Worth investigating in case it’s not your thyroid.

[Mama196 in reply to Harper]

Thanks for your reply. I just can’t tell if I’m worrying unnecessarily or looking for a reason or factor I can control. I think I’d like to do some extra testing just for piece of mind.

[Mama196]

Hi JaneyJaney thanks so much for this, that’s really interesting- gosh that poor woman!! My Dad once had to diagnose himself with Lymes disease and was then rushed into hospital at risk of brain infection- it’s a strange thing when you’ve been used to trusting Drs for so long to question their judgement, and a really hard thing to do in person I’ve found.

I’m just annoyed that they have a rule that you need 3 miscarriages before testing, which I can understand due to NHS being underresourced but if you have hypothyroidism (a known risk factor for miscarriages), then shouldn’t they consider that and test earlier?

I’ll do ask you suggest and ask for recommendations for a private Endo. I am seeing a fertility specialist next week too as I’m hoping she might test for other autoimmune conditions.