My TSH has gone down but so have my FT4 and FT3

[HungryHungryHypo]

Hey everyone! After finding out I was pregnant, my endo increased my dose. I’m now on 88mcg/day of levo.

I just received my results back from medichecks. After one month, my TSH has gone down but so have my FT4 and FT3. I’m not even half way through range with my FT4.

What’s happening? I have emailed my endo but I don’t know when I’ll hear back. For full disclosure, I’m also on 400mg of progesterone twice per day, in case it has an incidence.

TSH 1.47 [0.27 - 4.2]

FT4 16.8 [12 - 22]

FT3 4.8 [3.1 - 6.8]

A month ago, on 75mcg/day, my levels were:

TSH 2.05 [0.27 - 4.2]

FT4 18 [12 - 22]

FT3 5 [3.1 - 6.8]

[radd]

HungryHungryHypo,

Well, if anything the progesterone should increase the ‘frees’. I would say perhaps test wasn't carried out exactly like-for-like because TSH is correlating with the increase, and hormones are never static anyway.

Presuming you are on an ART, & as such must have regular bloods? You are not waiting for the T4 total cell saturation that the usual recommended six week blood test determines but an immediate TSH blood serum level of low-normal range & FT4 concentration in the upper reference range as stated by NICE. Ask your endo for another Levo increase. It is usual to requires several dose raises quickly in the first trimester.

[HungryHungryHypo in reply to radd]

Yes I have emailed her asking if I should go up to 100mcg or maybe more. At that stage, I don’t even know if my exhaustion is due to my thyroid or the pregnancy or the extra progesterone and I’m worried 🥴

[HungryHungryHypo in reply to radd]

Oh and thank you so much for your reply. What is ART?

[radd in reply to HungryHungryHypo]

HHH,

Oh sorry, assumed you were using IVF because of the progesterone, and infertility is common on this forum.

ART stands for assisted reproductive technology. Basically procedures used to address infertility.

It is usual to feel extreme tiredness during the first 12 weeks as your body accommodates a multitude of change.

[HungryHungryHypo in reply to radd]

Ah i see! No assisted reproduction. I had a progesterone test at 5 weeks which showed very low progesterone (I’m told a common side effect of hashimotos) so I was put on cyclogest.

[radd in reply to HungryHungryHypo]

HHH,

Fab you are being well looked after 🤗

[SlowDragon Administrator]

22 days ago you posted that you were about to increase levothyroxine to 75mcg

Now you say you’re on 88mcg

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

How much levothyroxine are you actually taking

When was dose increased

[radd in reply to SlowDragon]

SD,

The O/P is pregnant.

[HungryHungryHypo in reply to SlowDragon]

I’m on 88mcg/day. My endo increased it a few days after my last message after discussing it with colleagues because of my BMI.

I was told by my endo to test every 4 weeks. But because I was feeling so tired, she asked for me to test now as opposed to next week. Perhaps I should have waited? It’s the fact my FT4 went down when usually I react quite well to levothyroxine. I worry about my pregnancy 🥺

[SlowDragon Administrator]

Congratulations on pregnancy

You may need further increase

Pester endocrinologist for their guidance

Suggest you retest again in another 4 weeks if you stay on current dose

Have you had vitamin D, folate, ferritin and B12 tested

[HungryHungryHypo in reply to SlowDragon]

No I haven’t tested anything else. How long should I wait before retesting ? I was thinking of doing the medicheck thyroid one with vit d etc.