TTC or Pregnant with an under-active Thyroid.

[hippychick66]

Hi,

We were talking about this a lot on the charting thread and thought it would be good to start a separate thread.

There's about 3 of us at the moment but please do join us too if you are TTC with this added probem.

My results were 9.07 and then a few weeks later 5.5. I'm due another blood test in 5 weeks and hopefully my GP should be starting me on Thyroxin soon.

Quite worried cos the NHS guidelines say your numbers should be a lot lower when pregnant. still i haven't got that BFP yet so I guess I'll worry then.

ladygonegaga and Bessie26 - hurry up and join me here .

hello everyone supersunnyday pointed me in the way of this thread had already posted on pregnancy board about my situation I'm currently 19+4 and not diagnosed with any thyroid problesm as yet, so here's a copy and paste (Sorry for the laziness)

"I have had my tfts done by g.p before pregnancy and during due to having lots of hypo symptoms(am 19 weeks now) the first pre preg showed tsh of 1.99 and free t4 of 9.6 which is below normal but because my tsh is fine docs weren't worred, 2nd tft at 11/40 tsh was 1.19 and free t4 of 12.4 low end of normal, as of 17 weeks my tsh was 1.09 and free t4- 9.6 again below normal.

I have read that during pregnancy free t4 should be in the upper end of range, does anyone know about free t4 and if anything could or should be done? they won't even refer me to endo"

lily and sunny have given me some advice saying I should see an endocrinologist even if I need to pay privatly so I am going to have a last ditch attempt to get referred on nhs if not will have to get credit card out.

If anyone has any more advice/esperience of low free t4 and normal tsh in pregnancy or not please let me know.

I wish you all the best if your efforts to concieve and congrats to those already pregnant.

I don't remember what my tsh was during pregnancy (I wasn't diagnosed till 6 months after DS was born) but I remember having a T4 level of 11 and I also remember feeling unbelievably ill that month and like all the strength had been sucked out of me. I really wish I'd known to push for medication back then, it could have made a real difference to how I'd coped.
In your situation your T4 seems so low, and coupled with any symptoms you are experiencing, I'd go back to the GP. Try a different GP in the practice if necessary.
Congratulations by the way

louin - your chart probably won't mean much until you've done a while cycle - as super says, do have a look at the lessons on Fertility Friend, as they will help explain what's going on, and do join the lovely ladies over on the charting thread as they will help you make sense of it too!

super - I am always a nervous wreck the day before a scan, hope it all goes well for you, I guess at 5+4 you're not going to see much - don't think you get to even see a heartbeat until past 6weeks?

me - afraid I'm no expert on this thyroid stuff as I've only recently been diagnosed, but it does seem strange they're not giving you any meds... they must be taking things reasonably seriously to get your bloods done so regularly... Perhaps they think that your thyroid can't be that bad as it's managing to keep your T4 at a reasonable level (although on the low side) while you are pg?

Have you been to see a different GP? Don't know what your symptoms are, but have you properly explained them to your GP? I think when I told mine I was having to nap for 2hrs every afternoon and sleeping for 8-10hrs at night she realised I was serious when I said I "felt tired"!

I am consultant (rather than midwife) led, partly because of thyroid & partly because DD was 6wks prem, so I can now quiz him about my levels too. Is it possible to request to be consultant led?

Hi girls, I know some of you from Charting, and me23 from my old AN group.

Can I ask a quick and panicked question?

I've just rung to make a GP appointment and the receptionist said they've just written to ask me to come in and see them. Apparently my blood test results have shown I have an underactive thyroid.

(Back story - I have had a MMC found at 20 week scan, delivered my baby 3 weeks ago and had vast numbers of blood samples taken just after birth to test for all sorts - it is these results they are ringing about)

New to this, so what is a thyroid and what happens if it's underactive?
Could it be the reason I lost my baby??

Thanks bessie for your comment,
I have seen all the GPs in the surgery they all agree 'something' is not quite right but have so far refused to send me to endo but instead I have endless repeat tests at my next gp appt I am going to push for a referral,
My symptoms are extreme fatigue i.e wanting to sleep/lay down all the time, no energy to do anything i.e if I do a simple task like dropping dd to school (10 minute walk) I feel like I will collapse. Irregular periods when they were previously like clockwork, memory problems brain fog, I had to take a break from uni because I could not longer cope with placement hours and doing the essays couldnt focus at all and too tired to do my shifts at the hospital, weight gain weakness muscle ache.
I have been signed off work for the whole of this pregnancy as the fatigue is so bad I cannot function normally.
Even 2 of my lecturers who had thyroid problems and are nurses ans mws said I am classic hypo and should be treated.

hello split I hope you are doing ok, I think it must be the bloods they took in hospital that they are phoning about. I do not know much about thyroid and miscarriage but I'm sure some of the ladies on here can help.

me23 I'm so sorry you're still feeling so awful. IIRC you were having issues with sick pay etc because of being off so long. I hope there's been some useful resolution on that.

I'm very variable at the moment, still signed off and can't cope with people because they are mostly hopelessly clueless about what to say to me so just pretend nothing happened until I get really upset and go off and cry . I have been shocked at the depth of my grief. I did think I was making very small progress and then these blood results have sent me slightly loopy and I am a gibbering wreck again.

Thanks for asking spilt I am now having to take maternity leave at 29 weeks and use up my annual leave before that so should be from 24-25 weeks depending how long I have. I will be half pay from end of this month so can't afford to be on that long term.
I'm not surprised you are still feeling bad, you need to allow yourself time to grieve and not feel pressuried to get back to normal.

I have been looking at nhs website about my results and normal/low tsh and low free t4 is classed as secondary hypothyroidism and requires urgent referral
this is direct from the site
"If a person has suspected secondary hypothyroidism (e.g. a low serum free thyroxine level with a low or normal thyroid-stimulating hormone level) urgent referral is necessary to investigate for hypopituitarism (in particular secondary adrenal insufficiency) and pituitary or hypothalamic disease"
so all this time they haven't even been following nhs guidelines.

Hello Split, so sorry you find yourself in this situation. I'm not an expert, there is a recommended level for thyroid function during pregnancy so it isn't good to have an untreated thyroid disorder when pregnant. Having said that, I'm sure like most pregnant women you had blood taken at various points which would have been tested, and the doctors didn't see anything wrong with it. I hope you will get the answers you need. Once you get the thyroxine it will help you feel better (physically: I know the other side is the hard one )
Me23 the symptoms you describe sound classic. Why can't your GP try you on thyroxine, since they are doing bloody nowt else for you? You don't need a referral to get the medicine. God it makes me angry.
For me, AF arrived today, so that's another month written off.

Hi everyone supersunnyday also recommended this thread. I just found out today that my pregnancy is not viable (empty sac) and will probably miscarry soon.

I have mild hypothyrodism which was diagnosed before I conceived by 2 months. Here's a quick outline:

We were going to start trying in March/April and had preconception tests done.
I had my thyroid measured years ago (don't remember the reason) and it was normal but on the smaller side and the doctor told to keep an eye on it every few years.
Had tests done by endocrynologist in May 2010 and all came back OK (incl antibodies) - this was done in Poland as I have access to private medical care and wanted to make sure everything is OK
Had some more blood work scheduled for June but the lab messed it up (this is in UK) and also found out that I am immune to chicken pox (and I work in a nursery so a big concern) anyway GP failed to inform me of this fact and I made a huge complaint and got very upset so they decided to run all my tests again as a precaution - had elevated TSH and prolactin but normal progesterone indicating spontaneous ovulation but GP referred me to endo just in case(due to summer travels etc didn't happen til August)

Because of the chicken pox we stopped ttc until Aug and I went to see endo on Sept 11. He did an HCG just in case (we had actively tried that month) and looked at my levels, said I was borderline subclinical - his quote 2 on a scale of 10 so didn't give me any treatment and told me to come back on Oct 2.

On Sept 11 I wasn't pregnant but got a positive on morning of Oct 2 (did the test before going to see endo). He said that my blood tests from Sept 11 show that my levels dropped down to normal but since I am pregnant he decided to put me on 25mg of levothyroxine.

Based on my calculations I am 6 weeks +/- few days and just found out the bad news.

Have an appointment this Saturday with endo to monitor my levels.

Sorry for very long post but was wondering if any of you had any similar experiences? Is there anything in particular I should ask the endo? What extra test should I do if any?

On a separate not, and I 've already posted this in my thread on preg forum but no one told to make sure there is enough space between taking my thyroid medication and my prenatals with iron (which to be honest I had started taking way back in may).
I am just wondering how really important is the whole iron thing.

I've only been taking the thyroid meds 2 weeks into my pregnancy. I'm wondering if that was too late?

So sorry for long post again - it's been a difficult day and I am trying to rationalise and find answers :(

sorry meant to say I was not immune to chicken pox!

also I haven't had a chance to read through the whole thread, am sorry for the impersonal message - it's been a loooong day and I am tired but scared of going to sleep so not really thinking straight :(

Hopefully I'll have a clear head tomorrow and can properly get to know who's who here and introduce myself

Me23 the guidelines you quote are for when thyroid hormone levels are below the bottom end of the range not just when levels are at the lower end of the normal range. Not saying everything's perfect, but you wouldn't warrant an urgent appointment.

On my phone so can't look back at who said what but taking thyroid mediation away from iron is important as iron inhibits the absorption. It's also important to get the iron if you need it as anemia and hypothyroidism can be quite closely intertwined.

Spilttheteaagain , sorry for your loss, Developing babies actually start making their own thyroid hormones after the first trimester, so being slightly hypothyroid beyond this, whilst not ideal, is not likely to be responsible for miscarriage.

my free t4 is 9.6 the refernce range starts at 10 so they are techinically below the range. Also in pregnancy free t4 should be maintained in the upper third of the range, so I do warrant an urgent referral based on that no?

on my resutls from under the free t4 range it says abnormal speak to doctor and note new free t4 range 10-24 from 2008.

Ah ok, reference ranges on my tests have started from 9.

The keep T4 in upper half relates to people who are being treated, they wouldn't treat just because T4 is in lower half of range. Although I appreciate that yours appears to be below range based on the ref ranges you've been given and along with your symptoms and the note on the results to see a doctor it seems like they should be doing something.

Wow busy old thread here. Hello to newbies. spilt have left a message for you on the charting thread. I have heard that you MAY be more likely to have a second trimester loss with an under-active thyroid but again, like you, I got that from googling about (a dangerous pass-time) and as yet you don't know exactly how under-active it is. See what the GP says.

beesok Sorry to hear your news. I had the same thing in June. I was meant to be 6 + 3 but only a small sac was seen. i started bleeding at 7 weeks. It may not be much comfort to you but all i can say on the positive side is that it wasn't much heavier than a bad period (I get bad periods anyway due to endometriosis). I did pass the sac and I did look at it but I kept expecting awful cramps to kick in or masses of bleeding and it wasn't physically too bad at all. Having said all that a loss is a loss and you still have to cope with losing your dreams etc.

I take my thyroxine at the same time as my pre-con vits - is that wrong then????

hippy yes, you defn need to take them at different times, they say you should take them before breakfast (I have "an hour before" in my head, but am not sure where I got that from) I take mine as soon as I wake up at 645 (usually swearing at the stupid little fiddly 25mcg pills) and then multi-vits after breakfast at 8ish. Am hoping that's enough of a gap? The pregnacare pills I take do say you should have them with your main meal, but I am rubbish at remembering to take pills at any other time than breakfast!

spilt so sorry for what you are going through, sorry I have been too focused on my own feelings for the past two days :( I cannot imagine what you must be feeling :(
Again, I am not an expert but from what I read and heard so far from doctors is that, yes, an underactive thyroid is not a good thing to have while pregnant but as someone pointed out - the danger is big in the first trimester because the baby cannot produce it's own hormones until 12 weeks so totally relies on the mother.

Now I am not saying that it didn't have an effect on your situation and you should absolutely push to get as many tests done to get to the bottom of this. I know I had to fight with my GP practice (ended up in tears at one point) and finally they recognized that I wasn't just some crazy women and the last GP I saw, who was super professional referred me to the endo. I will be seeing him on Saturday and asking lots of questions - I can ask him about the effect on an advanced pregnancy.

However, he never told me about not mixing my antenatals with the thyroxine and although in my case I doubt (sincerely hope!) it had nothing to do with my miscarriage it makes me angry and upset that such a silly thing was not mentioned me that can potentially have serious consequences. Obviously, I am in a much easier place than you I hope you will find the strength and peace to go through this but don't give up and keep pushing for information about your health - you are entitled to the best care!

hippy thanks for the reassurance :) I am hoping that it will happen sooner rather than later. I am 6 + 3 so maybe by the end of the week if I am lucky. Still feels weird writing about it when just a few days ago I was telling our best friends that we're having a baby :(

bessie26 I can't believe that the endo didn't tell me this! He knew I was pregnant the last time I saw him!

To be fair my levels were high in August (we weren't pregnant yet) then dropped to normal by the 2nd of October so he only put me on 25mg as a precaution since I was in fact 2 weeks pregnant by then.

I think it's only if you take vitamins containing iron that it's a problem, you're not meant to take anything at the same time as tablets containing iron.

The prenatal vitamins I've taken in the past haven't contained iron and were fine to take with thyroxine

Thanks tyler, hippy and beesok, I didn't know babies start to look after themselves a bit from 12 weeks, that's reassuring. GP tomorrow so I will see what they say.

beesok I am so sorry to hear you've just lost your baby too. I hope you are being well looked after and supported. It's a vile thing to go through

beesok I honestly don't think taking tabs at the same time could actually cost you a viable pregnancy. It's so hard not to try to place blame or find reasons for these things but now with hindsight I do believe that both my MC's were down to faulty embryos and there is nothing I could have done differently.

My GP said to me that neither of them was a fault with Mrs Hippy (except she used my real name), she said you just need a decent embryo like you had with your two boys and you'll be fine. Your body did it's very best to nurture the embryos.

If all they saw was a small sac then that pregnancy wasn't destined to go any further, it just didn't have the required info to continue - please don't blame yourself or wonder about the timing of the vits etc. Hopefully, you will find with time that you are able to look at it more abjectly as I am doing, but these things take time and emotions run high. I wish you well. X

spilt thinking of you and hoping you get your answers from the GP soon. take care, honey.

Thanks split I have taken some time off work and everyone who knows has been really supportive - we go excited so we told a few close friends and family that we're having a baby and now it's the explanation bit.

Hippy thanks deep in my heart I agree and I hope that soon I will be able to look back at this with different emotions.

This was my first pregnancy, albeit a planned and much wanted one and I think I threw myself into it - was just sooo happy and strongly believed that it would all be OK so obviously now these emotions are just as strong on the opposite spectrum. I am so glad there is a site like this where I can pour out my random thoughts to people who actually understand what it feels like. I am grateful for your comments, they do help!

The one thing this has taken away from me is that joy when you see a positive test result - I know that when
I get pregnant again it will be different, I probably won't tell anyone about until much later and will be scared etc. I know it's a bit early to be thinking like that now but it's how I feel, I guess it's my "lesson" :(

beesok I could have written what you have just posted about losing your pregnancy innocence. I crapped myself all the way to 12 weeks expecting to miscarry but didn't, had the scan and though "phew, sorted now, we'll be ok". My god I can't describe the shock I have gone through since losing my first at 20 weeks. It's going to be a terrifying road next time and we'll both need a lot of hand holding. I won't relax until I have a screaming baby in my arms, and even then the ugly spectre of cot death and infant illnesses will be there. I am now incredibly anxious about something that should bring so much joy and excitement

spilt honestly, I don't know how you're coping :( My heart goes out to you because what I feel now is unbearable but to be 20 weeks and lose the baby is just awful. I hear you - all the stuff you put to the back of your mind like cot death and stillbirth and other horrible things start haunting you when you go through a loss, I guess you are just more aware of what can happen :(

But I believe that we will get over this! We have no choice :) Hope that we will be talking about our bumps before we know it :)

beesok I know what you mean. I was so lucky that my first 2 pregnancies were fine and then I decided to try for one more cheeky late baby - what a daft idea .

I've had 2 MC's this year and they have taken all the joy out of getting that BFP.

I saw a programme where a woman was telling her DH that she was pregnant the other day and I turned to my hubbie and said, "Ahhh do you remember when a positive pregnancy test meant you were getting a baby?" Cos that's how it was the first 2 times and I realise now from talking to so many people that I was actually dead lucky back then.

I'm sure you will both go on to have healthy pregnancies and take home babies and I am genuinly sorry that you've had the experiences that you have. I think you especially spilt will be very scared next time around but you WILL get your baby.

Also, I hate to tell you this - but once you have kids there is ALWAYS something to worry about . I still check that mine are breathing when they sleep etc and they are 10 and 7. But they are worth it, as you two will discover, my lovelies.