I suffered a missed miscarriage in September 24 and no cause was found. On Jan 17th 2025, bloods were done and my TSH was discovered to be 4.8 which I know is linked to miscarriage. On Jan 17th, I was also 4 weeks pregnant. At first, they were reluctant to put me on medication, but then they did and I started 25 mg of levothyroxine. And I have been on this since 24th January. Now, I am around 7 weeks.
has anyone any insight or advice regarding this. Was my TSH abnormally high? Is 25mg sufficient?
I am Terrified of going to another scan and being told my baby is dead.
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Laubelle
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Standard starter dose of levothyroxine is normally 50mcg
Request GP do full Thyroid evaluation
So you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12
Are you currently taking any vitamin supplements?
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Ideally you would wait 6 weeks between starting Levo and testing, but in your case it is probably best to get tested ASAP
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
IMO, a TSH of 4.8 is too high for pregnancy. I think 1.2 in the morning is ideal for anyone in normal health otherwise, especially for someone your age. And doctors should never shrug off miscarriages! Of course, take a look at your dietary iodine levels; I get my info from FDA tables online. Dietary iodine in the right amounts won't fix hypothyroidism, but it can keep it from getting worse.
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