Whilst gearing up for another round of IVF, by some miracle I have managed to find myself pregnant (naturally). I have Hashimotos and after a frustrating time on Levo only (low T3 high TSH) I switched to NDT which sent my antibodies up to 1000. I am currently self-medicating and I now take 25mg T3 and 75mg of Levothyroxine daily. My TSH is 0.1 and my T3 is creeping up (currently at 4.5). I am doing well on this combination, however my GP has warned me against self-medicating on T3 and said that I should be taking Levo only at an increased dose.
I plan to remain on T3 but am worried that without the support of a Dr. Does anyone have any advice on whether T3 is safe for pregnancy?
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HarrietJW
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Congratulations HarrietJW. I was on T3 when I got pregnant. I chose to stay on it as under the care of an Endocrinologist i was tested for polymorphisms of the DIO2 gene. These gene mutation inhibit the conversion if T4 to T3. My dosage was reduced but frequency put up to 3 times a day to try to stagger it more. However at 21 weeks I was suffering terrible swelling and palpitations. My T3 was too high so dose had to reduce again. It was hard to diagnose as maternity units dont standard test for this. I have a healthy baby girl now who was a bit premature due to other complications. GP will advise against it due to lack of medical data. If you are in the South East find Dr Abbi Lulsegged. He is a fantastic endo and got me through my pregnancy.
Look into that Gene as I have not heard of it. It’s so hard to know what to do, I feel I am out on my own at the moment as I can’t get a decent endo, I’ll keep trying all avenues. I am in the SE so will also see if I can see your Dr, anyone who is willing to consider T3 as an option is going to be helpful to me. Thanks for taking the time to reply!
Thanks! I'll be sure to keep an eye on those ones too! Seems the UK is not the best place to have Hasimotos! Do you know anything about TPO antibodies and pregnancy? Mine were 1000 last time I was tested.
Many of us with Hashimoto's find strictly gluten free diet slowly lowers TPO antibodies
Your experiment with NDT may have caused rise too
Getting Levothyroxine dose high enough to bring TSH down to around one and FT4 in top third of range and FT3 at least half way in range should help too
I had my family before I was diagnosed but I've heard many being told to come off T3 but also success stories so a difficult one to call without knowing local doctors feeling. Many doctors are wary of T3 though as they know nothing about it so I hope you get replies to enable you to make a decision on what you would be happy with and take it from there. Previous posts suggest getting an early referral to the hospital so you have more time to talk to them and make a decision that you are happy with. Oh and congratulations as well!
Thanks very much for taking the time to reply, I hope to get some responses from the (mostly) ladies on the forum, it’s great to have some support here whilst I feel I am trying to guide my own healing. Just hope I can do what ever is right for the little bean growing inside me!
The important parts are that your T4 level is adequate as the forming fetus utilizes T4 during neural development and that you are getting adequate iodine (should be in your prenatal vitamin/mineral supplement) so it’s available when the baby starts making her own T4. The baby doesn’t utilize T3 so if you are taking any it is very important your Free T4 is being tested (usually every four weeks in the US) as T3 can lower your TSH even if T4 isn’t adequate. Again in the US, this frequent testing may be done by the obstetrician or midwife, not an endo.
Thanks Patti, that's really helpful and I apprieciate you taking the time to comment. My T4 has been at the low end of normal for ages (between 11-13), hopefully I will have a dose increase once I manage to see an endocronoligist.
If your FT4 was near bottom of range your GP should have increased dose of Levothyroxine
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctort
Thanks that's really helpful. I will email to get a copy and show my Dr. I am not seeing him untill the end of the week, is it worth increasing my own Levo?
"As soon as you find out you are pregnant, you should immediately increase dose of Levothyroxine by 25mcg......Don't wait until you see your Doctor or midwife ....."
Suggest you print this out and take with you to see GP
Congratulations !!! Great News . As far as I know my daughters Dr told her T4 is the important thyroid hormone needed during pregnancy . My daughter has Hashi and her T4 was raised a bit higher than usual .
Congratulations I appreciate your worry and confusion I have had the same thing. I’ve got 5 weeks left till my due date and had to manage my pills alone the whole way and hope for the best. I’m T3 only and couldn’t afford as regular blood tests as I would have liked. My TSH is pretty much 0 but I’ve felt well and just stuck to my dose as results showed it was around the right levels on most things. As I don’t take t4 I’m not able to advise on the increase but I know it’s supposed to go up as first 12 weeks it’s crucial. Only advise I have is split your t3 dose as much as you can. I had the medical reasons explained to me but medical stuff seems to go in one ear out the other with me I can’t understand it to stick! But I know it’s vital you don’t take too much at once.
Trust your body and instincts take someone to dr app who can help fight for you as they will tell you that your wrong and t3 is no good etc take your research with you.
I was lucky got a great consultant who admitted he knew nothing about any of it and so ordered my full bloods inc t3 so I could take advise on them elsewhere and not have to pay for more private ones.
I had a baby 6 weeks ago and continued to take NDT throughout my pregnancy. I was under an endocrinologist who wasn't happy with me self medicating, but I informed them that I would not be willing to take levothyroxine and they continued to monitor me throughout the pregnancy (and I adjusted my dosage according to bloodtest results.
It has been my healthiest pregnancy to date, had no growth issues with baby (having had two babies previously that stopped growing at 32 weeks), she was born at 6lbs 10, my heaviest baby yet and was absolutely perfect.
You do not have to take levo. As long as you know how to interpret your bloodwork. Good luck! X
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