Underactive thyroid

[bessie26]

I got diagnosed with an underactive thyroid around the time I fell pg & have been having my bloods tested every 6-8 weeks since.

I'm now 34wks & seem to remember being told or reading somewhere that your thyroid gets put under extra pressure towards the end of your pregnancy and so wondered if I should be having my blood tests performed more frequently?

Any one know anything about this?

When was your last test done? Get one done at 34 to 36 weeks, your tsh should be between 0.4 - 2.0 during pregnancy under official nhs guidelines. A Dutch study showed that women with undertreated hypothyroid probs were more likely to end up having interventions in labour ... May as well get it checked out and then confidently pack your hospital bag with one less thing to worry about!

When was your last test done? Get one done at 34 to 36 weeks, your tsh should be between 0.4 - 2.0 during pregnancy under official nhs guidelines. A Dutch study showed that women with undertreated hypothyroid probs were more likely to end up having interventions in labour ... May as well get it checked out and then confidently pack your hospital bag with one less thing to worry about!

If you are being tested every 6 -8 weeks and are taking enough thyroxine then should be fine. They are testing me about every trimester so sounds about right. The critical point for baby receiving Thyroxine is early on in the pregnancy as the babies own Thyroid gland is working by now and supplying its needs. The only issue would be with you - of course, if you are feeling symptomatic (cold, tired, sluggish, brain fog etc) then feel free to ask for another test - won't hurt.

Just realised it's you, Bessie

34 weeks already!

I have been taking thyroxine since age 21 (now 36 and also 9 weeks pregnant) and do a lot of work in conjunction with a thyroid charity. I intend to get tested every 4 weeks when pregnant but I have been at the stage for years where I monitor my own levels and ask for a blood test when I need one and adjust my medication accordingly. I much prefer to be at a lower rate of TSH than the doctors would mind me at. Anything around 1 or under works for me.

One thing I am getting when pregnant is quite a few palpitations, but I think I went into this pregnancy at the low TSH range and have reduced my dosage slightly. My last test result was 0.03 a few weeks ago and a T4 of 23. Going to have this tested again next week.

I would say ask for a test as often as you want just for peace of mind, and make sure you get your exact numbers right rather than just the doc saying you are 'normal'.

hi ladyggg good to see you over here! how many weeks are you now?

My last test was at 28wks, my TSH had snuck up to 3.8 & T4 12.7 but no other symptoms (I am a bit tired, but I think that's just because I'm pg!) My next test is scheduled for around 35wks.

My consultant said to try to keep TSH under 3, but not to worry unless it went over 5 so I'll be asking for an increase in dosage if it's still around the same or got worse.

blondie DD came 6.5 weeks early, so I've had my hospital bag packed for weeks!!

Do either of you know if baby will have any thyroid tests? I've heard that it can be hereditary, but that you don't usually get symptoms until you're older?

Actually bessie, just as a PS, make sure you know what normal ranges your docs are using. There is a huge discprency between what surgeries and labs think is a normal thyroid level (mainly with the TSH). Here's a great article by Mary Shomon (thyroid patient advocate and all-round thyroid genius) explaining why a huge body of people think anything over a TSH of 2 can be classed as underactive:

thyroid.about.com/b/2008/06/10/thyroid-confusion-why-the-tsh-test-range-is-still-up-for-debate.htm

I recently relapsed up to a TSH of 3.5 and felt like I was walking through mud. This is a range some docs would think was normal and it most certainly isn't. Most thyroid patients find they function better if their TSH is around 1. Sorry if anyone thinks that is controversial, obviously do your own research and make up your own mind!

hi freelance - yeah, I always ask for the actual figures as I don't trust them like to know how the results change.

It will be interesting to see what happens to my results after the birth - I was only just hypo before I got pg (TSH 6.61, T4 11.5, but very tired) & so had to wait for another test before they would give me any thyroxine, by which point I was pg!

eeek - keep xposting!

my GPs think that a normal range is 0.25-5.0 TSH & 9->23 T4, they were surprised when I went in with the NHS guidance printed out saying it needed to be under 2 when TTC! (I have also shown this to my consultant)

I think that different people's bodies can probably cope with different amounts of TSH/T4 & you defn need to take into account the symptoms being experienced not just the figures you get back from the lab.

Someone also told me that the time of day your bloods are taken can make a noticeable difference to your results - apparently it's always worse in the morning so try to have them taken first thing (or at least be consistent with the time you have them taken!)

Hi again, bessie it's great you aware of the discrepancy between thyroid normal levels already, I don't trust any gps re knowledge about thyroid conditions. A TSH of 6.61 would make me feel really hypo, like I said I felt like I was walking through treacle on 3.85. Your last test of 3.8 is way too high as far as I am concerned. I think you would really feel better around the 1 mark. Hopefully it will have gone lower next time you test.

I don't know much about baby testing (doesn't every baby get the heel pin prick test for thyroid?) but yes it can be hereditary, although most people don't develop it until much later on.

I am aiming for tests around every 4-6 weeks during pregnancy, just so I know where I am at.

The good news is though, it is easy to live with the condition as long as you are on the right dose. I was 21 when I developed it and it took me two years to get diagnosed. I went from a size 10 part time model to a size 14, slow, miserable and three stone heavier than before. It took me a few years to get down to a healthy size 12 (am 5.5) and then later, with lots of exercise, to a 10 again. But keeping a handle on your own levels is key. And finding a doc who uses the new levels!

Hope it all goes well for you. Happy to chat about thyroid probs all day as I have had it for 15 years and feel I've swotted up enough, so anyone need any advice let me know!

I've been on thyroxine for almost 20 years now and am pg with DC3. My consultant said to keep my TSH under 2 during pregnancy. Personally I like to keep mine under 1. If mine went as high as 3.85, I'd be a mess. I second finding a friendly GP who knows a bit more about TSH tests. Mine lets me decide what to do (within reason), so my last test was just under the normal range but she didn't say anything about adjusting it 'cos she knows I prefer to be like that.

Both of my DC's had thyroid tests when they were days old (blood tests as well as the heel prick). TBH, it was horrible. They have to take blood from their heel or hand and it clearly hurt them. Both of them were a bit high but by 4 months were down to normal. The ridiculous thing though was that the hospital kept taking blood each month to monitor them but wouldn't do anything about their high levels as they weren't massive (around 10). So with DC3, I'm just going to say we'll have the blood test at 6 months and rely on the heel prick to start with.

Saying that, it is hereditary. My Gran, Mum and both sisters are also hypo. So it is probable that my DC's will become hypo at some point. It is just something I'll keep in mind if they become ill.

Hi everyone,

I thought I would update as (if you are feeling emotional look away now!) I had an awful miscarriage this weekend, contractions for 2 days, in and out of hospital. Monday was my scheduled 12 week scan but as I had been in pain and bleeding all weekend I knew it was not going to go well. Turns out the baby died at 7 weeks in and had had a missed miscarriage and I am now 'waiting to expel' as they say.

The reason I am posting on here is that - even though I like to think of myself as a very well informed thyroid patient - my worry was that I wouldn't get pregnant. Actually I did get pregnant quite easily (three months very casual TTC) as my thyroid is in the normal range but I just wanted to warn you all about thyroid antibodies. If you have a high level of antibodies (as you would if Hashimoto's and/or autoimmune issues have been mentioned) you are probably at greater risk of miscarriage. I found this article and others saying to help counter act this you should take selenium:

www.ivf1.com/anti-thyroid-antibodies/

Of course plenty of people who have had thyroid issues go on to have perfectly normal pregnancies but I just wanted to tell you it's something to watch out for. Get your antibody levels tested and look into supplementing with selenium if they are raised.

Hope that helps someone not go through what I just went through xx

Really sorry to hear your news, Freelancegirl. Just to reassure you a bit - I have anti-thyroid antibodies as well and miscarried a baby at 7 weeks in September. But...I did have a DS before that who is fine, and I got pregnant after my mc very quickly (first "proper" full cycle) and am now 22 weeks. I've been taking low dose aspirin as have been advised that may help too. Worth remembering that brzil nuts are a very good source of selenium too so worth including in your diet.

Also bear in mind when you do conceive again to mention the anti-thyroid antibodies to your midwife when booking and to your consultant as they should monitor growth etc more closely.

Really sorry you are going through this. I know how shit it is . Take care and hope to see you back in Pregnancy soon xxx

that is very true. i had an underactive thyroid a few years ago; l-thyroxine cured it. however, i have been taking iodine daily (spirulina pre-pregnancy and kelp (dried seaweed) throughout pregnancy). in many countries, including usa, germany, russia, pregnant women are prescribed iodine in addition to pregnancy vitamins. unfortunately, many doctors in the uk have "have a cup of tea and everything will be ok attitude" and don't rely on preventive medicine. my friend's thyroid function has been completely destroyed after pregnancy as the baby took it all and she was not monitored... i am under consultant care but he did not suggest that i take iodine. i have been taking it anyway as in my homeland doctors encouraged me to take it once i fell pregnant. it won't do any harm. you can buy it from specialty pharmacies. i use an american brand in an organge jar called kelp powder.

Hi LadyG yes that does make me feel much better, thanks for the post. I am really glad this one is working out for you! You must have been terrified and yes I can't wait to be back on this board with better news.

I didn't actually get a consultant this time - do you have to be a high risk to get one? All I had scheduled (after one GP visit) was a mid-wife appointment the day after my 12 week scan, and of course I didn't get that far.

I will definitely consider the aspirin too. Going to start taking selenium supplements now as I was on the low side last time I was tested for it but have slowed down on my previous high brazil nut intake!

Hi Bessie, I?m not sure I agree with your consultant?s advice. The US Endocrine Society is clear that the TSH should be under 2.5 in the first trimester and under 3.0 in the second and third trimesters. Also, some consultants have told me that in practice they aim for a TSH below 2.0 in pregnancy. T4 levels in pregnancy are usually towards the top end of the normal range, so your T4 of 12.7 seems quite low for pregnancy.

Here are the Endocrine Society?s guidelines on the management of thyroid disorders in pregnancy, which you could show your consultant. The relevant section is on pages 16-17:

www.endo-society.org/guidelines/final/upload/Clinical-Guideline-Management-of-Thyroid-Dysfunction-during-Pregnancy-Postpartum.pdf

This recent post on an obstetric website is also interesting, although the upper range for TSH in the second and third trimesters is quoted as 3.5, which does not match the Endocrine Society?s guidelines:

thischangedmypractice.com/2011/03/14/management-of-maternal-thyroid-disease-in-pregnancy/

Interestingly for those TTC, the post recommends that as soon as you realise you are pregnant you can increase your own thyroxine dose by doubling two days? doses a week, or if you prefer you can have a test at 4-6 weeks (ie in the first two weeks after the missed period) and adjust your dose according to the results.

Freelancegirl, I?m so sorry to hear your news. Look after yourself. When you start trying again can I suggest you also have a look at the BellaOnline website in the USA?

www.bellaonline.com/articles/art21171.asp

Although aimed at couples with infertility issues, the site has good advice about managing thyroid antibodies to reduce the chance of miscarriage, eg with low dose steroids, aspirin and heparin injections.

Also, hypothyroidism can be associated with coeliac disease, which can affect fertility, so even if you don't have symptoms of coeliac disease you might want to think about being tested by your GP or simply trying a gluten free diet while you're TTC and pregnant.

Lilly, hello again on a different thread! I'm taking iodine 140 micrograms/day in my multivitamins plus lots of dairy products, eg 1 glass of milk contains 60 micrograms. Do you think this is enough? The US Food & Nutrition Board recommends 220 micrograms/day for pregnancy and 290 micrograms/day for lactation.

Hi bessie I was diagnosed with an underactive thyroid at the same time as I fell pg with my ds. I think the other posters have said it all really but I just wanted to reassure you that everything was fine.

Confused2011 that is brilliant info! I have saved all those links and am going to print them out asap and give them a thorough read. Thanks so much!

carrots what are you doing over here in pregnancy? Is there something you haven't told me?

confused thanks for the links, I'll have a proper look at them later when I'm on the PC. I had my bloods re-tested at 35wks TSH 2.65 & T4 11.7 I don't have any symptoms so am not concerned, but will have a good read of those links before I see my MW next week & the consultant the week after.

freelance so sorry to hear your sad news I've had a couple of MC too, one at 5wks & another at 8wks (after the second one I asked for tests which is when they discovered my thyroid problem) I fell pg 3 cycles later & am now 37wks I am consultant led (partly) because of the thyroid problems and first saw him at 9 wks (I got an early scan because of the 2 MC) so do ask to see one sooner rather than later next time. Take care of yourself xx

Ha ha! No exciting news here bessie was just looking through active threads and spotted underactive thyroid and thought I would take a look!
Good luck to everyone trying. We got there so it can be done!

Thanks Bessie! And huge congratulations.

Incidentally what did they do once you had the thyroid prob confirmed? I am already on 125mcg thyroxine and know how to monitor my levels so they are normal so am thinking it is the thyroid antibodies I have to address with Selenium? Would love to know what issues your consultant addressed and what measures you took.

freelance after the initial tests I had to wait a few weeks to get my bloods re-tested, and then got put on 25mcg (was then 8wks pg). Dosage was upped to 50mcg after my next test a few weeks later & has stayed the same since. Will be interesting to see what happens to my levels once I've had the baby.

My antibodies are all ok so I'm afraid I don't know anything about them, but love brazil nuts so may have to start eating more of them just in case it helps!