Thyroid in pregnancy

[Hannahde]

Hello, I’m currently 9.4 weeks pregnant . I have had 3 miscarriages , one being a partial molar. One a missed miscarriage, and one a chemical. I also have hypothyroidism. Just got my results back today and My thyroid is 0.49 (after increasing my dose by 50mg on BFP) my midwife said I have tested negative for antibodies. Does this mean I can’t have NK cells? Can you have hypothyroidism and not have antibodies? When I thought that’s what hypothyroidism was. I have an app with my endocrinologist at the end of Oct. but until then I wondered if anyone knew anymore? Thanks.

Do you mean your TSH is 0.49? That’s good - it should stay below 2 in pregnancy.

I never was over the level considered normal for antibodies when tested for them. Most hypothyroidism cases are auto-immune, but not necessarily so. I don’t know anything about NK cells though.

It’s quite late to see an endo if you’re already 9 weeks. You should be on consultant-led care and have regular blood tests, every 4 weeks. Can you call your midwife and ask to be referred to a consultant at your antenatal centre?

Do NK cells have anything to do with the thyroid?

Are NK cells in pregnancy widely recognised? I thought it was just a handful of fertility doctors believing and treating them.

You don't necessarily need your thyroid tested so regularly. I had mine tested once in early pregnancy and that was it. I was consultant led but that just meant I saw the consultant once at 37 weeks.

I have regular blood tests. And the endo was a gp referral before I even got pregnant.
My midwife said I’m classed as high risk so I’ll have a doctor at my scans.

NK cells can be related to antibodies, yes - but not always thyroid ones. In my case they were as my antibodies were nearly 200 and my NK cell count was four times higher than the highest count my consultant had ever seen (he needed to get advice regarding my treatment from another specialist clinic). I had to have my thyroxine but also steroids and a lipid drip to get my bfp and maintain it to 16 weeks.

If you want to explore NK treatment I suggest you reach out to a fertility clinic that offers the treatments. Care fertility is a good one

And yes you do need your thyroid to be tested 4 weekly when you are pregnant as results can change really fast. I have been on a high dose thyroxine since last year but within the space of the last 4 weeks my dose had needed to be doubled. You need to talk to your GP and MW to ensure these tests get done properly - your mw can refer you for monthly tests or book them for you.

Yes you do need regular blood tests! The baby needs to use your thyroid hormones until it has developed a thyroid itself. That’s why you up your medication from 6 weeks or so. If your thyroid hormones get too low, there’s a higher risk of miscarriage and it can damage the baby’s development, which could cause low IQ and delayed development once born.

You really need to see a consultant regularly, who specialises in pregnancy and thyroid issues. I see one every month at least.

Congenital hypothyroidism is caused by a lack of iodine in the mother (possibly due to her own thyroid issues) and can lead to abnormalities in the child if left untreated but this is one of the conditions tested for in all newborns - the heel prick test. As a teacher, I had a child in class who was diagnosed at birth with this condition. His parents had no history of thyroid problems within their family. He was on thyroxine and he was just like any other child.

In the past, when this condition went undetected, affected children were small in stature and had learning difficulties. Due to swelling of the tongue, their mouths would gape leading to a certain 'marked' appearance. This is medically called 'cretinism'.

A swollen tongue is a symptom of an under active thyroid - along with many other symptoms.

I have the auto immune form of under active thyroid (Hashimoto's) and have three children without the condition. Saying that, my mother, three aunts and my grandmother had Hashis. My children are adults and have been specifically tested for this condition.

My thyroxine dose was doubled before I got pregnant because it was preventing me from getting pregnant. I was TTC for five years. When my dosage was doubled it took three months to conceive.

Low thyroid levels produce high prolactin levels - high prolactin levels prevent pregnancy.

I had the usual blood tests during pregnancy but, once pregnant, my thyroxine dose did not change.

My dose has changed/increased as I have aged. I have found liothyronine to be the best treatment for my under active symptoms.

Generally, thyroid problems are fairly easy to manage in pregnancy and surprisingly common.

Interestingly, my grandmother and mother weren't diagnosed until later in life. My mother had twelve miscarriages before she had her first 'live birth'. My brother was full term and weighed less than 2lb. It was thought he wouldn't survive - because he was still breathing after 20 minutes he was put in an incubator (a warm cot) - he's 55 now and 'normal '. My mother was diagnosed shortly after giving birth. When she commenced thyroxine she regained the colour in her snowy white hair. She had been prematurely aged due to lack of treatment. All the females in my family affected by this condition have developed vascular dementia in their 60s/70s.

Not much hope for me then -