How did your appointment with the endocrinologist go?

I've just been told I had high T3 and T4 after my latest miscarriage. TSH was within "normal" range (not sure what it was). I'm going to the Endo on Tuesday, so should know more after that.

I'm so sorry for your loss, but I'm glad to hear you have a good endocrinologist.

I know someone- a doctor- who had hypothyroid symptoms such as fatigue and experienced not one but two miscarriages. Even though her TSH was "normal" it turned out she had very high levels of anti-thyroid antibodies. After being put on thyroid meds she went on to have three normal pregnancies.

I tested positive for the thyroid peroxidase antibodies after we lost Abby. My endo tested me further and I tested positive for both Hypo & Hyper antibodies. my thyroid is in normal range, but it is watched closely and when I was pg with Alison I was on synthroid as a preventative.

That is great that you were tested for anti-thyroid antibodies during pregnancy. My last endo here in the US would also test during pregnancy, but she alas seems to be the exception not the rule. Her explanation was that although [url=http://www.endo-society.org/guidelines/final/upload/Clinical-Guideline-Management-of-Thyroid-Dysfunction-during-Pregnancy-Postpartum.pdf]most hypothyroid women need their thyroid dose uppped during early pregnancy,[/url] some women almost seem to go into "remission" and their antibody levels drop when pregnant.

I'm always surprised that some docs don’t know more about thyroid disease when it is so common. [url=http://www.preeclampsia.org/forum/viewtopic.php?t=18419]Thyroid disease is a risk factor for preeclampsia, but treatment may lower risks.[/url] Even so one study that looked at pregnant women with treated hypothyroidism still found almost [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15804784&dopt=Abstract]double the rates of hypertension and preeclampsia compared to that of the control group.[/url]

And numerous studies have found [url=http://www.ncbi.nlm.nih.gov/pubmed/2118190]an increase in the miscarriage rate among women with anti-thyroid antibodies.[/url] One recent follow-up study found [url=http://www.ncbi.nlm.nih.gov/pubmed/16621910]treatment of antibody-positive women (even in the presence of “normal” TSH) with thyroid hormone replacement may lower risk of miscarriage and pre-term labor.[/url]

If the last study is replicated it might mean that the recommendations for screening could change. Right now they just recommend a TSH test for pregnant women with a family history of thyroid disease or a history of pregnancy complications. That could broaden to include an anti-thyroid antibody test for all pregnant women or women TTC.

I had my prenatal care in the Netherlands for most of my last pregnancy. I already had a hypothyroid diagnosis and they still tested me for thyroid antibodies immediately. She let me know that I had an increased risk of pre-e because of those results. When I got to the US the OB couldn't figure out why they'd bother running that test and was shocked that they felt there was a correlation between those antibodies and pre-e risk.

[color=#0000FF]More than one-third of women who test positive for thyroid peroxidase antibodies during pregnancy will develop abnormal thyroid hormone levels within 2 years of giving birth, prompting researchers to call for more follow-up in this population.

“We need to be following up these women to try to catch their thyroid disease early, as this could have major implications for the health of the mother, baby and any subsequent babies who may be carried while the mother has a thyroid condition,” Potlukova said. “In addition, we need to educate women to be aware that having this antibody can have serious health implications for themselves and their families.”[/color]

[color=#0040FF]http://www.endocrinetoday.com/view.aspx?rid=83262[/color]

Most docs don't routinely test for antibodies here, so I'm not sure what the implications are for most of us. We have enough posters with thyroid issues that I thought I'd mention it just in case!

The Endocrine Society also reccomends thyroid screening via TSH (Thyroid Stimulating Hormone) for pregnant women in the following categories:

[color=#400080]1. Women with a history of hyperthyroid or hypothyroid disease, PPT, or thyroid lobectomy.
2. Women with a family history of thyroid disease.
3. Women with a goiter.
4. Women with thyroid antibodies (when known).
5. Women with symptoms or clinical signs suggestive of thyroid underfunction or overfunction, including [b]anemia, elevated cholesterol [/b], and hyponatremia.
6. Women with type I diabetes.
7. Women with other autoimmune disorders.
8. Women with infertility who should have screening with TSH as part of their infertility work-up.
9. Women with previous therapeutic head or neck irradiation.
[b]10.Women with a history of miscarriage or preterm delivery. [/b]

http://www.endo-society.org/guidelines/final/upload/Clinical-Guideline-Executive-Summary-Management-of-Thyroid-Dysfunction-during-Pregnancy-Postpartum.pdf[/color]