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How to prevent hypothyroidism from causing another miscarriage?
I was diagnosed with hypothyroidism in 2010 and have taken Levothyroxine since then. My TSH has been between 1 to 3.5 up and down in the past 6 years with a February 2016 TSH of 2.5. I got pregnant for the first time in July (found out early August) and had a blood test done in early August and my TSH had jumped to 6.14 but normal in range T4 and T3 levels. They changed my levothyroxine dosage from 88mcg to 100mcg, Two weeks later we went for our first ultrasound and saw the baby and saw and heard the heartbeat at 122bpm and measured 6w5d. Two weeks later I went in for ultrasound and there was no longer a heartbeat and baby measured 8w3d so had just died a couple days before and I had to get a missed miscarriage d&c. Since this was only about a month after my spiked TSH level I have a feeling it was due to my thyroid. How can I prevent my TSH level from escalating so drastically if/when I get pregnant again? How can I prevent miscarriage from thyroid issues? Since it takes 6 weeks until you can get another blood test to see how the levy dosage is working, there's nothing I could have done to help my baby it feels like.
Doctors are taught that TSH accurately reflects the thyroid status of a patient. In reality it cannot be shown to correlate well with either of the biologically active thyroid hormones, Free T4 or Free T3. TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms and also levels of Free T4 and Free T3. Of those Free T3 is the most relevant test since it is used by all the cells of the body. T4 is basically a prohormone, that has to be converted to T3 in order to be metabolized throughout the body. In the future you should make sure that they always test for both Free T4 and Free T3 every time you go in for tests.
You did not show any Free T3 test result. Were you even tested for Free T3?
Your TPO test in 2010 showed positive for the antibodies of Hashmoto's Thyroiditis. With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland. As this proceeds, the output of natural thyroid hormone is diminished and has to be replaced with thyroid med. A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. From the experience of our members Free T4 should be at the middle of its range, at minimum, and Free T3 should be in the upper third of its range, or as needed to relieve symptoms. Your Free T4 was only at 39% of its range, we don't know about your Free T3 level, and you haven't mentioned any symptoms you have had.
Before conceiving it is very important to get your Free T4 and Free T3 levels to at least mid-range, and then test and adjust your meds as needed to at least maintain those levels. Using only TSH to diagnose and medicate a hypothyroid patient does not work. You can get some good info from this link. I recommend reading at least the first two pages, and more if you want to read the detailed review, and also see the scientific evidence supporting the 6 listed suggestions. Then with that knowledge you can use the paper with your doctor to make sure you get the testing and clinical treatment needed, or find another doctor.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
You did not show any Free T3 test result. Were you even tested for Free T3?
Your TPO test in 2010 showed positive for the antibodies of Hashmoto's Thyroiditis. With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland. As this proceeds, the output of natural thyroid hormone is diminished and has to be replaced with thyroid med. A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. From the experience of our members Free T4 should be at the middle of its range, at minimum, and Free T3 should be in the upper third of its range, or as needed to relieve symptoms. Your Free T4 was only at 39% of its range, we don't know about your Free T3 level, and you haven't mentioned any symptoms you have had.
Before conceiving it is very important to get your Free T4 and Free T3 levels to at least mid-range, and then test and adjust your meds as needed to at least maintain those levels. Using only TSH to diagnose and medicate a hypothyroid patient does not work. You can get some good info from this link. I recommend reading at least the first two pages, and more if you want to read the detailed review, and also see the scientific evidence supporting the 6 listed suggestions. Then with that knowledge you can use the paper with your doctor to make sure you get the testing and clinical treatment needed, or find another doctor.
http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
Is TSH the only thyroid related test being used to determine your Levo dosage? Also, please post your August test results and reference ranges shown on the lab report.
1 Comments
My August FreeT4: 0.99 ng/dL
Standard: 0.59 - 1.61 ng/dL
My August TSH: 6.14 microIU/mL
Standard: 0.34 - 4.82 uIU/mL
But in 1st trimester pregnancy limit is 2.5.
They upped my levothyroxine dosage to 100mcg daily in August when I got pregnant and TSH level had spiked.
Earlier in 2016 my T4 was 0.9 and TSH was 2.23 and I was at .88mcg Levothyroxine.
I've had my TSH under 2.5 since 2010 when I was started of Levothyroxine due to a TSH of 10 at the time.
In 2010, my TPO was at 143 where standard range should be below 35. That was the last time my TPO was tested.
I am currently 34.
Standard: 0.59 - 1.61 ng/dL
My August TSH: 6.14 microIU/mL
Standard: 0.34 - 4.82 uIU/mL
But in 1st trimester pregnancy limit is 2.5.
They upped my levothyroxine dosage to 100mcg daily in August when I got pregnant and TSH level had spiked.
Earlier in 2016 my T4 was 0.9 and TSH was 2.23 and I was at .88mcg Levothyroxine.
I've had my TSH under 2.5 since 2010 when I was started of Levothyroxine due to a TSH of 10 at the time.
In 2010, my TPO was at 143 where standard range should be below 35. That was the last time my TPO was tested.
I am currently 34.
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