jjdavis7 wrote: Does everyone with hypothyroidism need to see an endocrinologist? We are thinking of TTC soon and I am trying to cover all my bases.
Not everyone with hypothyroidism needs to see an endocrinologist, but my personal experience has been that endocrinologists and MFMs (maternal fetal medicine docs) tend to know more about the effects of thyroid disease on pregnancy. And as a specialist an endocrinologist should be more updated about the latest guidelines regarding thyroid management during pregnancy.
There are exceptions to every rule though. I saw a bad endocrinologist once (who never even bothered to "check my neck"), then saw an awesome one who had done thyroid related research, and picked the last one based on his age/graduation date. I figured the youngest endo in my area was probably more up to date on all the thyroid related research that has come out in the last decade. Unfortunately, some endos seem to focus more on diabetes than thyroid issues.
My first OB and current GP are actually great dealing with thyroid stuff too though. However, it can take a while for the latest guidelines to trickle down to care providers, and different docs have different definitions of what is "normal" thyroid-wise. So I always ask for a copy of my blood results and try to read the latest pregnancy reccomendations.
Here are links to some recent guidelines regarding management of thyroid and pregnancy:
2011 American Thyroid Association (ATA) guidelines: http://thyroidguidelines.net/sites/thyr ... 1.0087.pdf
2007 clinical guidelines from The Endocrine Society (co-sponsered by American Association of Clinical Endocrinologists):http://www.endo-society.org/guidelines/ ... partum.pdf
Personally, before choosing a doctor to manage my thyroid levels I would ask some questions. Such as:
"What should my target TSH be pre-conception and during pregnancy?" (If they don't say below 2.5 mIU/L, I would print them out a copy of the latest thyroid guidelines & move on).
My favorite endo's goal for TSH was 1-2 mIU/L, but she also made sure to check free T3 and free T4 levels during pregnancy.
"How often should my thyroid levels be tested during pregnancy?" (If they say once a trimester and not more frequent checks in first half of pregnancy, again I would educate them or move on). Right now my thyroid levels are being checked every month, will be checked again at least once in third trimester, and will be checked again postpartum. Most hypothyroid women need their thyroid dose upped in first half of pregnancy, and if so it is common to drop back down to a pre-pregnancy dose postpartum.
Hope this helps, please let me know if you have any more questions!