Thyroid and pregnancy

[Girlieplease]

Right knowledgeable ladies need advice please. I am 8 weeks pregnant with baby number four, I was diagnosed with an underactive thyroid at the same time as I found out I was pregnant with ds1. My gp referred me to specialised Endocrinology team and I was booked in at 8 weeks and my medication increased beyond the increase my gp had made. With ds2 my levels were always stable so no issue. I got my levels checked in June as I was struggling toconceive and I was then seriously hyper, having been hypo since 2012. I think due to my weight loss. My meds were reduced and bloods rechecked in July. Bloods fine and gp recommended I remain on the lower dose. When I went to go about the pregnancy I asked to get my levels checked. He rang me the following week to say my tsh was 3.85, he recommended I increase my meds by 25 ml g, and get rechecked in 4 weeks time. I got my hospital booking appt at the weekend and it is not until am nearly 12 weeks. I really hoped to see the Endocrinologist before then. My gp referred me to the hospital before he would have been aware of my tsh levels. I rang the hospital today and explained the situation and my concerns re miscarriage. She said she would speak to the Endocrinologist but thinks it is unlikely that I would get seen before my arranged booking appt when am nearly 12 weeks, any advice? Are my numbers maybe not that bad? Maybe I am worrying over nothing? I worked so hard on my diet, exercise and to get pregnant I don't want to take risks! Thanks for reading x

[Girlieplease]

My above post is confusing, with my first ds1 I was referred immediately to the Endocrinologist service because my levels were unregulated that was in 2012 and I was seen at 8 weeks, hope that makes sense x

[atomic sagebrush]

Get into see SOMEBODY as quick as you can. I'm not trying to be an alarmist but I think this needs attention right now. I know in the UK it is not so cut and dry as it is here, but I would call and call anyone you can think of who may be able to address this. For them to tell a pregnant woman her mediation needed to be changed and then not be able to see you for that long is not cool and needs to be addressed IMO.

[Girlieplease]

Thanks atomic. I am not sure what to do or who to ask. I will keep pushing at the hospital. I will write them a letter tomorrow as they might take more interest if I put my concerns in writing. I could speak to my gp again but I think he would be reluctant to further increase without the blood work to back it up. I really don't know who else to ask? Or who else to push to do something? Thanks for your help x

[Eko]

I think it sounds normal treatmentwise.
Your TSH is a little high for pregnancy, but would still be within range if you weren't pregnant or ttc - so it isn't that bad or alarming. Increasing your meds by 25 mcg sounds like the normal treatment for the slight elevation in TSH and nothing more than that can really be done for the next 4 weeks anyway, that's how long you should wait for the next test to evaluate if your new dose is good or should be adjusted (up or down) again.

I'm in Sweden and I had my thyroid checked right at the beginning of my pregnancy. My TSH was 3.1 and gp told me to increase meds by 25 mcg and to recheck in 6 weeks (I asked about 4 weeks, but he wanted me to wait the full 6 weeks). I've just rechecked last week (at the maternity unit that will be taking over from my gp now that I'm pregnant) and this time my TSH had lowered to 0.28 and my T4 was slightly above range. I will recheck in a week and if it doesn't look better they will probably adjust my meds again. Because my levels had changed so much they consulted with the endocrinologist, but I never spoke to him myself and they won't refer me to him unless I get Graves disease again (My thyroid is underactive after being treated for Graves/hyperthyroid.) I'm happy just to hear that they actually consulted with him, they usually take care of the thyroid issue themselves and only consults if there's something they're unsure of.
I don't mean to make this post about me, I just wanted to share so you'd see that the course of treatment were sort of the same: TSH just a little bit elevated (2.5-4.2) -> increase meds by 25 mcg -> recheck in 4-6 weeks to evaluate.
I tend to not trust doctors completely and want to be informed and have control over the situation myself, and when I read up on the guidelines they matched this course of treatment for TSH within that range.

Myself I'm not worried a bit. The slightly elevated TSH is very unlikely to cause an elevated risk of misscarriage. Okay I don't really know that my fetus is still alive in there, but if it isn't it's most likely because of some other issue and not my TSH being a little high in the beginning and now the opposite me being slightly hyper, it needs to be off by more to cause harm.

[atomic sagebrush]

Thanks eko, very helpful.