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Thyroid, Synthroid, Pregnancy, & Miscarriage
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Thyroid, Synthroid, Pregnancy, & Miscarriage

I am a healthy, but overweight 36 y/o female with no medical problems and no past fertility issues (I conceived two children on the 1st try at the ages of 29 & 32.  In 01/09, I was referred to Endo by OB due to OB blood work-up and fatigue.

On  March 4, 2009 I was seen by him and had my initial blood work done that produced these results:
Thyroid Antibodies: Thyroid Peroxidase (TPO) Ab=<10 w/ limits of: 0 - 34; Antithyroglobulin Ab=<20 w/ limits of: 0 - 40
(Siemens (DPC) ICMA Methodology)  
     TSH = 1.468 w/ limits of: 0.450 - 4.500; T4 = 10.2 w/ limits of: 4.5 - 12.0; & T3 = 166  w/ limits of: 85 - 205

He prescribed Synthroid .1 which I began taking in March 2009.  On April 1, 2009 my levels were: TSH = 1.090 w/ limits of: 0.450 - 4.500; T4 = 12.3 w/ limits of: 4.5 - 12.0; & T3 = 164 w/ limits of: 85 - 205.

In May 2009, he increased my dose of Synthroid to .112 and on May 6, 2009 my levels were:  TSH = .358 w/ limits of: 0.450 - 4.500; T4 = 10.8 w/ limits of 4.5 - 12.0; & T3 = 154 w/ limits of: 85 - 205.

In July 2009, my levels were: TSH = .147 w/ limits of .450 - 4.500; T4 = 11.9 w/ limits of 4.5 - 12.0; & T3 = 124 w/ limits of 85 - 205.  My OB says I may not be absorbing the Synthroid & my endo wants to increase my Synthroid dose to .125.  I just want to have one more child.  

I had a miscarriage w/ D&C at end of March 09 and a conception w/out implantation 07/09.  I have gained 9 pounds since March despite increasing my exercise.  My questions are:  Does it appear that my thyroid was ever not functioning properly?  Can my current thyroid levels be preventing implantation?  Is it true that TSH is irrelevant if in treatment for thyroid disorder?  Can my low T3 be preventing pregnancy?  Will increasing my Synthroid help me achieve pregnancy?  If I stop taking the Synthroid, will my thyroid return to normal level of function or is it permanently stalled?                                                                                        
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603463_tn?1220630455
Hi!
I am pretty confused.  It appears to me that your thyroid was within the normal range before they put you on medication.  They have now suppressed your TSH outside the normal range.  A low TSH means an OVERACTIVE thyroid, not an underactive one.
Also, despite several increases in your dose, your dose is still low.
I can only guess that they are treating the symptoms and not the results.  
An overactive or underactive thyroid can both cause problems with ovulation.  From your history, you must be ovulating though, or you would not have conceived.
A normal BMI (body mass index) would improve your fertility probably more than synthroid, although, granted it is much more difficult to achieve.
The fact that your anti-thyroid antibodies are negative is good!
Most miscarriages are caused by abnormal development of the embryo due to chromosomal abnormalities. Chromosomal abnormalities are increased in frequency with increasing age. (Reversing the hands of time would help too!)  
If you were my patient, I would get a second opinion about your thyroid, and advise you to keep trying!  
I hope this is somewhat helpful!
Dr B
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