Over medicated Thyroid Third Trimester

[bloatedorpregnant]

Hi all, I’m currently 29 weeks pregnant. My midwife took some routine blood tests last week and included a test for my thyroid as it hasn’t been checked for a little while (it was monitored closely during early pregnancy).

My results have came back and suggest that I’m being over medicated. I’ve booked an appointment to discuss my results with my GP but this is just over a month away. I’m planning to call and see if I can get an earlier appointment as I’m concerned about continuing to potentially over medicate for another month and I have no idea if this can impact my pregnancy.

I was just wondering if anyone has experience of this and how hard I should be pushing for an earlier appointment?

Are you not under the care of an endocrinologist? You should be referred to one and there might be one available one day a week at your hospital.

Mine is ordering blood tests and then sends me the results per letter including his recommendation for the Dosis I should take.

Hi @Peachi82 I was originally but they seem to have referred me back to my GP and sad they’d only want further tests if I happened to be at the hospital seeing the obstetrics team.

I was thinking if the GP couldn’t see my sooner to ask to be referred back to them.

I'm seeing an endocrinologist whilst I'm pregnant, they test my bloods, then phone me with the results every 4 weeks. I was told once the baby is born that I'd then be referred back to my GP for any tests or prescriptions.

Did they tell you what your blood results were?

Thanks @Pitstop1986 they just said that the results indicate that I’ve been over medicated and would be referred to the GP. The doctors have said if I call in the morning they should be able to arrange a same day telephone appointment. I’m going to ask if I should still be under the endocrinologist.

It's hard to tell without knowing what your values are and what they've tested.
I had a very low TSH in my first pregnancy, but free T3 and free T4 were still in range and I had a normal pulse and no other signs of being over medicated.
The endocrinologist said that the TSH could have been influenced by my hyperemesis and was OK to carry on with the dosis I was taking.
Depending on what parameters they've measured, over medicated thyroid might be the wrong conclusion. Or the right one. It is hard to say.
I would speak to the GP ASAP and ask for a referral back to the endocrinologist department.
Good luck!

What were your TSH and T4 levels?

This is all I’ve got for my results. I originally thought my TSH wasn’t recorded but actually I’m assuming it’s that it’s actually zero!

I’m not sure how to interpret those results but I would defo be pushing the hospital via your next antenatal clinic to refer to endo dept or if you don’t have an appointment coming up in next week or so then get your GP to look at it asap in interim. I am under a private endo anyway but I was also separately monitored by hospital endo during my pregnancy. Definitely wouldn’t be laissez faire and leave for as long a period as they have suggested to you.

So please do not substitute this for medical advice. I suggest you request an urgent appointment with your GP so ring at 8am and demand an appointment stating I am pregnant and have just found out my thyroid levels aren’t right. Your TSH is over suppressed and your T4 is within normal range but towards the upper end which is 25 or similar depending on the lab. Lower end of tSH is 0.27 or similar depending on lab so you see yours is undetectable and lower than this. I would request an urgent appointment with an endocrinologist if your GP is not confident or willing to address the levels and if they do not play game contact a private endo where you will be able to be seen probably the same week for around £150-250. The T4 is the active thyroid hormone and what the developing baby will use and the TSH is the hormone that stimulates the thyroid gland to produce more T4. What dose of thyroxine are you on? You may need a small dose adjustment, as in reduction x

Tell the GP receptionist (gatekeeper of the GP appointments in most places, I've found) that your midwife has said you need to speak to your GP urgently. Say you need a telephone consultation today.

Thanks everyone. I’ve just called and the receptionist wasn’t helpful. I cried (pregnancy, pgp, lack of sleep and genuine worry over this won’t have helped) but it semi worked and she’s going to speak to the GP and someone is going to call me back.

When were your bloods taken (so which time of the day?) and did you take your medication in the morning?
How much L Thyroxine are you taking?
*)

It might be a little bit too much, but as someone else said, this is not medical advice. However as I previously said there are other factors in pregnancy that can influence the TSH.
You need a referral to the endocrine department. Make sure you don't get referred to the main endocrine department, but to the one looking after pregnant women in your local maternity ward as this will be quicker route.

*) I always leave out taking my thyroid medication on the day when bloods are taken as the tablet practically contains what they measure as "free T4" (as far as I understood, happy to be corrected).

They took the test in the afternoon and I’d taken my meds in the morning. I’m on 150mcg a day. When I finally speak to the GP I’m going to ask to be referred back to the endocrinologist.

Oh I’d never heard of not taking the tablets the day of bloods. Interesting!

I don't think this is official advice.
This is just what I do and what makes sense to me ;-)

@bloatedorpregnant

They took the test in the afternoon and I’d taken my meds in the morning. I’m on 150mcg a day. When I finally speak to the GP I’m going to ask to be referred back to the endocrinologist.

Oh I’d never heard of not taking the tablets the day of bloods. Interesting!

Don't do that during pregnancy its common outside of pregnancy but you never do it during

@Peachi82 sorry I’m being slow here - could you explain about the not taking meds on the day of your bloods? I’ve not heard of that. I thought they had a long half life so taking or not taking them wouldn’t be effective immediately. Is that not right? Really interested in this theory

I'm also interested. I'm due to have my bloods checked tomorrow, so don't know if I should wait until after my bloods are taken to have my thyroxine.
They'll take bloods at 8am, so it's not too difficult for me to delay breakfast until after 8.30

I would need to do a better search in English. In my native language are several articles about it, I was diagnosed before I came to the UK and read a lot at this time.
The articles claim that if you take the tablet and have your bloods taken shortly after (within 2 to 4 hours), you might get a false high reading for the free T4.

However, I am not a GP or anything.
I'm a thyroid patient and a chemist and I tend to read a lot.

@Peachi82 Thanks for the info. I'll have a look on pubmed for a few articles and if they confirm what you say, I'll delayy meds in the morning. Since I get my bloods done first thing in the morning, usually about an hour after taking my medication, I'll hold off from taking it first thing tomorrow morning and take it just after my bloods have been taken.

By the time I've driven home I won't have to wait too much longer before I can eat breakfast.

Here are a few short sentences (www.labme.ai/laboratory-test-results/)

"Taking synthetic T4 medication

These medications deliver gradually and consistently, bringing about a moderately stable chemical level in your body. Its half-life is nine days, implying that if you do not take any more medicine, it requires nine days to free half from it from your body. Blood tests are influenced like this:

*TSH and free T3 are the same as whether you take your T4 medication previously or have held as long as 48 hours to take the blood test.

T4 tops 2 hours after taking it in medication to influence a blood laboratory test results when taken during that pinnacle time. For the more significant part of the remainder of the day, the T4 levels will be stable.*

A few specialists change portions of medication dependent on TSH, so all things considered, no distinction. If the blood test’s understanding incorporates T4, the prescription and blood test’s circumstance should be regarded for an exact evaluation."