subclinical hypothyroidism?

hnelson · 07-30-2009, 03:00 AM

I just got back from my RE and they did my 6dpo bloodwork and finally fit in my thyroid function testing. The results were normal T3, T4, elevated TSH (at 6.0). I'm in Japan and don't speak japanese so I wasn't able to ask a lot of questions (and I stupidly didn't ask for a printout of results, so I don't know if they measured free T4, what the units are, etc). I have been recommended to the Internal Med doc tomorrow for further testing, but the RE doesn't think it will be an issue.

Well, I've done a little research on the internet and it seems these initial results indicate I have subclinical hypothyroidism. I had been tested about 10 years ago before beginning treatment for depression and was told at that time that everything was Ok. Now I read that hypothyroidism can be harmful to a fetus, especially low T4 (which I don't currently have) and also high TSH (which I have but doesn't seem excessively high). I am now concerned about my 18 mo (normal developmentally now, but I'm still worried) and i'm currently 6 dpo on a medicated cycle actively ttc.

Anyone else have this? What have you done - treat it or just monitor it closely? If you're pregnant or have been, did it get worse during pregnancy? Were you able to keep meds at good dosages to keep hormone at the right levels?

I'm kind of freaking out now and tomorrow won't come fast enough for me to get some more information (all be it in fragmented english).

meggowiggle · 07-30-2009, 05:59 AM

I do not have subclinical, but clinical, hypothyroidism. However, I am willing to wager the treatment is relatively the same. I am on Synthroid (Levothyroxine) to bring my levels to where they should be. Once pregnant, the dosage is usually increased since not only is your body providing thyroid hormones for yourself but for the growing baby. I started out at 50mcg, and was increased to 75mcg when we got a BFP, and it was imperative that I continue taking the medicine through the pregnancy. After we miscarried, my doctor went ahead and had me stay at 75mcg. I was told my TSH was to be between .2 and 2. Borderline is about 3, and anything above that is way too high. I hope that helps some.

hnelson · 07-30-2009, 06:58 AM

Thanks for your reply. Can you tell me where your levels were (TSH, T4 etc) before you started synthyroid? I just want to make sure they are not being too conservative initially because I could have conceived 6 days ago and want this addressed asap! One good thing - I found out that the doc I've been referred to is the endocrinologist at a major Tokyo hospital (clinic) so I think I'll be in good hands. Unfortunately the upper TSH level they quoted me today was 4.5, but I'm well armed with American Assoc. of Clinical Endocrinologists papers, so hopefully they'll work with those guidelines especially because I'm American (they are relatively reasonable to work with our home country norms so keeping my fingers crossed).

melindaleigh · 07-30-2009, 12:41 PM

My TSH was 8.6 and I was put on Synthroid 75mcg. I was then asked to get a thyroid ultrasound - preventative and get the thyroid antibody screening. They then discovered nodules (small tumors) on my thyroid and the thyroid antibody screening came back positive for Hashimoto's Disease. Because of my experience, I would recommend asking for all of the tests possible to rule out other problems.

Don't freak too much - lots of ladies further develop thyroid problems in pregnancy and they can get them under control rather quickly. I think as long as they put you on synthroid you will be fine.

meggowiggle · 07-30-2009, 05:22 PM

When I was first diagnosed, my TSH was at 7. It was at a 4 when I got my bfp. Now, after the dosage adjustment, it is down in normal range.

Another option is to have your thyroid "killed" (purposefully not working at all, even removed), and provide your body the thyroid hormone completely artificially through medication. The benefit in this is that you do not spend time trying find the correct dosage to compensate for your lacking thyroid function.... they can start you off right away at a dosage that will replace a fully working thyroid. For subclinical hypo, though, that seems pretty drastic. It is an option though.

mindaleigh, I was not aware there were such tests! I will look into them for myself!

Sara-Elizabeth · 07-30-2009, 05:42 PM

I was a borderline hypo- My tests were slightly over 3 (somewhere around 3.3), but with the lack of energy and the hair loss, my PCP started me on 12.5 mcg synthroid, just to see the effect. It really helped, and when they tested to check levels, he took me up to 75 mcg, which is where I am nearly a year later.

hnelson · 07-31-2009, 03:52 AM

Thanks for all of your replies. I had my Endo appt this morning and was put on 25 mcg. I actually had to ask for that because the endo wanted to start at 12.5 mcg, but I may be pg (7 dpo) and I want normal levels asap. I go back for more bloodwork (antibodies, medicated T4 levels) and thyroid u/s in 2.5 weeks. If I conceive this cycle, I would then be 5.5 weeks pg - I hope my TSH levels respond well!

does anyone know what affects a person's response to synthyroid? It seems as though it is an individual response for each person rather than a formula (e.g. 25 mcg to reduce TSH by 2). Even though I have started synthyroid I am concerned that it isn't enough to get me into the normal TSH range and will have negative affects on a pregnancy. Any insight would be appreciated!!

Sara-Elizabeth · 07-31-2009, 01:46 PM

I think a lot can depend on when and how you take it, and how well your body absorbs the Synthroid and uses it. For example, I've been told to take it on an empty stomach, first thing in the AM, and then no soy, walnuts, fiber capsules, or calcium supplements within a few hour of taking it. This means that I'm staggering meds all through the day to fit in the 1200mg of calcium I take. But it's worth it to me, since I finally feel like I have a little energy