It it normal for levels to change so much in two weeks? (TTC after loss)

[Fizzyinch]

TW: miscarriage

Unfortunately had a miscarriage on 1st July. Since then I had a thyroid test at the GP and carried out my own at home finger prick test because I wanted to check out my antibodies and vitamin levels before TTC again.

13 July:

TSH 1.35 (0.35-5.5)

T4: 17.5 (10.5-21)

Attached latest results.

I’m really surprised by the latest results because I feel really good.

I know pre-pregnancy TSH should be under 2.5 so I’m confused at how quickly this has raised.

Will it prevent me from getting pregnant? If I fall pregnant again then my dose will increase immediately anyway so should I be worried?

Pre pregnancy dose levothyroxine : 75mcg M-F, 37.5 S-S

100mcg when I found out I was pregnant. Went back to pre pregnancy dose after miscarriage.

Also is there any evidence that TPO antibodies cause miscarriage?

Thanks for your insights.

(I stopped my pre-natal one week before because of possible biotin interference with second test)

[Fizzyinch]

vitamin and ferritin results 30 July

Results

[HealthStarDust]

What was your levels immediately prior to and immediately after pregnancy? I would caution that while there is so much literature on increasing dose upon confirmation of pregnancy, there is no actual official national guidance on this (NHS UK anyway) and the best thing to do is have your thyroid tested immediately upon confirmation of pregnancy before changing dose.

The whole endocrine system needs time to settle after being pregnant and miscarriage in quick succession. Based on personal experience, you’ll get a better gauge of your levels after a couple of period cycles have passed.

If you haven’t already, ask your GP to refer you to a Preconception Endocrinologist as is your right (if you are not already under endocrinology).

I am sorry about your loss.

Edit: I’ve just seen your previous posts and realised your GP increased your dose to 100mcg a day (from 75mcg M-F, 37.5 S-S), so an increase of:

-450 per week, average 64mcg daily

- 700 per week, average 100mcg daily

So an increase in dose by 36mcg daily.

And your levels at the time of the increase:

TSH: 0.07 (0.35- 5.50)

T4: 18.8 (10.5- 21.0)

T3: 4.7 (3.5- 6.5)

Even though at that time your TSH were below range and your had good FT4 levels. I can’t understand why the advice given to your GP from the endocrinology team is that TSH is suppressed during pregnancy anyway (and to increase your dose by a rather quite a big margin). That isn’t true. TSH doesn’t magically suppress or go low during pregnancy. I’m sorry your health team let you down as it seems to me you didn’t need a dose increase, let alone such a big one.

Edit again: tidied up some additional details with calculations.

[Fizzyinch in reply to HealthStarDust]

I take your point about hormone levels needing to settle. It is quite early, the main reason for testing was for the vitamin and antibody levels but was just shocked with the results as i haven't been that hypo for years and ironically feel really well.

I am not sure what's best for next steps really!

[HealthStarDust in reply to Fizzyinch]

Just heal for now. Come to terms with what has happened with your partner (if you have one) and heal together.

There’s no need to test some more at this point if you feel well 🫶🏽

[Fizzyinch in reply to HealthStarDust]

Levels during pregnancy on 100mcg:

TSH: 0.38 (0.35-5.5)

T4: 18.1 (10.5-21)

T3: 3.7 (3.5-6.5)

[HealthStarDust in reply to Fizzyinch]

How long was you 100mcg before being tested? These levels same OK. Remember there is a margin of error in all blood tests.

[Jaydee1507 Administrator]

I'm so sorry for your loss.

So when was the Medichecks test run and what time of day were both tests taken?

Did you remember for both tests to stop Levo 24hrs before the test?

On the 13th July result your FT4 is only 67% and no FT3 result to check conversion. I suspect you really needed that extra 25mcgs anyway. Ask GP for an increase.

Miscarriage is more likely to be caused by low thyroid hormones than antibodies. Antibodies only are the result of an autoimmune attack on the thyroid, they dont cause other issues.

Vitamins look good other than ferritin, so keep up with iron rich diet. Try eating chicken liver pate a few times a week.

Link with ideas for dietary iron:

dailyiron.net/

[HealthStarDust in reply to Jaydee1507]

Dose: 75mcg (M-F) 37.5mcg (S, S)

TSH: 0.07 (0.35- 5.50)

T4: 18.8 (10.5- 21.0)

T3: 4.7 (3.5- 6.5)

*from poster previous post*

Posters result a couple or so months ago during the early days of pregnancy, and their dose was increased after this result. I am not sure an increase in dose was warranted with these levels and very surprised it was.

[Jaydee1507 Administrator in reply to HealthStarDust]

I'm struggling to understand the medichecks results and how that could possibly happen.

[HealthStarDust in reply to Jaydee1507]

Fluctuating hormones between pregnant and non pregnant states, something to do with HCG. It is thought that to get a gauge of levels after loss, it’s best to wait two period cycles (for those of us with regular cycles).

Plus, the test results could just be wrong!

[Fizzyinch in reply to Jaydee1507]

Yes, hence my confusion. However could be too early to test post- pregnancy perhaps, i don't know.

[Jaydee1507 Administrator in reply to Fizzyinch]

I think thats the most likely scenario. Leave it a few months and retest using the usual 9am or earlier protocol etc

[Fizzyinch in reply to Jaydee1507]

Thank you. First test was taken at 11.00am not fasted, no levo (if i remember correctly). it was the only appointment the GP had.

For home tests i always do them fasted, 8.30am, no levo 24 hours before.

My levels on 75mcg were very low TSH prior to pregnancy and good T4 T3. (shown above)

What level of Ferritin do i need to aim for?

[Jaydee1507 Administrator in reply to Fizzyinch]

Ferritin should be around 90 - 100 for best use of thyroid hormone.