Underactive thyroid in pregnancy

[SpanielFace]

Does anyone have any experience of this? I had post partum thyroiditis after DS, and developed an underactive thyroid as a result. My GP is still tailoring my thyroxine dose, I was increased to 100 micrograms daily at the start of January, due to have bloods in 2 weeks.

I just discovered I am pregnant - very early still, approximately 4.5 weeks by my calculations. I will phone the gp ASAP on Monday, but I'm aware I will be under consultant care this time. Will I be referred before my 12 weeks scan? Should I have bloods sooner? I'm worried that my dose might be too high (no reason - I feel fine - but obv not had bloods yet) and that could have an impact on the pregnancy.

Also3 stone heavier than last time, in part due to the thyroid - I gained 2 stone in the 6 months after DS was born, before I was diagnosed! I've lost about 10 pounds, but it's slow, and my BMI is currently about 33. Really worried about this complicating my pregnancy as well, gestational diabetes etc. I was fine last time except for SPD.

I have an underactive thyroid. I am on a really small dose and it hasn't had to be changed through pregnancy my levels have remained pretty consistant. However quite a lot of people do need a dose increase when pregnant. Yes it will be shared care so you'll have to see a consultant too. Your first appointment should be around 12 weeks then I don't think I had another oneuntil 24 weeks then I had ones at 28, 32 and 36. With them I hadgrowth scans too as if your levels are not in range it can mean baby doesnt grow as much. Because of your BMI you would have had consultant care anyway I think and don't worry too much if you didnt develop gd last it doesn't necesarily mean you won't this time but id say it was unlikely. Also they may automatically put you down for glucose test too which will put your mind at rest. Just be as healthy as you canand try and exercise during pregnancy. I appreciate this may be hard if spd comes onagain! Oh Abd because your dose still isn't settled is get your gp to do a blood test before your consultant appointment because apparently if you're out of range it can lead to miscarriage.

Thanks juju, that is really helpful. Ill phone the gp tomorrow & see if I can get an earlier appointment for bloods and also see the nurse for my booking appointment ASAP.

Just a wee note - doesn't ness need to mean that you are consultant led. I had BMI of 31 at the start, saw the consultant who discharged me from their care as if everything was controlled fine with very regular blood tests at the GP there was nothing for them to do, so appts would be waste of time. I was extremely happy to agree to this.
Sure enough after an initial increase in dose at the start, i've had blood tests every 2nd appt with the midwife and its all been fine.
Obv this would have been completely different if my levels got out of control.

I'm under consultant care due to my underactive thyroid. I saw my GP straight away who referred me (I'm already under an endocrine team, are you not?) to the midwives and I quickly got seen by my endo consultant too who has increased my thyroxine.

They generally increase it within your 1st trimester as they like your TSH to remain low during pregnancy. You will have to have bloods done to see what your levels are and you should have them done every trimester. You also should have an extra scan at 36 weeks. An untreated thyroid can effect baby's development so it's important you are looked after.

My bmi is fine, all my extra care is due to my thyroid. I've been told I'm high risk and have to give birth in the delivery suite too. Whether this will change as things progress I have no idea.

I would get seen as soon as you can as you'll need to know what your bloods are. I saw the GP at five weeks and had my booking in appointment at 10 but my endo team phoned me as soon as they got my referral from the GP.

When I had ds I was advised to increase dose immediately as low thyroxine can impact on brain development. I was referred to endocrine consultant who monitored me closely and discharged me after ds was born. The pregnancy itself was midwife led as the obstetricians weren't endocrine experts. I was concerned about ds but he is 4.5 now and academically doing well.

I am severely under active thyroid and I also have a pituitary tumour that secretes very high levels of prolactin. I saw a consultant every two weeks and had blood tests just before each appointment. Conversely my thyroid levels remained constant throughout my two pregnancies so I didn't require an increase in medication (currently on 250mg thyroxine).

Usually they will just test your bloods regularly though the doctor and increase as necessary. It doesn't necessarily follow that pregnancy = more thyroxine..

Thanks for everyone's advice.

Pobble, no I've just been managed by my GP, other than a referral to ENT to have my goitre checked and ultimately biopsied. I've not seen an endocrinologist.

At my last bloods (December) both T4 and TSH were within normal range, but my TSH was towards the upper end of the range, which is why she increased the dose. Hopefully that means that I won't be on too low a dose - if anything, I would say that there is a risk that it could be too high, although I've got no symptoms to suggest it.

I would be a hospital birth anyway as it will either be a VBAC or ECS, depending on what they decide I guess - DS was footling breech but undiagnosed until I was 5cm dilated with a foot in my cervix(!), so ended up with an emergency CS - so to be honest, I would have been pushing to have a late scan anyway.

I've an underactive thyroid. 150 mig thyroxine daily. I was only diagnosed 4 days before my bfp!

Pregnancy has been fine. I had my booking in appointment early at 7 weeks. Thyroxine dose has stayed the same. Levels are good. Bloods every 6/8 weeks. No extra scans as no concerns about baby's growth. I'm giving birth in the birth centre.

Take care. Hope everything works out well.

A well managed underactive thyroid isn't a big deal IME. It's if it's poorly or not managed then it can be catastrophic.

This is my third pregnancy now with under active thyroid and all 3 times they have, the gp that is, increased my dosage of thyroxine BEFORE having the blood tests. I was under consultant care from the beginning and before my 12 week scan. You usually have 6 weekly appointments where they check your levels of ts4 etc. all has been well and usually 6 weeks post birth they will adjust your dosage of thyroxine depending on a final blood test.