Hypothyroidism in pregnancy - advice/reassurance please

[SniffyBee]

Hi everyone, I'm new to this mumsnet thing, so please be gentle! I'm 21 weeks pregnant with my first DC. At 18 weeks I went to the doctor due to extreme tiredness, like nothing I'd ever felt before. After some persuasion, my rather dismissive gp agreed to run a blood test, and last week I received a call to say my thyroid levels were 'a bit off'. It seems that I'm subclinical hypothyroid with anti-thyroid antibodies present. I've been prescribed levothyroxine (25mg) and will be made an appointment with a consultant in the next few weeks.

From the brief explanation I was given by my gp, and from what I've (unwisely) googled, it seems that hypothyroidism can lead to severe complications in pregnancy (preterm birth, still birth, pre-eclampsia, placental abruption etc.) and also to fetal developmental defects and intellectual impairment in the child. So obviously I'm now completely freaking out. I had my 20 week scan only a couple of days before receiving this news, and all the relief and joy I felt from that has been taken away from me.

Sorry for the long post. I suppose I'm just wondering if there is anyone here with knowledge or experience of hypothyroidism in pregnancy who might be able to put my mind at rest.

For reference, my levels are:
TSH: 5.23 mU/L (above reference limit of 0.54-4.25)
FT3: 3.7 mU/L (within reference limit of 3.5-6.2)
FT4: 10.0 mU/L (within reference limit of 8.0-16.0)
TPO antibody: 671 (above reference limit of 0-8.0)

Don't Google. If your thyroid was that bad you wouldn't have conceived or would have miscarried. You caught the symptoms early and are getting treatment. Your tsh should drop to 2ish and your dose will be increased until it does.

I'm on 125mcg levothyroxine, it's recently been increased and will probably be increased once more after 30 weeks. I'm 22 now.

When I first started levothyroxine I'd be fine and then suddenly get absolutely shattered, couldn't talk properly and needed to sleep, I also felt anxious in a stomach churning sort of way. Took about 5/6 weeks to settle down and they are normal side effects as long as they don't last.

Baby will be fine, by now it's making it's own thyroxine. Baby will be tested for congenital hypothyroidism at birth.

My two weren't tested at birth, I thought it was only hyperthyroidism they tested for.

Aim to get your TSH below 2 and T4 top of the range. You should have your bloods checked every trimester, and after birth too as it can take a while for your body to adjust. As previous poster said your baby will be making its own thyroid hormones now. Have you been referred to the endocrinologists? I was automatically under consultant care because of my hypothyroidism (although I gave birth on the mlu so it was irrelevant really). I have two healthy dc and wasn't diagnosed until after the birth of my first.

Seems you can test at birth, wonder why the mw told me otherwise.

Thanks for the replies. My gp said they'd referred to me a consultant - I assume an endocrinologist? Obviously I am relieved that its been caught and is now being treated. From what I've read though (I know, I know, google again) it's the first and early second trimesters that are crucial for fetal development as they are entirely dependent on the mother for thyroid hormone. As my T3/T4 level are within the normal range (although towards the lower end), could it be that the baby still managed to take what it needed?

Also just wondering what else I can expect in the way of monitoring - is it likely I'll receive growth scans etc.?

I had undiagnosed hypothyroidism ( hashimotos) during my pregnancy (my blood records pre pregnancy showed sub clinical hypothyroidism). Baby was healthy and is a healthy toddler now although I do worry of course.

Your should aim for tsh to be under 2 (at least) and around 1 ( post partum as well). 25mcg is a tiny dose and as it doesn't readily cross the placental barrier I think you might feel better on a higher dose.

I'm sorry you have been this condition. It can be more challenging to manage than many doctors believe so I would recommend posting on the thyroid UK boards at health unlocked where there are many, many experienced posters.

PS your free t3 is very low - to feel well most people need the FT4 to be in the upper quartile. When this has gone up you should also feel better. T3 is the active form of the hormone that the body can use after converting it from t4.

I have an appointment with endocrnology at the antenatal clinic every 6 weeks- I get my bloods done at my gp the week before my appointment, so again every 6 weeks. Care does vary between health authorities.

Baby will v.likely have taken what it needs.

You'll only get extra scans if you need them. Well managed hypothyroidism doesn't cause growth issues. I'm having an extra scan due to placenta previa which isn't related to the thyroid!

I found that a lot of forums focus on how bad things are with thyroid problems but properly managed and you and baby will be fine. I scared myself stupid reading them when I was diagnosed, turns out it's been fine.bi know what my levels need to be for me to feel normal and if my gp won't agree to a dosage increase I have been known (prepregnancy) to fake my results by not taking my tablets for a few days pre blood test. Not that I'd advise that!

Now my levels are in my optimum range I feel well and don't notice my condition at all. I'm slightly overweight but that's the fault of my diet, not my thyroid!

I had hyperthyroidism diagnosed years ago, a couple of years later and I had radio-iodine to get rid of the thyroid. Now I've got hypothyroidism and I'm on thyroxine (and have been for about 5 years). Apart from taking the tablets, there is no change to any day-to-day life, and if I start to feel really tired or have any other symptoms I just get my bloods tested.

I started on 75mg at the beginning of my pregnancy and it's steadily increased to 125mg, I'm now 32 weeks. I've had to see the consultant at the hospital and was being tested every 2-3 weeks in the first trimester and then twice in the second trimester and just been tested again but I've been told that's it now until the birth and just to get tested after at my doctors. So I'm now back to midwife led care for the end.

I've had no extra scans or anything, just the normal appointments and no one seems to think there will be any issues at all. As long as it's managed and monitored it should be fine .

Hiya I was diagnosed with an overactive thyroid after the birth of my dd. and since then have been monitored regularly at the diabetes and endocrine clinic, my thyroid levels are currently under control and I'm not taking any medication at present. I'm now 25 weeks pregnant with my 2nd baby, everything seems to be going well, I have blood tests every 8weeks and see the specialist after every scan. I'm having extra scans at 28weeks and 34 weeks I think.