Anyone had a thyroid problem diagnosed as cause of recurrent miscarriage?

(24 Posts)
waterviolet13 Sun 04-Aug-13 13:39:36

http://www.btf-thyroid.org/index.php/thyroid/research-news/thyroidnantibodies-andnlevothyroxine

Mamakate75 Thu 04-Jul-13 20:22:03

Hi, you sound a bit like me. I am hypothyroid. Diagnosed in May 2009 after the birth of my son (in Oct 2008). Since then I have gone on to lose every pregnancy. I have had 4 miscarriages in total, three missed miscarriages at 12 weeks gestation and another earlier at 5-6 weeks. In my last pregnancy we tried aspirin, clexane, high dose folic acid and progesterone but it failed. I don't often hear of this treatment plan failing so I am despairing.

I had all of the standard recurrent miscarriage tests done, karotyping, uNK cell testing (with Prof Quenby), a hysteroscopy, specialised genetic testing of the last baby and standard pathology examination of two others and hubby had DNA sperm fragmentation testing done....and absolutely nothing could be found. Everything is normal/negative.

My thyroid was monitored closely in three of the four pregnancies and my TSH was kept within normal pregnancy ranges. I had a swathe of blood tests done (by my Endocrinologist) to look for antibodies, including thyroid antibodies and again nothing was found. Yet every time I get pregnant my babies develop as normal until 11 weeks and a few days and then they just die!!! I am heartbroken. I have no answers, nor does my Consultant or other every eminent doctors in the field of recurrent miscarriage research.

The next time we are going to try prednisolone but it is really just on a 'just in case' basis - i have no medical indication for it.

I am worried that I have an allo immune cause for my miscarriages and may need IVIG or intralipids...my doctors wont give me them as they either don't think they work or they think they are actively dangerous....but what if this is my only hope to carry a baby to term?

Anyone out there have any ideas?

Cx

ladybonifer Sun 02-Jun-13 01:18:15

freelance Im a newbie currently on another thread for miscarriage but just noticed your post on Mr Shahata. Im in Australia but saw Dr Gorgy in London when visiting home for a bit. Im on an immune protocol (asprin,clexane,prednisone,feldine,folate,vitamins) here in Australia bar the LIT as my doc says it's potentially very dangerous. I've not heard of any complications with it. Did you try it with your last one? Sorry for asking as well but what's MN? I was diagnosed with Hashimotos after a full term still birth and since then had 2 miscarriages and I think I'm going through my 3rd now! It's all getting a bit much. Might risk the LIT in Sydney. Bit scared though!! greengoose yes get your antibodies tested. Koala hugs xxxx

greengoose Wed 15-May-13 18:24:07

Hi DG31, I was tested for thyroid issues after two MCs and loosing my little girl (she had a tumour) when she was born prem at 32 weeks. I had a third MC and they started looking for a problem. My thyroid was borderline, but after advice here I pushed to be tested for autoimmune causes, and was found I had problems with thyroid antibodies. Was put on thyroid meds to keep TSH under 1 and am now 25 weeks pregnant.
Not sure if that's why (I also have a ten and five yr old). I am also on asprin, and was on high dose Folic acid. Hopefully something is working! I'd ask to be tested for the thyroid antibodies, to rule it out if nothing else....
Good luck, it's a horrible and scary, but you sound determined and that really helps!

freelancegirl Wed 15-May-13 10:44:39

Sounds like you really have done your research. Good luck! And if you want to know more about nkcs there are loads of us here

DomesticGoddess31 Tue 14-May-13 14:18:19

I haven't been tested for NKC but its on my (very short) list for possible other causes if the thyroid issue is a red herring. I am waiting for results for a full thyroid work up but having researched more into it I have SO many symptoms that point to either an underactive thyroid or hashimotos disease so will be interesting to see if I have high antibodies. I have printed off lots of literature to support me getting some treatment if that is the case too. Just got my fingers crossed that my consultant will be willing to give treatment a go even thought my TSH and FT4 are 'normal'. They are borderline if you ask me and they were willing to treat my borderline low protein s with heparin (which according to my research is only recommended for 2nd trimester mcs, mine are all 1st trimester).

Thanks all!

freelancegirl Mon 06-May-13 10:09:21

I was first diagnosed with a thyroid problem (hypo / hashimotos) when I was in my early 20s and had 4 mcs before having my DS 9 months ago. Like people have already said it is now thought a tsh of sround 1 is best for conception and pregnancy.

I also found out about immune issues - very connected to thyroid problems on these boards. Yes MN is wonderful! I probably wouldn't have my DS without it . Have you been tested for immune issues like natural killer cells? I know a lot of medical practitioners don't know about this or believe in it unfortunately. I saw Mr Shehata at The Miscarriage Clinic. Try reading Dr Beer's Is Your Body Baby Friendly or come say hello on the Conception boards with the 'TTC on Prednisolone or similar' thread. We all know a lot about the subject now and are happy to help.

AnyFucker Tue 30-Apr-13 15:20:08

MN is brilliant, isn't it ?

WouldBeHarrietVane Tue 30-Apr-13 14:14:45

Sorry about the waiting sad

Here is the guideline:

cks.nice.org.uk/hypothyroidism%23!scenario:3

You need to scroll down to 'pre-existing sub clinic hypothyroidism' and then you will see it says: 'Aim for a TSH concentration in the low-normal range (0.4-2)'

You will have to scroll quite a long way down. Are you in London/near? I can pm you the name of the endo I saw privately and then transferred to his NHS clinic at Uch.

I'm not an hcp btw - just a hypothyroid patient!

DomesticGoddess31 Tue 30-Apr-13 14:01:19

Thanks for that link, interesting reading. It certainy looks like I could have found the problem. Do you have the link to the nhs guidelines? I can't find them anywhere.

And yes, oh my giddy Aunt the waiting is excruciating.

AnyFucker Tue 30-Apr-13 13:43:13

Isn't the waiting just the pits ? sad

WouldBeHarrietVane Tue 30-Apr-13 13:25:01

You might want to ask their views on this article:

www.thyroid.org/wp-content/uploads/publications/clinthy/volume22/issue7/clinthy_v227_6_8.pdf

The NHS guidelines are clear - in pg tsh should be below 2.

DomesticGoddess31 Tue 30-Apr-13 13:22:03

Thanks for your replies everyone. I do realise my results are within 'normal' but v borderline if you ask me and if I were to be pg surely my tsh would likely be above normal if you take 3 as the upper limit. Although that might be ok for some women, just maybe my body says 'nah, no good for babies' and hence mc. Its so hard to judge as the ranges differ so much depending on what document you read and there are opposing opinions everywhere. Anyway, I'm having blood taken on thursday at my go surgery for a full thyroid screen so I can take the results to my gyno apptmt on the 30th May (aaaaaaages away). Will see what that tells me.

WouldBeHarrietVane Tue 30-Apr-13 00:03:35

I am so sorry about your mc op sad

I have had a mc which I believe was due to thyroid issues (karyotyping showed the baby was normal), though the cause could never be determined with certainty.

The latest NHS guidelines say that tsh should be under 2 for conception and pg (and as close to 1 as possible is ideal). As your pg progresses your tsh will increase, so in pg your tsh could be quite a bit above the 2 limit.

I think in your position I would ask to be referred to an endo to see whether they would be prepared to give a small dose of thyroxine to being your tsh down below 2.

rosiecheeks2 Mon 29-Apr-13 23:00:55

Thank you AF

AnyFucker Mon 29-Apr-13 22:59:12

Oh Rosie, I am so sorry x

rosiecheeks2 Mon 29-Apr-13 22:56:41

I have an under active thyroid which was monitored closely during my 2 pregnancies as more often than not the dose needs increasing early in pregnancy. With my 3rd pregnancy my thyroid wasn't monitored as often and my dose was never increased. I lost my daughter at 5 months. The medical team found no reason for the miscarriage as baby was healthy.

AnyFucker Mon 29-Apr-13 22:42:06

oh, and I would also ask for repeat thyroid testing in 6-12 months if still no luck/other explanations

mine took a very quick nosedive when it decided to pack in

AnyFucker Mon 29-Apr-13 22:40:49

have you seen this table of normal values

your results seem ok re. thyroid function

I would be pushing for more answers re. the erratic cycles though.

DomesticGoddess31 Mon 29-Apr-13 22:32:33

Noone has even blinked when I've mentioned my crazy cycles. Likewise when I've mentioned strong family history.

My TSH was 2.78 and T4 9.6 at last test (dec last year after MC in Oct).

AnyFucker Mon 29-Apr-13 21:59:01

Yes, those cycles are erratic. Have you been given any explanation for that at all ?

Actually, thinking back (am talking 20 years-ish now, so probably out of date/possibly memory getting a bit muddled) when I was first started on 25mcg I think I was borderline hypothyroid (couldn't tell you actual levels after all this time)

My endocrinologist reckoned my thyroid was just about to pack in, hence the rapidly increasing prescription.

How far within "normal" are your levels and would it be worth asking if correcting them to more of a mid-range would be helpful ?

DomesticGoddess31 Mon 29-Apr-13 21:50:50

thanks for replying, and I'm sorry for your losses too.

I'm def ovulating no problem, it took me a year to conceive my daughter but since having her, I seem to fall pg just from holding hands.

My cycles are erratic though, between 33 and 50 days long.

I've had testing for PCOS which was negative. All other tests were normal. Maybe I'm grabbing at straws but theres got to be some reason for this, you don't lose 4 babies for no reason. My daughter was born 6 weeks early too so I can't help thinking its linked.

AnyFucker Mon 29-Apr-13 21:31:12

Hello, I am sorry about your miscarriages x

I am not sure if my underactive thyroid was ever the cause for my (two) miscarriages as it was discovered incidentally during blood tests earlier in my infertility journey when I was failing to ovulate

Back then I was initially put on 25mcg thyroxine which was gradually increased to 100mcg over the next couple of years and is stable now.

I successfully conceived and carried to term on 100mcg.

My (presumed) diagnosis was hypothalamic amenorrhoea though. I am not sure how much that is connected with an underfunctioning thyroid.

Obviously you are ovulating, but is everything ok with that ? Cycle length within normal limits and rest of hormone profile ok ?

DomesticGoddess31 Mon 29-Apr-13 21:21:06

I've just had my 4th miscarriage and was on clexane and aspirin for that one which clearly failed to work sad.

I had the usual barrage of tests after MC 3 and the only thing that came up was a borderline low free protein s result. This apparently can cause blood clotting issues but all my MCs have been before 12 weeks, 3 have been before 6 weeks so I can't see how that can be to do with blood clotting if placenta hasn't yet taken over??

I have a family history of underactive thyroid disease and my own thyroid function test results are showing that mine is not as healthy as it was but still within 'normal' range so hcps have not flagged it up as a problem.

Has anyone else been in similar position or had a successful pregnancy after being prescribed thyroxine?

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