Going on six weeks pregnant (Levothyroxine)

[GinaR86]

Hi everyone,

About 8 weeks ago my doc increased my Levo by 50 and we just retested and my levels are:

T4 - 14 pmol/L

TSH - 2.3 mu/L

My normal doc is away at the moment so the duty doc said no need to increase. I am now 5 and a half weeks pregnant and because the studies say to increase dose and my TSH is borderline - I am concerned that is the wrong decision. I am going to call my doc when she is back in but in the meantime I am contemplating increasing by 25.

My only concern with doing this is the high level of t4 I have now.

My folate, ferritin, vitamin d, vitamin b12, iron were all low ahead of pregnancy but they are all back in line after about 6 weeks of supplementing.

Any help please? TIA

[GinaR86]

Bump

[SeasideSusie Remembering]

GinaR86

I'm afraid "bumping" on this forum's platform doesn't bring it to the top of the main page. You probably haven't had a response because it's bank holiday Saturday and the weather is good, there doesn't seem to be much traffic on the forum this morning.

My only concern with doing this is the high level of t4 I have now.

Unfortunately, we don't know how high your FT4 is. Can you add the reference range please so that we can base any reply on that.

My folate, ferritin, vitamin d, vitamin b12, iron were all low ahead of pregnancy but they are all back in line after about 6 weeks of supplementing.

What are the new levels? Just being in range doesn't mean they are optimal, and optimal is what we need to aim for. Are you continuing to supplement?

[GinaR86 in reply to SeasideSusie]

Thanks very much - here are my results! Also yes I am continuing to supplement!

Blood results

[SeasideSusie Remembering in reply to GinaR86]

GinaR86

No need to worry about your FT4, it's well within range (70% through range) so nothing to worry about. Your TSH could be lower, for a successful pregnancy it needs to be less than 2.5 and to be honest you haven't got a lot of wriggle room there so if you can speak to your normal GP and see about increasing Levo to get that TSH down further.

You've a way to go with your Vit D and B12. You have Hashi's and this tends to cause low levels and deficiencies. Aim for optimal, which is what we Hypos need, which for Vit d is 100-150nmol/L and for B12 it is at least 550ng/L and it's even recommended to go to top of range.

What about Ferritin? Around 70-80 (13-150) would be good.

Is your GP looking after your nutrient levels, they tend to know very little about nutrients as they're not taught at med school. If you want some guidance just ask.

Oh, and sorry I forgot to say early, many congratulations on your pregnancy, wishing you a happy and healthy journey to motherhood 😊

[GinaR86 in reply to SeasideSusie]

Thanks so much for all your advice on this. My ferritin is 35 so still a way to go on that too. I’ve not been supplementing ferritin so I will go up to the health store and buy some supplements today!

So I read a book about Hashimotos called “Root Cause” it gave me a list of things to test so I went to Thriva for a private blood test and found my deficiencies. They don’t give you much advice save for to see your GP who just tells you to supplement anyway. So it’s just been a steep learning curve but I’m not sure I’d be pregnant if I didn’t start supplementing! Slowly I am feeling better and happy that I have my levels at ok levels for hopefully a healthy pregnancy.

Also the duty doctor I spoke to said is only need to have my thyroid tested once a quarter - it seems too long for me? The research I’ve seen says 4-6 weeks - I think I’ll speak to the doc about that too.

Thanks so much for your congratulations - it’s my first one and I am older (35) so hoping for the best! Thanks so much for all your help - I really appreciate it.

Blood results

[SeasideSusie Remembering in reply to GinaR86]

GinaR86

Also the duty doctor I spoke to said is only need to have my thyroid tested once a quarter - it seems too long for me? The research I’ve seen says 4-6 weeks - I think I’ll speak to the doc about that too.

Duty doctor is wrong (how worrying!) and you are correct:

btf-thyroid.org/pregnancy-a...

Arrange to have follow up blood tests every 4-6 weeks during pregnancy .......

There are some links on that page you can check out.

NICE Clinical Knowledge Summary:

cks.nice.org.uk/topics/hypo...

From ThyroidUK:

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

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

An exciting time for you and you should be having the best care so do please push for the correct adjustments to your dose.

PS - about your ferritin. It would be worth asking your GP to do an iron panel and monitor you regularly if you are going to take iron tablets. It's possible to have good serum iron levels with poor ferritin level, and taking iron tablets could push the serum iron level too high. Maybe your normal GP would prescribe the iron tablets and monitor your levels, I think that would be safest. Iron is complicated and self supplementing isn't something that's encouraged due to the monitoring of levels needed.

[Serendipitious]

GinaR86,

Congratulations! I’d also recommend reading up on these articles. According to Dr Izabella Wentz, known as The Thyroid Pharmacist, your TSH should be no more than 2. Echoing the same thoughts as SeasideSusie regarding TSH.

These two articles by her are about the thyroid and pregnancy and are invaluable:

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

All the best!

[GinaR86 in reply to Serendipitious]

Brilliant thanks so much for the articles and the well wishes on my pregnancy. I will give the articles a read - I think she is the same author of the book that I used to figure out my deficiencies - it was called root cause?

I’ve decided to just up my levo by 25 mcg until I see my usual doctor when she returns from holiday! I’ll ask her if there is any harm upping by 50 mcg given these articles. I’ve read that dosage should go up by 30% at first positive pregnancy test - that would be roughly 45 mcg for me!

Also the duty doctor I spoke to said is only need to have my thyroid tested once a quarter - it seems too long for me? The research I’ve seen says 4-6 weeks - I think I’ll speak to the doc about that too.

[humanbean]

If anyone in the medical profession starts to have a go at you about your thyroid hormone levels for any reason at all, please read this thread. There is a lot of fear-mongering about thyroid hormone treatment that is directed at patients by doctors, and it is completely unjustified.

healthunlocked.com/thyroidu...

Obviously I'm not suggesting that anyone takes huge amounts of thyroid hormones under any circumstances - it would make anyone feel awful. But taken at sensible amounts it simply isn't dangerous.

[humanbean in reply to humanbean]

P.S. Congrats on your pregnancy.

[GinaR86]

Hi everyone, I went for my 12 week scan yesterday and they’ve informed me the baby passed - 8.5 weeks measured and no heart beat. Just have to wait for baby to pass naturally.

I am 35 so keen to try to conceive as soon as possible and wondering if you guys have any advice on what I should now test in bloods.

I am worried I have caused this as I was going gluten free for months before becoming pregnant but at week 8 I had to eat gluten as I couldn’t tolerate gluten free bread with the nausea from pregnancy…

Sad times and would welcome any advice. Thank you x