Thoughts - Thyroid and First Tri

[cocobellaf]

In March, I had a partial thyroidectomy done due to a large benign tumor.  I started taking Synthroid around April.  Once I got established on Synthroid, my TSH would stay around 1.5-1.7.  

Right before I found out I was pregnant, they started me on Cytomel, thinking the Synthroid wasn't quite enough for me.  At first I really, really liked it.

When I got my BFP, I was under instructions from my doctor to increase my Synthroid.  So twice a week, I would take 2 pills.  The rest of the time, I just took 1.  I still stuck with 1 Cytomel.

My first pregnancy thyroid labs (16 dpo, I got a BFP on 9 dpo) were off the charts.  I don't remember my T4, but my TSH was 0.04.  They immediately had me back off the Synthroid to my normal dosing.

I had my next lab at 7.5w.  My TSH was slightly better at 0.16, but my T4 was 0.6.  My PCP faxed those labs to my OB/GYN and said that she thought I needed to quit taking the Cytomel, but she'd let my OB/GYN tell me what she thought.

I am a little bit anxious about my thyroid levels (not crazy-worried or anything).  I'm also wondering if they are contributing to the extreme NVP I've been experiencing.  I was under the impression they would go up (become more hypo) rather than plummet (become hyper).  At the time I got my first bloodwork done, I felt awful... my resting HR was really high for me and I just felt bad.  I feel better, except for the NVP and tiredness now.

Any thoughts?  

[tootsie]

I am not a medical professional, so take my opinion with a grain of salt. I'm frustrated for you, and it seems like they shouldn't have switched up dosage immediately after your BFP, perhaps the better route would have been to wait to see how your body responded to pregnancy before changing things up. 1.5-1.7 for TSH is pretty good, right?

I am hypothyroid, and my dosage has stayed the same, although perhaps they'll change it after bloodwork next week. Anyway, I hope you and your docs get it worked out. If it were me, I would push for ceasing Cytomel. Good luck and I hope you feel better soon.

[TheTuna15]

cocobellaf, Firstly, I'm sorry that you felt so shitty before. Second, I'm not an MD, but I spend an inordinate amount of time around them, so the first thing I would do is try to get both your doctors on the same page. It seems that you're doing a really good job of following up on your medical care and following recommendations. However, if things are making you anxious that's 100% reason enough to say to your OB "This is something that seriously concerns me, and I'm not completely sure how this can be effecting my pregnancy. It would significantly benefit me if you could speak to my PCP and together come up with a plan for my medication." Or something along those lines. It's never unreasonable to ask your doctor to explain things further to you or speak to another doctor for you. Good luck with everything and I hope that everything get's sorted out soon.

[cocobellaf]

Thanks for the comments!

TheTuna15, now that I'm 8w, my PCP is transferring my thyroid stuff to my OB/GYN. She'll continue to see me for things like a cold, sore throat, etc. but at the 8w mark she prefers to hand over anything that might affect the pregnancy to my OB/GYN. So there won't be any further confusion after my appt Monday... I HOPE.

[madamewaffles]

cocobellaf, I am not on any thyroid medications, but my TSH was 0.02 at 9 weeks after having a TSH of 1.5 just before IVF a few months ago. From what my OB told me, such a low TSH number does not really matter much in first tri. It is important to have a "regular" number in second tri as it can lead to hypertension. Usually our fluctuating hormones in 1st tri cause our thyroid function to sway so hopefully around second tri you will even out again. My OB will have me tested again at 14 weeks to see if it has changed and if not, think about intervention. I hope you have a nice convo about it with your doc!