Unfortunately I recently had a missed miscarriage and I have a feeling it may have been due to my thyroid which had a TSH of 5.5 when I was 5 weeks pregnant. I also have Hashimotos. I’ve now been referred to an endocrinologist on the nhs due to wanting to conceive again. I’m on 75mg of levothyroxine, they put me up to this from 50 when I was pregnant but it took them two weeks from them knowing I was pregnant for them to do it.
What should I expect from my first endo appointment, are they likely to do the full panel test including T3 and antibodies? When I get pregnant again will they monitor me through the pregnancy? I now know my TSH needs to be under 2.5 which I didn’t know before.
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MeganChar1
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Which brand of levothyroxine are you currently taking when on 75mcg levothyroxine
Bloods should be retested 6-8 weeks after each dose increase
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 as you have Hashimoto’s
Ask GP to test vitamin levels NOW
Are you on strictly gluten free diet?
If not request doctor does coeliac blood test BEFORE considering trial of strictly gluten free diet
Thyroid testing
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Hi I’m currently pregnant and also had a missed miscarriage early last year so I’m so sorry that you’ve been through that.
I am type 1 diabetic as well as having hashimotos so I have tended to have a lot more appointments than most during pregnancy I think. But hopefully this would give you a bit of an idea of what to expect when the time comes again.
Having read up on guidelines I saw posted here and also on Thyroid UK’s website, when I found out I was pregnant I immediately increased my dose of Levothyroxine. I didn’t wait for any Drs appointments, just increased it straight away as you could possibly be waiting weeks if you’re waiting for an appointment. I increased by 25 micrograms. I also immediately asked my GP for a thyroid function test which he agreed to order (I’m used to telling him exactly what I need with diabetes so I think to a certain extent if he can he’ll just agree!).
This gave a baseline for what my level was before the dose increase and when I did see my diabetes Dr he agreed I’d been right to increase my levo dose.
I have also been told that with NHS blood test labs they will test TSH and probably T4, but will only test T3 if the others are out of range. The requesting Dr doesn’t have any control over that and the lab will decide whether to include T3 or not based on the other results. Also if a thyroid function test is repeated within 4 weeks the lab will simply decide not to carry out the tests without telling you so always leave at least 4 weeks in between tests. This is just what I’ve been told by Drs but both seem to be correct in my experience.
Lastly, apart from my diabetes antenatal appointments, I have had 2 phone appointments so far with an actual thyroid endocrinologist who discussed my latest thyroid results and dose. I think this might have been at 12 weeks and 20 weeks and I think I may be due a third at 30 weeks but I’m not certain. It is a bit muddied because the diabetes team also get involved in the thyroid stuff a bit.
I did ask for a dose increase at one point early-ish in this pregnancy because I was getting very cold and feeling extremely tired all the time. The Dr agreed and given my subsequent results I was correct so I’d say listen to your body. With thyroid I’ve found it’s often a case of negotiating your dose with your Dr to get to a dose you’re both ok with and giving it a try.
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