hi all,
I’ve recently experienced 2 early miscarriages. After blood work, my TSH is 4.8 and it’s meant to be <2 to sustain a healthy pregnancy. I’ve been put on 25mcg of levothyroxin to get it down so I can become pregnant again and hopefully not miscarry. I didn’t know I had hypothyroidism before the miscarriages and I display no symptoms.
Does anyone have any experience of something similar or how long it takes?
Thanks
Welcome to forum
Sorry for your losses.
More importantly what are your thyroid hormone levels.
FT4 & FT3. (and lab range) These are the free thyroxine & Triiodothyronine. The TSH is a pituitary hormone it should rise when levels are low but for lots of reasons it can be unreliable.
25mcg is a half starter dose, most start on 50mcg and titrate up. Re-testing after 6 week then increasing by 25mcg per day.
Have thyroid antibodies been tested TPO & TG?
TPOab (Thyroid Peroxidase antibodies) TGab (Thyroglobulin antibodies)
Do you always have the same brand?
Also important to test folate, ferritin, B12 & vitamin D. Levo wont work well i& nutrients not optimal.
Many use private complained to get a full picture.
Recommendations for thyroid tests:
A - Always check what’s being tested & collect test results with reference range.
B - Biotin - cease 3 days before draw to avoid possible test interference
C - Consistent unchanged dose - minimum 6 weeks previously before retest
D - Delay replacement dose on day of test (take after blood draw)
E - Early morning appointment. (Book as close to 09.00 as possible)
F - Fast overnight. This can have a slight impact. Drink lots of water
Thankyou for this.
I have attached my results. Antibodies are slightly out of range but TSH is very out of range for pregnancy.
I only started this week but have had the same brand so far. Dr said give it 4 weeks on starter dose and see how much it helps then will reconsider dosage.
Positive TGab antibodies show autoimmune thyroiditis. This is Known as Hashimoto’s - UK doctors simply refer to under-active thyroid. The immune system attacks thyroid, and leaves less functioning thyroid.
In severe attacks (early on), it’s possible for the levels to fluctuate & become too high, this is from damaged parts of thyroid releasing hormones. The autoimmune aspect can’t be treated.
The hormones that the thyroid can’t made (as a result) are replaced.
Standard treatment is 50mcg starting then 25mcg increments until TSH always under 2 most feel best when TSH 1, FT4 top 3rd of range & FT3 at least 50%. Pace increases at 6-8 weeks.
Initially levo tops up thyroid levels but by 6 weeks -it replaces what failing thyroid cant produce. One of the reasons for gradual increases.
Starting on too little & testing too early can potential worsen / complicate the results & progress. It’s not unusual to feel slightly better - than feel worse again, during introduction & gradual increases.
Best to wait TTC until your thyroid levels are stable.
As soon as a pregnancy is confirmed it’s important to increase levo by usual 25mcg adjustment.
You Might make faster progress to arrange a private test, as Doctors often won’t / can’t test everything such as FT3 and key nutrients - folate, ferritin, vitamin D & B12.
You order test online the kits arrives via post sample taken by finger prick (extra fee for private venous draw). Post back and results available online quite quickly.
List of companies offering different options, some packages include thyroid function, key nutrients and thyroid Antibodies. (Medicheck advanced) Others basic function only. (Monitor my health)
some also have discount codes available.
So sorry for your losses.
My ex-daughter-in-law had multiple miscarriages - four miscarriages in total but five babies lost as one pregnancy was twins - in between three successful pregnancies.
I recognised signs and symptoms of hypothyroidism but GP wouldn't do anything, presumably due to TSH not being high enough.
Eventually she went private, got diagnosed and started Levo which resulted in her last successful pregnancy. I don't know for sure but I suspect Hashi's which may account for two successful pregnancies alternating with miscarriages and she was successful in her more stable periods (Hashi's causes fluctuations in results amd symptoms).
Eventually her GP had to accept the diagnosis as her discharge report after the birth of her last baby stated "thyroid levels fine for someone on levothyroxine" so the GP said "I suppose I'll have to prescribe your Levo now".
Being on such a low dose could make things worse rather than better, you should be aware of that. Your TSH could actually rise. Doctors think that the dose should correspond to the TSH level, but that's not how it works. He should have put you on 50 mcg. So, don't let him stop it after four weeks if the TSH doesn't drop, insist he raise the dose. Good luck. 
ESSENTIAL to get vitamin D, folate, B12 and Ferritin levels tested too
Low vitamin levels common when hypothyroid
what vitamin supplements are you currently taking
Request GP test vitamin levels if not been tested recently
Pregnancy guidelines
thyroiduk.org/having-a-baby-2/
gp-update.co.uk/files/docs/...
See pages 7&8
btf-thyroid.org/Handlers/Do...
Also here - dose increase in levothyroxine as soon as pregnancy test confirms conception
cuh.nhs.uk/patient-informat...
thyroidpharmacist.com/artic...
Low ferritin, low thyroid levels and miscarriage
preventmiscarriage.com/iron...
Low iron and hypothyroid
endocrineweb.com/news/thyro...
Folate and B12 and Neural tube defects and autism
Thankyou. I will ask GP for vitamin levels.
I am taking pregnacare (which has lots of vitamins in including b12 and D), omega 3 and coq10.
Multi not recommended by many on this forum, many include the cheapest form of supplement eg for B12 they include Cyanocobalamin, whereas Methylcobalamin is better bioavailable & absorbable form.
Most Multis do not contain doses at meaningful levels. If deficient - you’ll need much higher doses.
Taken in a multi some nutrients may bind together & not absorb either.
Many contain Biotin (in low doses) so would need to leave off around blood tests.
Extra Iodine (in addition to normal diet) can affect those with hypothyroid in complex & unpredictable ways. Normal diet & levo includes adequate iodine.
Recommended to complete an iron panel complete before taking any iron.
Extra calcium not recommended. If taking D3 and K2 dietary calcium should be adequate. (K2 directs calcium to where needed -bones & teeth- away from tissues/arteries. Magnesium other vitamin D co-factor)
Always best to test & see exactly what & how much to supplement by is needed.
I took multis for many years. When I learn this, I finished the supplements I’d already had & brought better version in stages. Many say better off throwing away.
Just wanted to log in to say that I had three miscarriages, but ended with two healthy kids as well--most of the places in the US don't even care to check you until 8 weeks, which is late if the pregnancy makes you need more thyroid. With the first pregnancy that made it, I had to throw a fit that I felt way too tired, even for a pregnant mom, and had to demand that they test my thyroid, and sure enough, I needed to increase the dose.
I wish you the best!
So sorry to hear about your losses. I have Hashimotos which was diagnosed a few years ago. I had to really fight for the diagnosis as my levels were borderline like yours…
After 2 years TTC I had two early miscarriages last year but I’m now 35 weeks pregnant. With no offence to the medical professionals, they will draw out this process by starting you on a low dose etc - you’re really going to have to push (if you are NHS) to get them to take you seriously.
My TSH levels were fluctuating during my miscarriages which I’m sure is what caused them… you need them to be nice and stable. I cut out gluten from my diet which I believe helped massively as my antibodies dropped significantly. Worth trying.
Good luck. It’s a battle but you’ll get there!
Thankyou very much. Do you mind telling me what your TSH levels were when you conceived your successful pregnancy? What dose were you on?
and congratulations on your pregnancy!
Sorry you have been struggling with this. I was put up 25 on levo and within 2 months I was pregnant so it worked for me. Your dose will need to be monitored carefully when you fall pregnant and especially throughout the early stages to keep levels optimal.
I had raging hypothyroidism (Hashimotos) for years before it was diagnosed. I could not get pregnant. I started getting treatment with Synthroid and it was not long after that, although I cannot remember how many months it took, that I did become pregnant. My son is now 32 years old.
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