TSH is virtually zero in first trimester - worried and frustrated

[Shelldon]

I have a goitre and for the past eight years I have been asking GPs for a referral to an endocrinologist because my TSH has always hovered around 0.3-0.4 - just on the cusp of the lower end of normal.

Unfortunately GPs have always refused to send a referral to an endocrinologist.

I am now in my first trimester of a much longed for pregnancy after infertility and failed IVF.

My TSH has just come back at 0.05. I am petrified about the potential effect of this (miscarriage?) and I am so frustrated because I have been shouting in the wind to try to be heard about this for the past eight years and now look where I am.

Can anyone advise please? FT3 and FT4 are in normal range, they usually are.

Any advice appreciated, thank you.

I would contact your local maternity unit and ask to be referred to the consultant antenatal clinic as soon as possible for advice. They usually have an endocrine clinic (for diabetes and thyroid issues in pregnancy). At the very least the antenatal clinic can offer you advice of if there's anything that needs to be done at this stage based on your current results.

Morning, yes my midwife is taking care of that referral for me. I just wondered if there’s anything that can be done or if anyone else had experienced this? I can’t believe that I have been trying to get this sorted to no avail for nearly a decade and now it could have grave implications.

The consultant is on leave so I can’t be seen in clinic for almost another two weeks.

If anyone has experienced a very low TSH I’d be very grateful to hear your experiences - good or bad. Thank you.

A low TSH is a common finding in the first trimester of pregnancy. I presume the fT4 and free T3 are normal?
The pregnancy hormone known as the HCG is very similar in structure to TSH and so can interfere with the thyroid function blood test.
Beta HCG is what you detect when you do the pregnancy test. It is the highest in the first trimester. Even higher levels are found in hyperemesis gravidarum (bad morning sickness) or in twin pregnancy.

If it was an IVF pregnancy you would have had your thyroid bloods checked prior to getting pregnant.
The thyroid just needs to be monitored every so often.

T3 has now come back as high - outside the upper reference range.

I feel as though I am going to lose this pregnancy, if I haven’t already.

Eight years of trying to be heard and continually being fobbed off by GPs.

I simply cannot believe my bad luck. I feel like contacting all the previous GPs and saying I told you so.

I am the opposite and have an underactive thyroid which was discovered after I had 2 miscarriages so I really truly understand the stress and worry.

I hope I can reassure you a little - I carried my last baby to term and I'm now 32 weeks with my second.

I promise they do know what they're doing and they do monitor you. I am under consultant care and they review bloods when they're done each trimester and if they are really worried you get a call the next day. If they're not worried they see you at the next clinic appointment.

What was the final result of this? Sorry to be asking at this point

Eight month old DS is playing merrily downstairs with DH! 😊

I was under the endocrinologist for the entire pregnancy and at one point my TSH was virtually undetectable. But we decided not to medicate and I trusted his opinion.

He diagnosed me with subclinical hyperthyroidism (SCHT) and said it should have been picked up and medicated years ago. I had a DEXA bone density scan after I gave birth which thankfully came back okay.

I was supposed to see him 3-6 months after giving birth to discuss ongoing management options for my SCHT… but I’m still on the waiting list 😅