Tsh high

[Yvesme]

Hi. I am 5 weeks pregnant and just find out that my tsh value is 5.06. T4 is normal. My ferritin is also low(always been) and vit D low. I am very concerned about this as I wasn’t giving any medication for it. Did anyone had a similar problem ?

[SlowDragon Administrator]

Contact GP as emergency tomorrow

What is actual Ft4 result

How low is vitamin D

How low ferritin

You need full thyroid testing

TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also EXTREMELY important to test folate and B12 too

TSH should be under 2.5

GP should prescribe levothyroxine

Pregnancy guidelines

thyroiduk.org/having-a-baby-2/

gp-update.co.uk/files/docs/...

See pages 7&8

btf-thyroid.org/Handlers/Do...

thyroidpharmacist.com/artic...

[Saggyuk in reply to SlowDragon]

Yes GP tomorrow. Are you hypothyroid normally and on Levo already as not clear? Yes get all your results including blood count and post on here in full with ranges - you can request them from the receptionist at the surgery.

[Yvesme in reply to Saggyuk]

Hi. Thank for your reply. My thyroid was always normal and never been on Levo.

[Saggyuk in reply to Yvesme]

Did you get a blood count? The GP should be referring you to an endocrinologist as per the NICE guidelines for out of range thyroid results during pregnancy. All my docs would have prescribed Vit D with a level of 33 - my bones hurt a lot if under 40. I'm assuming doc told you to take folic acid/folate if not already done so? You need higher Iron storage than that especially during pregnancy. I would also be tempted to do my own active B12 test too to ensure nothing out of place there - the NHS test tests all B12 whether active or not.

[Yvesme in reply to SlowDragon]

Thank you for your reply. B12 is 509nG/L

Ferritin 22

Folate 5.2 uG/L

T4 16 pmol/L

D3 33nmol/L

[SlowDragon Administrator in reply to Yvesme]

Ferritin is far too low You will need full iron panel test for anaemia

Likely to need iron supplements prescribed

Folate within range, but on low side

B12 ok

Low vitamin D obviously needs improving and GP should prescribe 1600iu everyday for 6 months

GP will often only prescribe vitamin D to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need,

GP should test thyroid antibodies to see if you have autoimmune thyroid disease

Standard starter dose of levothyroxine is 50mcg. They might start you on higher dose

Bloods should normally be retested 6-8 weeks after each dose increase

But as pregnant, perhaps test after 4 weeks, as likely to need next dose increase ASAP

[Masief]

That is too high, you need medication or an increase asap. I had TSH 6.3 at 6 weeks pregnant. My GP prescribed 50mcg levo immediately. As it was my first ever prescription it wasn't enough. My symptoms were major fatigue, and my metabolism started slowing down. Now these are also related to early pregnancy but looking back I think my thyroid was the main driver. If you can get a referral to a reproductive endocrinologist, even privately that would be great. I'm having another test to check my thyroid and antibodies this week.

I've lost my bean sadly, and we don't know the cause. Having high levels of TSH is certainly a factor both my consultant and I. From every thing i have read anything above 2.5, and esp 4 starts increasing chances of miscarriage. My next IVF round will need to be focused entirely on my thyroid levels with support from an endocrinologist! Good luck x