subclinical hypothyroidism?

hnelson · 07-30-2009, 03:17 AM

I posted this on the TTC forum, but thought I would post over here too as my major concern is if I conceive this cycle and start meds for hypothyroidism - doesn't seem ideal as they monitor dosages to see how I respond, etc. Would like to hear other pg women's experiences.....

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).

AMYvsPCOS · 07-30-2009, 03:46 AM

A TSH of 6 is high. Anything over 3.5 is considered abnormal and you should definitely be on synthroid especially if you are trying to get pregnant. I was diagnosed right at 4 which isn't very high but was very symptomatic for me. I'm almost positive that undiagnosed hypo caused my m/c at 17 weeks.

hnelson · 07-30-2009, 04:51 AM

thanks. how long did it take your tsh to become regulated once you started meds? was it a lot of adjusting the dosages, or did your doctor get it correct immediately?

Vern · 07-30-2009, 12:04 PM

I think for me, once on meds, it only took a month to get my TSH into a better range. But probably a few months until it stayed steady where we wanted it to be.

jsr72 · 07-30-2009, 12:34 PM

Quote:

Originally Posted by AMYvsPCOS
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A TSH of 6 is high. Anything over 3.5 is considered abnormal and you should definitely be on synthroid especially if you are trying to get pregnant. I was diagnosed right at 4 which isn't very high but was very symptomatic for me. I'm almost positive that undiagnosed hypo caused my m/c at 17 weeks.

Amy is right, a TSH of 6 is high. My endocrinologist considers anything over 4 high and if you're in the 3-4 range, he considers it "sluggish". Ultimately, your TSH should be somewhere between 1-2 for it to be working efficiently (this would also be an ideal range for pregnancy).

Before I got pregnant, my TSH was at 4.5. When I got pregnant, it skyrocketed to 11! My synthroid was quickly adjusted from 100mcg to 137mcg. I will go for blood work in two more weeks to see if that dose is working for me.

Try not to worry about your 18 month old. If DC is developmentally on target now, that is a great sign. I had similar thyroid problems when I was pregnant with DS (my TSH fluctuated a lot and he is a happy, healthy 3 year old). But you definitely want to get your thyroid under control while TTC and especially while pregnant.

You definitely should be taking synthroid. You should also have your thyroid tested AT LEAST once a trimester. HTH.

Vern · 07-30-2009, 03:02 PM

I'd like to add that my endocrinologist tested my TSH every 4 weeks during the first trimester, and now that its holding steady, every 6 weeks during trimesters 2 & 3.

I miscarried my first pregnancy and at that time my TSH was 4. Since then I have been medicated and this time I got pg when my TSH was 1, with no complications.

AMYvsPCOS · 07-30-2009, 05:44 PM

I started on the lowest dosage and my TSH was under 1 in just 4 weeks. The when I got pregnant it skyrocketed and we had to double my dosage which got it right where it is suppose to be. I'm being tested every 8 weeks.

hnelson · 07-31-2009, 04:00 AM

Thanks for all of your replies. I had my Endo appt this morning and was put on 25 mcg of synthyroid. 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!!

jsr72 · 07-31-2009, 12:11 PM

It is GREAT that you were able to start on synthroid! Even better that you were able to start on 25mcg. As far as what affects one's response to it, I have no idea. It's a great question & I wish I had asked my endo when I was just there but I will during my next visit.

My endo did spend a lot of time trying to decide what dose to increase me to, looking it up on his computer & weighing the pros/cons with me. He decided on a larger increase from 112mcg to 137mcg, skipping the 125mcg all together.

With this pregnancy and my last, my TSH level changed once I got pregnant and therefore I needed my medication adjusted. And with both pregnancies, my TSH level was within normal range (3 & 4) but still not as good as I would have liked.

I think the fact that you're taking the synthroid will help tremendously. As soon as you get a bfp, get your levels tested again so adjustments can be made to your dosage sooner rather than later.