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