I'm very new to this and my GP has been absolutely useless so everything I've learnt so far has been from my own research. I could really use some advice/next steps as I'm having a pretty rubbish time at the moment.
I found out last week at 8 weeks pregnant that I have thyroid issues. I've never had issues before, at least none that I knew of.
These were my results from a blood test my GP did:
TSH: 6.09 (out of range)
Thyroid Peroxidase ABS: 252 (out of range)
Thyroxine (free): 18.1 (in range)
From my research, my TSH should be max 2.5 during pregnancy and the presence of antibodies suggests Hashimotos. I contacted my GP and asked for medication and they put me on 25 of levothyroxine.
Sadly, I found out a couple of days ago (just 3 days after starting the meds) that I've had a missed miscarriage. I don't know if it's due to the thyroid issues or something else. I've continued to take the levo the last few days anyway but now I'm left utterly confused on whether I should still be taking it or what should I do?
I don't know if the hypothyroid was triggered by the pregnancy, so if my levels return to "normal" now and I'm still taking the levo is that dangerous? I've read online that some women after giving birth/miscarrying swing the other way so again I'm worried about taking levo when maybe I don't need to be?
On the other hand, I'll probably want to try to conceive again in a few months so I need to make sure I'm stable.
My husband thinks I should just stop taking the pills and get tested and see what's happening with my levels but I have no clue whether to continue or not.
Any advice/guidance would be appreciated please. I'm a little overwhelmed by it all and not sure what my next steps should be.
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RLG123
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Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.
Firstly I'm sorry for your loss. Its quite possible that not having enough thyroid hormone caused the miscarriage, but it could also have been caused by many reasons that aren't fully understood.
The body needs more thyroid hormone to maintain a pregnancy so if you retested in a few weeks your levels of TSH might well have gone down, but you've been taking Levo anyway so that alone will reduce TSH.
If your TSH has gone to 6.09 in early pregnancy then likely you will need some Levo anyway. As you have learnt you need a TSH of 2.5 really for conception as well as pregnancy it would be wise to continue the Levo and see what your results are in 6-8 weeks time.
Its not dangerous to continue taking Levo. Its a very small dose and most people need an average of around 125mcgs Levo when fully replaced.
Usually you start on a low dose, some GPs start with 25mcgs but a more usual starting dose is 50mcgs. Retest after 6-8 weeks and increase by 25mcgs until TSH is at or below 1 where most people feel well.
Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
Do you do tests as per the protocol recommended here?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
It's difficult to know whether your thyroid contributed to your miscarriage, your fT4 was good. TSH stimulates the thyroid to secrete hormones, as your fT4 and fT3 go down TSH goes up.
There is more demand on the thyroid during pregnancy and your thyroid needed more TSH stimulation than normal to sustain normal fT4 levels. This along with your elevated antibodies puts you at greater risk of developing hypothyroidism in the future. Your thyroid might be OK at the moment, except during pregnancy.
I would stay on your levothyroxine tablets at the moment and have another blood test in a month or so. If you come off the tablets you may have difficulty getting them prescribed again (because you have a poor doctor).
As you are planning pregnancy you should ensure you receive sufficient levothyroxine to bring your TSH down below 2.5 and have your levothyroxine increased by 25 or 50 mcg when you become pregnant. Your TSH should remain below 2.5 for the first three months and below 3..0 thereafter. These are the guidelines, minor variations should not cause concern.
It may be that your thyroid is in the early stage of failure, if so, you may need levothyroxine dose increases as it progressively fails
Nobody knows if your thyroid contributed to your miscarriage but it's a risk that can be easily and safely eliminated. If your doctor doesn't get onboard ask them to consult an endocrinologist or go to a different doctor.
The admins on here deserve medals with the work they do to fill the void of what should come from NHS ... you will get help.
It is busy forum though ... In future repost if not getting replied to. Do not be bashful.
LevoT4 is not a medicine it is a hormone. Your TSH levels are indicating that you need a lit more.
I do not know anything about pregnancy effects. Hopefully people will chip in.
Ask doctor to measure T4 and ideally T3. T4 is the tablet you take. Your body should convert it to T3 which is like the battery level on your car to keep everything working correctly.
Thyroid glands are being attacked and this process generates the antibodies. Thyroid can release T3 during this and make blood results erratic.
Some people are fine with underactive thyroid. My wifes uncle has had it over 30 years and he just takes his 125 mg of T4. Hopefully this is how you will be.
A small minority need to do more and this forum is dominated by them ... Just flagging up because this scared me at the start.
Issue is slow to sort out, 2 to 3 months between dose changes. Let those around you know you will need more rest and help. Once levels are right the body still has to do repairs to stuff impacted/ damaged. Brain fog and fatigue are pants while trying to sort bloods vitamins etc. and carry on with life.
Home blood test with T3 T4 and TSH is about £30. I would try with GP but unlikely to get T3 done.
Knowing T3 levels gets you to know if you are in the more complicated group.
Getting vits and iron levels is harder to do at home and better to get from GP. Get celiac / gluten blood test too.
Thyroid UK have a paper info pack that I and my wife found useful.
Similar experience (see profile) and I am so sorry for your loss. It is most heartbreaking and a lot to process. So, my best advice based on personal experience is don’t rush to find answers as to what to do next. Be kind towards yourself and husband as you heal from this.
My husband thinks I should just stop taking the pills and get tested and see what's happening with my levels but I have no clue whether to continue or not.
I think your husband has a very valid point.
Another thing, ask you GP for a referral for preconception endocrinology. You are entitled to these. I can’t say they’ll be useful or not, but it’s worth a try. See here:
Arrange a referral to an endocrinology specialist for all women with overt or subclinical hypothyroidism who are:
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