Hypothyroidism and pregnancy

[Thingsthatgo]

I have hypothyroidism and I take 25mg Levo daily, which seems to keep it balanced. (So only a mild problem I guess?)
DH and I are mulling over the idea of having another DC, but are keen to just see what happens. Do I need to see my GP before we start trying?

They’ll monitor you closely when you conceive and may double your dose- it used to be that they would double it automatically but now they just seem to test regularly and up if necessary. I am on 150mg thyroxine and didn’t need to increase during my pregnancies. No complications from thyroid issues at all.

As 25mcgs is a quarter of the recommended starting dose for a 'young' woman, I would strongly suspect that you are under-medicated. The NICE guidelines used to say that your TSH should be under 2.5 if you are pregnant or TTC, and although they've now conveniently taken that out, it's not a bad rule of thumb.

I'd say, see your GP and make sure you're optimally medicated first.

Thanks for your advice. I think my meds are well balanced at the moment. I take 25mg daily, and once a week I take 50mg. I feel really good at the moment. When I took more (I was taking 50mg every other day) I felt awful. I was shaking and weak and jittery. My bloods showed that my I had become hyperthyroid.

It's hard to tell in your case as you clearly have some thyroid working.

A healthy thyroid grows during the first trimester to accommodate the pregnancy and baby's thyroid hormones which slowly start to kick in during the second trimester. So it's most important to be monitored during the first trimester. However, your thyroid may grow and accommodate the pregnancy.

Midwives don't do this and not all gps know about it either; you usually see a specialist obstetrician at the 12/14 week scan which can be a bit late.

This is an up to date guide the the BTF on pregnancy which you could refer to.

I'd get a test now to check tsh and adjust if needed (sounds like you're fine), around 6 weeks, 10 and 14 weeks to check progress. My tsh In both pregnancies was at its highest around 14 weeks. I've had to take 50-75 more in both. I also think it's helpful to touch base with the Gp now to clarify they know what to do etc. (I've had mixed understanding of it).

2.5 is the upper range; it can obviously be much less than this healthily.

www.btf-thyroid.org/projects/pregnancy/375-pregnancy-and-thyroid-disorders-guidance

Also please do take a prenatal vitamin pill that includes iodine. Just the rda, from about 3 months pre conception ideally. As your thyroid is partially working this will be important as well as for baby. (I know of research about to start in this area plus an obstetrician once told me vit d, folic acid and iodine are key for healthy pregnancy regarding thyroid.)