Thyroid meds pregnancy

[T2024]

Hi all, I'm around 5ish weeks pregnant, I'm on 25mg thyroxine pre pregnancy for subclinical hypothyroidism.

Had to go to a private consultant to be prescribed the thyroxine (recurrent miscarriages as a result of tsh level).

Long story short, the GP won't increase my dosage until I have a high tsh blood test but I've read online that it needs increased at positive preg test.

I've been upping my own dose slightly and haven't had results from the blood test yet. How do I convince the doctors to up my dose to help my body cope with extra pressure of preg on my thyroid?

Or I do I need to go back to the consultant to get him to adjust dose? Also, I'm worried the doctors may think my tsh level is fine in blood tests but obviously won't know I'm taking a slight increase of my own accord.

Thanks!

@Kofifi this is super relieving to hear. I had my bloods taken Sunday just gone and the level was 5.5 and I was on 75mg per day. They’ve upped it to 100mg every other day at the moment but I’m so worried every single day. I’m so pleased to hear your level is around mine and you’re doing well!
did anyone have any antibodies taken? I only had mine done a year ago but they were 600 which is so much :( top edge of healthy is 50.
im only 4.5 weeks but just freaking out

Is 0.938 OK for tsh? I've been taking a slight increased dose since and before test, (was on 25mg, but on some days increasing to 35 or 50).

Also, my T4 range is optimal but on the higher side, what would happen if tsh goes too low and t4 goes too high?

I’m not a doctor but from my experience those results look great, I’d swap you!

@catmumma84 thanks so much, I thought I had overdone it upping some of my doses as tsh has come down from 1.2 to 0.93 in around 5 weeks 🙈

I had 25 does for the same reason and prescribed privately. Had a few tests during pregnancy and as the level remained stable and did not rise did not need to increase dose.

My private ivf consultant said anything below 2 or 2.5 was fine, so you are well under. I can’t imagine an nHS doctor increasing your prescription unless tests indicate it is needed.

@Timeforachocolate your level never changed at all throughout? That's brilliant! Yeah I had read up on most people needing a slight increase and thought it may be needed but thinking mine could be more like your levels.

Yeah I'm going to stick to 25mg dose, having levels tested with NHS every 4 weeks and doing a private one every 2 incase it jumps quickly.

I have had recurrent miscarriage. subclinical hypothyroidism was diagnosed around 6 months ago and I have been taking 25mg of levothyroxine since then.

I recently had an appointment with a reproductive endocrinologist and he advised me to get a blood test done as soon as I find out I'm pregnant, then every 4 weeks during the first trimester. His estimation was that I wouldn't need to increase the dose but the blood test would check that.

So I would have regular blood tests but would be wary of changing your medication without a doctor's advice. I agree that the GP is generally clueless on TSH in pregnancy so I have taken advice from gynaecologists in the past.

Hi, no it didn’t! I was surprised too.
though only on levothyroxine for my 3 pregnancies ( well before conception as well).

Hey all, asking for advice - I've been on 25mg thyroxine, had my bloods done at 9 weeks pregnant last week and tsh is now down to 0.34.

Is this too low, how low is acceptable? Also should I be asking a doctor to cut my dose or is it safe to be borderline hyperthyroid? All other thyroid values were acceptable.

Thanks so much!

it looks low to me, but I am not a Dr. I would ask your Gp for advice. Or the consultant that prescribed it.

i only needed 25mg all the way through pregnancy as my levels would not be classed as high enough for normal NHS levothyroxine. But mine was always above 1 in pregnancy.

A quick google says below 0.4 is below the threshold, so would want to contact the consultant that is prescribing it tomorrow. Or failing that a Gp.

I thought I was low too, the gp has the minimum as 0.27 - only saving grace is ft3 and ft4 is ok.

I'll not take any more thyroxine until I contact them and see if I need to half the dose or take less per week.

I've been looking into it online since and it seems high levels of hcg can suppress tsh levels in late first trimester, which I hadn't ever heard of.

This is what I had found

OP - did you get referred to the endocrinology team and have they been monitoring you?

That sounds wise.

as low levels can cause issues as well, which you certainly do not want for a developing little one.

@Carrot678 no unfortunately not, Private gynecologist recommended thyroxine and GP is monitoring it. Tbh I'd feel safer if I was being monitored by an endocrinologist.

I'm worried as the GP hasn't contacted me re the lower level because it hasn't went below the 0.27 minimum, but surely an endocrinologist would tell me to half the dose or take less per week?

So worried that this could harm my little one 😔

Hi I was on 25 mg as well pre pregnancy. Because I was on thyroxine I was under an endocrinologist (check with your midwife when you have your booking in appt). He put me up to 50 mg without a blood test to support the pregnancy but within a week or so I felt weird - heart racing, couldn't sleep etc so phoned up endocrinologist who agreed toput me back to 25 which is what I took without incident for the rest of the pregnancy. The endocrinologist made sure that I had regular blood tests throughout the pregnancy and all was well!

Just realised you are still quite early but assuming you have had your booking appointment with a midwife? Did you ask her about being referred to endocrinology? If not I would get in touch x

As soon as I was pregnant I upped mine immediately myself by 25 mg per day and this always worked fine. Dropped straight back down after birth. I’m on 100 mg / 125mg alternate days when not pregnant

@Carrot678 no haven't had my booking app yet but I'm under EPU also, I wonder if they can do referrals? Alternatively I can wait till the booking app.

@helseeee Yeah my tsh has dropped from 0.93 to 0.34 in 2 weeks, I think I'm starting to get symptoms too, sleep etc and I'm so warm at times! Hopefully the GP will cut my dose or tell me to take less.

@greenredyellow are you hypothyroid or subclinical hypo? I'm only subclinical but maybe that's why I'm not needing the increased dose 🤞

I was not allowed a referral to endocrinology if it helps … as the nhs would say I did not need levothroxine as my levels were never above 4. Only on it as 2.5 and private ivf consultant recommended it. The Go said the nhs Col suit at would stop the prescription as not needed from a thyroid point of view.

Got in touch with the GP yesterday, he is going to refer me to the endocrinologist via my midwifery team thankfully. He's recommended a retest in 2 weeks as one test alone wont tell him much, he wants to see a trend moreso.

Also only going to take 25mg 5 days a week until then, so hopefully levels will even out at end of first trimester.

Good Gp!

Yeah he's been so helpful even from my previous miscarriages, he's so thorough. Let's hope my thyroid balances out 🤞