Something else to worry about

Wednesday, August 15, 2012

So my RE's nurse called me back this afternoon with the results of my TSH results.  I was just scrambling to head to a meeting where I was presenting to the group and I was incredibly flustered.  I should have let the call go to voicemail, but instead I picked it up and with my co-worker right next to me.  She told me that my TSH level was 3.28 and that she had asked my RE if I should start treatment and my RE said no, that I was fine without treatment.  I didn't really have time to think about this and couldn't mention my pregnancy in front of my co-worker, so I thanked the nurse for calling me back and headed to my meeting.

After my meeting I first consulted Dr. G.oogle who felt it necessary to tell me that the normal levels during pregnancy are as follows (from about.com):

First Trimester: 0.24-2.99
Second Trimester: 0.46-2.95
Third Trimester: 0.43-2.78

So umm yeah, I am totally over the limit for pregnancy.  Not by a crazy tremendous margin, but I am over nonetheless.  Having an elevated TSH, or being even mildly hypothyroid can cause miscarriage or other later problems such as preeclampsia, placental abruption, and low birth weight.  Not things I'd ever like to experience, thank you very much.

I consulted with 2 friends who have have bee treated for mild thyroid issues during pregnancy.  One has been through 2 consecutive losses and was put on thyroid medication when she became pregnant with her daughter with a level of around 3.  She actually consulted with her PCP since her OB would not treat her.  My other friend who is currently pregnant and went to the same fertility clinic as me had a level of less than 3 and was put on thyroid medication.  So the same freaking RE's office put her on thyroid meds with lower levels than me!  WTF?!

For a better reference point, check out my previously tested TSH levels:

1/10/12: 2.50 (not pregnant)
8/31/11: 1.41 (was pregnant)
6/24/11: 2.87 (not pregnant)

So clearly being pregnant this time has caused a jump in my TSH.  I am not a doctor and I can see that.

I called back my RE's office and left a message asking to speak to the doctor about why she decided NOT to treat me.  I am going to express to her my concern that I don't know what caused my first 2 losses and that I'd like to be more safe than sorry.  I am more than likely certain mild hypothyroidism did not cause any of my losses, but why gamble, right?

Does anyone have experience with this?  I would LOVE to hear any and all advice.

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7 Comments »

7 Responses to “Something else to worry about”

  1. I could not agree with you more. This past year has taught me one thing.. you have to be your own advocate. You are the one that has to live with the outcome, not the doctors or the staff. I do not care how crazy I sound, I double check every single thing with my doctor now. Every single time someone tries to tell me I am over reacting, I explain to them (the staff) that I paid for an IVF cycle in cash with which I was told to take the wrong amount of medicine for the entire cycle because of a typo. On day one of that cycle, I knew something was wrong, but I trusted them. So I didnt ask questions. When offices quit making mistakes at the expense of others, then and only then would I not question.

    You have to be okay with what's happening, like I said... you have to live with the aftermath, not them. Do whatever you have to and dont let them make you feel crazy, you arent.

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  2. I know one of my REs will treat over 3, but my current will only treat over 4. Keep us posted.

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  3. Hi from ICLW...I do not have any advice but if you think there is something off def speak up...you def are your best advocate and its your body!!!

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  4. Ahh, the thyroid - a topic near and dear to my heart! I have autoimmune-related hypothyroidism, so hope to be able to offer you some helpful thoughts here.

    Here's a link to a super resource by the American Thyroid Ass'n on thyroid levels during pregnancy: http://thyroidguidelines.net/sites/thyroidguidelines.net/files/file/thy.2011.0087.pdf

    They recommend a maximum TSH of 2.5 during pregnancy, although some researchers believe an even lower maximum, 1.2, is better. (My own endocrinologist takes the latter approach.)

    Although your TSH falls into the normal range for the general population, it is above the range recommended by this study. I strongly disagree with your RE's decision and would suggest that you immediately you see a "real" (i.e., non-reproductive) endocrinologist to see if s/he'll start you on the thryoid replacement hormone to get you within the range for pregnant women.

    You should also ask the endocrinologist what is causing the hypothyroidism, which requires an external physical examination of the throat and a blood test for anti-thyroid antibodies. My hypothyroidism is caused by presence of these antibodies, which also (in addition to too-low thyroid levels) causes fertility issues, as the body can attack a developing embryo/fetus/etc., just as it is attacking its own thyroid.

    I don't mean to alarm you, but I think it is incredibly important that you get further medical advice on this! Try not too worry too much, though - the hypothyroidism is easily brought under control by taking thyroid replacement hormone.

    You can also check out my blog posts labeled "hypothyroidism" and "autoimmune disease" if you want to read more of my experience.

    Hope this helps! Message me if you have any questions. xx

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  5. I don't know anything about this but it sounds like you have a great resource in Elizabeth. I would definitely want to find out more about your doctors decision. I a m totally with you on the better safe than sorry plan!

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  6. Good for you for being your own advocate. I, too, love to consult Dr. Google :)

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  7. Mine is 3.4 and OB is on top of it and ready to treat!

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