Underactive thyroid and consultant led care??

[Beccadugs]

I have read online (danger!!) that as I have an underactive thyroid I will need consultant led care... However, when I saw my GP (because I feel like death) he suggested that I might not, and the midwife will decide this when I have my booking in appt at 10 weeks.

I am confused as all the websites seem to say see a specialist ASAP. Can anyone with more experience shed some light on this?!

Thanks

The reason the web sites are saying you need specialised care asap is due to the need to have your thyroxine (generally but not always increased).

I have an underactive thyroid but it was only diagnosed 4days before i got BFP so thyroid very low & far from ideal scenario.

If your thyroid levels are good& stable it helps! Has your GP done blood tests since your bfp?

You will need more frequent blood tests. I booked in at 7 weeks so i could access the obstetric endocrinologist team.

I am currently having consultant led care but if all goes to plan i will transfer to midwife led care & will be using the birth centre.

Hope all goes to plan for you. Call your GP if your worried & if your not confident in your GP, demand a referal.

I have an under active thyroid too and have consultant-led care. But then I'm type 1 diabetic too. I have it all managed under the same consultant.

Interestingly, my thyroxine dose wasn't increased during this pg. In fact it has decreased slightly in third trimester. But then I'm not hugely under active and my last blood results were on the high end of normal.

Bloody hell, diabetic, underactive thyroid & pregnant! Bet you feel pretty rough! I've read about people who don't need an increase in thyroxine... Did you have a straight forward birth?

Diabetic, under active thyroid and past cervical cone biopsy so monitored for cervical weakness too! Not to mention a huge bleed at 12 weeks. It's been a pretty terrifying first pg all in all. I'm not sure i could actually go through it again...

I'm still in third trimester. 33 weeks today! And while I'll never be complacent. I'm feeling a little less terrified.

I'm in the States, so perhaps things are a bit different (and arguably more gung ho), but I was referred to an endocrinologist for my Hashimoto's. As it turned out, I did need an increase in my medication (I take dessicated thyroid, as opposed to thyroxine) as my TSH was 2.7 and most doctors like to see a TSH under 2 in the first trimester.

I'll see the doctor for two more blood tests, and the doctor said, unless there's a real problem, he generally leaves things alone in the third trimester, as the thyroid settles down.

BeccaDugs your dose should be upped by 25mcg once you get your bfp and you should have blood tests at least once a trimester official NHS guidance here.

You will need a blood test at 36wks to ensure your levels are right details here

I have UAT and have consultant led care...but haven't actually seen the consultant yet (am 20 weeks) see her next week. At booking in the midwife done bloods to check thyroid as shebtold me its standard procedure to up the dose asap. My GP never done that even after the test results so the midwife sent a letter to the gp at 13 weeks saying to do it. My bloods were checked again and throxine was eventually put up by 50mg at around 15weeks. They are now checking levels every 4 weeks.

Hi i was consultant led till 20 weeks then transferred to mw led only with a consultant app at 40 weeks.
You do need regular blood tests and most have to up dose a bit.
Also make sure your levels are monitored post pg. Research I've done says it can effect milk supply if levels drop down. However if levels are ok bf is fine.
Congratulations. Xx

Hi there OP

I have had Hashimotos for 24 years (I'm 34!) and I'm currently 23 weeks pregnant. I get annoyed at people saying you MUST have your dose increased as this is simply not true! My dose has actually come down by 50mg a day from 200 to 150mg.

I went to see my midwife at 4 weeks and she referred me back to the endo consultant at my local hospital - same one as the maternity which is handy. I saw the endo at about 8 weeks and have been every 6-8 weeks since then. My dose was actually dropped at the last test to 100mg 4 days a week and 150mg for 3 days but after yesterdays test its been put back to 150mg every day.

I am on shared care so that meant seeing the maternity consultant at the 10 week appt (sometimes thats at 12 weeks) and also again at 28 weeks for a growth scan. Inbetween times I just see the normal midwife team and also my endo.

IMO you def need to see an endo consultant earlyish on to get a good base dose sorted. But dont be worrying about needing a consultant led birth etc as I was told that unless anything else went drastically wrong then there was no reason why I wouldnt be midwife led. The early part of pregnancy is the one that you need to have the right doses for as your baby takes first from your medication. Ask for an urgent referral as they take flipping ages!

Feel free to pm if I can help further

Without wishing to annoy anyone the reason why most hypothyroid mums need their dose increased is that as you physically get bigger though the pregnancy you need a slightly higher dose to keep levels where they should be.

Under treated or untreated hypothyroidism can be a factor in miscarriage (speaking from bitter experience here as I lost a baby before I had DD and was told the hypothyroidism was a likely factor), and also in a raised incidence of interventions at birth, and in low birth weights.

Early monitoring by a clued up mw or by a consultant endocrinologist is very important to give hypothyroid mums the best possible chance of a safe, normal pregnancy and birth.

TSH should be between 0.5 and 2.0.

I am hypothyroid and initially scared myself witless reading about pregnancy and thyroid online. My GP didn't put my dose up, so I hassled them for a blood test. Once I saw the consultant (about 12 weeks I think) I had that test ready which was useful and my dose went up from 175mcg to 200mcg.

I had another test around 20 weeks and have now been signed off until after the birth.

It seems approaches vary a lot. Having read stuff online I was surprised my bloods weren't tested sooner and really panicked, but it turned out ok (as far as I know) in my case.

Congrats and good luck.

I have an under active thyroid and was sent to the consultant, but signed off at 35 weeks as all was fine. Was supposed to get 6 weekly checks, although missed a few as my gp is rubbish. Thyroxine didn't need to increase anyway, in the end. It's very common

Thanks everyone! Some really valid advice. I might try to refer myself back to my private endocrinologist in the first instance as I can then get an appointment ASAP. Will phone the GPs again tomorrow anyway.