Blood Results and finding the right dose of Levo for pregnancy

[Lilacsocks]

Hello,

I have a few results here so bare with me.

07/09/20 monitor my health test

(I had very similar NHS results around the same time but no T3)

TSH 0.34 (0.27 - 4.2)

T4 15.5 (12 - 22)

T3 4.4 (3.1 - 6.8)

18/09/20 NHS test

Haemoglobin 107 (115-165)

serum ferritin 12 (5-85)

B12 240 (145-910)

Folate 23.7 (3 - 20)

15/10/20 NHS test

TSH 0.08 (0.2- 4.5)

T4 10.8 (7-17)

Taking replacement levothyroxine after RAI in 2008 to treat graves.

I take 150mg 5 days a week

125mg 2 days a week

I'm 29 weeks pregnant and have had a pretty tough time feeling tired and really struggling with anxiety for most of it, I have found managing thyroid issues so stressful this pregnancy as I know the usual nhs route leaves me feeling terrible so I have had to insist on upping the dose a couple of times which has come with a lot of scaremongering from Drs.

The last few weeks I have started to feel so much better, more grounded and connected, able to exercise a bit and a more manageable/normal level of tiredness. (I'm not sure if its possible not to feel tired when pregnant and parenting after a toddler full time)

However this last result has freaked me out and I am feeling a anxious again. The TSH has dropped without me changing dose, the only difference is this test was taken by the midwife in the afternoon, would this account for it?

I wouldn't worry about my TSH being that low normally (not pregnant) but I am feeling extra vulnerable, I don't want to cause any problems for baby by being outside of normal range. I speak to the endo next weds and I don't think he will be happy for it to be that low. Until I got this result this is the best I have felt all pregnancy!

Thoughts, reassurances, experiences?

Thank you

x

[SlowDragon Administrator]

Never agree to dose reduction based just on TSH and Ft4

TSH often drop low when vitamins are low .....and your vitamins are low

Haemoglobin 107 (115-165) - BELOW RANGE

serum ferritin 12 (5-85) - EXTREMELY LOW

what’s GP doing about this?

You are likely to need iron supplements, possibly iron infusion

Important to have good ferritin levels when pregnant,

tommys.org/pregnancy-inform...

ouh.nhs.uk/patient-guide/le...

B12 is rather low too

What vitamin supplements are you currently taking?

Folate? Or vitamin B complex?

Are you vegetarian or vegan?

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Testing vitamin D here (if GP won’t)

vitamindtest.org.uk

Or can test along with a TSH, Ft4 and Ft3 at Monitor My Health

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)

Is this how you do your tests?

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

[Lilacsocks in reply to SlowDragon]

Thank you for your reply. I didn't know that vit levels could make TSH low, how intertesting.

I should have said that I am taking iron supps and doing what I can diet wise (vegetarian) but struggling to get the numbers up, my hemoglobin has actually gone down to 105 in the last test despite supplementing, obviously iron demands in pregnancy are high. Not sure where to go with this other than upping my dietary sources of iron.

I am taking a pregnancy multi, I know you are not always fond on multis on this forum but its a good one with folate and not too much iodine and I feel like its my best option to cover all bases in pregnancy.

I'm also taking iron along with vit c.

I would consider adding in b12 though.

I will order another private test this week, I assume its very unlikely my t3 could be too high when t4 is well in range and I am only taking levo.

I do follow that protocol for tests I do myself however the most recent NHS test were done by the midwife at my app so it was out of my control.

Thanks again

[SlowDragon Administrator in reply to Lilacsocks]

Then you need to push for iron infusion or consider changing your diet

[Lilacsocks in reply to SlowDragon]

I am going to introduce some red meat and really up the veggie iron sources.

Do you know of any information or research I can read about low iron lowering TSH so I can discuss with endo.

Thanks