Subclinical hypo with antibodies ? Help!

Fellow hypothyroidism and Hashi’s veteran here 👋 It’s possible to have hypo without Hashi’s, and it’s possible to have hypo with Hashi’s. With antibodies, typically you want it as close to 0 as possible. The threshold, at least where I am in Ontario, Canada, is 34 and below is not Hashi’s. 35 and above is. Even if you just have elevated TG or TPO. In my case, both of mine were elevated! It’s possible to put your Hashi’s into what’s called remission. There is no cure for Hashi’s but with remission, you can lower your antibodies below that threshold. However, it is *temporary* and you still have Hashi’s even if it’s in remission. Anything can kick those antibodies back up—stress, trauma, pregnancy, postpartum, the list goes on. It’s good to test antibodies a couple times a year (no more than that as they don’t change that quickly) to keep an eye on things. In pregnancy, you definitely want you tsh tested every 4 weeks and adjust meds as necessary. Do this and you should mitigate

your risk of miscarriage. For reference, my TSH was 3.67 when I was pregnant at 4 weeks (too high). Within 5 days of the positive test, it went to 5.1. Cue panic from me! Doc increased my dose. I finally got an endocrinologist and I’m closely monitored. My TSH is down to 1.6 which is a beautiful number. Best it’s ever been! Hang in there. It’s a beast.

Also, your antibodies likely will lower through pregnancy! There’s a weird phenomenon where pregnancy actually improves autoimmune diseases meanwhile postpartum just aggravates them lolc

@Rachel thank you for this info! My doctor never mentioned anything about Hashimoto so I guess I don’t have it?? How often do you get your TSH checked during pregnancy? And do you check your T3 and/or T4 regularly as well?

@Makayla I wouldn’t necessarily say that you don’t have it because your doctor didn’t say you did. Doctors can be ignorant, and it’s important to remember that autoimmune diseases are not a speciality of family doctors. They aren’t the experts! An endocrinologist is. My endocrinologist tests my TSH, t3 and t4 approximately every 4 weeks and adjusts my medication accordingly. Advocate, advocate, advocate! Someone who doesn’t have hypothyroidism would only have their TSH checked once a trimester. So make sure you don’t slip into that schedule because you need it tested a lot more regularly.

@Rachel I did IVF and working with a reproductive endo so they are pretty on top of things. So yours went up even within 1 week from 4weeks pregnant to 5 weeks pregnant? I just had mine checked at 4 weeks with my hcg test and it came back 1.6. I don’t think they will test it again until 8 weeks. Should I get it done before then? I’m currently at 6 weeks.

@Rachel also does it make a difference that my thyroglobulin was positive but peroxidase was negative? Everything I see on google talks about positive peroxidase.

@Makayla if you have a reproductive endocrinologist, you’re in very good hands! My TSH was not properly managed before I got pregnant; I couldn’t get an endocrinologist so my nurse practitioner was handling things and she honestly sucked at it. So my TSH was in the 3’s before I conceived which was why it was high when I first got pregnant. And no one was monitoring me at the time I conceived and my fertility doc refused to increase my levothyroxine. It sounds like you’re in a better spot than I am. 1.6 at 4 weeks pregnant is an amazing number. I couldn’t get to 1.6 until I was 14 weeks.

@Makayla with Hashimoto’s, it doesn’t matter which antibody is elevated, or if both are. One or both = Hashi’s! The TG antibody is usually the one that’s impossible to lower. My TG has been in the 400’s meanwhile my TPO was 35-39 so just barely elevated but enough to earn me a diagnosis! You want to keep an eye on both since at any point in time they can get elevated.

@Rachel thank you sooo much for this info!! I was feeling so confident about this pregnancy until today I hit 6 weeks and I don’t know if it’s the emotional side effects of pregnancy but I all the sudden got major anxiety about something going wrong and just couldn’t stop thinking about the thyroid issue! So basically regardless of antibodies or not, if you’re managing with properly medication, your risk of miscarriage and other preterm complications goes down? That’s all I need to know to reassure myself!

@Makayla the intrusive thoughts during the first trimester are out of control. Especially if you’re on progesterone so be gentle with yourself. You miscarry with thyroid issues if your TSH is unmanaged. So many women unfortunately don’t know they have a thyroid issue, get pregnant and miscarry and then find out. But because you have the right team and you’re being closely monitored, take a breath. There’s no way you’d miscarry with a TSH of 1.6. If you do, it isn’t because of your thyroid. Like I said, I was 3.67 at 4 weeks and then 5.1 at 5 weeks. I’m 18 weeks now and everything is great!

@Rachel you made me feel so much better, thank you so much!!! 💗 Goodluck with the rest of your pregnancy!