upping meds in pregnancy plus vitimins.

[Needlehaystax]

I went to my GP in very early pregnancy (4.5-5weeks) as had cramping and spotting, and also arranged bloods, as I knew I should be monitored as high risk with hashis/hypo. So on the 1st March my TSH was 0.13 mIU/L but after discovering I was pregnant and going for said bloods on the 18th March - I was tested at 4ish in the afternoon, post levo pill and had eaten and drunken and it was 0.52 mIU/L. The GP said that at 0.13 I was so well controlled that they would t be upping my levothyroxine but they never contacted me about the slight raise in TSH to 0.52. Should I being upping meds yet? shouldn’t they be monitoring me regularly? I had a very early scan,(4.5-5. Weeks) due to the spotting and cramping I mentioned and then they couldn’t locate a pregnancy, so I had a suspected ectopic pregnancy. I then went in again at 5.5 weeks and they thankfully are 99% sure they’ve located it . I go in again to make sure tomorrow for a 6 week scan but as yet I have had no contact with the GP or midwife - is that normal merely because it’s not a confirmed pregnancy yet?

Currently only taking the following vits, as I understand pregnancy vitimins contain too many things that hypothyroid people shouldn’t have like iodine and are also apparently not that effective anyway in multi vit form.

10ug vit D drops

210mcg ferrous fumerate every other day (as apparently aids absorption) taken with vit c

400ug Methylfolate

the rest I’m relying on a good diet. Is this enough for now??

Any advice would be great

[Jazzw]

How much levothyroxine do you take? Just trying to gauge an approximation of how likely it is you’ll need a dose increase.

Unfortunately you really can’t tell much from TSH alone—an FT4 result would have been much more helpful (an FT3 result even more so). It’s not going to be much use for working out whether you do need a dose increase but sadly many doctors don’t seem to realise this.

All the very best for tomorrow. I’m sure the reason you haven’t heard from your GP/midwife is because you aren’t far enough along yet—and if not, I’m sure a phone call to your GP will get things moving in due course.

[Needlehaystax in reply to Jazzw]

healthunlocked.com/thyroidu...

[FallingInReverse]

Hi, you must get your FT4 tested as soon as you can. Go private if you need to.

Even when not pregnant, dosing on TSH is not sufficient.

When you are pregnant - it definitely isn’t.

How much Levo are you taking? When was your last full thyroid blood test and what were the results?

edit: 22 days ago results:

healthunlocked.com/thyroidu...

[FallingInReverse]

OK, so it looks like you are about 60% through the FT4 range.

This is great news!

You should search this forum for pregnancy related posts - there are a few but you will find responses to the posts are sometimes sparse.

Here’s one reply I did recently -

healthunlocked.com/thyroidu...

But others on this board (I can’t recall from who!) have links and info they share, so you should take a look.

Because believe it or not starting in weeks 5-6, through the 1st trimester is the most critical period for the moms FT4 to be optimal because the baby doesn’t have its own thyroid production until later. You are the baby’s only supply of FT4 right now!

Here is a good article talking about the need to increase your Levo through the pregnancy.

nejm.org/doi/full/10.1056/N...

That being said - as you know hypo is usually misunderstood by doctors, and I would guess it’s equally true for pregnant hypos.

Definitely read up on the forum, and always validate for yourself!

[Needlehaystax in reply to FallingInReverse]

Thanks for all the replies!

So I had my scan and they think they have calculated my dates slightly wrong due to a longer cycle length, so im actually 5 weeks! Which would explain them not locating it as it was way too early. Today they found a yolk sack inside the gestational sack which is apparently tlyvwhere you’re meant to be at 5 weeks, so at this stage that’s the best outcome I could have. Booked in for 2 weeks time for my 7 week scan where they can check viability and a heart beat so fingers crossed. Thanks to all your replies I pushed for more bloods and I have the results already:

So currently taking 125mcg of Levo to treat my hashi/hypo and as of today my levels were taken at approximately 10am, no levo, vitimins (methylfolate, vit D, iron) taken yesterday and I had eaten a tiny bit of breakfast - so perhaps not 100% accurate but to give an idea as follows:

T4: 21.1 pmol/L (11.0-21.2)

T3: 4.4 pmol/L (3.1-6.8)

TSH: 0.77 mlU/L (0.27-4.20)

Slightly concerned about my T4 being very high is that good or a bad thing? Any help on these levels would be great and I’ll be contacting my gp too and maybe a private endo that I have seen before.

many thanks everyone

[FallingInReverse in reply to Needlehaystax]

I have never been pregnant while hypo, but I did a very very detailed deep dive on primary research studies on the role of the mom’s thyroid levels in weeks 5-10.

Long story short - there is huge risk during those weeks if T4 is low. Although all of us are different, the baby does not start to make its own thyroid hormones until 2nd trimester. And, the baby needs T4 for brain development. (There is some debate about moms on T3 mono. I never found a study on that, and can’t add anything to that. All I can say is that all the clinical studies focus on T4).

I don’t know about risks if it’s high. But You should definitely feel very reassured you are not towards bottom of range!

[Needlehaystax in reply to FallingInReverse]

Thanks! Well I’m still technically within the normal range but only just. I’ll keep an eye for sure

[Needlehaystax in reply to FallingInReverse]

healthunlocked.com/thyroidu...

[HealthStarDust]

Your TSH is not near high enough to consider an increase by many professionals. Please remember, some women do endure the whole of pregnancy without a dose change just fine despite many recommended guidance to increase dose on pregnancy. Thyroid treatment is very individualised and we can not take that for granted.

FT4 must always be tested in pregnancy.

High risk individuals usually get a midwife appointment by week 8 depending on availability.

It’s such a scary time. Trust me, I know. The best thing you can do is find ways to relax alongside keeping an eyes on your levels.

P.S. Congratulations. Try and find a pregnancy app where you can find more peer support from fellow hypo mums going through it right now or recently. But, mostly relax. Glad everything is OK with you and bump.

[Thyroid2 in reply to HealthStarDust]

What type of App would you recommend for communicating with other expectant hypothyroid mothers? I’m at a loss in locating one.

Thanks, in advance.

[HealthStarDust in reply to Thyroid2]

There isn’t a specific one. But, and pregnancy related app will have much more pregnancy related queries including thyroid.

[Needlehaystax in reply to Thyroid2]

Gosh we could do with starting one! Wish such a thing existed

[Needlehaystax in reply to HealthStarDust]

healthunlocked.com/thyroidu...