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thyroxine dose after bfp?

(12 Posts)
ciwi Sat 09-Jul-11 19:17:08

Hi to all the hypothyroid ladies out there. I am getting ahead of myself and worrying about what would happen to my dose of thyroxine if i were to get my bfp (currently in the 2ww). My dose went up to 50mcg 4 weeks ago, do you think it would need to go up again if I get my bfp? If you have got pg with hypothyroidism did your dose automatically go up or did you get levels checked first? and how often were your levels checked in pregnancy?
Any advice greatly appreciated as I really don't think my GP has a clue xxx

PoppyAmex Sat 09-Jul-11 19:52:29

My endo in Australia is one of the world leading specialists in this field and strongly advised an increase of 30% to 50% dosage upon diagnosis of pregnancy. He also warned me that most GPs advice wouldn't be in line with this recommendation so I'm to put them in touch with him as soon as I test positive.

Having said that, I'm no expert so I think you should really try to get a referral if possible.

Watching with interest to see if anyone has been in similar position and has first hand experience.

cluelessnchaos Sat 09-Jul-11 20:03:16

Yes your dose should be increased ASAP after bfp. The gp may want to refer you to the consultant to do this but make sure you have a blood test done for him to refer to. My dose before was 50 mcg and went up to 150 mcg by the end, it's back down to about 125 now ds2 is 8 months.

getawiggleon Sat 09-Jul-11 20:10:08

Hi, I was diagnosed with Hashimotos thyroiditis in March this year. I was initially put on 50mcg of thyroxine which was later increased to 75mcg. I became pg the following month and contacted my consultant who recommended I increase my meds straight away (ie upon bfp) to 100mcg - this was before I had been re-tested (TSH was around 3.1 at that time) My initial TSH was 5.1 and the most recent one was 0.37 so it has come down dramatically whilst pg and on thyroxine. T4 levels have also normalised.

Sadly at our 12 week scan yesterday we were told that the baby has Acrania, lethal neural defect which means that it wouldn't survive beyond birth (the front of the brain has not developed). I am booked in for a termination this week sad. My endocrinologist advised that I should reduce thyroxine by 25mcg after delivery (which is now going to be after an erpc). I guess it will then be a case of finding the optimum level of medication when I am not pg. He was aiming for a TSH level of around 0.5-1 when pg or ttc. Hope this helps a little and good luck for the 2ww!

ColleenEatsVeg Sat 09-Jul-11 21:37:41

I'm TTC and taking my normal 100 mcg. I talked to my GP armed with nhs info about raising my dose. When I get a BFP I will go straight back to my GP and ask them to raise my dose to 125 or 150 and then schedule a blood test for two weeks time (time it take for my body to regulate the new dose)

ciwi Sun 10-Jul-11 09:36:11

Thanks ladies, I just know I will have a battle on my hands as I had to beg my GP to up my dose to 50mcg for ttc even though my tsh was 6.4! As I am subclinical they are reluctant to treat but after losing my first baby at 24 weeks and then having a mmc I really don't care who I upset to get the treatment I need.
wiggle I am so sorry for what you are having to go through at the moment, I know only too well the pain of losing a much wanted baby and I wish you lots of strength to get through the coming days xxx

getawiggleon Mon 11-Jul-11 00:27:53

Ciwi I'm very sorry about your losses and thank you for your kind words x

I know what a struggle it can be with GPs and thyroid issues and the majority seem to think that if you are within the NHS limits (even if you are just below the maximum) then the situation is under control. I printed off info from the internet and showed it to my GP and whilst she was 'interested' in the findings she wouldn't prescribe thyroxine.

My consultant said that there is evidence that women with lower TSH levels (around 0.5-1) have more successful pregnancy outcomes and he constantly tries to educate GPs with regard to this but often feels like he is banging his head against the wall. Is there any way you could get a referral to an endocrinologist (or even a reproductive endocrinologist)? I would really push for another opinion.

Have you been tested for thyroid antibodies? I didn't have any symptoms either but my TSH was creeping up and it turns out that this was because my immune system is attacking my thyroid.

I hope you manage to get some answers. (Not sure where in the country you are but of you are in London I can recommend a consultant who works both privately and on the NHS) x

getawiggleon Mon 11-Jul-11 00:33:29

Sorry, made a mistake in both my previous posts - consultant was aiming to get tsh to around 1 iirc.

ciwi Tue 12-Jul-11 11:28:04

Hi all, well I got my bfp! I really thought I would as i just felt pg and as I thought, have had trouble with the GP who told me I didn't have to do anything, just go for my bloods at the end of the month!
Knowing this was wrong I looked up guidelines from the NHS and the BTF and made an appointment with another doctor. He has referred me urgently to a medical dissorders in pregnancy clinic, sent me for bloods today and wants me to go back for the results and decision on my dose tommorrow. It's just such a hassle and more stress than I need but at least its getting sorted. I am really happy about my BFP just really hope this is a sticky one and I will eventually get my happy ending. Good luck to everyone ttc and thanks again for your advice xxx
wiggle I will be thinking of you this week, I hope you get your happy ending very soon too x

getawiggleon Tue 12-Jul-11 17:49:54

Fantastic news ciwi, congratulations!

Amazing how one doctor can brush you off and tell you to come back in 2 weeks whilst another will refer you urgently, where's the consistency? Good on you for seeking a second opinion though. I hope you get the right meds and the monitoring you need (I was put under the care of an endocrine consultant as well as the antenatal team at my hospital so hopefully they'll do the same for you)

I really hope that this one is a sticky one and you have a very uneventful 8 months ahead now.

Ps I saw that you were on the ttc after mc board (I used to post on there but graduated to the sixth form common room when I felt a bit long in the tooth for it all!) If you move on to the freak out room or even pg after mc threads there are some lovely, lovely girls on there who totally understand the anxieties of pg after mc) Best wishes for a healthy pregnancy and I hope your thyroid behaves! xx

ciwi Tue 12-Jul-11 17:56:39

Thank you wiggle what lovely, kind words. I did totally go behind the first doctors back but so what! I am trying my very best to stay positive but it's not easy. How are things going with you? Have you had your erpc yet?

getawiggleon Tue 12-Jul-11 18:10:53

I think in these circumstances you just need to push and push and see whoever you can until you get the answers that you need! I really hope everything goes well for you this time.

I'm booked in for a termination early tomorrow morning, we've been to the hospital to sign a few more papers today. It's v sad but we will try again and hope for some better luck next time. We are very fortunate to have a dd who is 29 months and an absolute treasure so she is keeping us going at the moment.

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