Thyroid

[Healthanxietyhater]

Hi everyone I am 21 weeks pregnant today, in my last appointment the doctor said my thyroid results have come back subclinical but I do not need to be treated. I don’t have any symptoms that really tell me I need to be treated so I’m not too concerned but tonight I’ve read up that not having a good thyroid number can effect the baby and even stillbirth. Should I chase it up?

[greygoose]

It says herel

niddk.nih.gov/health-inform...

That at 21 weeks your baby's own thyroid should be working. But, it depends how long your thyroid has been subclinical. When did you have your last thyroid test before this one?

Do you have the actual numbers: results and ranges? Your doctor's idea of subclinical may be false. Or he might not have done all the correct tests, so you do need to check.

[jimh111]

The guidance on TSH in pregnancy apply to women who have been diagnosed with primary hypothyroidism. It is assumed that a mildly elevated TSH in pregnancy in women with a healthy thyroid will be OK as their thyroid will be able to cope. (I say ‘assumed’ as I don’t know of any trials that confirm it).

‘subclinical’ is a misleading term as many people are hypothyroid with an elevated TSH. and normal fT4. I would get hold of your results so you can see what the numbers are. If your TSH is above e.g. 8 or fT4 close to its lower limit OR you have hypo symptoms such as substantial tiredness I would ask for some levothyroxine to bring your TSH down a bit just to help you through the pregnancy and early days after birth. You could then try slowly withdrawing the levothyroxine a few months after the birth to see if you really were hypothyroid or whether it was a short term form caused by the stresses of pregnancy.

Please note I’m a male patient not a doctor.

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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

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 all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

TSH when pregnant should be under 2.5