What to Know: Your Thyroid, TSH Levels, & Pregnancy

I recently spoke to a nurse at my OB/GYN's office about women and thyroids, prompted by her questioning my medical history and use of thyroid medication during pregnancy. She said she used to work at an infertility clinic, and she was so surprised at the number of women who were then able to get pregnant after having their thyroid levels tweaked with medication.

I mentioned that I had gotten a physical before I even started to conceive, and despite knowing that I wanted to try for a baby that year, my primary care physician told me that all of my bloodwork came back fine even though my TSH levels were high.

"Maybe some doctors just don't know about it," the nurse said.

If your doctor doesn't know about it, then chances are, you aren't going to know about it. As January is Thyroid Disease Awareness Month, I thought I'd share what to know about your thyroid, TSH levels, and pregnancy, as experienced by me.

According to the due date calculation used by my OB/GYN, my due date was in February. That meant that I had conceived in May. The only problem with that? We hadn't started trying for a baby until June.

But still, I trusted my doctor. They use this due date calculation all the time. (Going back to the first day of your last missed period.) It couldn't be wrong, right?

Well, thank God that it was.

After my first ultrasound at which the ultrasound technician kept referring to the baby as “the pregnancy” and gave us zero pictures to take home (Shouldn't there be pictures? Isn't that what everyone else got?, I wondered), I got a phone call from my OB/GYN.

“Either our calculations are off or the pregnancy isn't viable,” she said. I was only measuring four weeks, when they had expected me to be eight weeks along. “Call me if you start bleeding.”

Uhm, WHAT?

Okay, so she said a little bit more than that. But when you hear “Call me if you start bleeding” as you're standing in the hallway at work taking this personal phone call and trying not to cry, you don't really remember the rest.

Apparently, my thyroid levels were “slightly elevated”, and I needed to see an endocrinologist. The high thyroid levels could have been what was causing my pregnancy to not be “viable”.

This was something that I had never heard of before, and after Googling it (still while at work and trying not to cry at my desk), it's apparently not something that every OB/GYN tests. TSH levels, as they are called, should be between 2 and 3 during pregnancy, according to my doctor. Mine were at 3.3 (and had actually been 3.9 at my physical just a few months before). So not as high as the 10 that some other women had experienced, but still concerning enough to my OB/GYN and new endocrinologist to put me on a low dose of a prescription medication called Synthroid.

I went back in for another ultrasound after another two weeks, and this time I was measuring six weeks along. So everything was as it should be, and the due date calculator was WRONG WRONG WRONG. (I mean, come on people. I knew when we started trying to have a baby. I was there!)

July 2015 - Made it to eight weeks! Right on track!

But I still had to stay on Synthroid for my entire pregnancy just to keep my TSH levels in check, and I was told that if I ever decided to have another baby, I'd have to check in with my endocrinologist first.

If you've never heard about thyroid levels affecting your ability to get pregnant or you've never had your thyroid levels checked, definitely make sure you do, especially if you are trying to have a baby or are thinking about it! Even if you're still able to get pregnant with high or low TSH levels, your thyroid needs to be functioning properly in order to help support your developing fetus and your own expanded metabolic needs, according to the Thyroid Awareness website.

So be proactive about your health and the health of your future baby. Ask your primary care physician to order labwork to check your thyroid at your next physical. Make sure your OB/GYN tests your thyroid when you go in for your first prenatal visit. Thyroid problems during pregnancy are easily treated, but you've got to know if you have a problem first.