High TSH and T4

[Lavge]

I have a question as I'm a bit confused after my last results. First a bit of background. I was diagnosed with hypothyroidism in 2009 when my daughter was just over 1 year old. The funny thing is that I had bloods done because I was loosing weight and feeling tired. I had gained 60+lbs during pregnancy and was at that time about 20lbs below pre-pregnancy weight. I was started on 50mcg of levothyroxine. The weight loss stopped.
About a year ago I moved to Spain, and when I needed my first prescription I was put up to 75mcg as TSH came out on the high side (about borderline I can't remember exactly). Since then its been put up to first 88mcg and lately 100mcg. The last results came back as TSH 5.11 (0.27-4.2) and T4 1.62 (?-1.71).

In the last year I have also suffered 4 early miscarriages. I'm being tested for anti-bodies in April.

My question is, how can TSH and T4 both be relatively high? Could there be a relation between this result and the possible presence of antibodies, or could it explain another issue that could also play a role in miscarrying?

[Lavge]

Thank you. I'm really getting rather desperate on this issue. My doctor seems to believe that as long as the Free T4 is normal everything is fine. I'm feeling symptomatic at the moment, being horribly tired all the time no matter how much I sleep.  I've also spend the entire winter with virus infections. However as TSH always comes back only just over the limit he doesn't consider it a possible cause and just puts everything down to stress because of the miscarriages.

Have I completely got the wrong end of the stick or is it possibe the fatigue can set in with a TSH of just over 5. Could it also be a reason for a weakened immunesystem? I have literally had one cold on top of another for 4 months.

I'm trying to decide if I'll have to accept the expense and find myself a private endocrinologist rather than rely on y doctor.

[Mark Lupo, M.D.]

This is not unusual, would focus on the TSH and bring that into the 0.3-2.0 range if you are planning another pregnancy.  Miscarriages appear to be more common in women with thyroid antibodies.