Underactive thyroid and pregnancy

[Jane4534]

Hi all. I am 5 weeks pregnant (first time) and absolutely terrified as I’m sure most people are. I have a underactive thyroid (diagnosed last July) and Hashimotos. I am on 50mg and it got my levels to ‘normal’ last test in September result was 3.44 and the GP agreed for me to stay on 50.
I found out I was pregnant last week and got a letter for my first midwife apt on the 15th Feb. I spoke to my GP today after scaring myself online about underactive thyroids and pregnancy and they confirmed I needed urgent blood tests tomorrow and upped my levo medication to 62.5mg to wait for the results from the test tomorrow and then test again in 3 weeks.
The GP seemed concerned that my midwife appointment isn’t for some time and told me to request an urgent appointment as I will need to be referred to a specialist thyroid team (can’t remember the name). When I did this the midwife team seemed confused and said they have no space for earlier as people don’t see anyone until 8 weeks earliest and they’ll get back to me.

Sorry for the huge ramble but I am panicking now that 1) my TSH was 3.44 and I’ve read below 3 is optimal for fertility and pregnancy 2) if I do need a earlier midwife appointment and 3) just terrified generally of miscarrying and something going wrong.

any advice from anyone would be much appreciated on if there is anything else I should be doing. I know it’s still such early days and the risk is there but it’s hard to feel any level of excitement with it looming over everything x

Hi, I am undergoing testing for my thyroid and I'm TTC. From what I've read, you need to double your medication dose over a week. There is info about this on the Thyroid UK website :)

@riverlodge90 thank you - I thought the same so I was confused the GP only increased me by 12.5mg. So much conflicting advice and just worried I’m doing something wrong! I’ll check out the thyroid website.
good luck with TTC and the testing x

Don't double your dose! Listen to the doctors advice. I went from 100mg to 125mg in a recent pregnancy. It depends on your blood tests.

I meant mcg not mg. It autocorrects on mobile.

Wait to see what your thyroid results come back as. You want it under 2/2/.5 although I'll say in both my pregnancies my TSH has been higher and first baby is perfect and now growing the second (26 weeks)

The advice seems to be to increase dose by 25-50% on confirmation of pregnancy, so your increase is the lower end of that but within that. If you are having blood tests tomorrow that’s great and will tell you quickly whether a further increase is needed.

And please don't take advice on here about how much to take - listen to your doctor and eventually your consultant. Your results could be a lot lower than you were expecting and doubling your dose could put you in more trouble.

In my first pregnancy I increased from 100mg to 175mg over the whole pregnancy and this pregnancy I've increased from 125mg up to 200mg at my last appointment

In my experience the specialists will only see you at 12 weeks, and until then the GP is meant to manage your thyroid. Good luck!

Try not to worry too much, I was in the same boat when I first got pregnant and really stressed myself out! My TSH levels had been well under control and then shot up similar to yours by 5weeks. My dose was increased then by GP and my levels stabilized really quickly. I am now 19 weeks and haven’t been referred to any clinic, I just have to get bloods checked every 6 weeks and so far no more increases have been needed. You will feel much better once you get the blood test and are on a properly tailored dose x

Thank you everyone. Really appreciate the advice and reassurance - it helps so much! I will wait to see what the outcome of the blood tests are and go from there x

My thyroid TSH was around 4.8 when I was 5 weeks and I was put on 25mg levothyroxine.
The GP aren't experts and I was referred to endocrinologist and have bloods tests every 4 weeks.
I had blood test at around 11 weeks and again about 16 weeks. Both times TSH was still around 4.6 and after each test I have upped my dose. I'm now on 100mg and have another blood test in around 2 weeks.
I'm 19 weeks now and, so far, pregnancy has been fine.
My advice, you're already on medication so you are putting the hormones you need into your body (that's what I have been told) so not to panic and don't change your meds without a conversation with an expert.
You should already be under an endocrinologist, or have been, if you have thyroid issues, so contact them (even if you have been discharged) for advice and make sure your GP has you referred back to them.
My midwife doesn't manage my thyroid at all, for me it seems to be completely seperate. I wasn't seen any sooner due to my thyroid and I don't have any additional midwife appointments because of it either. The management of my thyroid is all down to my endocrinologist and me making sure I am on top of blood tests and chasing up the endo when my results are back to keep up with my dosage amounts.

Thanks @allatonce99 - I’ve never been referred to an endocrinologist before. I was just diagnosed following a blood test and given a prescription and a blood test 6 months later! I will mention this to the GP as it would be reassuring to get some specialist advice.

I would definitely ask to be referred to an endocrinologist as they are the experts with these things. My GP really wasn't sure what dose to put me on or if I should be on levothyroxine as it was only a little bit out of range but, when I saw the endo, he reassured me that levothyroxine is totally safe in pregnancy and I should definitely be on levo as in pregnany my TSH should ideally be under 2.

You're on medication already so I would wait for your bloods and see where they are before changing your dose.

Your TSH isn't too high so try not to worry.