Hey, I’m 5 weeks pregnant after IVF and my had my TSH checked on Monday, it was 2.14, I spoke to my GP yesterday who said I’m under 2.5 so it’s ok and they will check me again in a few weeks and to stay on same dose 125. I had another blood test yesterday and it’s come back at 2.41. I know technically still under 2.5 but I’m worried it’s going to keep increasing and I won’t find out till a few weeks down the line. I would rather up my dose now and get it down under 2 ideally.
I’ve upped my dose my self by 25 until I speak to my GP on Monday.
My T3 is 3..7pmol
My T4 is 20.2pmol
I’m also on 4.5 LDN
any thoughts or suggestions?
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You could try a 12.5mcg increase but likely it won't help your FT3 that much.
Its probably wise to wait until after the baby to add T3. Its not the easiest thing to do getting T3 prescribed in the UK but its perfectly possible and for you I would say recommeded.
I would really like to add here that I do not feel a low ish FT3 is something to worry about if someone is not symptomatic.
The numbers are not be all when it comes to how we feel, and how someone feels and where there perfect numbers lands is not so black and white. Everyone is different.
Agree, and would also add basic thyroid hormone replacements needs can not be assessed when pregnant . In fact FT3 levels often reduce to protect baby from overstimulation and RT3 is known to elevate. In other words the ratios naturally change during pregnancy.
I am sorry, I appreciate how frustrating this all is. However, I do not think anyone can provide you with a suggestion on what to do, be that forum members or medical professionals, with any certainty. Furthermore, anyone who does simply could not be trusted.
The fact of the matter is, the research of thyroid disease and even more so of it in pregnancy simply isn’t there in any sort of abundance.
However, you are discussing the situation with your GP and that’s the best next step as (hopefully) they’ll be aware of all your needs.
And, I can not emphasise this enough but go with how you feel rather than just numbers alone.
I never have symptoms so it’s hard to go by and my GP is useless and doesn’t even care about T4 T3. I’ve got a private appt next week with an endocrinologist but being honest I just find them all useless!!
I am afraid largely they will be, but you can always ask for recommendations. I shall private message you of one that has been recommended to me.
It’s a good sign you don’t have symptoms. I’ve seen your other posts so I understand how nervous you must be feeling right now. And, I have been where you are.
For now, breathe. The fact that you’re symptomless suggests doing nothing is a good thing right now.
Inadequate thyroid hormones risks causing severe fetal brain damage but you are not under-dosed at present. Your present FT4 levels are very good but should remain at least two thirds of way through range to allow enough for both yourself and baby.
During the first trimester not only will baby depend on your supply of thyroid hormone until about 12 weeks but oestrogen levels will raise, encouraging TBG (thyroid binding globulin) to raise correspondingly and this binds to thyroid hormones, disabling a proportion.
In addition, usually hCG raises when pregnant and this acts like TRH & TSH to encourage more thyroid hormone to meet the higher needs but when medicating thyroid hormone we don’t have the luxury of that automatic increase.
Given these factors it is imperative to have regular tests and dose raises if required, and if your GP is hesitant, point out the decrepancy between the FT4 and TSH. As yours & babys thyroid hormone needs will increase quickly, in your shoes I would have upped my Levo dose too 👍. Ask for another test next week. If they palm you off remind them pregnancy protocol is to dose for immediate needs and not the usual 6 weeks cell saturation. Also that some women require weekly/fortnightly dose raises.
With regard to TSH, it is important to keep it low during conception and the early weeks of pregnancy as if raises, prolactin may raise inline with it. Prolactin should raise steadily but only be high later in the pregnancy (ready for breast feeding) or can create luteal phase defects and is one of the main causes of miscarriage. At this moment your TSH is not over range and is slightly variable with timings and food, etc so do not worry as this is not that high.
You can see it is a balance of many hormones and if were me I would be concentrating on adequate FT4 levels, that will hopefully keep TSH in check. Have you been referred to a specialist yet? If you are worried ask your GP to seek further help immediately and if he dismisses you again, remind him NICE states a doctor must discuss urgently with an endocrinologist regarding initiation of or changes to dosage of Levo while waiting for a review when pregnant.
I'm not a health professional, but congratulations and good luck 😊
A good read is "Your Healthy Pregnancy With Thyroid Disease" by Dana Trentini and Mary Shomon.
Your TSH is high because your FT3 is low. But your FT4 is good. So, quite apart from being pregnant, how do you feel? Because I really would not suggest raising your levo any further.
A high TSH does not cause miscarriages. TSH is just a rough guide to thyroid hormone levels - T4 and T3 - TSH is a pituitary hormone.
TSH - Thyroid Stimulating Hormone - is a chemical messenger from the ptiutiary to the thyroid to tell it to make more thyroid hormone. You pituitary is sensing that your FT3 is low, which is why it's increasing output of TSH.
If you increase your levo, your conversion could get worse, and your FT3 could drop even lower, which will cause your TSH to rise even further. Increasing your levo will probably not stop it rising.
It is thought that the FT4 is the most important number when pregnant because, as your baby will have no thyroid of its own until the second trimester and will therefore live off yours. (So why they test the TSH and not the FT4 is beyond me!) You have plenty of T4, so the baby will not suffer. The only thing is that you might start to suffer with such a low FT3.
Were you diagnosed hypo before you got pregnant? Or is this something new?
OK, your antibodies may have decreased, but you still have Hashi's. That won't go away.
If it were me, I would want some T3 added to my levo to bring my FT3 us a bit. Even at 4.5 it was too low. However, I don't suppose you'd get any endo to prescribe T3 now that you're pregnant. So, just leave things as they are. If anyone says anything about your TSH, tell them it's rising because your FT3 is decreasing, so it's only to be expected. See what they say.
Keep an eye on your FT4 as another 25mcg could see you go above range and that may not be good either, but mainly keep an eye on your symptoms.
I am not altogether convinced by the whole ‘TSH under 2.5” or over in fact, as that could still render you symptomatic. However, I do certainly understand your concern. If it helps, the only good ish piece of advice a preconception endocrinologist shared with me is not to worry if the numbers are slightly over or under.
Congratulations on your pregnancy. It’s hard not to worry, I know, and that in itself is not good for your right now so I hope you are able to find ways to relax.
Best wishes 🫶🏽
Edit - according to guidelines, in pregnancy both TSH and FT4 should be tested regularly.
HiI'm currently 10 weeks pregnant after IVF. My Tsh was at 3.14 when I got tested a few weeks ago, so I increased by 25mg a day (in line with what the specialist told me to do) and so far everything seems fine. I don't know if this is any help to you but I reckon you're ok as you've already increased the 25mg. Good luck!
Hi. Congratulations on your pregnancy. Just to reassure you but once you have your initial appointment with the midwife you will be referred to an endocrinologist as part of your ante-natal care and have regular check ups.
Congratulations on your lovely news. Just to reassure you, because there are so many worrying articles online , that my daughter gave birth to a healthy baby boy four months ago. He is doing all the right things at the right time, so he seems to have developed normally despite a worrying lack of care in her first sixteen weeks of pregnancy.She was not prescribed anything at all when she first became pregnant, being one of those poor souls who had to wait for her TSH to go over 5 before they would consider medication. Her TSH had crept up to 4.6 and she had miserable symptoms so began taking Metavive (6 months, ). This worked a treat, but when she conceived she was worried about self medication, and sought the advice of her GP. He told her to stop theMetavive and referred her to endocrinologist at local hospital. She saw the 'expert' when she was 11weeks pregnant, and her TSH had risen to 4.1.I went with her to the appointment and he stated that the baby will take what it needs, that 4.1 isn't too high,even for pregnancy...and that the lower recommended levels are outdated. Luckily for us , he dismissed her, (sorry discharged her) back into GP care, and the GP did his best to keep her TSH lower than 2.5. But it never went below 3 because she had to be started on 50mcg, then wait 4 weeks, increase by 25 every 4weeks...and what with waiting for blood results she ended up on 125mcg and a TSH around 3 for the rest of her pregnancy. Blood tests were done six weekly. Baby makes its own hormone after 18 weeks or so, I think. Needless to say it was an anxious pregnancy wondering if the low T4 and high TSH had brain damaged the baby....but he is absolutely normal and doing all the things he should.
It looks like you have plenty of T4 ( daughters was always around 12) so please try not to worry, and enjoy your pregnancy. I know its a long winded story, but I hope it helps. X
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