Anyone get pregnant with low tsh and have sucessful pregnancy?What does this mean?

[here we are]

To make a very long story short, i am pregnant.. My thyroid was being tested every six weeks since march, but the drs hardly t respond to my calls about results, needing to get bloodwork done again(requiring their help),or even if i needed to stop my med they were very late in responding, causing my levels to get worse . This is after i call them many times,trying to get help. I basically have to beg.So i started getting my own results by mail, until the last time, my result did not arrive. I have been calling for weeks now, trying to find out why and needed to know when i was due for more bloodwork. I realize i couldve figured this out by looking at previous blood work, but i didnt think of that before. So i am overdue for bloodwork, find out i am pregnant!, and finally my obgyn is going to help confirm and figure out whats going on. I tried so many times and when i tried to get a new thyriod dr, they needed my old one to respond, so i got fed up. I would call the old one, get treated rudley, they'd say its not their job and leave another msg. So now i will go to app as an urgent patient, because i am pregnant and finally dont have to do it all by myself. The obgyn before told me i had to go to primary care b/c i wasnt pregnant, pcp said i didnt need to be tested or anything, maybe it was normal levels then. I guess i need to get this out, i am mad, and worried. My tsh level was 6.7 in september, after being "normal" in july , but i got pregnant mid oct. Is anyone else familiar with this kind of situation? What damage could be done the first month of pregnancy with bad tsh levels?I feel like i tried so hard to avoid this and now that i am pregnant , finally something will be done, but is it too late to stop the damage? I know i can only go forward. Anyone know whats going on? Off to my app.

[tiqa]

I'm surprised your OB isn't taking this more seriously.  Can you get a second opinion?  A TSH with your level doesn't sound TOO extreme but even subclinical TSH levels can affect pregnancy with increased risk of miscarriage, etc.  (It's also harder to get pregnant - so if you got pregnant already, then congrats! and hope for the best.)  The first weeks of pregnancy are the most important to have your thyroid levels worked on because at this early stage, the embryo/fetus doesn't make its own thyroid hormones.  Even under the best of circumstances thryoid meds have to be adjusted and frequently monitored during pregnancy.

Good luck, and I hope you can get a second opinion.  I found out I have Hashimoto's during this pregnancy and my TSH has been all over the place.  I'm past 30 weeks now but still get nervous due to bloodwork results.  It wasn't even on my radar before they tested me at 7.9 early in the first tri, and it has been back and forth since then.

Try not to stress, but I would really press for a second opinion, and soon.

[here we are]

I dont know if i need to take a med. In the past i have, but we never figured out what dosage worked for me.The new Dr I saw said not to worry about miscarriage and the risks and that the growing baby will make its own thyroid just fine. He said the place i used to get care from was wrong b/c according yo them i shouldnt even be pregnant. He talked about what "normal" is and how some people can be a, little high or low and be okay. He said another endo Dr may recommend a completely different treatment than him and believe something is much more troublesome. He called it idiosyncratic . He was saying I should decide if i want the med, he would just be guessing and telling me not to let anyone else tell me what too do. ??!! So, i think if i was really in trouble he would let me know, right? Or what could change later on, if my thyroid needs to work harder? Will it maybe surprise everyone and not get extremely messed up? Will i inevitably need the med and its just a matter of when? If so, i would think taking it earlier would be like a preventative. But i didnt like being on it before. So tiredof all this. This pregnancy was a long time coming and now i feel like i tell the Drs and cant understand whats going on and its making me worry, which i woild probably do anyway. Anyone else not need the med? It must be possible?

[here we are]

Because what if the med causes ups and downs just as not being on it will, so what's the difference assuminh nothing drastic happens and they monitor closely...

[here we are]

Bumping. Cant sleep thinking of getting another opinion tomorrow from new Dr and needing to make a decision fast without having enough info. Anyone else in this situation? Is it very rare? I have reae about people having miscarriages due to this but it was sounding like they also could not get pregnant without a certain level. I am not too sure. Its hard to try and compare myself to others experiences , dont know what to do to figure this out. Could it just be normal for me, and its just not the standard? Is everything fine even though it may change? I will ask Dr the best guess if my levels will eventually get worse, might it not though? Stresses me out reading about how everyday counts thinking of the damage that could be done, but the other Dr said its not necessarily true. Who to trust? Is he just saying that to make me feel better b/c will see more signs of trouble and then become more aggresive in my treatment plan. I cant stand feeling like i am supposed to figure this all out alone. Its so far to go to the offices and expensive and i always get seen very late and then end up confused . Cant tell whwte going on.

[tiqa]

OK, here...

If you have Hashimoto's, you will, in theory, always need to take medication.  (I'm still unhappy with this.)  If you don't have it, just have hypothyroid symptoms, it may or may not fix itself.

It IS much harder to get pregnant when you are hypothyroid, but it's possible.  It doesn't mean you won't have problems.

The baby will make its own thyroid hormones, but not until after the first tri, and there are developmental risks before that.  Additionally there could be other issues further on in pregnancy.

Your TSH *will* go up and down regardless if you're on meds or not.  There's also T3 and T4 hormones that they need to look at.

This is not an extremely rare condition and doesn't necessarily make you high risk, but you do need someone to take it seriously and take a look at your bloodwork regularly.  This is from someone who does homebirths and UC's and goes to a midwife instead of an OB.  I'm not chicken little, but it's good to be proactive about this.

Hope this helped a little.  PM me if you want to talk more.

[writinglove]

Dear here we are,

Have you had your blood tested in the last week? I don't have a thyroid and have had managed my thyroid levels with medication through two pregnancies. In my opinion, knowing your TSH levels is the best place to start.

Once you know your most recent TSH, allows you to start thinking about next steps.

Here's a good webpage with links discussing the American Thyroid Association's latest decisions about optimal TSH levels during pregnancy. http://thyroid.about.com/od/hormonepregnantmenopause1/a/2011-Guidelines-Thyroid-Disease-Pregnancy-Postpartum-Reviewed.htm

According to the Guidelines, if a laboratory has not established its own trimester-specific reference ranges for TSH, the following reference ranges should be used:

First trimester: 0.1-2.5 mIU/L
Second trimester: 0.2-3.0 mIU/L
Third trimester: 0.3-3.0 mIU/L

That said, everyone is different, and these are just guidelines. They do have evidence backing them, but they are not without controversy.

If you want to follow the American Thyroid Association's guidelines and you feel like your current doctor isn't responsive to them or you, then I would seek a second opinion. If he is open to dialogue and working with you, then it is my advice to stay with him.

It is important to monitor your thyroid during the first trimester, but please give yourself some TLC. You will figure this out! I recommend working step by step with your doctor to manage the situation.

Good luck!

[here we are]

Writing Love, what to do about the evidence backing them that is met with controversy? How do we know what is right? My dr is open to taking meds and i will ask about these guidelines.How do i know if i want to follow the guidelines if my Dr gives me a choice? Is it better safe than sorry, especially if i might be havibg twins?

[writinglove]

Dear Here We Are,

You questions are good ones.

Evidence: Whether you decide to trust evidence-based medicine is up to you. I recommend reading up on it, particularly related to studies that back the current guidelines for thyroid levels and pregnancy. Here is a wikipedia link to what evidence-based medicine means: http://en.wikipedia.org/wiki/Evidence-based_medicine Wikipedia is just a start, but it can point you to more in-depth information.

Controversy: People always question guidelines and evidence-based medicine, which is what I meant by controversy. Learn more about people's questions/concerns about the current American Thyroid Association's guidelines to inform your decision. The link I sent your earlier, http://thyroid.about.com/od/hormonepregnantmenopause1/a/2011-Guidelines-Thyroid-Disease-Pregnancy-Postpartum-Reviewed.htm, will tell you more about the questions and concerns people have (see the bottom of the page). Here's one way to frame it (and please know this is not me telling you what to do): If you don't think the questions and concerns are relevant and you agree with the evidence backing the guidelines, then you can go with the guidelines. If you do think the questions and concerns are relevant, then you will want to do more research.

None of this is black and white (ah, life!), but you can become very informed! If your doctor is giving you a choice, then it sounds like it is up to you to decide how you want to proceed.

I personally choose to monitor my thyroid levels very closely (with the help of my medical practioners) when I am pregnant. I think there is enough evidence that being hypothyroid can cause developmental issues for my fetus, and I have chosen to be very cautious and pragmatic.

Good luck with all of the decisions you have to make!

[here we are]

I don't like that my obgyn dr is giving me a choice because i dont know what is right so how can i make an informed choice? My tsh was 6.3 earlier this week. My pcp said obgyn is full of crap and to get a new dr. I am taking the med. I called him, obgyn, after i saw pcp, i was in tears and his nurses said he never wrote down in the notes that i had a choice to take the med . As if i am the pregnant , confused , hormonal one, obsessing. Pcp said ,"why do uou want a midwife? If it was me i would want a Dr." I said "why?", she said they know more. The place i went to uses CNM and if you need a cesarean, you get a Dr. I dont know what she was suggesting. I kept telling her what he said, making myself look.like a fool, and probably making him look bad. I am so confused. She kept emphasizing the risks to the baby, suggesting i had my mind set one way and it couldnt be changed. I just want to understand why i need the med, especially after what the obgyn said or why i dont. I think they both don't know all the answers. I feel trapped, taking the med, and worrying about it ever since i went to see them. Now i need to get ultrasound b/c my hcg suggests i may be further along, which i guess would be worse for the thyroid or catching up to where i am supposedly supposed to be with my tsh. I need to relax. I tried to get referrals from them both for an endocrinologist, but only pcp gave me one, which i have to wait one month . Pcp's nurse said i shouldn't eat too many servings of cruciferous veggies b/c they cant moniter it and it will affect my thyrour, and its "like a diabetic eating chocolate, and try to eat other foods".Saying the amount in my prenatal is enough. I told her that was crazy, she said.ask the endo dr. And no more eating seaweed, miso, soy sauce. Obgyn said my vitamin was ok, but too expensive, its New Chapter. I told him what i ate, he said we could consider that in my dosage if i am not absorbing. For some reason, he wont give me a referral to endo dr until after ultrasound or maybe not at all? I dont understand how i am supposed to go to two people with such different opinions and not go crazy.

[OceansEve]

Why do you have to wait a month to get into the endo if you pcp is willing to give you a referral? Is that just the wait time for an appt? I would call every endo under the sun and find one willing to get you in NOW given that you are pregnant.

What are your Free T3 and Free T4?

Here's what you need to understand - the OB is not an endo. They don't know anything about it other than what tiny bit they may remember from med school. Don't ask your OB for help with your thyroid. Find a YOUNG endo, go to a teaching hospital if possible. They have the newest info and are not dead set in their old methods and ideas. My OB was fine with my TSH being over 7 because my T3 and T4 were in the  "normal" range, by maybe a tenth or two, but they were. The more looking I did I realized my OB didn't have the newest info for hypothyroid and pregnancy. I found a young endo who started me on a low dose and tested me every 2 weeks till I got close to a tsh of 3. It has made a world of difference in my ability to function during this pregnancy.

I lost two pregnancies last fall with my tsh just above 7. Was it the thyroid that caused it? Who knows for sure. Maybe I'm not understanding correctly, but you have meds on hand? Personally if you have the meds I would continue to take them until you can get into an endo. That being said I didn't get on the meds till near the end of my first tri by the time we discovered the tsh problem and I got into an endo. And here I am 38 weeks, still pregnant.

Yes there is a large range of functioning tsh. I function fairly well in the 6-7 range when NOT pregnant, but that is because my T3 and T4 are keeping up, but my thyroid is under duress. Most drs consider lower than 5 to be normal, but there are people who can hardly function with it over a 3. It depends on your body and there's not definitive study because of the wide range of functioning. However when it comes to your growing baby I say err on the side of caution. Go with the most up to date recommendations by the organizations that KNOW.

Good luck!

[tiqa]

Re: Diet - Cutting out gluten and coffee have helped me feel much better.  You can still eat cruciferous vegetables if you cook them first.  Soy, yeah, I would cut that out.

I also plan on going back on a lower dosage once the baby is here, going by symptoms rather than numbers.  I felt much better pre-medication.  But I'm trying to keep the numbers low for the baby's sake.

[sunshine28]

Try to get  it checked well. A family member had an issue with the thyroid being off, where she lost a few babies, and once she started on the thyroid med. (synthroid), she was pregnant 2 weeks later. Healthy baby.
 

[TIFF4NY]

Just wanted to say that they found me to be subclinical hypo at around 12/13 weeks and then proceeded to find that I had hashimoto's. I started taking synthroid immediately. I didn't have any trouble getting pregnant but they said I had low progesterone in the beginning so I got to take those wonderful pills until 14 weeks. I'm 19.5 weeks now with no known issues and baby looks good.

I would definitely recommend a gluten free diet. I have been paleo since early 2011 so maybe that is what aided me in getting pregnant. I had been doing a strict Whole30 the month I found out that I was.