Under active thyroid

[indecisivewoman81]

Hello I wonder if any one is in the same position?

I have recently found out I am 5 weeks pregnant and have requested to my doctor for an increase in my Levothyroxine by 25mcg as this is what they did in my last pregnancy.

I can't get in to see the doctor and instead he has sent me out a blood test form instead of simply increasing it.

I am worried if I don't get it increased now I will be more at risk of a miscarriage.

Has anyone else experienced this?

Hi. My thyroxine was put up by 50mcg at my 8 week booking appointment but she took bloods as well and then a couple of days later I had a phone call from the consultant telling me to lower it back down.
He said, that if your thyroid levels are being well managed when you fall pregnant, you don't normally need more until the second trimester. I am now 18 +5 and still on my original dose although this will be discussed at my consultant appointment tomorrow.
Good luck. X

I have Hashimotos, was very well managed and increased my dose by 25mg in both my last pregnancies. Sadly I had a MMC with the first but I'm now 25 weeks with my second. My endo and the recurrent miscarriage consultant both said to increase by 25mg as soon as I see a BFP and then get bloods 6 weeks later so the meds can be adjusted if needed.

Monitoring in the first trimester is vital. For the first 12 weeks the baby can't make their own thyroid hormones so they take it from you, if you need your supplimented then there is a risk to their health and yours so an increase of 25mg is really important initially.

Do you have an endo you can go to directly if the GP isn't being helpful? Or show your GP this page from British Thyroid www.btf-thyroid.org/pregnancy-and-thyroid-disorders-guidance-for-patients. Good luck!

Thank you for your replies. The most annoying thing is I can't get a doctors appointment to even see him face to face to explain. Was very shocked that he didnt just agree to increase as my last doctor did immediately. I have extra tablets at home so will increase by 25 mcg myself. Have a blood test booked for next Wednesday but no booking in app with midwife yet.

Do you have a consultant you can call from your last pregnancy and see if they'll email your GP

Also can you call your midwife - even if it's your last midwife and you've not had your booking in and see if what she advises so you can get the extra levo.

I took extra too in both. GP advised it though both times

I had to show my GP the NICE guidelines which at the time stated to increase straight away. I can't find it now though, so maybe it has changed.

Ring the surgery and ask to speak to a duty doctor they will have to call you back

I have an under active thyroid, when I was pregnant last year they only increased my dose when my bloods suggested it was needed. I had the blood tests regularly and appointments with a consultant to monitor throughout.
I would just do the blood test, they get the results back very quickly and will give you an increase if it’s required.

I really don't know what to do for the best.

The doctor will not see me. And will not increase the dose. I'm assuming until after a blood test.

I don't have a blood test appointment until next Wednesday as it's all gone up the creek During Covid.

I don't have a booking in appointment until a week after that.

Should I increase the dose myself right now? Should I wait and get the blood test some first

I have a history of miscarriage and really don't want to do something that will harm
My baby.

@Fs84. The advice is still the same

Hey @indecisivewoman81 if you want to get a blood test sooner I ordered TSH blood tests through Medichecks which was quick, if you order tonight you could probably have the result by the weekend and then go armed with that to your GP. I did just this, I did panic when my TSH initially jumped up after my BFP (perfectly normal) my Levothyroxine was increased and I’ve stayed on the increased dosage throughout this pregnancy.

Buy an online testing kit for about £50 and go from there. There are loads of companies that do it now. You prick your finger, squeeze it into a little tube and post it off. Will be quicker than waiting until next weds.

Honestly OP if I were you I’d just up the dose myself. In fact, that’s exactly what I did in this pregnancy at 5 weeks. I only had 50s (was on 150mcg pre pregnancy) so took an extra one every other day. I had been on 175 in my last pregnancy so assumed that would be right, but when I did finally get bloods back at 8 weeks TSH was still high so I ended up increasing to 200.

NICE guidelines as pps said are to increase immediately on bfp. If by the time you get your bloods your TSH is too low you can just reduce again, but pregnancy places extra demands on your thyroid so the chance of that happening is very slim indeed, whereas worst case scenario you’re risking miscarriage if you’re not on high enough a dose.

PS my first pregnancy I was on 175 throughout (150 pre pregnancy), whereas this one it’s been 150 - 175 - 200 - 175 - back to 150 at 30 weeks! So it does vary between pregnancies. Really important to get it checked every 6-8 weeks. I always have to prompt my midwives to do it, but then have it done at my routine hospital appointments rather than GP as it’s easier.

Mine never needed increasing during pregnancy. I just had some appointments with consultant in the endocrinologist antenatal clinic later one. Reading above comment though, it might be best to push or as suggested dose up while you wait

I really feel for you. I hope you get the results quickly next week and they sort your dose out.

Thank you all for your replies. I'm so angry with my doctor!! I am going to phone them tomorrow and demand a telephone appointment. I will state al the stuff I've seen online by NICE etc. I'm the mean time I will Increase the dose myself. I am on 75 so just need to add the extra 25mcg.

X

Just found this thread what was the outcome OP?

I'm wondering the same as @footprintsintheslow I might call the endo today, found out I was pregnant a week ago

I cannot stress enough how important it is to up your dose as soon as you get a positive pregnancy test.
Drs can be so hit and miss with their knowledge on this.

www.btf-thyroid.org/pregnancy-and-thyroid-disorders-guidance-for-patients

Thanks @footprintsintheslow I'll up mine. I'm kind of scared now that I should have done it before

@grandmasterstitch you must be very early on that I'm sure it's completely fine but so not be fobbed off. Stand up for yourself. Look up the American and Uk and NICE recommendations so you are armed with info before seeing a dr.

I've been through a whole pregnancy where mine was never upped the whole time. I wasn't aware it needed to be and the baby was absolutely fine.

@footprintsintheslow thanks, I'm about 5 weeks. The Gp receptionist told me to do an online assessment thing which was entirely useless because I'm not ill. Fortunately I managed to leave a message with the specialist endo nurses so hopefully they'll be able to help

I had a telephone appointment with my doctor and he completely refused to up my dose. I begged him, he said that I need a blood test first (which I'm having tomorrow). Apparently the last time I had a blood test my levels were good.

I haven't upped my dose because do. Said they would interfere with my results. I am paranoid and hoping that this hasn't had a detrimental effect on the pregnancy

@indecisivewoman81 my GP and endo nurse said the same thing, that I need the blood test before I change my dose. I would be sceptical with the GP but I'm assuming a specialist endocrine nurse should know. It's weird because everything I've read says to up the dose immediately

I have found that most GP and endos aren't thyroid specialists and aren't necessarily up to date on current research. When I was first diagnosed, the endos I was referred to specialised in diabetes rather than thyroid issues and some of the advice I got was shocking and very out of date, including the one who suggested I go on an unsupervised 1000 cal a day diet and saw nothing wrong with taking calcium supplements at the same time as levothyroxine. I used to ask what should i do if I got pregnant as a test of their thyroid knowledge and if they told me I didn't have to do anything then I didn't see them again.

@indecisivewoman81 You don't need a blood test before you increase your dose, that is poor management by your GP. Do they know how to interpret a pregnant persons results? Your TSH should be close as possible or under 1 during pregnancy and your T4 closer to 22. I would be concerned that if your TSH bloods are in the 'normal' range (under 3.3) they will say you're fine and not adjust your dose. Always get them to give you the exact numbers of your results not just fob you off by saying their normal.

If the blood test is today then take the test and if you feel comfortable you can increase your dose afterwards as advised by NICE and the British Thyroid Association while you wait for the results. It may also be helpful for future issues to change GPs to someone who had better knowledge of your condition.