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Underactive thyroid in pregnancy(9 Posts)
I'm 8 weeks pregnant with my first baby. I have had an underactive thyroid for about 5 years now which is well controlled on thyroxine. My GP knows and has kept my medication at its current level. I haven't seen a midwife yet.
Someone mentioned to me that as I have an underactive thyroid, my pregnancy would be considered high risk and I would have consultant led care? Has anyone else got any experience of this/whether it's true/what it means practically if that is indeed the case, please?
Thanks very much.
I have a history of overactive thyroid but I'm slightly under at the moment. My specialist has said as soon as I got pregnant to ask my doctor to refer me to their antenatal clinic.
I believe that they watch your levels very carefully But I don't know yet because my midwife didn't refer me last time
I was consultant lead last time for different reasons but I didn't really see one until my c-section (because ds was breech not for any other reason)
I've and underactive thyroid. I've had three children - youngest 18. Your TSH needs to be monitored regularly. Your GP can do it. Doesn't mean your pg is high risk at all.
Do be quite firm about regular monitoring though and make sure they do check the TSH.
First thing is to get your bloods checked asap to see if your dose needs to increase, as many women do find they need more when pg. In fact I believe the "best practice" is to increase dosage as soon as you know you are pregnant - even before you have any blood tests. Here is a quote from the British Thyroid Foundation's guide to pregnancy
As soon as you know you are pregnant, and if you are already taking levothyroxine, it is recommended that the dosage is increased immediately by 25-50mcg daily. You should then arrange to have a thyroid function test as soon as possible.
Re consultant led care: Technically this is correct. However I found that it didn't change much in practice - I got seen by a consultant once, they looked at my blood test results, saw that my thyroid and medication were very stable and said they didn't need to see me again. I was also told that being hypothyroid would not in itself stop me from giving birth in the midwife led unit (consultant had to write this in my notes).
I had to have blood tests every 6 weeks in the first trimester and then I think every 2-3 months after that (can't quite remember).
Please do get your bloods checked soon, or put your dose up a bit.
Please look at NICE guidelines for underactive thyroid. Then go to your gp and inform them about it, I've had to tell 5 gp's about it they don't come across it often/ever.
Basically you need your thyroid level tested asap it needs to be <2 rather than the normal <4 required for non-pregnant ladies. Also nice suggest that Levothyroxine amount should be increased by between 25-50% whilst waiting for the test results come back. Regular retesting of levels also needed, I've had my levothyroxine dose increases by 100%, slowly over pregnancy, been stable for several months.
High risk - not sure, I'm high risk for other reasons so don't know whether you'd be consultant led. There is no added to risk labour/birth as far as I'm aware so you could always be transferred back to midwife led for birth.
If you can't get through to your gp - I've not had a problem because I mention nice guidelines politely and they research it and ring me later in the day. But maybe I'm lucky and have a great practice. Then Ring the midwife service, hopefully you have a phone number already or can leave a message with gp receptionist to pass on. My midwife knew about all the guidelines.
Sorry for rambling on hope it makes sense
Thanks for all the guidance. I had my bloods done the month before we conceived and they were slightly low; the TSH was 0.02 so when I told my GP she just said to maintain the current dose and I have a blood test booked for this week. I will make sure I've got a copy of the NICE guidelines to hand for any consults with GP/Midwife so I'm well informed.
Cheers all. Been telling family this weekend and a few friends today so it is all starting to feel a bit more real and exciting
Hi, I have the same issue but was told that it doesn't have to be under 2 when pregnant (does before to help with fertility) but just had to be in the normal ranges. Mine creeped up to over 2.5 so I freaked out anyway, doubled my dose (25 to 50) and it's now at 0.83. No one has mentioned seeing a consultant to me.
Hi, I'm bang on 40 weeks now and also underactive after a tumour knocked out most of my thyroid function. I went to the GP pretty much the minute I found out I was pregnant and she bumped up my thyroxine by 25mcg as a matter of course. I've had blood tests every month since and it's been consistently perfect, in fact thyroid-wise, I've felt better while I've been pregnant than I have in years!
I had one appointment with a consultant after my booking in with the midwife, at around 14 weeks I think. He looked at my bloods, more or less shrugged and stamped 'MIDWIFE LED' on my notes and that was that, I've definitely not been classed as high risk! I think unless there are signs of things to worry about in your blood tests, they'll just keep you with the midwife and keep on testing.
Congratulations by the way!
I'm pleased there is now guidance and support. 20 years ago, the view was that fluctuations were normal and best ignored and they would not accept that TSH readings were the essential ones.
Even with sub optimal care all was well. Could have been better but it was ok.
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