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Advice needed re thyroid levels for breastfeeding

(7 Posts)
chloechloe Tue 09-Jun-15 12:11:30

A bit of background: before I got pregnant I was diagnosed with an underactive thyroid and was taking varying amounts of L-Thyroxin, between 25-75mcg. During my pregnancy this was increased to 100mcg, which I have continued to take since the birth 11 weeks ago.

I went to my Gyn for a postnatal check-up last week. She has just left a message to say my TSH is 0.38 and that I should now stop taking my medication entirely.

I understood that the TSH should be well under 2 to get pregnant and also during breastfeeding, so I am really surprised to hear that I should just stop taking the medication cold turkey, rather than lowering the dosage, which is currently pretty high. Does anybody have knowledge of the levels needed to sustain BF and how the levels change post-birth?

I have struggled long and hard to get BF established over the last few weeks. Now that it is finally going well I am loath to risk doing anything that might cause problems with my supply. I also have PCOS which can sometimes lead to supply problems, so am perhaps overly cautious.

I have tried to call my doctor back to discuss, but getting hold of her is pretty near impossible...

EldonAve Wed 10-Jun-15 11:58:41

I wouldn't stop taking it entirely

Are you seeing an Endocrinologist?

Somethingwitty2015 Wed 10-Jun-15 14:12:04

Thyroid hormone levels tend to increase (I.e. TSH gets lower) post-pregnancy so your Dr probably wanted you to stop while you are comfortably in the healthy range. They should be booking you in for a test in 1-2 months to check how you're doing without medication so they can adjust your levels accordingly - for what it's worth my doctor told me it wasn't worth doing a test until about 3 months postnatal as levels are all over the place and don't meet anything before then.

Regarding effect on supply, this is anecdote not evidence but I bf one child while thyroid very underactive and one while very overactive and saw no difference.

chloechloe Wed 10-Jun-15 15:04:30

I'm not seeing an Endo. My Gyn has always written prescriptions for me - I live in Germany and over here it's usual to see a Gyn every 6 months for preventative care and then when pregnant I was seeing her at least once a month.

It was 10weeks after the birth when I saw her so hopefully this was long enough for things to have settled down. I'm to go back in August for the levels to be checked again.

I'm really worried about going hypo again. The condition was only discovered when I had trouble TTC but as soon as I started on just 25mcg I felt like a new person, it was truly life changing. Before that I was tired all the time but
put it down to working too much. I can't face the thought of looking after a baby and being even more tired than I am now!

witty Didn't realise the BF connection was anecdotal. Good to know you didn't have any problems either way.

TrobadoraBeatrice Wed 10-Jun-15 15:12:06

Sounds very strange to tell you to stop the thyroxine entirely, especially if endocrinology is not her specialism. Can you see an endo anyway? TSH of 0.38 in someone on medication is I think spot on - mine (during and post pregnancy) has been lower (nearer hyper levels) than that and my medication hasn't been reduced.

EldonAve Wed 10-Jun-15 16:07:22

If you were hypo before pg then without meds you will be likely hypo again

Do you see a General Practioner / Family doctor?

Somethingwitty2015 Wed 10-Jun-15 19:42:46

Sorry I meant that my experience was only an anecdote - not sure what received wisdom is on whether being hypo can have an effect on bf but no matter what you need to keep your energy levels up! Not sure what it's like in Germany but I also got my thyroxine from a private OB when TTC, but after the birth one of the nice GPs agreed to do a test and when that came back hypo they took over the management - I only got referred to an endo in second pregnancy when I suddenly went very hyper. In my experience GPs can be a bit rubbish when it comes to thyroid issues and the Gyn may have thought you only needed meds to conceive, not for everyday life (as ideal levels for TTC are different than "normal" ranges). Can you see your normal GP, explain that you felt the meds made a difference and you'd like to stay on them, and ask for a referral/second opinion?

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