I had a baby just over 13 months ago and the pregnancy didn't quite go to plan. We're considering baby number 2 and I thought, given the issues I had in pregnancy, it might be a good idea to have a general health check-up. I didn't want to bother an NHS GP just yet as it was very much exploratory. I've got my throid test results back and if I'm reading it right I probably should book a GP appointment to get the tests repeated as there may be an underlying thyroid issue?
TOTAL THYROXINE(T4) 72 nmol/L. Normal range: 59 - 154
THYROID STIMULATING HORMONE 5.98 mIU/L. Normal range: 0.27 - 4.2
THYROXINE 15.2 pmol/l. Normal range 12.0 - 22.0
FREE T3 5.0 pmol/L. Normal range 3.1 - 6.8
Thyroid peroxidase ab's 199.0 IU/ml. Normal range 0 - 34
Thyroglobulin Antibody 85.0 IU/mL. Normal range 0 - 115
I'm hoping someone here will be able to advise whether a follow up GP appointment is worth it or not. I don't want to waste their time if I don't have to.
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Curiosity1012
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Thyroid hormone levels should alter inline with other hormones during pregnancy to accommodate baby’s needs. However, a pregnancy can also exacerbate and expose any underlying hormonal issues.
Your elevated thyroid antibodies mean you have Hashimotos which is a common auto-immune disease attacking the thyroid gland. Your TSH is elevated meaning your pituitary is working harder to encourage further thyroid hormone secretion.
I had two dreadful pregnancies or else would have had loads more kids 😁.
In autoimmune disease lymphocytes (T-Helper cells) attack normal tissue. This produces cytokines, hormonal messenger proteins responsible for the biological effects of the immune system. They are divided into subgroups;
TH1: - cell-mediated immunity, usually dealing with infections (viruses, certain bacteria, etc), tending to be pro-inflammatory & involved in development of organ-specific autoimmune disease (ie Hashimotos).
TH2: - humoral-mediated immunity dealing with bacteria, toxins & allergens (pathogens found in blood, other body fluids, etc), tending not to be inflammatory.
In a well-functioning immune system, both groups of these T-Helper cells work together in unison. However, over activity of TH-1 can suppress activity of TH-2 & vice versa, and in autoimmune disease can further attacks on healthy tissue, so worsening symptoms.
Amazingly pregnancy can shift the immune system temporarily to TH-2, which is why a lot of women find out they have Hashimoto’s after they give birth and their immune system returns to TH-1 dominance. It might help with a second pregnancy if you were to try reducing thyroid antibodies.
I haven't provided links as you haven't advised of the issues surrounding your first pregnancy but if you wish to investigate further, google something like 'TH1/TH2/cytokine response in pregnancy' for many peer reviewed articles surrounding this little understood subject.
Thanks for the additional information. The issue I had was a placental abruption. I was suffering from partial abruptions from 25weeks onwards and then eventually fully abrupted at 33+2. Fortunately, the baby and I received fantastic care and you wouldn't know he was almost 7 weeks premature.
That's what led me to get my thyroid checked first. I read paper after paper on risk factors for placental abruption. One of the things I saw in a few of them was hypothyroidism. I'm in a fortunate position that I could afford to pay for a private test, you can imagine my shock when I actually received the results today though.
For a successful pregnancy TSH needs to be below 2.5
Your raised antibodies confirm autoimmune thyroid disease (known to patients as Hashimoto's), which is where the immune system attacks and gradually destroys the thyroid.
Primary Hypothyroidism is diagnosed when TSH reaches 10. However, when antibodies are raised, along with over range (not not necessarily as high as 10) then an enlightened doctor should start prescribing Levo.
Please take these results to your GP, he may wish to do his own tests but ensure that TPO antibodies are included. Tell you GP that you are considering pregnancy and understand that TSH needs to be below 2.5 for a successful pregnancy.
Also take the following article/information:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
Question 2:
I often see patients who have an elevated TSH but normal T4. How should I be managing them?
Answer:
The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat thyroid function tests in two or three months in case the abormality represents a resolving thyroiditisis.
But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive - indicative of underlying autoimmune disease - the patient should be considered to have the mildest form of hypothyroidism.
In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to be come worse and try to nip things in the bud rather than risk loss to follow up.
NICE Clinical Knowledge Summary - Pre-conception and Pregnancy:
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Your high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Essential with Hashimoto’s to regularly retest vitamin D, folate, ferritin and B12
These are often EXTREMELY low
Frequently need supplementing to maintain OPTIMAL Vitamin Levels.....for your good health and health of any baby too
Have you had any vitamins tested via GP or privately
Contact GP with these results and request vitamin testing
Also coeliac blood test too
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. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct 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 first or buy test online for under £20, just to rule it out first
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
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Thank you for the additional details and all the links. I'll definitely read them. It's good to know about the extra vitamin checks. I'll ask the GP about this and if it's not an option for me I'll make sure I arrange it myself.
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Blood test results - odd ?!? 
need help understanding my results pls!
Help with test results please.
Re-posting - thyroid & vitamin test results
