Hashimoto's and 7 weeks pregnant. Concerned about GP advice

[Amymone]

Hi everyone,
I am newly pregnant with my first and I'm on Levothyroxine (50 mg).

I happened to have a blood test before I knew I was pregnant - around the time I conceived. My TSH then was 2.04 (having risen from 1.1 over 2 months) and so getting much closer to the 2.5 boundary.

My GP said when I found out about pg not to up my dose, and simply test again in 6 weeks time, which would take me beyond the first trimester. Have had an early scan and I'm 7 weeks now.
I'm concerned that in this time my TSH could be rising above 2.5 and I'm not offsetting this with more meds.
Concerned about the risk of pregnancy loss anyway with Hashimoto's and just wondering if any of you have followed similar advice with a successful outcome? Should I be pushing for earlier testing / higher dose right away? Not overly keen to go to hospital for test due to Covid if it's not needed.

Don’t up your dose without medical advice. Ffs. Everyone’s an expert on the internet 🙄

My TSH always hovered around 4/5 when pregnant, I had a blood test every 6 weeks and usually needed an increase of medication each time. I would ask for a second opinion.

Also I needed 3 iron transfusions because of my absorption issues and a PPH.

I found many endos are diabetes specialists rather than thyroid specialists and they don't have the most up to date info on Hashimotos management. SayingTSH under 10 is fine is a huge red flag! I went through three before I found the one I'm with now who finally helped me get better and get pregnant. Again, look on the British Thyroid Association website for info and use this to fight for what you need.

I also wouldn't advise upping your needs without medical supervision but I was given the same advice as @feelinguseless78, that as soon as I get a BFP I should up my meds by 25mg. This was advice from both my endo and GP. It's really important your self advocate here, unfortunately there are risks of having unmanaged levels, as well as higher risk of miscarriage it can impact on the baby's congative abilities and their overall health as well as your own. I'm not saying all this to scare you, it's just the first 12 weeks are the most important for getting the right level of meds so getting a good endo is really important at the moment.

Oh gawd... I hadn't even considered that antibodies could destroy the baby's thyroid too. Docs are often reluctant to check TPO but last reading in jan was 316 (had climbed from 167 in Oct when I went on meds. Had previously been >1400!).
All a bit alarming really. I'm over 7 weeks now so really need to up my dose now if I'm going to. Will call docs again on Tuesday.
By the way...all of you who have upped your dose in pregnancy, how have you done it? Did you get a new prescription, or did you take a double dose on a couple of days in the week? Not sure of the mechanics of this.
Thanks again for all your support and advice!

I found many endos are diabetes specialists rather than thyroid specialists and they don't have the most up to date info on Hashimotos management. SayingTSH under 10 is fine is a huge red flag!
That explains why I never got as far as an endo referral. The gps I've mainly dealt with have endo specialisms apparently but all go with the under 10 and you're fine thing. My tsh ranges between 3 at best and 8 at worst. Mine is hashimotos related too.

Sorry for the merail but it's explained a lot!

op hope you can get hold of a gp who is more knowledgeable or a referral to someone who is

Absouletly, needs a increase dose. Gps are hopeless, this is how I lost my first baby she was unmedicating me and my tsh got up to 7.2 baby stopped growing at 9 weeks. With the successful pregnancy I was managed by a endo. Worth every cent. It's really important to keep in range.

OK so I just spoke to another GP at my surgery. She has agreed to up by dose by 25mg and send me for a blood test this week. Feel like I may have pushed her a little but if the bloods show I'm over medicating I can just go back to my normal dose. Rather be safe than sorry.

Thanks again everyone for your encouragement! Feel heartened by taking action.

Good on you for advocating for your baby. Your thyroid is so important for baby. A tsh above 2.5 can cause birth defects and cognitive delays.
It's extremely serious and for some gps to not understand this and think it's okay to be elevated should have their license removed. Sorry I'm just so passionate as It wasn't until my 7th miscarriage I did my own research and found a endo who helped women with thyroid issues and pregnancy. If I had stayed with my gp I wouldn't be where j am today! What state are you in?

Ps! It can take 4 to 6 weeks for the upped dose of thyroxine to show in ur results so well done for doing it asap! Also this book was amazing!! Soon insightful

well done OP. At least you can relax now knowing you've done everything you can to make sure there's no problem

Alot of doctors have very little understanding on upping the dose in early pregnancy

I'm on 200mg currently... Everyone is so different on the doses they are on

@Harhar8777 What state are you in?
Do you mean which US state or what condition I'm in? I'm in the UK... I'll take a look at the book. Thanks for the tip!

Hi all, hope you don't mind me barging your thread? :) I'm about 6 weeks pregnant - if all goes well will be my second baby but my first since being diagnosed with Hashimotos.

My GP is great and lets me get all the blood tests I think I need, bless her! So my last set of results happened to be from the week after I conceived (obviously unbeknown to me at the time!), when T4 and T3 were normal and TSH was 0.34. Based on this, when I told her about my BFP she said hold off on raising the dose now - I'll test again this week and if any of the levels have moved I'll change my dose. (My baseline levels are "volatile" and I've been having trouble keeping them stable even before pregnancy, so I'm going to test every 3 weeks if she'll let me!)

To @Amymone feeling nervous, and to @Idontwantthis's point about not changing the dose without medical advice, the expert advice is that a Hashimoto's patient would increase their own dose by 25mcg daily as soon as pregnancy is confirmed, THEN arrange to discuss and test with medical practitioners. All laid out here by the good doctors at the British Thyroid Foundation, with a handy printout to take to your GP if they're giving you any back-chat! :) www.btf-thyroid.org/pregnancy-and-thyroid-disorders-guidance-for-patients
Hope that might help somebody stumbling on this thread in future.

As I said, I didn't do it only because my recent TSH levels were slightly below range. If they'd been in-range or high, I'd have followed the protocol advised here.

Wish you all super-healthy & happy pregnancies!

@Amymone I'm in a similar situation to you. 6 weeks pregnant and diagnosed with Hashimotos (not Graves' disease) but my thyroid antibodies are extremely high at 1300. My doctor has told me this particular type of antibodies won't cross the placenta so I don't need to be concerned. Would love to know how you are tracking?

I'm slightly concerned this will lead to another miscarriage and not sure what other measures( diet and lifestyle) other have taken to sustain a pregnancy with hashimotos and elevated thyroid antibodies.