Hi all, I m currently 7weeks pregnant. Early 2021 I was diagnosed with hashimoto’s but I never took any medication for it. Now I just got my blood test results:
Tsh: 4.43 ( 0.35-5.00)
T4: 12.1 pmol (9-22)
T3: 5.1 ( 2.40-6.00)
TPO 577.8 ( increased compared to my previous tests 6 months ago)
Also , I am currently having thyroiditis , my thyroid hurts ans it’s pressing on my throat… so it’s just gonna get worse.
I think the results are way is too high !! My surgery thinks it’s normal! I don’t know what do to or where to go. I m willing to go private but I just moved to this country (uk) and I don’t know any good specialist.
Can you please help. Thank you
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Jaz_40
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This result is dire. In the UK a result below 30ug/L is considered to be iron deficiency. Your GP should do an iron panel to confirm iron deficiency and a full blood count to see if you have anaemia - you can have iron deficiency with or without anaemia.
I’ve always struggled with low ferritin. Before 18 I was 6! My body can’t handle very strong ferritin medication so I m only supplementing by 14 mg per day.
Because of my thyroiditis I completely skipped talking to my doctor about iron…
Also the medical system here is very new to me… and so confusing…referrals , phone call consultations… not be able to go directly to see a specialist.. the long time waiting for an appointment… all this + pregnant… I m really struggling .
Congratulations and wishing you a safe pregnancy and a healthy baby 😊
I have these links saved, TSH should be below 2.5 and an increase in Levo is normal during pregnancy. Your GP needs to gen up on pregnancy in hypothyroidism to keep your baby safe.
You absolutely must start Levo, fight for it if necessary. As the grandmother of four babies who miscarried due to the mother being undiagnosed this is a subject close to my heart. Daughter in law got diagnosed and prescribed Levo privately, and after the birth of her daughter the hospital's notes on blood test report said "Thyroid results acceptable for someone on levothyroxine". This then prompted her GP to say
"I suppose I'll have to accept the diagnosis now and prescribe your levothyroxine".
Absolutely shameful and something the family will never forget.
By the way, it's possible she has Hashi's (she's an ex-daughter in law now so no contact) because she stopped the Levo at some point and wasn't taking it when she and my son parted, no idea whether she's back on it now.
It may be difficult / impossible to get an NHS GP to agree to start Levo at the moment .
All the references to "TSH should be below 2 .5 for pregnancy" refer to patients who are already diagnosed as hypothyroid ,and already on treatment , (therefore their TSH level is being managed by doctor adjusting levo dose )
For patients who are not diagnosed as hypothyroid and not taking levo , then a TSH result that is "in range" is considered ok .
( The exception is for people who are trying to conceive/ having difficulty conceiving/ having fertility treatment etc .. then i think ? there is some guidance in those circumstances to start levo even if TSH is still in range. but that doesn't apply to you).
But in patients who are NOT YET diagnosed as being hypothyroid , (but just have raised TPOab indicating Hashimoto's ) .... there are not yet any official NHS guidelines to say THEIR TSH in pregnancy should be below 2.5 .. and no guidelines to say people whose TSH is still in range should be started on Levo, even if they are pregnant .
You may find a GP who will consider it ,,, but unfortunately many of them would just stick to the usual NHS guidelines for when to start Levo .... which are "2 over-range TSH results (3 months apart) + symptoms "
Thank you for you message. I think I got lucky!! I was just on the phone with another doctor in my surgery, not my GP, and she put me on thyroid medication! She said I have to start on lower dose , 25 , but I need to be monitored and will probably increase my dose to be 70.
I m gonna run to the pharmacy to get it. She said I have to take it in the morning before eating anything, is this right?
however .... once you've got your hands on it ... read this and see what others have to say about 'dose'.
I have some concerns that starting on just 25mcg may not be such a good idea whilst in the middle of a fairly critical phase of being pregnant ..
i'm out of my depth a bit here . but i think ? you should try hard to get her to agree to start you on 50mcg due to your fT4 already being fairly low.
Levo doesn't 'top -up ' low thyroid hormones .. it sort of 'replaces them' ... so if starting on a very low dose , you can sometimes end up with LESS T4 than you started with , until the dose is increased by 'enough' .
25mcg can be just enough to lower TSH(Thyroid Stimulating Hormone) a little .. and a lower TSH means your own thyroid takes it's foot of the accelerator , meaning it then produces less T4 of it's own .... so you have to take 'enough' Levo to compensate for this .
The usual starting dose is 50mcg, but the GP was probably being cautious because your TSH is in range. Normally if they gave somebody a cautious 25mcg for few weeks , it wouldn't cause any real problem if they had a few weeks of lower fT4 until their dose was increased ...... But the last thing you want to happen at 7-12 weeks pregnant is to suddenly have less T4 .
SeasideSusie , SlowDragon what do you think about 25mcg starting dose @ 7 wks pregnant ? ... i'm in over my head.
Now I feel my thyroid is working very hard, it’s painful and I feel it struggling. BUT It still doing it’s job . I didn’t know exactly what the medication does, but now that I know it’s doesn’t to up but it replaces , I don’t feel confident taking the lower dose. Because even if my Tsh is out of range for a pregnancy, the thyroid managed to “secure “enough t4 for the baby… even if it’s low but the baby is served first, and my t3 are good .
it's not medication as such .. Levo is simply T4 .( just made in a factory , not your thyroid ) So it does the same as T4 .
As well as responding to low T4 levels (feedback) .... you TSH also controls how much T4 /T3 your thyroid produces (feedforward) .
Higher TSH stimulates the struggling thyroid to try its hardest to keep T4 production going , AND to make as much T3 as it can (a bit more T3 than it normally would )
(T3 is the active form of T4.. T4 is basically just the carrier.
T3 is mostly converted from T4 in the body, but a bit is made directly by the thyroid, as a sort of 'safety net' .. and this 'safety net ' can be turned up or down by the TSH )
But it is going to stop your thyroid from functioning.
Your thyroid can only produce thyroid hormone in response to stimulation by the TSH. When you take levo, the TSH reduces so the thyroid stops producing hormone. And, 25 mcg levo is probably not enough to replace the hormone your thyroid was making.
Your T4 is already too low for pregnancy. So, you really need to start on 50 mcg now, rather than 25 mcg. At your age, 25 mcg is too low to start on, anyway. 50 mcg is the normal starter dose. 25 mcg for people over 60. So, ir I were you, I really would insist on starting on 50 mcg.
Also thank you for all this valuable information.it’s sure that I have to educate myself when it comes to thyroid and autoimmunity’, and I am finding this place to be very helpful. So thank you all for your time and dedication , very much appreciated 🥰
You absolutely must not let them leave you on a low dose of Levothyroxine for an extended period. They should have started me on 50 ug but didn’t 🙄 I got the 25ug.
I wasn’t pregnant but what happened to me (detailed on profile). You must pay very close attention to your symptoms and push for timely increases. They have an arbitrary “See you in 3 months” at my current surgery that bares no relationship to how I felt as each dose increase petered out. Being in range does not mean you are NORMAL. Normal is a meaningless word. You can have a dose increase and still be in range. I pushed for increases successfully. But you need a specialist.
As tattybogle says if they haven’t got a guideline, many GPs will not exercise latitude- which they have - they just don’t use it, often because they are way out of their depth! They play it safe for themselves and frequently won’t refer up as it costs the surgery - it’s all money 🙄
Yes, agree that a starter dose of 50mcg would be more appropriate, baby needs T4 doesn't it? So need enough for mum and baby. Then retest, not sure how often during pregnancy, maybe after 4 weeks but definitely keep an eye on your levels frequently Jaz_40
Okay, so I’ve been trying to contact the doctor to increase the dosage with no chance. I ll call back tomorrow to hopefully get a phone call on Friday. I want to start taking 50mg and then Friday will inform my doctor. My question maybe a bit off but I just want to be sure , Is it ok to take 2 pills of 25 mg?
Yes, that's right. Early morning, on an empty stomach, at least one hour before eating or drinking anything other than water. Leave at least four hours between your thyroid hormone and the supplements you're taking.
On the subject of supplements, what is in your pregnacare vitamins? We do not recommend any kind of mult-vit, but especially not if it has iodine. Iodine and Hashi's doesn't mix. Also, a lot of the ingredients in multi-vits cancel each other out. Iron, for example, should be taken at least two hours away from everything else, except vit C. But, you must take vit C with it to help absorption and protect your stomach. B12, on the other hand, should be taken at least two hours away from vit C, because it affects the way the body uses B12.
Thank you greygoose for your clarifications regarding Vitamins. I indeed take a multi vitamine that has iodine … Can you recommend a supplement for vitamines bs ?
Yes, since early 2021 when I had my first thyroiditis . I was taking a supplement that supposed to make the thyroid function better. I stopped it when I became pregnant and replaced it with the multivitamins. I want to stop the multivitamins now but I need to find a good replacement for vitamins b.
So yesterday I had my first midwife appointment, she didn’t seem very concerned about my condition and told me that the obstetrician will only see my after my scan , means after July 17th...
I had a blood test the same day in The hospital to check my hormones and other things.
I called my GP today and he gave me the results:
just for a reminder, I have been taking Levo 50 since June 16th . Before medication my levels were:
Tsh: 4.43 ( 0.35-5.00)
T4: 12.1 pmol (9-22)
T3: 5.1 ( 2.40-6.00)
Now my doctor just told me verbally the results:
Tsh:1.6
T4: 13
T3: 4.5
I don’t know if the blood test was done very early ( 13 days after starting Levo 50) ? but I found t4 pretty low…and t3 is even lower that before medication.
I am a bit concerned especially that my GP said that he will contact me only in 2 weeks to see what we can do… (it’s not even about my hormones but about a nodule that I have on my thyroid).
I feel like nobody knows what to do and no one is taking this seriously. I don’t know what to do either or if these results are ok (for my doctor they are in the norm…) I asked him If I should increase my intake he said no. I asked him if he can refer me to an endocrinologist he said will see what to do in 2 weeks. (2 weeks!!!, why not tomorrow??)
I really need some guidance from you. I am very concerned .
You really, really do need an increase in dose. These tests were done too early, because it takes at least six weeks for thing to settle down after an increase. But, your FT4 is much too low. What time of day was the blood draw? Because one thing that doctors do not know - although god knows why they don't know! - is that TSH is highest in the early morning. If your blood draw was around 11 am to 3 pm, it will be at its lowest and doctors will say it's fine. With that low FT4, your TSH should be higher than that. When you're pregnant, it's the FT4 that is the most important level because it is T4 that crosses the blood/placenta barrier for the baby.
I did the blood test in the afternoon around 1pm. I too think I need an increase but when I suggested it to my GP he said no. I can’t believe they wanted me to start on 25…
My GP is very nice and a good listener but I feel like he has no clue… he told me that he will discuss “the matter”with someone and call me back in 2 weeks…
I feel like all the professionals I dealt with so far have no clue about thyroid hormones related to pregnancy. As long as it’s on the norm it’s fine. And that is scary because we know that it’s not fine and I think I need a proper follow up with a specialist, however no one want to refer me. I looked up the fees for private consultation it was minimum £300, unfortunately very very expensive for me.
None of them know anything about thyroid period. Perhaps you could print out, or email some of the information Susie has given you. As a last result, tell him that if he doesn't increase your dose you'll buy levo on-line and give yourself an increase. I often find a little blackmail goes a long way.
Thank you Charlie-Farley:)) I guess I feel alright , except that can still feel the thyroiditis , that means that I still can feel my thyroid struggling … it feels heavy and it’s pressing against my throat … not a pleasant feeling.
Hi everyone, I just wanted to come here and update you on my journey . You were very supportive and helped me tremendously during my ordeal with my thyroid. Thank you for that.
I unfortunately lost my baby at 12 weeks to multiple abnormality that were detected on the ultrasound and blood test. I had to undergo a medical termination. The least thing I can say that it was very traumatic…
After when I saw the doctor she told me that my antibodies were high (around 600) and that can cause the abnormalities. She suggested that I take some levo (25 or 50) to help lessen the antibodies and prevent miscarriage in future pregnancy.
I honestly don’t know what to think about it, I stopped taking the medication the day after I lost my baby , i just don’t want to take it anymore. But I still have to do blood test to see if everything is ok, and I m still going to keep asking my GP to refer me to a specialist .
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