Underactive thyroid and pregnancy - NICE guidelines

(14 Posts)
Gardenbirdy Sat 12-Nov-16 07:19:23

I've just got my bfp after three miscarriages and (finally!) a diagnosis of underactive thyroid.
So I'm going to my gp on Monday to ask about adjusting my medication as my tsh level was 4 the last time I had it checked, and I know it needs to be below 2.5 for pregnancy.
Could anyone post me a link to the NICE guidelines? My googling hasn't come up with the right ones and I want to have some backup if my gp tries to brush me off with "oh but 4 is normal".
I've lost 3 babies so I'm going to fight for this one! TIA

pinkpostitnote Sat 12-Nov-16 10:15:18

http://www.nhslothian.scot.nhs.uk/Services/A-Z/DiabetesService/InformationHealthProfessionals/MUHEndocrineManagementProtocols/007c_Thyroid%20Function%20Testing%20in%20Primary%20Care%20Guidance%2017.10.08.pdf

This is from NHS Scotland. No, 4 is not fine!

There are two radio 4 progs on inside health relating to it too, I'll try to dig out.

pinkpostitnote Sat 12-Nov-16 10:16:14

Sorry, that's the wrong one. There's a pregnancy one somewhere.

pinkpostitnote Sat 12-Nov-16 10:17:21

This is it

http://www.thyroiduk.org.uk/tuk/guidelines/Lothian%20Guidance%20for%20Diagnosis%20and%20Management%20of%20thyroid%20function%20in%20pregnancy.pdf

pinkpostitnote Sat 12-Nov-16 10:19:45

I found this while looking for nice

https://www.gp-update.co.uk/files/docs/Hypothyroidism.pdf

sparechange Sat 12-Nov-16 10:21:12

They key thing you need to point them to is "Patients with established hypothyroidism should have T4 dose increased by 25 micrograms as soon as a positive pregnancy test is found. Further monitoring after 2 weeks and possible further changes in T4 dose may be required to ensure FT4 is 16-21 pmol/L; TSH <2 mU/L as quickly as possible."

congrats on the bfp flowers

Gardenbirdy Sat 12-Nov-16 10:22:53

Thank you all! X

Tootsiepops Sat 12-Nov-16 10:27:21

Garden my endocrinologist told me to go right ahead and increase my thyroxine myself as soon as I got pregnant. GPs barely know anything about thyroid disorders, and in fact when I did get pregnant, my GP told me that they would take a 'wait and see' approach to adjusting my dose. We had a monumental argument about that one grin

pinkpostitnote Sat 12-Nov-16 10:35:04

•"Women with known thyroid dysfunction who are taking levothyroxine may need the dose increased by 30–50% from as early as 4–6 weeks gestation De Groot et al, 2012]."

Taken from here- Did you find this?
//https://cks.nice.org.uk/hypothyroidism#!scenario:3//

Author of BMA patient book on understanding thyroid disorders is A Toft who wrote the Lothian links.

As spare says (and BMA book says) increase by 25 but you will probably need to go up by 50 eventually. The Lothian advice is the most detailed.

Gps also refer to patient . Co .uk.
For reference. http://patient.info/doctor/thyroid-disease-in-pregnancy

pinkpostitnote Sat 12-Nov-16 10:38:18

tootsie I had a similar battle brandishing nice print outs too!

There's a really bad gap from conception to 12 wk scan. Booking midwives at 8 weeks know nothing in my experience and it's actually too late by 12 weeks. The key is the first trimester.

pinkpostitnote Sat 12-Nov-16 10:38:30

http://www.bbc.co.uk/programmes/b04kbl8w

pinkpostitnote Sat 12-Nov-16 10:39:51

The BTF are running a campaign to increase awareness. Their info page.

http://www.btf-thyroid.org/projects/pregnancy

Gardenbirdy Tue 15-Nov-16 07:14:00

Just an update for those who posted: my gp was fab, upped my dose by 50% without quibble, advised me to see the midwife at 6 weeks rather than the usual 8. He said to get my levels checked again after Xmas but to make sure to ring the surgery as he's going away for Xmas and wants to make sure the results go to him and not one of the others. Faith in gps restored!

VIOLETsunflower Tue 15-Nov-16 09:05:05

Ive only just seen this - but great links and I'm so glad to read of this outcome!

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now