hashimoto's and trying to conceive

[liriodendron]

I'm almost 38 and trying to conceive. I was diagnosed with hashimoto's thyroiditis back in early May (highest TSH was 5.1/lowest was 4.5, TPO was 149) and have been taking 50 mcg of synthroid since then (a little over 3 months). My lab results after 6 weeks on the medication were TSH = 1.5, TPO = 133. My doctor has kept me on the same dosage and I have been feeling pretty good, however I've noticed a change in my periods and wonder if this is going to continue or eventually regulate again. I used to spot several days before and after (now I just get my period starting with a very heavy flow, sometimes clotting). I used to have a pretty predictable cycle of about 30-32 days... now I'm getting my period after 25-28 days. I don't notice any pain around ovulation now (I used to). I should also add that I had two miscarriages back to back a year ago, which is why I eventually got my thyroid tested. Given that I'm trying to conceive, my questions are: Is this initial cycle irregularity normal when taking Synthroid or should I mention it to my doctor? Should I be concerned that my cycles are so short and I'm not feeling ovulation anymore? Could this mean that I'm not ovulating? How soon will my TPO levels come down to the normal > 30 range?

I am also having other symptoms that aren't "normal" for me, like occasional anxiety at night if I wake up and can't fall back to sleep. (I feel like my skin is crawling and feel the need to get up and walk around. The only remedy is breathing exercises.) I have a slight "lump" in my throat feeling, and my hair seems to be falling out a bit more than normal, but nothing alarming. Otherwise I feel a lot better on the medication (no more "foggy brain" and I'm less lethargic. Should I get my labs done again? How often should I be tested?

[liriodendron]

Thanks for the feedback. I'll talk with my OBGYN and see what she advises.

[Mark Lupo, M.D.]

if you have an enlarged thyroid, consider neck ultrasound to make certain there are not suspicious nodules.

[Mark Lupo, M.D.]

The goal TSH for trying to conceive/pregnancy is about 0.3-2.0 (in my opinion). The TPO antibody may never "normalize" - would not continue to follow that.  Hashimoto's is a chronic thyroid problem, so the TPO antibodies will persists.

Slight menstrual changes can be seen -- but this may not be thyroid related and with the current TSH on 50mcg, there is not any recommended change in thyroid therapy.  Would also discuss w/ your OBGYN.