Concerned about thyroid issues in pregnancy

[YourCoralPoster]

Hi, I'm about 8 weeks pregnant and recently went to my GP to get some blood tests. I've had no known issues before but my thyroid results are this:

• Thyroid stimulating hormone: 6.09 (out of range)
• Thyroid peroxidase abs: 252 (out of range)
• Thyroxine (free): 18.1 (in range)

I haven't been contacted by my GP but have an appointment tomorrow for something else so am going to ask then. In the meantime, can anyone tell me what these things mean?

I'm especially concerned as I'm pregnant and heard thyroid issues can cause miscarriage or other issues.

You should be put on levothyroxine for your TSH which will bring it right down.

Nice guidelines say your TSH should be 4 for everyday life. In pregnancy your TSH should be 2.5

Your doctor may or may not know about the adjusted guidelines for TSH during pregnancy (mine didn't) but you can look up the guidelinee to take with you and ask to be referred to a antenatal endocrinologist which you should be seen as urgent (don't worry though it just means no waiting list)
If you see your midwife first she can also refer you.

It CAN be a cause but definitely not always. My TSH was 5.4 during the first trimester for my first and hovered around that unmedicated and he is currently asleep upstairs all 18 months of him.

I am medicated for my current pregnancy as it can be made worse postpartum.

Good luck.

Lots of useful info here

I'm addition to the great advice from pp, you need to get repeat bloods every 4 weeks or so during pregnancy as the baby puts additional demand on your thyroid so it's likely you will need dose changes to keep up.
Don't worry though, the scary stuff you read online is mainly about persistent unmedicated thyroid issues in pregnancy. It's great that yours has been picked up early.
My TSH was a bit high in the first trimester and my daughter was born perfectly healthy 4 months ago😊

As the others have suggested, go armed with information and that you insist a on being put onto medication as your TSH level needs to be ideally under 2.5 during pregnancy.

As a person with thyroid disease and it causing issues when wanting to conceive, I’ve found the whole levels and statistics thing very frustrating. The ‘normal range’ that GPs and the NHS go by is for a man, not a woman and certainly not a pregnant woman.

A lot of GPs dismiss this and don’t even consider that a woman and a man would require different TSH levels, so if you aren’t happy with the answers from your GP, request to be referred to a consultant in fertility or an endocrinologist. You may have to pay privately due to waiting lists but if you can afford it, it would be worth it to get the levels sorted out ASAP.

Best of luck xx

Hi! Thanks all for the responses. My GP has prescribed me 25mg of levothyroxine which I'll start taking tomorrow but this seems awfully low to me from what I'm reading online for pregnancy. I have repeat blood tests in 4 weeks. Should I follow their advice and take the 25mg or take more? Any advice? x

Follow their advice. Over medicating is also dangerous.

Hi, my understanding is that it's usual to start off on 25mg to see how that dose affects you and then they'll adjust it accordingly after your next blood test. As the above poster said, too high a dose can also be dangerous. In all likeliness you'll probably need a higher dose at some point though, I started on 25mg but needed 50mg to bring TSH down from 7 to below 2.5, definitely do wait for the blood test results though.

As the others have said, over medicating is also not good. 25mg is a good start and go from there, best of luck! X

Of course follow their advice. 25 mg is quite low but that’s all you need so taking more would be dangerous.

@YourCoralPoster I completely understand your worries, I had a similar situation with tsh etc. I was prescribed 25mg which seems low, but I haven't had my consultant up the dose at all and I'm 18 weeks.

I got private blood thyroid tests done in between the NHS ones, so I could double check the tsh level was OK. If it was rising slightly, I took an increased dose a few days per week and noticed it dropped. (I know alot of people wouldn't do this)

Your tsh should start to even out in 2nd trimester when baby develops its own thyroid.

Ask to be referred to the endocrinologist under your maternity care so you'll have a consultant, they have much more indepth knowledge of thyroid function in pregnancy.

Don't self medicate, levothyroxine takes a while to level out so taking more than prescribed means you aren't going to get an accurate picture when they check your levels.
I would recommend keeping on top of them re regular testing though, dont assume it's being taken care of and chase up the results so that dose changes can be made promptly. I had a couple of tests come back where TSH was a bit high and I would up the dose before the consultant bothered to tell me to, which took ages!

Thanks again everyone. I've been taking the 25mg as suggested for the last few days, fingers crossed it's working okay - I guess we will see in a few weeks! I have also been referred to endocrinologist but haven't heard anything yet.

I know this is unrelated and don't know if anyone will see this, but I'm going for an early scan tomorrow at the EPU. I've been worried since getting diagnosed with thyroid issues and have noticed that for the last week or so all my symptoms have disappeared... No more feeling sick, no bloating, no sore breasts... I'm scared something has happened :(

I know nobody can offer any advice but just getting my worries out!

@YourCoralPoster symptoms really aren’t in indication of how the pregnancy is progressing, try not to worry!

@YourCoralPoster symptoms really aren’t in indication of how the pregnancy is progressing, try not to worry!

Agree with PP, symptoms aren't anything to go on. I lost all symptoms at 9 weeks pregnant, didn't have strong symptoms before that either - good luck with your scan tomorrow x

Re the thyroid levels, there's a few private places that do blood tests, if you're wanting results before you get to endocrinologist. GP may even order thyroid test if you say you're wanting them checked sooner.

Good luck at your scan! Don't let the thyroid issues put a label on your pregnancy, if medicated and under control your odds are very good.

Unfortunately it was a missed miscarriage. Baby stopped growing at 7+3. Currently waiting for it to pass at home :(

I’m not sure if it was the thyroid issues or just bad luck.

My question now is… What’s next? I’m in no huge rush to try again, but also not sure if my thyroid issues were caused by pregnancy in the first place (my GP suggested they likely were) so how do I know whether to continue the levothyroxine?

I guess I’ll have to speak to my doctor but they don’t seem the most knowledgable 🫣

Just unsure whether I’ll have to continue the medication before trying again or stop and start again if I do get pregnant in the future..

i was similar

diagnosed hypothyroid after miscarriage

suspect i had it long time before then as i had symptoms - i reckon it caused the miscarriage as it was a missed MC as i had no signs and found out at 12 week scan

was on 50mg for a year and it took me over 12 months to get pregnant after miscarriage

then during pregnancy still never had more than once a year test (no one told me you needed closer monitoring) - all was fine and i stayed on 50mg throughout disparage it likely being too low (i’m now on 100).

id wait til thyroid regulated as i belive it’s quite linked to miscarriage of unregulated

I'm so sorry for your loss, really sad to hear things didn't work out.
I'd continue pushing to have your thyroid tested once things have settled, you might find GPs dismissive (speaking from experience) but it's well documented that imbalances can have a dramatic impact on pregnancy. It's goof that you have an endo referral in the works.
Ideally you want TSH below 2.5 pre conception and regular testing thereafter.
Wishing you strength on your journey.