Levothyroxine dose adjustment postpartum -- urgent

Hello community! hope you can help me.

I am 7 weeks pp. I have Hashimoto's but was not overt hypo and actually in remission before getting pregnant. My TSH shoot up to 4 during pregnancy so I was put on 50 ucg levo with which I worked really well.

Upon delivery, I had 4 different expert instructions in regards to this medicine:

- Stop altogether as it was " a pregnancy thing" (hospital)

- Reduce dose to 25 ucg and re-test in a month (public health doctor and a doctor friend)

- Stick with 50 ucg (private doctor and health coach)

- Retest and see- might even have to encrease dose (endocrinologist).

My TSH with 50 ucg was 0,65 mc UI/ml (0,35 - 5,10) and T4 0,84 ng/dl (0,50 - 1,40). My reason told me to reduce to half about 8 days ago but I am now terrified, as things aren't going great with Breastfeeding and Im doubting my supply (not necessarily with reason, but you can understand).

I now there is no point in retesting on the new dose until 4-6 weeks on new dose, so I wont do that yet, but I have a feeling this is too low of a dose, my basal temperature doesn't reach 36 degrees Celsius anymore and my baby seems agitated and unsatisfied (even though she puts on weight, wets enough nappies etc.).

My B12, FERRITIN (69), MAGNESIUM, ZINC, IODINE AND VITAMIN D are within range. Can you please advice?

[greygoose]

- Retest and see- might even have to encrease dose (endocrinologist).

I would have gone with the endo's advice. Hashi's is not 'a pregnancy thing' it is for life. Why did you feel you needed to reduce?

TSH 0,65 mc UI/ml (0,35 - 5,10)

T4 0,84 ng/dl (0,50 - 1,40) 30.91% through the range.

Your FT4 isn't even euthyroid. That would be about 50%. And, it's only that good because you were taking 50 mcg levo. I dread to think what it is now.

If I were you, I would go back up to 50 mcg and stay at that for six weeks, then retest and get an increase in dose.

My B12, FERRITIN (69), MAGNESIUM, ZINC, IODINE AND VITAMIN D are within range

Just being in-range is not good enough. They need to be optimal. Can you post the actual numbers: results and ranges? And, let's have a look.

[Hidden in reply to greygoose]

hello! thank you so much for your answer. You're right, I jumped the gun going down to 25 ucg, I did it "rationally" based on comments on how if Ididnt take any before and the demand increased due to baby, now with baby out I should be able to slowly wean off it, but I see how I should have focused more on optimal range lab values, and my gut feeling quickly told me I might be wrong having done that.

On the other hand, its only been 10 days on 25 ucg, do you think it should have affected me deeply? Ive gone back to 50 today and will retest.

I have updated the post with labs, these were 6 weeks pp, ferritin doesnt show but its currently 69. Thank you again!

[greygoose in reply to Hidden]

I did it "rationally" based on comments on how if Ididnt take any before and the demand increased due to baby, now with baby out I should be able to slowly wean off it

Who on earth told you that? Whoever it was has no understanding of thyroid. We're talking about hormones, here, not drugs. You can't wean off a hormone, they are fundimental to life. And, it's during pregnancy that a lot of women become hypothyroid, sounds to me as if you're saying you were hyperthyroid beforehand. So, why would giving birth restore your thyroid? It just doesn't work that way. And, you have Hashi's. Hashi's just doesn't go away, it's for life. But, very, very few doctors have any understanding of thyroid. They're just plain ignorant, for the most part.

What is 'HEIRRO'? I can make out most of the nutrients, but not that one. And, that one is over-range. Don't know what YODO is, either. But that is quite low.

Blood tests for magnesium are pretty useless, actually. Just because the result is ok in the blood, doesn't mean you're not deficient. You could just try some, see if it makes you feel better.

[Hidden in reply to greygoose]

I agree! Most doctors have no clue about how thyroid works. I was in remission, not hyper, but agree with your comments.

Hierro is iron and Yodo is iodine.

I did think magnesium might be worth a try.

[greygoose in reply to Hidden]

Ah, right. I should have guessed that!

Did you have any inflammation markers tested? Because high levels of inflammation can raise iron levels.

Iodine may be low, but you really don't want to supplement it, that would be a very bad idea. You will be getting iodine from your dose of levo - every molecule of T4 contains 4 atoms of iodine which are recycled. So, I shouldn't worry about that.

[HashiFedUp]

I was undiagnosed throughout pregnancy, had a 5lb baby, and pp didn’t produce enough milk to feed baby. So bottle fed after a month of awful breastfeeding!

My symptoms got A LOT worse pp and still the GP palmed me off when I knew something was wrong. Long and short of it - go by how you feel..!

Don’t let them dictate removing t4 if you feel ill from not taking it or reducing it.

At least you were diagnosed which is good - i wasn’t and it was dangerous. I was lucky and got away with it. My son is healthy as far as we know.

Having a baby is a known trigger for thyroid problems and worsening existing thyroid problems.

[tattybogle]

Yes, you would feel the effects of reducing dose within 10 days.

T4 has a half life of about 7 days (after 7 days half is left, less any that was used , after another 7 days , half of the remaining half is left etc etc)

I feel the difference within 2 days.

Don't worry . you won't have done any harm by reducing for 10 days. but i think you're right to put it back to 50 and keep testing.

If baby is putting weight on, all is well . even if it doesn't feel like it. Hang in there . Babies pick up on your emotional state too, so try not to worry. It get's easier

[Purpledreamer]

If there was a type of music you listened to while pregnant or one that you just like and makes you feel relaxed, try playing that as you breast feed. If they heard it in your tummy it helps them to feel secure. You are doing a wonderful job x I would agree to stick with the original dosage and retest in 6-8 weeks x