What Every Pregnant Woman Needs To Know About Hypothyroidism

What Every Pregnant Woman Needs To Know About HypothyroidismThe launch of my blog Hypothyroid Mom is intentionally timed this October 2012 during Miscarriage Awareness Month in memory of the baby I lost to hypothyroidism and in dedication to my two boys who beat the odds and made it to the world. This is Part 2 of my 5-part series entitled Miscarriage Awareness Month: The Dangers of Hypothyroidism And Pregnancy. Be sure to read Part 1 Have You Suffered A Miscarriage? Your Thyroid Could Be To Blame, Part 3 Miscarriage in New York City…Be Thyroid Aware, Part 4 Hashimoto’s Disease: The Danger of Thyroid Antibodies and Pregnancy, Part 5 Hypothyroid Mom’s Story of Hope: Her Miracle Babies, and Hypothyroid Mom’s Top Resources.

Did you know that the American Thyroid Association has issued multiple public health statements to warn about the dangers of hypothyroidism and pregnancy?1 Hypothyroidism, an underactive thyroid, increases the risk of pregnancy complications, such as miscarriage, still birth, infertility, maternal anemia, pre-eclampsia, placental abruption, postpartum hemorrhage, premature delivery, low birth weight and deficits in intellectual development in infants.2,3 Despite the warnings, not all doctors know the ramifications of an undiagnosed or under-treated thyroid condition on a mother and her fetus, and very few patients know the facts to insist on proper testing.

I learned this the hard way. I was diagnosed with hypothyroidism the year following the birth of my first son in 2006. I trusted my doctors and followed their thyroid drug protocol to the letter never once thinking they might not know everything there was to know about hypothyroidism. I trusted them as the experts especially when I became pregnant again in late 2008. This is the biggest regret of my life.

There is ongoing debate over universal thyroid screening in pregnancy. The argument is that there is insufficient evidence at this time to recommend for or against universal thyroid testing at the first trimester visit, however, as I outlined in Part 1 of this series Have You Suffered a Miscarriage? Your Thyroid Could Be To Blame, the scientific research is mounting to show that even mild thyroid dysfunction can have serious adverse effects on mother and child.

What happens to all the women and their babies while we wait for thyroid screening to become mandatory in pregnancy?

The American Association of Clinical Endocrinologists issued a press release in January 2003 warning that 1 in 10 Americans suffered from thyroid disease yet half, over 13 million, remain undiagnosed.4 The Thyroid Federation International claims up to 300 million people worldwide suffer from thyroid problems, yet over half are unaware of their condition. According to TFI, thyroid problems are eight times more common in women than in men.5

Given these statistics there are pregnant women worldwide this very minute with thyroid disease but they don’t know they have it and their doctors are not aware they are at high-risk. Women will experience miscarriage, still birth, infertility, maternal anemia, pre-eclampsia, placental abruption, postpartum hemorrhage, premature delivery, and births of babies with intellectual development deficits, but they will have no idea their thyroid was to blame.

Take Charge Of Your Thyroid Health

Every woman planning to get pregnant, should get their thyroid tested pre-conception and then again as soon as possible in their first trimester of pregnancy. In early pregnancy the fetus is dependent on the mother to supply the thyroid hormones essential for brain development. If the mother is hypothyroid, she may not be able to supply her fetus with enough thyroid hormones, putting the fetus at risk. Thyroid levels change quickly in pregnancy, so do not delay.

Thyroid testing is currently not mandatory in pregnancy. If your doctor refuses thyroid testing because they do not consider it necessary in prenatal medical care, make your case. In November 2011 The American Thyroid Association updated their guidelines for the diagnosis and management of thyroid disease during pregnancy. According to the new guidelines:6

Women who are at high risk for thyroid dysfunction and may benefit from selected screening during pregnancy include those with the following attributes:

  • Women with a history of thyroid dysfunction and/or thyroid surgery.
  • Women with a family history of thyroid disease.
  • Women with a goiter.
  • Women with thyroid antibodies.
  • Women with symptoms or clinical signs suggestive of hypothyroidism. It is important to note that women with overt hypothyroidism are not invariably symptomatic.
  • Women with type I diabetes, in whom the rate of development of new onset hypothyroidism in pregnancy was 16% in one series.
  • Women with a history of either miscarriage or preterm delivery.
  • Women with other autoimmune disorders that are frequently associated with autoimmune thyroid dysfunction, including vitiligo, adrenal insufficiency, hypoparathyroidism, atrophic gastritis, pernicious anemia, systemic sclerosis, systemic lupus erythematosus, and Sjögren’s syndrome.
  • Women with infertility should have screening with TSH as part of their infertility work-up. The prevalence of hypothyroidism (overt and subclinical) among infertile women ranged from 1% to 43% in different studies.
  • Women with prior therapeutic head or neck irradiation.
  • Women with morbid obesity. A body mass index greater than or equal to 40 kg/m2 has been associated with an increased prevalence of hypothyroidism.
  • Women age 30 or older. The prevalence of hypothyroidism increases with age.
  • Women treated with amiodarone.
  • Women treated with lithium.
  • Women with a recent (in the past 6 weeks) exposure to iodinated radiological contrast agents.

Take charge of your thyroid health. Your baby’s life depends on it.

What about you?

Were you aware of the dangers of hypothyroidism and pregnancy?

Are you pregnant now? Are you planning to get pregnant? Has your thyroid been tested?

Have you experienced miscarriage, still birth, infertility, maternal anemia, pre-eclampsia, placental abruption, postpartum hemorrhage, low birth weight, premature delivery, or the birth of a child with intellectual development deficits? Do you wonder if your thyroid was to blame?

References:

  1. American Thyroid Association (2012, June 4). Thyroid Disease and Pregnancy. Retrieved from http://www.thyroid.org/thyroid-disease-and-pregnancy
  2. American Thyroid Association. American Thyroid Association Statement on Early Maternal Thyroidal Insufficiency: Recognition, Clinical Management and Research Directions. Thyroid 2005; 15(1):77-79
  3. American Thyroid Association. General Information/Press Room. Retrieved from http://www.thyroid.org/thyroid-events-education-media/about-hypothyroidism
  4. American Association of Clinical Endocrinologists (2003, January). 2003 Press Release – Over 13 Million Americans with Thyroid Disease Remain Undiagnosed. Retrieved from http://www.hospitalsoup.com/public/AACEPress_release-highlighted.pdf
  5. Thyroid Federation International (2012, May 21). International Thyroid Awareness Week 2012 – Be Thyroid Aware. Retrieved from http://www.thyroidweek.com/en/be-thyroid-aware.html
  6. Stagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E.N., Soldin, O.P., Sullivan, S., and Wiersinga, W. Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum. Retrieved from http://thyroidguidelines.net/pregnancy

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About Dana Trentini

Who knew that little butterfly-shaped thyroid gland at the base of my neck could affect my life so completely? I founded Hypothyroid Mom in memory of the unborn baby I lost to hypothyroidism. Winner of two 2014 WEGO Health Activist Awards: Health Activist Hero & Best In Show Twitter. *Hypothyroid Mom includes Affiliate links. Connect with me on Google+

Comments

  1. marie trentini says:

    Wow!!! I had no idea Dana of all the different symptoms that women could have
    that would affect them carrying a child to full term. Or even to conceive for that matter.
    It would be interesting to know from any Toronto viewers if they in fact do test the thyroid in the first tri-mester.
    Great info look forward to learning more from you!!!

    • Hi I lost twins 18 years ago i was 11 half weeks,all i was ever told was that they were conjoined twins, never did they test my thyroid until about 10 years ago i kept falling a sleep, and it got so bad that i came home from work on the Friday nite and slept through until the Sunday morning just waking up for a coffee. So i made a doctors app on the Monday where they sent me for a blood test which came back under-active thyroid i have been on tablets since, all i have been ever told even now is it may not help. I have had IVF which failed, and have since fallen pregnant but as i get to 7-8 weeks i miscarry, i fell pregnant in July this year done the test which my husband and I see a faint pink line, and miscarried at 7 weeks. When i went to the doctors they done another blood test and now say that my thyroid is still under active but its gone hyperactive which i don’t understand, as i always thought i was one way or another.When ever i have asked could it be my thyroid all they say is it doesn’t help but i can still fall pregnant. I been very interesting reading what you are writing and has helped me greatly at last

      • Dana Trentini says:

        Oh Barbara, I had goose bumps reading your email. I know too well that “sick tired weak” feeling of an underactive thyroid. I hope to never feel that way ever again in my whole life. I felt it when I was pregnant with the baby I lost and I get chills thinking about it. Abnormal thyroid levels, both underactive and overactive, are dangerous in pregnancy. I have so much to say about the number of women who undergo IVF these days that have no idea their thyroid dysfunction was the underlying cause of their infertility and recurrent miscarriages. Please come back on Monday morning and read the post I will publish specifically on the TSH (thyroid stimulating hormone) levels recommended for pregnancy. I found out too late that my doctors had no clue about the safe TSH levels for pregnancy which led to my miscarriage. Please come back on Monday Barbara.

  2. Dana Trentini says:

    Thanks for commenting Marie. You make a great point. I would be interested to know whether my readers had their thyroid tested during pregnancy and if there is a difference between countries. This is a global problem so I welcome comments from readers in all locations.

  3. Hi Dana,
    I never thought about my sister and possible thyroid disorders. Her first pregnancy had her in bed at 5 1/2 months until the baby’s premature birth. She was hospitalized for months because she would go into labour. Her second pregnancy with twins ended sadly with a miscarriage at 5 months. Her third was again a high risk bed rest in the hospital until the baby was born. My pregnancies were very normal. My Mother had one miscarriage, and otherwise three normal pregnancies. I never once heard it mentioned that my sister could have a thyroid problem,. Sadly she was forever being told by naturopaths after the births to take iodine and thyroid supplements. She was told her thyroid was low. Might be one of the several reasons why my sister is a strong proponent of Holistic Medicine. It would be interesting to find out if all of her torture could have been prevented with a good endocrinologist. There was no real explanation except for ‘the baby just wants to come out.’ Then I didn’t hear that any more with the miscarriage and the third highrisk difficult pregnancy.
    Any thoughts?

    • Dana Trentini says:

      Johann,
      It is very sad for me to hear about your sister’s pregnancy complications. There is research that clearly links miscarriage to thyroid dysfunction. Of course there are other reasons why people suffer miscarriages. However anyone who has experienced one or more miscarriages should have their thyroid checked. There are 3 times in a woman’s life when she is particularly vulnerable to develop thyroid dysfunction, namely puberty, pregnancy and menopause, which are times of great hormonal change. In my case I believe I had thyroid problems since I was a teenager but the symptoms worsened for me with each pregnancy. The key is finding great thyroid doctors who truly understand thyroid dysfunction, proper testing and treatment. Much more on this to come from me. Thanks for sharing.

      • Dana Trentini says:

        One more point Johann on your sister’s pregnancy complications. Not only does the research link hypothyroidism to miscarriage and still birth, but it also links an underactive thyroid to infertility, maternal anemia, pre-eclampsia, placental abruption, postpartum hemorrhage, premature delivery, low birth weight and deficits in intellectual development in infants. When I was carrying my second son, I developed placental abruption during week 35 of my pregnancy and my son was born premature. If anyone reading this post has experienced any of these symptoms in any of their pregnancies recently or in the past, get your thyroid checked.

  4. Dana, thanks for commenting over at my blog. as i said there, i am so sorry about the loss of your precious baby. i am glad that you have launched this blog — i hope it will help many others. i’m hoping in the coming months to expand my blog to be more of a resource for women seeking answers, help, and hope after experiencing pregnancy loss, and i’d like to link your blog to an appropriate post at that time. thanks!

    • Dana Trentini says:

      Hi Hadashi,
      I enjoy following your blog Tummymuffin about finding your way through pregnancy, loss, miscarriage and motherhood. I feel your pain in your blog posts about the loss of your babies and then the joy of motherhood. As mothers, we carry our babies inside us and attach to them as people and feel their loss so deeply when we lose them.

  5. I’m am currently 6 months pregnant with my first child. My thyroid levels were one of the things checked at my first OB visit. My levels were at 27.7. I understand that the normal is 4 or under? While I was put on medicine to bring my levels down I was never told any of the potential complications named here on your blog could become an issue for me. My levels are still high at 9.1.

  6. Dana,

    Thank you so much for starting this blog and sharing your knowledge on hypothyroid. In December 2010 I was told my baby had stopped developing at 7 weeks. When I started asking for testing the doctor said I had to have 3 or more miscarriages before they could do any testing. At that point I decided I needed to change doctor right away if I ever wanted to try to get pregnant again. My new doctor is a high risk doctor and when I met him the first question he told me is that there is always a reason for a miscarriage and that he would not wait for another miscarriage to find out. He then asked if there was history of hypothyroid in my family. Since my sister suffers from it I said yes. From there he proceeded to test if I had it plus many other things. My tests came out fine and my doctor said I was clear to try again. So in June 28, 2012 my doctor delivered my baby boy. Anyway, I am just so thankful that he was one of the few doctors that tests for hypothyroid on pregnant women. Now, my sister is thinking of starting her family so I have shared your blog with her. Again, thank you for starting this blog.

    • Dana Trentini says:

      Irene,
      Congratulations on the birth of your little boy. How great to hear your doctor understood the dangers of hypothyroidism and pregnancy. Finding great doctors who truly understand thyroid dysfunction is key. I too was fortunate to change doctors and find one that changed my life. Thanks to her I delivered my second son in 2010. Great doctors are out there, you just have to be thyroid aware yourself so that you know if your doctor is keeping up to date on this disease. It is unfortunate that lack of awareness among the medical community about thyroid dysfunction exists. It is up to us Hypothyroid Moms to take charge of our thyroid health. Thanks Irene for sharing my blog with your sister.

  7. Dana,

    Thank you for the information. I have been searching everywhere for information liek this. In September of 2010 I had my son at 30 weeks due to placental abrubtion and spent 6-1/2 weeks in the NICU, but now have a the greatest gift of enjoying life with a boy that just turned 2. We recently just found out we were pregnant and had a miscarriage at 10 weeks. I have been researching if those two had anything to do with each other or if I am going to have more miscarriages or complications in the future. My mother who passed away took medicine for her thyroid. I believe this is something I need to discuss with my doctor. Thank you for the information.

    Denise

    • Dana Trentini says:

      I am sorry to hear about the loss of your baby Denise. It is heartbreaking. Your story is similar to mine. In addition to my miscarriage, my second son was born at 36 weeks, early due to placental abruption. Absolutely please get your thyroid checked. Please read all 5 posts of this series “Miscarriage Awareness Month: The Dangers of Hypothyroidism and Pregnancy” so that you have all the details you need. Keep in touch with me. I will be very happy when I hear back that you are expecting again. Best of luck.

  8. samantha horner says:

    I am a 35 year old mother w/one nearly 3 year old boy. Shortly after he was born premature, I was diagnosed w/Hashimoto’s. I have been on hormone replacement for 2.5 years and have all my levels in good ranges. I get my TSH, t4 free t4 and free t3 tested every couple months. I take 125 mcg’s of levoxyl and 25 mcg’s of cytomel daily. In October I became pregnant. My husband and I were trying so we were not surprised. My endo immediately increased my meds. A couple weeks later I miscarried. Everyone tells me there is no way to know why or if it was thyroid related. I have since been watching my levels closely and once my ob gave me the ok to try again, we did. I am 4.5 weeks pregnant and scared. Now I am reading everything about antibodies and how they can be high when your TSH presents normal. I am going to call my dr. in the morning and demand an antibody test. My last labs a week ago showed my TSH at 0.02 and my free t3 at 3.6. The lab range for that was 4.2 on the high end. I forget the low end. I thought I was in good shape but now I am having second thoughts. Any advice? I don’t think I can handle another miscarriage.

    • Dana Trentini says:

      Hi Samantha, Congratulations on your pregnancy. While hypothyroidism, including hypothyroidism due to Hashimoto’s, increases the risk of pregnancy complications, there is also great hope to deliver a beautiful healthy baby. Please don’t be scared. I see that you are a proactive MOM WARRIOR doing everything you can to be healthy for your baby. FANTASTIC!

      The key is being checked regularly during your pregnancy. First off, it is great that you had your labs done last week. Laboratories use different units of measurement, so take a look at your lab results and normally to the right of your scores, you should see the normal reference ranges for each score. Check where in the range your Free T4 and Free T3 levels fall, as well yes please have your thyroid antibodies tested. You want your Free T4 and Free T3 levels to be in the normal range so that you have enough hormones to provide your growing fetus. The risk with Hashimoto’s is that your condition can worsen with the stress of the pregnancy which is why you must ensure you are regularly monitored.

      According to the American Thyroid Association 2011 guidelines for pregnancy:

      http://thyroidguidelines.net/pregnancy

      “Recommendation 18 – In pregnant patients with treated hypothyroidism, maternal serum TSH should be monitored approximately every 4 weeks during the first half of pregnancy because further dose adjustments are often required.” “In pregnant patients with treated hypothyroidism, maternal TSH should be checked at least once between 26 and 32 weeks gestation.”

      ***However use your motherly instincts. Since you’ve been carefully monitoring your thyroid levels you are well aware how you feel when you are well and when you are not well, contact your physician immediately when you start feeling hypothyroid or hyperthyroid symptoms. You know yourself what they feel like so trust your instincts and don’t wait 4 weeks between visits if you don’t feel well!

      Please stay in touch with me and let me know how your pregnancy is going.

    • roxanne tucker says:

      So what happened with baby?

      • Dana Trentini says:

        Hi Roxanne,

        I miscarried my baby because my doctors were not aware of the guidelines for treating pregnant women with thyroid conditions.

  9. Hi there,
    I was diagnosed with Hashimoto’s after having trouble conceiving. After starting on Levothyroxine my TSH went down to normal levels (1.9) and I almost immediately got pregnant. My doctors have told me that as long as I regularly monitor my thyroid levels and keep them between 1 and 2.5 the condition does not pose any additional risk to the pregnancy. Your postings disagree, but I am confused about what steps you are suggesting to take other than test for TSH. Any clarification you can give would be great.
    -Laura

    • Dana Trentini says:

      Hi Laura, Congratulations on your pregnancy! It is great to hear that your doctor is aware of the pregnancy guidelines to maintain the TSH below 2.5. That’s great because many doctors are not aware of this. With Hashimoto’s as with any form of hypothyroidism, the main danger is that the demands of the fetus for thyroid hormones from the mother can cause your TSH to rise during pregnancy to unsafe levels. I’m assuming your doctor will be monitoring your TSH regularly throughout pregnancy. If not, please be sure it is monitored regularly. Here are the guidelines:

      According to the Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpartum:3

      RECOMMENDATION 2 – Trimester-specific reference ranges for TSH are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

      RECOMMENDATION 16 – In pregnant patients with treated hypothyroidism, maternal serum TSH should be monitored approximately every 4 weeks during the first half of pregnancy because further dose adjustments are often required.

      RECOMMENDATION 17 – In pregnant patients with treated hypothyroidism, maternal TSH should be checked at least once between 26 and 32 weeks gestation.

  10. I have had Hashimoto’s thyroiditis (hypothyroidism) for many years. I did not realize the importance of closely monitoring in early pregnancy; I just thought I was basically healthy. After all, the doctors had told me it was all in my head! When I was first tested at 20 weeks, my numbers were all over the place. I was frightened and quickly made the necessary changes to get my t3 and t4 back within range. I then monitored labs every 4-6 weeks in pregnancy, with resulting medication changes. I developed a rapid heart rate near the end of pregnancy, but my doctor was not concerned as long as it stayed below 100-110 bpm. I developed pre-eclampsia around 37 weeks, delivered a healthy, developmentally normal, 10 1/2 lb baby at 37 1/2 weeks via section. My antibodies in the last half of pregnancy were around 500.

    I guess I should consider myself lucky that I was so ignorant of the role of hypothyroidism in pregnancy (and granted, there was precious little information available to me), yet I had no trouble conceiving or carrying a pregnancy (I was age 35 at conception, first time trying to conceive); I only had trouble near the end of pregnancy (as mentioned above, also severe swelling but normal blood pressure, from about 20-25 wks). Plus, I am beyond grateful that there was no apparent developmental delays or mental deficiency resulting from those first 20 wks.

    I wish to have more children, I suspect hypothyroidism as being to blame for the the pre-e, and I would love to know how to have a healthier pregnancy, next time around. I am one who still has symptoms even in the presence of “normal” lab values, as the pre-e occured in the presence of “normal” t3 and t4 levels, but elevated antibodies. If you can point me to any more info for a healthy pregnancy, it would be much appreciated.

    • Dana Trentini says:

      Kyra, Great to hear from you. Your baby is a miracle a real miracle. All the babies born to hypothyroid women are truly miracles. Hypothyroidism including Hashimoto’s puts our babies at risk during pregnancy. Your fast heart rate, pre-eclampsia, 37 1/2 week delivery (earlier than expected) and 10 1/2 lb size baby could all be potentially linked to hypothyroidism. While of course those pregnancy complications may have been due to other factors, there is a good chance they were or at least some of them were hypothyroidism related. You baby is a miracle! Now the key for your future pregnancies is to get as thyroid healthy as possible pre-conception. It’s great that your antibodies were tested so you know you have Hashimoto’s (crazy thing is many doctors don’t even test for antibodies!) and that your doctor tests for T3 and T4. My guess is that you are with a doctor who is open minded about thyroid issues. Check your lab results to be sure that your T3 and T4 tested were the Free versions not the Total. The lab results will say Free. Free T3 and Free T4 is what is unbound thyroid hormone circulating in the blood available for the cells to use. If your Free T4 and Free T3 levels were tested and they were normal, it’s important to know where in the “normal” range they fall. On your lab results to the right of your scores will be the “normal” reference ranges. In many cases our levels are in the “normal” range but not at the ideal point in the range. Thyroid advocate Mary Shomon wrote a great article, where she wrote: “More innovative doctors are beginning to believe that a TSH of around 1 – 2 — in the low end of the normal range — is optimal for most people to feel well and avoid having hypothyroid or hyperthyroid symptoms. Similarly, some practitioners feel that optimal hypothyroidism treatment includes Free T4 in the top half of the normal range, and Free T3 in the top 25th percentil of the normal range.” In particular with Free T3 for many of us we don’t feel our best when Free T3 is in the lower half of the range, so make sure yours is in the top half of the range and bring this article by Mary Shomon to your doctor. Also, there are many potential underlying issues in Hashimoto’s that need to be tested to rule out, including food allergies in particular gluten, gut issues, blood sugar imbalances, sex hormone imbalances, adrenal function, iron/ferritin levels, as well as deficiencies in Vitamin B12, D3, magnesium, selenium and zinc. I’ve included a link to my post on Hashimoto’s below to be sure to investigate these things with your doctor. Also there is a link to a thyroid expert group named Holtorf Medical Group who posted a guest blog post on my blog for potential Hashimoto’s treatment options to discuss with your doctor. I know there is so much information to digest. Best of luck to you and welcome to Hypothyroid Mom!

      http://thyroid.about.com/cs/hypothyroidism/a/notwell.htm

      http://hypothyroidmom.com/hashimotos-your-body-is-not-supposed-to-destroy-itself-right/

      http://hypothyroidmom.com/hashimotos-thyroiditis-its-a-genetics-thing/

      • Thank you. I didn’t go into labor early; they took him due to the pre-e. He was and is still a very large child, now almost 2 1/2 years, but he is literally off the charts, being a year ahead of his peers in height and more than that in weight.

        Free t3 was high normal near the end of pregnancy, free t4 was about midrange, iirc (all of this from memory). I was gluten free, but not on an autoimmune diet.

        I will peruse some of these links.

        • Dana Trentini says:

          Sounds like you have a beautiful healthy baby. So great to hear. So many potential underlying issues with Hashimoto’s that need to be looked an including gut issues, other food allergies, blood sugar imbalances, stress levels, adrenal function, ferritin/iron levels, vitamin and mineral deficiencies including vitamin D3, B12, zinc and magnesium. If your labs are normal but you still aren’t well then it’s time to find a second opinion.

          http://hypothyroidmom.com/top-10-resources-to-find-a-great-thyroid-doctor-in-2013/

  11. Hi,

    I would just like to share my experience of pregnancy and underactive thyroid,

    I was just over five weeks pregnant when the doctor diagnosed me with an underactive thyroid and advised me I had 50% of the hormones required in my body. I was immediately put on 50 micrograms of levothyroxine and requested to have my levels checked monthly. The following weeks I had all the pregnancy symptoms, nausea, fatigue etc and at 10 weeks 3 days I had a tiny amount of spotting. Worried about seeing this I went straight to the early pregnancy assessment unit who offered me a scan the following day. I thought everything was going to be fine and it was normal to have slight spotting. At the scan the doctor advised my baby only measured 3mm and should of measured 17mm with no heartbeat. They said the baby measured 5.5 weeks. The doctor said we had to wait a week to allow the baby time to grow in case I had my dates wrong and said that many women come back the week later and everything is fine. The following week was torture and I had come to the realisation that I hadn’t got my dates wrong and that I had suffered a missed miscarriage. At the scan a week later the doctors told me the same as the week previous and confirmed missed miscarriage. I then had to decide on my options and wait a further week for a d&c.
    On reflection I have thought long and hard as to whether the underactive thyroid was the reason for my miscarriage and whether going on the medication 5.5 weeks pregnancy affected the growth of my baby. With a history of hypothyroidism in my family I am shocked at how this had not been picked up previously having gone through numerous tests for painful periods and low immune function. I just hope in a few months once my levels are stabilised I will go on to have a healthy pregnancy which is all I wish for.

    • Dana Trentini says:

      Gemma, I am very sorry about the loss of your baby. It is tragic how many unborn babies are lost to hypothyroid women. I wrote Hypothyroid Mom in hopes of finding women like you to tell you that there is hope to have healthy beautiful babies. The key is being as thyroid healthy as possible before trying to conceive again. The American Thyroid Association issued guidelines in 2011 on pregnancy recommending a TSH less than 2.5 prior to conceiving and in the first trimester. Before trying to conceive again after my miscarriage, I made sure my TSH was less than 2.5 ideally between 1 and 2, and had full testing Free T4, Free T3, Reverse T3, thyroid antibodies for Hashimoto’s (TPO-Ab and TgAb), adrenal function, full iron panel including ferritin, sex hormones, vitamin D3, B12, magnesium, zinc and selenium.

      Before trying to conceive again I asked my doctor for a lab requisition form for thyroid testing that way the very same day I got a positive pregnancy test I could go right away for testing. I bought boxes and boxes of pregnancy tests and tested early before a missed period to catch the positive test right away so the baby would only be a few weeks old and went for testing that same day to find my TSH had already jumped up and my medication needed to be increased. The key is being as thyroid healthy and then having a plan to be sure you test your thyroid right away no delay and be monitored every 4 weeks. Best wishes to you for a healthy pregnancy.

      http://hypothyroidmom.com/hypothyroid-moms-story-of-hope-her-miracle-babies/

  12. Thank you for this series and for being so specific in your information. I have had several hypo symptoms over the years and never paid much mind to them. I recently had a mmc at 12w5d, baby was measuring 9w4d. While in the hospital my heart rate was 50bpm and although I’ve known for a long time I’m bradycardic, I did not know that was also a symptom of hypothyriodism. I am currently wondering if my mc was as a result of hypothyrodism or subhypothyroidism. I will be making an appointment with my doctor to ask for some testing before we ttc again. I feel confident in knowing what to ask for now. I am nervous they will refuse testing as I have only had one mc (first pregnancy) and where I live in Canada they won’t test until you have had 3 which seems like a lot to me.

  13. Hi..I am 28 years old. I miscarried on 1st Feb 2013 because of low TSH 0.02. Free T4 and T3 was OK.But after that my DOC stated with Neo-Mercazole to me. and nw after 3 months my TSH value is raised to 23.73 on 16 July 2013. So, Is it Hypothyrodism? and what is treatment for it again? Am I able to get pregnant? TTC from 2years. Will TSH value reduced to normal level after stopping Neo-Mercazole? or shld have another medications? and will TSH will come to normal in 1 month?
    Help me

  14. Hi there

    Just got back from my first appointment with the ObsGyn at 11 weeks. I have been told I have hypothyroidism with a 4.48 level. I have been given a script and told to take the thyroxine sodium straight away. Im very concerned, especially reading about the potential intellectual disability to my unborn child. These tests were carried out when I was about 7 weeks pregnant, meaning had the results been looked at before my appointment, I could gave been on the medication in that critical development stage.

    I had a miscarriage at 6 weeks earlier this year. Unsure of my thyroid levels as I was untested. I have a two year old toddler and I’m not even sure if I was teed for thyroid levels with her.

    I’m feeling really concerned about the possible outcomes for the fetus.

    Any suggestions or comments appreiated.

    • Dana Trentini says:

      Hi Anne,

      Congratulations on your pregnancy. There are many hypothyroid women that go on to have beautiful healthy babies despite hypothyroidism so better to stay hopeful. We can’t change what’s happened before this but now you will be sure to bring a copy of the American Thyroid Association guidelines for pregnancy to your doctor. It is unfortunate that not all doctors know the guidelines so bring them a copy. Your TSH of 4.48 is too high and a dosage change can bring that to the recommended range so call your doctor to see them.

      http://thyroidguidelines.net/pregnancy/results

       RECOMMENDATION 2

      If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L. Level I-USPSTF

       RECOMMENDATION 14

      There exists great interindividual variability regarding the increased amount of T4 (or LT4) necessary to maintain a normal TSH throughout pregnancy, with some women requiring only 10%–20% increased dosing, while others may require as much as an 80% increase.

      ■ RECOMMENDATION 16

      In pregnant patients with treated hypothyroidism, maternal serum TSH should be monitored approximately every 4 weeks during the first half of pregnancy because further LT4 dose adjustments are often required. Level B-USPSTF

      ■ RECOMMENDATION 17

      In pregnant patients with treated hypothyroidism, maternal TSH should be checked at least once between 26 and 32 weeks gestation. Level I-USPSTF

  15. After 10 years, almost 11 years, of noticing “changes” in my body that did not feel right. After almost 11 years of being told my fatigue and weight loss were “normal” for new moms…after gaining almost 70 pounds (even though I ate very well and was previously a personal trainer, biking almost 20 miles a day and working out 6 days a week) that I needed to “just do more” and “eat better”…after losing almost 70% of my hair, after suffering severe and almost debilitating depression (that I was always prescribed anti-depressants for…that I never filled or took). After all of that, I finally found a doctor who was willing to order the thyroid tests that I wanted (although this doctor proclaimed me to be “beautifully healthy despite low VitD levels). I took my lab results to several doctors before I found one who looked at me and said, “Your lab test results are common, they are NOT normal…and we’ll get you feeling better.” I cried in the office…after 11 years feeling like I was slowly wasting away, feeling like my life was completely out of control and I couldn’t do anything about it because I didn’t know what the problem was…finally, I had someone who was not only willing to help me but able to do so.

    There are so many people who have thyroid issues that are misdiagnosed. Depression? Anti-depressants. Depression is not a cause to cure, it is a symptom of another problem. We are a society trying to cure symptoms. Let’s get this straight…if you are having symptoms…any symptoms, it’s a sign that you are NOT healthy. Healthy people do not have symptoms.

    After 6 full months of researching thyroid issues, I have run into many doctors who roll their eyes when I tell them what I found by Googling. “Oh, of course, you must have gotten your degree at Google University…” while rolling their eyes. And my response was always the same…”Well, maybe you should try it sometime because whatever you learned in medical school isn’t helping you.”

    If you do not feel right, if you feel that something is off, do not take a doctor’s “advice” that you are “normal”. Your symptoms may be common, but not normal. If you feel that something is off, do not stop pushing and searching for the answers. Unfortunately, most doctors have stopped listening and diagnosing based on symptoms and have come to depend on lab results that are inaccurate.

    I always wonder…if my issues were treated properly 11 years ago…would I be requiring meds now? After almost 8 weeks on Cytomel, I feel almost like myself again. Finally. It’s been hell…but finally, I’m feeling like I have almost reached the light at the end of the tunnel and life is looking up again.

    Be your own Patient Advocate.

    • Dana Trentini says:

      Hi “Natural Mom”,

      I had to reread your message twice. I felt like you were telling my story. You described so well what happens to so many thyroid sufferers. It’s shameful really what’s happening and why a site like mine even exists. I will also post the first paragraph of your message on my Hypothyroid Mom Facebook page because it’s so important. Thank you.

      • NaturalMom says:

        Is it sad that I don’t have a medical degree, but my friends bring me their labs for my opinion? LOL It is sad. And while I always say…I am not a medical doctor…they always respond, “I’ve learned more from you than my doctor.”

        Doctors have stopped looking at symptoms and just at test results…which are extremely important, but alone mean nothing. They’re supposed to be used together.

        Thank you for this blog, there are so many people (especially women) who have been taking medications to hide their symptoms without curing the cause. Thyroid and Adrenal issues are so quickly overlooked…and mimic so many other issues. But, doctors are not infallible and you (the person) know your body better than anyone else. If you do not feel right, then you are right and please do not take, “Oh, you’re fine.” for an answer. It’s not one.

        There is a light at the end of the tunnel. There is an opportunity to feel better and live instead of just survive, you’ve just gotta push for it.

  16. Weight loss in the 2nd sentence should actually read hair loss. Sorry!

  17. Hi Dana,

    I am 27 yrs, now I am in 7th week of pregnant with hypothyroid. I got checked in the 6th week and the results are like this, TSH: 24 and FT4: 0.79. Doctor suggested me to go with 75 mcg of levothyroxine per day. Please let me know if there is any problem to the baby and if there is any, Is this medication is good enough to have the healthy baby? Also I am taking Iron related medication along with the thyroid med. but I had seen your comment somewhere, it is better to take iron med at different time.

    • Dana Trentini says:

      Hello Rajeev,

      Congratulations on your pregnancy. Your TSH of 24 is high and needs to be lowered. This is why your doctor has prescribed Levothyroxine. We’re all different in terms of what dosage would be right to lower your TSH to the ideal. However one thing you should do is bring a copy of the American Thyroid Association guidelines for pregnancy in the link below to your doctor.

      http://thyroidguidelines.net/pregnancy/results

      RECOMMENDATION 2

      If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

      Yes please don’t take your iron at the same time as your thyroid medication because it will interfere with the absorption same with calcium supplements. Even your prenatal vitamin you shouldn’t take at the same time because prenatal vitamins often contain iron and calcium. Wait 3-4 hours between taking your thyroid meds and taking iron or calcium. Thyroid Advocate Mary Shomon has these guidelines for taking your thyroid meds properly. Best wishes to you and your baby.

      thyroid.about.com/library/howto/htthyroid-drugs.htm

  18. Hi,

    I am suffering from Hypo Thyroid my TSH is 2.76 but my anti bodies are very high my doctor told me to ignore the antibodies since my TSH , T3 , T4 are in the normal range.
    I am planning to start a family but scared that i might end up in a miscarriage due to high anti bodies please suggest what shall i do?

  19. Hi.

    I too have miscarried twice (missed abortion). Once early, around six weeks, no heartbeat detected and the whole thing was off from the start. Then I had a chemical pregnancy – positive test but started bleeding at 5 weeks so am not really counting that one. Then I got pregnant again. Had ultrasound at 8 weeks and all seemed perfect, the right exact size, strong heartbeat. At 10 weeks, there was nothing. I was devastated, upset, confused, hurt. I decided that I had to do whatever was in my power to find out what went on and to do my utmost to prevent it from happening again. I had all sorts of tests, felt like a lab rat for a bit – immunity, genetics, hystroscopy (v. painful!), blood clotting, toxoplasmosis… and a whole lot of other tests too, including tests for thyroid. I was diagnosed as hypothyroid as well as something to do with antibodies. I was referred to a lovely lady doctor, an elderly one and a scientist at that. She is a fighter for this cause, she researches, publishes does studies and tries to make sure that every woman trying to conceive or finding out that she is pregnant is informed and entitled to these simple tests. She is a true warrior.. She has been treating me since, screening regularly, readjusting dosage of my medication until she one day said I was ready to try again and get pregnant. This was about 4 months after first diagnosis. I got pregnant again after 3 months of trying. I am today 11w2d and ll seems perfect. I have my 12 week screening next week and I feel good. I intuitively feel different now, knowing things are good and I feel a bond with the life forming within. I also experience quite a lot of nausea and tiredness, none of which I had in my previous pregnancies. I am from the Czech Republic, live in Prague and I ma grateful for the doctors I have met and for their dedication and want to help. Good luck to all and do not underestimate this. Safe yourselves a lot of pain and time… B

    • Hey Barbara,

      What levels did your doctor want you to get to before trying to get pregnant again? What did she consider to be safe?

  20. Hey Dana,

    So what would you recommend for someone who has elevated antibody levels and wants to have another baby? I have went gluten free/basically a paleo diet in hopes of lowering my antibody level (which was measured at 68). I am also on levothyroxine to lower my TSH level. Will it ever be safe for me to conceive again!?!?! :-(

    • NaturalMom says:

      First, the TSH is not indicative of thyroid function. It is indicative of pituitary function. T3 and T4 are indicative of thyroid function. Taking T4 alone will not usually affect your TSH. If your doctor did not test your Free T4, Free T3, Reverse T3, TSH, Saliva Cortisol, Hashi and Grave markers, along with vitamin and mineral levels, he should not have given you anything.

      I hope you are feeling better. Remember in the end, it all comes down to how you are feeling. If you are on medication and you are not feeling good, despite what anyone says, it is not right for you and you should push for a change.

  21. Hi! I’ve been reading your blog.. Its very informative! I do wonder though, what is the normal healthy level for the tsh during pregnancy? I was diagnosed about two months ago and my tsh was at 357.9
    I have been on levothyroxine since then and I am now about ten weeks pregnant with the levels at 49.7
    Should I be on bed rest? Are there things I can eat or lifestyle changes I can make to help assist the medication?

    • Dana Trentini says:

      Hi Shari,

      I apologize for the delay in responding. I’ve had close to 4 million visitors here to my blog and on my Hypothyroid Mom Facebook page the last two months that I’ve struggled to get to everyone. Congratulations on your pregnancy. Your TSH is high. Please bring a copy of the American Thyroid Association guidelines for pregnancy to your doctor that recommend a TSH less than 2.5 in the first trimester and below 3.0 in the second and third trimesters.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

      ■ RECOMMENDATION 2

      If trimester-specific reference ranges for TSH are not available in the laboratory, the following reference ranges are recommended: first trimester, 0.1–2.5 mIU/L; second trimester, 0.2–3.0 mIU/L; third trimester, 0.3–3.0 mIU/L.

  22. I am 5weeks pregnant and I dont take my thyroxine everyday I forget. I wasn’t planing on getting pregnant and im no scared wgat could happen to my baby. My docter hasn’t told me to take any extra thyroxine just to get my bloods done as soon as I can. Ive bin advised to terminate my pregnancy as ive been missing tables 4 afew days at a time I need some more advice

    • Dana Trentini says:

      Candie, get your thyroid testing as soon as possible, even today if possible, because thyroid hormone is critical for your baby’s growth and development. The American Thyroid Association recommends a TSH less than 2.5 in the first trimester and many of us requiring an increase in medication dosage to maintain that and why thyroid testing should be done asap in pregnancy. The good news is that you are 5 weeks and not too far along yet so go test right away and bring a copy of the American Thyroid Association guidelines for pregnancy attached here below to your doctor. Best wishes.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472679/

      • The earliest I can have my bloods done is in 4days that’s the only appointment they have got will it be to late then I don’t want anything to happen to this baby as I’ve conceived naturally my first son was a clomid baby as I got told I wouldn’t conceive without them

  23. I’m 18 weeks pregnant now, I have hypotiroidism and ever since I got pregnant I’ve been asking my doctor to check mi levels, every time a different doctor sees me, and they said I was fine because of the test results before pregnancy. This last visit (2weeks ago) finally they made me a test and the result was 75, the doctor change my dose and now I’m at 11 but I know the firs trimester I was bad, I’m just hoping and praying for a miracle with my baby.
    I read a lot and realize that the reason was that I was taking the pre-natal vitamins and levothyroxin together, and though I said that to the doctor she never said to me that I should take them separately. So now they can blame me, but is not excuse because every month I asked for a test and they refuse to do it, because “I was fine”
    I’m a mexican living in us, and I know that in mexico this couldn’t happen, at least not with my doctor, he was very careful.
    How can we know if the baby is affected for the doctor’s mistakes?
    What can we do if our baby has problems? Can we sue the doctors or the hospital?
    I want them to pay for their neglect if my baby is not ok.

  24. Hi Dana – First, let me congratulate and thank you for this blog, you are helping so many people who otherwise would not have received this kind of information from their doctors. So thank you. I have been diagnosed with unexplained infertility and have been trying to conceive for 2.5 years. I had a son in 2009. My RE tested my TSH levels last June and they came out .656. I had read somewhere that if you have a low BBT than to look into additional thyroid testing so I started doing research. I don’t feel like I have any real symptoms, although I guess I could…I am a little tired throughout the day but it may be normal, my hands and feet are usually cold but its winter…etc. my toenails are yellow/whitish but I thought it was from too much nailpolish… so I never connected the dots since I’m in pretty good health and feel good otherwise, no stress, etc. I asked my RE this week to conduct a full thyroid panel to cover my bases and I get the results Monday. I know there were 5 tests ordered but I didn’t see a Total T3 or Free t3 on there as an option so maybe will need to figure out who can test me for those. I guess my question is – can you have a problem with your thyroid and not have any symptoms? I did suffer a MC in Oct. (the first time I got pregnant in 26 months of trying – I was on fertility drugs then and still am now). My doc doesn’t think there is anything wrong but I’m also nervous to get pregnant on meds and then suffer another MC. I have also started up acupuncture again…It is such an incredible shame that the doctors who are supposed to be experts in these areas fall short and treat us like a number and at the end of the day, we are responsible for managing our own care. Any thoughts appreciated. Thank you!

  25. Hi ,

    I am suffering from hypothyriodism TSH level is 7.05 .My age is 32 years . I am on 50 mcg of Thyronorm.

    I wanted to get conceived 2nd time . After reading everything i am scared . What do you suggest me hsould i have another baby or no ?

    please advice me

  26. Wow, marvelous blog layout! How long have youu been blogging for?
    you make blogging look easy. The overall look of your website
    is excellent, as well as the content!

  27. The diagnosis of hyperthyroidism in pregnancy can be complicated since some of the blood tests used for the diagnosis are altered because of the pregnancy. The diagnosis is based on high levels of thyroid hormones, T3 and T4, and a low level of thyroid stimulating hormone (TSH).

  28. I’m currently researching Hashimoto’s thyroiditis/ hypothyroidism due to a 2nd trimester miscarriage and subsequent diagnosis of a gene mutation of MTHFR. From what I’m finding, hashimoto’s seems to be particularly common with this gene mutation, and I have almost all the symptoms. Very interesting… Thanks for the info.

  29. Its so sad 2 read some of the storys, I was on tyroid medication for My 1st pregnancy wasn’t aware dat thyroid meds should be continued after baby was born. Now I’m 4 months preg and on meds. Just trusting god dat all goes well

  30. Christina says:

    Hello…. I am pregnant with my 3rd child and I’m a little over 13 weeks. I had my first prenatal check up at 8 weeks, and again at 12. They advised me my thyroid was low at 8 weeks and tested again at 12 and said it improved a little but was still low and they needed to test again in 4-6 weeks. This is the first time I have ever heard of having a low thyroid and I have done a lot of research on it and every thing talks about treat early. Why are they waiting? My Dr said its normal for pregnancy to effect ur thyroid but I haven’t seen anything that says that. I am terrified that they are putting my baby at risk the longer they wait. So please any advise thelat u can give me would be very appreciated.

  31. Mani Chopra says:

    Hi Dana,

    I just came across your blog, it is very informative, thank you so much for doing this. I am a 32 year old woman in my first trimester. I have been a patient of hypothyroid for past 10 years. I just got my TSH tests done and my TSH level is 1.86

    My hip bones & legs have been aching for a while. My gynecologist tells me to take calcium supplements while my endocrinologist tells me to start it only after 1st trimester. Please can you advise?

  32. Mani Chopra says:

    Hi Dana,

    I just came across your blog, it is very informative, thank you so much for doing this. I am a 32 year old woman in my first trimester. I have been a patient of hypothyroid for past 10 years. I just got my TSH tests done and my TSH level is 1.86

    My hip bones & legs have been aching for a while. My gynecologist tells me to take calcium supplements while my endocrinologist tells me to start it only after 1st trimester. Please can you advise? Thanks

  33. shweta Krishna says:

    Hi,
    I was planing my pregnancy and got my Thyroid tested in Dec 2013 as I have family history of thyroid and it came out 4.5. The Dr told me it is borderline and I do not need to take medicines.
    I am came to know about my pregnancy in my 6th week( May 2014) and my TSH value by then had shot up to 8. Dr has now put me on medicines.I am in my 7th week.

    I am really scared as I have read that high TSH can cause autism, low IQ, impacts brain and spinal cord development of the child.
    I do not trust the Dr any more and going for a second consult, but would really like to know with a value of 8 , should I be worried as the baby needs the TSH from mother till 12th week and more than half of of those weeks my TSH is value was not up to the mark.
    would really appreciate any guidance on it.

  34. Thank you so much Dana for this blog. I had two miscarriages (9weeks and 12 weeks) before realising that I was hypothyroidism patient (6.6 TSH). I was on thyroxine 50 for two months and my TSH came down to 1.6 and I realised I was pregnant. Doctor increased my dosage to 75. I started spotting on Monday and quickly went to emergency and got a scan… Doctor said everything looks fine and we were able to see the baby’s heartbeat. It measured 6weeks 0 day. My problem is I have been spotting since Monday non stop and I am getting nervous. I had another test yesterday but can’t get the result till tomorrow. My question is, can I still go ahead to have healthy pregnancy or is there anything I should be worried about? Thanks for your time, will be waiting for your reply. Help!

  35. Great post! My husband and I are talking about having another baby but I have a really bad thyroid (hypo) THS levels w/o treatment is 243 and I’m on 175mg synthroid to lower that number. I’m wondering if it’s even a smart idea to try again for a baby or are there just too many risks. Thanks!

  36. Molly Horn says:

    I’m so scared by everything I have been reading. I am 35 weeks pregnant and have had hypothyroidism for 10 years. I didn’t find out I was pregnant until 24 weeks, and I have had trouble controlling my thyroid levels despite several medication adjustments. My levels are still too low, though my OB is trying hard to get me on the right dose of medication. After reading several articles, I’m scared my baby will be born with developmental delays or mental retardation. There’s really nothing I can do about it, but I’m just scared.

  37. Number of women think that to get pregnant quickly they need to have lots of sex on day 14 of their monthly cycle, however this is not necessarily the case. The problem with this is that quite a few women will not ovulate on day 14 of their monthly cycle. This would be true if they were on a perfect 28 day cycle but each woman has cycles that are either shorter or longer than the 28 days and many do not ovulate exactly at the at the mid-point range. Even under the most ideal conditions, there is only about a 25% probability of getting pregnant each month.

    One of the easiest techniques for getting pregnant quickly is usually to find out about what time each month you ovulate. As every single woman has a unique cycle, it is crucial that you simply get to know your body and attempt to figure out exactly what time of the month you might be ovulating. Keep in mind that while you may typically ovulate on day 14 of your monthly cycle it can change every month. It is not really unheard of for a woman to ovulate on day 14 one month and then ovulate on day 16 the following month and on day 13 the next.

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  38. Katie Stone says:

    I’ve only just found this article and its so interesting. I have 3 children, 1 girl and two boys. I’ve had 7 miscarriages and I went to my doctor years ago as I am always tired and get sore throats a lot. Underactive thyroids run in my family. It came back clear but I am in the UK and since found out they only test for one thing either t4 or 3. Since having my third child I started to lose a lot of hair and my weight ballooned but I just couldn’t shift it. I have 2 boys with autism.

  39. I’m 22 weeks pregnant with my 2nd child. A 4 inch lump was found on my thyroid gland when I was pregnant the first time, it was removed when my son was 8 months old. The lump and 1/2 my gland was removed. My thyroid was working perfect until I got pregnant again. I was on .25mg of synthroid but was changed to .75mg 2 weeks ago. I don’t feel any different from before I got pregnant. In Quebec they test your thyroid function in the 1st trimester. How early were your kids?

  40. Dana Trentini says:

    Thank you to hypothyroidismturn.com for including my series “Miscarriage Awareness Month: The Dangers of Hypothyroidism and Pregnancy” on their blog. Your help in spreading awareness is much appreciated.

    http://www.hypothyroidismturn.com/blog/

  41. Dana Trentini says:

    Thank you “Graves Disease Info” for including a link to this article on your site. Much appreciated.

    http://gravesdiseaseinfo.wordpress.com/2013/07/11/why-rescue-pets-are-the-best-stuff-co-nz/

  42. Dana Trentini says:

    Thank you to “How To Lose Weight Naturally” for including my Hypothyroid Mom press release. Much appreciated.

    http://howtoloseweightnaturallyinfo.com/hypothyroidmom-com-remembers-the-babies-lost-to-thyroid-disease-on-october-15th-pregnancy-and-infant-loss-remembrance-day/

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