I’ve had 3 back to back chemical pregnancies since trying to conceive. I’m 34 years old now with two children I had without problems. I take 75mcg levo, and a little extra on 2 day’s of the week. My TSH is 0.34 , my free t4 is only 15 and my ft3 is 4 (I’ll find the ranges I don’t have them to hand. But I remember the t3 being the bottom one of normal.
I can’t help but think the miscarriages are all related to my thyroid. My doctor said I’ve always had the antibodies and always been a little hypo, but it’s only the last few years
It’s ramped up and therefore needed to begin medicine.
Does anyone have any advice or experience with this please? I’ve been referred to the recurrent miscarriage clinic but due to covid 19 they’ve cancelled my appointment for now.
What are your antibody levels? I have heard that in some cases of hashimotos, the immune system can turn on the baby, resulting in misscarriage. Izabella Wentz will have more information on this on her website.
What about my thyroid levels ? Do those seem ok? I don’t remember the ranges but I will post when I have them. But I do remember that t4 not being in the top half of the range.
It’s a funny one because I’ve read lots of women having huge antibody levels and way out of whack thyroid levels and having successful pregnancies , it’s so hard to work out what’s going off. I guess it’s possibly nothing to do with my thyroid at all!
High antibodies confirms that the cause of hypothyroidism is autoimmune thyroid disease also called hashimoto’s
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test, or buy test online BEFORE trying strictly gluten free diet
Assuming test is negative you can immediately go on strictly gluten free diet
If coeliac test is positive you will need to remain on high gluten diet until endoscopy, with maximum 6 weeks wait, officially
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
At the moment GPs aren't running coeliac tests if they aren't urgent - they're trying to limit unnecessary contact, and unfortunately the blood test needs contact.
Home fingerprick tests are available though (but the doctor would likely still want to do their own test to send for and endoscopy).
Hello Francesca - you're an incredibly lucky lady to be blessed with two children.
If a person is childless (am far far too old now) do be aware of MTHFR. I am not a medical person, however, over the years I have come across research and various situations that point to even "deeper" answers around diet such as leptins in our food causing inflammation and ways to deal with them. there's a famous US doctor who has written about this - sometimes such professionals are ridiculed but often their work and findings do make sense.
Going back to MTHFR, there can be a variety of health conditions (physical, mental and emotional) running through a family that is linked to MTHFR and sadly that includes miscarriages. Did the clinic test you for that? You may wish to investigate key organisations that help women wanting a pregnancy with natural support eg best high end bio-available supplements - even patches, and healthy living - though I guess you're already doing this?
Other things that I believe impinge over the decades on our health is the amount and variety of dental work that we've had done and also how we deal with stress. I wish you well with the route of your life's journey that you choose, Felicity
Thank you ! I haven’t had any tests by the recurrent miscarriage clinic as yet , I’ve just been referred. The specialist I mentioned was a thyroid specialist at the hospital (a different part of the hospital in a separate building).
Yes I do feel blessed to have two healthy girls xx
It may be nothing at all wrong, just my age and a decline in egg quality maybe. I was really wondering if my thyroid levels played a part in it x
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Can TSH be too low maybe ?
Hi, have you tested for mthfr? If so taking folic acid can actually block the uptake of folate in your body. I would look into the aip as well, it literally changed my life. How are your other hormones? Your progesterone and estrogen? Do you suffer with estrogen dominance? What levels were your vitamins? Usually what doctors deem to be normal are a massive range and a lot of the time not optimal. Have you read Izabela wentz books about hashimotos? I would recommend if not 🙂 there is also a book by Dana Trentini about healthy pregnancy with thyroid problems, she lost a baby with a tsh of 10 when doctors said that was fine, so I would make sure you learn as much as you can and do your own research on everything. My experience is also if someone is a thyroid specialist they ironically usually know the least about thyroid problems, and are the most dismissive. Wishing you luck x
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I haven’t had the mrhfr test I’ll be asking about that when the clinic sees me.
I have had many tests including vitamins and Estrogen and progesterone, those were the tests the thyroid man was able to do there and then and they all came back fine. The vitamin tests have been coming back fine for some time now. He did tell me to start taking 400 folic acid though.
Really hoping the miscarriage clinic will re open soon. My doctor has written to them to ask if we can get the ball rolling with blood tests. X
Seems to be an Inplantation issue, those are usually caused by Chromosome problems or issues with the uterine lining., which is affected by thyroid. It aaaall seems to be affected by thyroid hormone.I’ve spent some time overactive too before it was caught just recently
Do come back with some more blood results, you should be able to get a copy from GP. I went through two clomid induced pregnancys and at the time had enough faith in the medical profession to belive that I was fit enough to do so. I have since realised that I was anaemic, hypothyroid and vitamin D deficient and that a doctors idea of good health is about being able to breathe unaided rather than fit to cope with babys. I have two lovely boys both with significant learning difficaultys and one with ongoing, chronic health issues. I cannt turn the clock back but if I could I would make sure I felt as fit as a flea before pregnancy and I would hope that by doing so I would not have needed clomid. There is some very good advice, knowledgeable people on here so make good use of us and keep coming back.
Francesca0, I skimmed through the responses you've had, but no one seems to have mentioned what to me is the most important point. Yes, miscarriages are a hypothyroid symptom. We need good levels of thyroid hormone to carry a baby to term.
If the way you describe your freeT3 is accurate, then you sound quite undermedicated. This is the most important number in the thyroid panel, because T3 is the active thyroid hormone needed by every cell and tissue in your body.
We need good levels of freeT3 to feel well, which means the upper part of the reference range.
Thanks silver avocado. It’s quite frustrating really , I wonder why some people can have a dicky untreated thyroid and carry a baby to term, but others have to be bang on the nail perfect before they can have a successful pregnancy. I seem to always have a low TSH with “ok” t3 and ta but could be a few notches highs to be perfect. My ft4 used to be staying around 19, and my fr3 stayed around 5/6, both in the upper quadrant , but it made my tsh 0.02, so they took me back down a little.
Online , I only seem to read that the ideal TSH for pregnancy is 0.3 - 2, nothing about the free t’s.
I suppose a bit anxious and because I’ve got to wait to be seen my the recurrent miscarriage clinic until the covid has passed a bit, I’m trying to do what I can my end. It could be anything at my age though right ?
I think it's really disgusting that doctors don't know more about miscarriages being related to thyroid. Some of the stories that come through the forum are so painful
I think there is some variation in how well people do with low levels of hormone, and some people probably are fine with a doctor just quickly giving them the standard dose. Of coruse the people who turn up on the forum are those who are the most 'sensitive' ones and feel unwell when they're on the wrong dose.
On the other hand, we just never know how bad the population of thyroid patients do feel. I run into a lot of people who kind of say they feel fine, but then when you get to know them you realise their are very badly impacted by symptoms, including miscarriages.
Unfortunately doctors tend to rely very much on TSH, which is a very crude measurement. The suggestion in pregnancy to have it under 2 is more generous than that for people who aren't trying to get pregnant, but its hard to believe that anyone could feel well with a TSH in that kind of range, and it will have an impact on pregnancies. Most people need a TSH at the very bottom end of the range or below to feel well.
Thyroid care in general is terrible, in pregnancy I think it is even worse
I’ve got the ranges if anyone would mind looking for me please x
You'll need to make a new post with these figures, as its now buried down in the thread and most people won't see them. I'll have a look and tell you what I think.
So the full results are:
TSH is 0.34
Ft4 is 15 (12-22)
ft3 is 4 (3.1-6.8)
This is a classic clear cut case of being undermedicated. Both freeT4 and freeT3 are low in their ranges. They are both well under halfway through the range, so this is not even beginning to be an adequate dose. When I was in this position I needed three or more increases to get me up to good levels.
I'm a little bit out of practice at the moment, but I also suspect your TSH is not very responsive. These hormone results are pretty low, and the job of TSH ( thyroid stimulating hormone) is to increase when hormone is low, which is a chemical messenger asking the thyroid to make more hormone.
There is quite a bit of individual difference in how responsive a TSH is. Some people are lucky and theirs will bounce up as soon as hormone dips, and some are more unlucky and get a sluggish response. Then the problem is that a doctor will take that TSH as gospel and make life changing decisions about your dose.
I see from your earlier comments you've been on a higher dose in the past and met a silly doctor who reduced it based on TSH alone. These kinds of doctors cause a lot of trouble for thyroid patients.
The simple answer is that you need a dose increase of 25mcg of Levo, then retest in 6 weekend and adjust by 25mcg again, and keep going like that. In the first instance you want to see a freeT4 near the top of the range, or symptoms resolving. And if you don't feel yourself with high freeT4 then it's time to look at the next things on the list.
Of course the hard bit of that is to find a doctor who knows anything and will support that. If you're in a hurry to resolve things then buying your own can be an option, but then once you're pregnant you're at the mercy of more doctors who will have a hand in managing the pregnancy.
I think this situation of trying to get your numbers sorted, and have to deal with doctors through pregnancy who are determined to make you ill again, and put you at risk of miscarriages or danger to your baby is nothing short of a nightmare It shows up the cruelty and inadequacy of thyroid treatment at its absolute worst
An extra note is that TSH is produced in the pituitary. Extremely unresponsive TSH is caused by an issue with the pituitary, and this causes a more unusual form of thyroid illness called Central hypothyroid. When I say I'm a bit out of practice I mean that I'm not sure your TSH is discrepant enough to suggest Central or if it just a more sluggish response.
This could be something to bear in mind, particularly if you have any other pituitary issues.
Unfortunately many doctors have not even heard of this form of hypothyroid
Silver avocado I can’t thank you enough for taking the time to reply to me today!!
I’ll do another post like you said. I knew I felt under Medicated, and I knew I felt better on the higher dose with the low TSH, but my go frightened me by saying I was heading for a stroke and I needed to come of thyroxine immediately (he said this infront of my 9 year old too) so naturally this frightened me loads ! The father of my first two children has died and so for him to say that infront of my little girl knowing our situation I thought was cruel and so I said I’d never go to see him again and that I don’t feel I should come off thyroxine entirely , that’s when he referred to the specialist who confirmed I should never come off thyroxine and that my new thyroid levels seemed ok. He said my TSH was recovering after it’s period of hyperactivity.
You're very welcome Sorry to hear about that doctor frightening your daughter. Doctors can be so cruel, and they seem to often have a bit hostility to thyroid patients and say awful things.
Vitamin D deficiency is very common. Hopefully you'll get some treatment prescribed, but they will only get you to minimal levels and you'll need to continue supplementing after that's finished to get levels optimal. SeasideSusie is the person to look out for on the forum for good vitamin advice. The Vitamin D Council is also good.
Hi there. Are you taking LDN for your Hashimotos at all? There's a video on here somewhere that has a doctor talking about how women do better conceiving and carrying while taking LDN. I'll try to find it for you.
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Sorry to hear about that doctor frightening your daughter. Doctors can be so cruel, and they seem to often have a bit hostility to thyroid patients and say awful things. 
Graves - darkness under eyes
exercising with hypothyroidism 
Eyelashes
Weird sensation below right ribs 
ERFA
