Miscarriage/Pregnancy Loss

Hypothyroidism

Spartanrd4Spartanrd4 member
edited March 2016 in Miscarriage/Pregnancy Loss
So I am having a mild freak out day- sometimes my medical brain just doesn't know when to shut off and I feel like I'm a crazy hypochondriac most of the time. Anyways so I was looking at my past labs and realized that in December 2014 when I had my last annual physical that my thyroid was checked and my TSH was high (a little bit over the cut off for normal) but my T4 was normal. My PCP said everything was fine with my thyroid. Now I am worried that I might have developed hypothyroidism since then or have what is called "subclinical hypothyroidism"- I emailed my PCP and he said to have my TSH checked at my next visit. Can OB order this or should I follow up with him? I am just freaking out that something was wrong with me that was missed and it somehow caused my miscarriage. Anyone have any insight with this? I hope I'm not grasping at straws :( 

Re: Hypothyroidism

  • Your OB can orders labs as well. Totally normal freak out. I have had hypothyroid since I was 22 (30 now) and actually have nodules that have to be scanned every year. My endocrinologist conpletely brushed me off when I got pregnant and wasn't going to see me until what would have been the end of my first trimester. 

    I conpletely understand your feelings of grasping at straws with this. Every day I wonder if that was the cause since I felt like my thyroid levels were off before my MMC. I think our brains try to find some explainable issue to ease the pain. I asked my OB about it the day of my d&c and he said that thyroid very rarely is the cause. 

    Definitely ask to get it checked and with any future pregnancy you can always request the labs early on for peace of mind. 
  • Thank you @SnobunnieMel....I will ask my OB about it at my next appointment, hopefully won't have to go to the PCP. I need as much peace of mind as I can get....my mom is a nurse and she thinks I'm crazy! 
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  • Your ob can order tests as well as treat hypothyroidism. What was your TSH level? I recently learned that a TSH over 2.5 increases the risk of mc. I was very certain that this is what caused my losses, but I did a chromosomal analysis on my second loss and my baby had a genetic anomaly unrelated to my thyroid. 

    I've started treatment for my thyroid and it has gone down to within range,  3.8, but my doctor wants me to double my meds to lower it more. 
  • Spartanrd4Spartanrd4 member
    edited March 2016
    @ThePax89My TSH level was 5.42 (upper limit of normal is 5.0)...my level was 5.24 in 2011 but that was reported normal because apparently at that time the upper limit of normal was 5.50. T4 is .94 (normal). In my research I've been doing so far, you usually are treated if your TSH is over 10 but for levels 5.1-10 treatment is still controversial. 
  • ThePax89ThePax89 member
    edited March 2016
    @Spartanrd4
    thats exactly what my starting value was. 5.2 ish. Normal t4. 

    Just out of curiousity, what are your other symptoms of hypo? 
  • @ThePax89 I really don't have any symptoms of hypo- If I never had my thryoid checked, I would have no idea that anything was wrong. I'm clearly just going off my TSH level right now. 
  • I've had hypothyroidism thru all my 5 pregnancies. I've been on meds since I was 20. My ob followed it yearly and kept me at the 3.0range with my meds. But I just started seeing an endocrinologist last year because I still felt sluggish, hair falling out, patchy skin and she said for my age 36 I should be 1.5-2.0range. So she increased my meds. However I then had 2 miscarriages after the meds increase. Of course I thought that could be the reason but my endo & ob said no. But it's the only thing that changed since my 3 healthy pregnancies to then have 2 miscarriages. It's soo frustrating trying to find a reason when there just isn't:( 
  • @Becid24Do you recommend seeing an endocrinologist? 

    Shockingly, I LOST weight, like a butt ton with hypothyroidism. I weigh like 115 and am 5'6
  • She ran a ton of lab work on me that my ob had never done and swore I would have Graves' disease or hashimoto by looking at me but I don't have them. I'm not sure what to do honestly. My husband won't let us try again for a rainbow so I'm gonna continue on with the endocrinologist but if we were gonna try again my gut tells me to let my number go up s little and see if I could keep the pregnancy. It's so hard to say and my craziness still creeps in to my thoughts. Sorry I couldn't help more. 
  • I've been reading about hypothyroidism due my aunts illness.  If find this one a good read.
  • RiverSong15RiverSong15 member
    edited March 2016
    @ThePax89My TSH level was 5.42 (upper limit of normal is 5.0)...my level was 5.24 in 2011 but that was reported normal because apparently at that time the upper limit of normal was 5.50. T4 is .94 (normal). In my research I've been doing so far, you usually are treated if your TSH is over 10 but for levels 5.1-10 treatment is still controversial. 
    @Spartanrd4, this is actually outdated treatment information. 5 is the cutoff for the normal population. In the first trimester of pregnancy, your TSH should be below 2.5, and ideally below 2. I'll try to dig up the reference (I think it was and American association of endocrinologists paper from around 2012) when I'm feeling up to it. This is not the current standard of care for treatment of women who are pregnant or TTC, and not all PCPs are aware of this fact.
  • To chime in on this, I was at my endocrinologist yesterday. My numbers were great for a normal person but for some one conceiving and in their first trimester she actually is tweaking my meds. My TSH was 1.2 but she wants it in a 1.0 range and my T4 was 0.98 and my T3 was 2.4. I take armour which is desiccated pig thyroid gland so it contains both T3 and T4. Instead of increasing that and possibly suppressing my TSH too much can, she added a low dose of synthroid to just raise my T4 and get my TSH down to 1.0. 

    I would find someone more aggressive about treating this. when you are pregnant he baby actually uses up your circulating free T4, which is why my doctor added just a T4 medication, and it is essential to their brain development. She wants me monitored every 4 weeks with labs if I am able to conceive again. 
  • Thanks for your input everyone....I'm going to ask about my TSH level at my upcoming OB appointment and based on if he will do labs or not and how seriously he takes me I will definitely consider going to endocrinology. I just want to make sure that I am in the best position next time I conceive...unfortunately I thought I was on top of everything but in hindsight something may of been overlooked during my care and I just want to have peace of mind that I did everything I could to avoid complications.
  • So an update on my hypothyroidism. I had my TSH level checked at my last OB appointment last month and it was still high (higher than it was in Dec 2014 but could of been because of the pregnancy/miscarriage) but T4 was still in the normal range. So I made an appointment with an endocrinologist and after another month of waiting finally saw her yesterday. So officially I have subclinical hypothyroidism and she started me on synthroid and will recheck my TSH in 8 weeks and see if we need to adjust my dosage. She really is only starting me on meds due to my miscarriage and TTC- she did not tell me not to TTC but told me to tell her ASAP when I get pregnant to up my dose. I also had some blood drawn and my TSH did go down from where it was a month ago but obviously still too high. I also have positive antibodies as well which I expected. 

    She did not tell me that my thyroid was the cause of my miscarriage and like all the clinicians I have spoken to have said- its not my fault and so many different things could of happened there is no way to say for sure. But I am just so proud of myself for being proactive and pushing to get this checked out- that something with my thyroid has obviously been wrong for years and no one seemed to notice or want to treat. I wish I was more educated about it previously before I got pregnant but hindsight is always 20/20 and I can't keep dwelling on that.

    I'm feeling a lot more positive going forward in TTC that at least I am trying my best to do *something* to help me get the rainbow baby I want so badly. Thanks everyone for letting me babble on :) 
  • @Spartanrd4 I'm glad you are in a good place and feeling positive! TSH can take a few blood draws to find the right dosage for you, but good for advocating for yourself! 

    Don't feel bad about not pursuing this earlier. The guidelines for treating TTC women only started changing in 2012, and even now, many PCPs are still behind on the guidelines. You can't fix what you had no way of knowing about.

    As far as treatment when you get pregnant again, you may want to ask what your doctor wants to do dosage-wise. Mine wants me to up my dosage by 25% immediately, no matter what my blood draw says, so I've done that both times the day I got a positive HPT and before I went in for a blood draw. Good luck!
  • Good for you for being proactive!

    LlMy TSH was .19, so too low due to my medication being too high. My doctor said we'll just take half a tablet on Sunday without ordering new lower dose pills. When I got my BFP, I went back to taking all full pills since I thought I'd need to go up. Drew my levels at 7 weeks, and I was still .19. It's a weird thing. But maybe it had something to do with baby stopping growing.

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  • nmd9168nmd9168 member
    A week before my MMC, my doctor's RN called me to tell me that they overlooked my thyroid test results (3 weeks prior) at my first ultrasound. They gave me thyroid meds to "balance everything out." A week or so late, I found out I had miscarried. The doctor thought it might be because of the thyroid... so it may be a possible cause. It may not. That's what is so horrible about miscarrying. You may never know. =/
    Me: 28 DH: 29
    Married: 4-25-2014
    TTC: March 2015
    BFP: 2-18-16
    Confirmed MMC: 3-31-16
    D&C: 4-2-16
    TTCAL: May 2016
    IUI: 5/13/17-Femara and Trigger, POAS 5/27/17 BFP 5/27/17



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