Yes, over 4 years ago is when we got married. Kids weren't the #1 priority at the time, but I would say it was up there in the large decision making department. Fast forward now, and that's why I'm posting all this. A central location to have everything (details and thoughts) in one place.
Around 2-3 years ago is when I had the "big" miscarriage, the one at 8-9 weeks. I was charting at this time and caught it early, so I got to get an early ultrasound and saw the heartbeat around 6 1/2 weeks. Then I started spotting, no more heartbeat. There were a couple others a little sooner than that. One even right before the 8-9 week one. At that time, the OB doctor told me not to worry, things happen. He said they don't do any testing until you have at least 3 that are around that gestational age. I even went to another OB for a second opinion about testing, and he said the same thing.
It's been a couple years now, and no pregnancies. Not for lack of trying, I'm still charting and using ovulation (OPK) tests. Went to my doctor (new area, new job, new doctors) about it, and got some tests done and a referral to an OB - who did more tests.
One thing I noticed was my TSH level, it was 3.66. If you research TSH levels, you'll find different reference values. I think up until 2003 a TSH below 5 was still considered normal. But now there are endocrinologist groups pushing to get that level max changed to 3. In fact, women trying to get pregnant and those already pregnant have even more stringent levels - 2 to 2.5 MAX. I looked back on my previous TSH levels since 2007, not one of them under 2.5. Wow. How many doctors looked at this and assumed normal? Perhaps without obvious symptoms, but what about when I was experiencing the miscarriages? My free T4 is on the low-end of normal. Some people describe my thyroid issue as subclinical hypothyroidism. I did get tested for the thyroid antibodies, which came back normal.
In the middle of testing, I discovered my breasts were lactating. With no kids and not being pregnant, it was quite the surprise. My previous prolactin level was 19.1 and after the discovery I caught an OB during work to order another. This time it was 37.1. While 19.1 is still considered normal to my lab I've seen a lot of discussion that it should be lower, as close to 0 as possible.
I discussed all this with a coworker who mentioned the possibility of a pituitary tumor, which are actually pretty common. I took my concerns to a provider about the TSH and the galactorrhea and SLEW of printed journal articles highlighted about TSH levels and pregnancy. She barely gave the paperwork a glance, and tried to give me the usual "that's normal" speech. Maybe 4 years ago I would have felt foolish and listened to the doctors trying to tell me I shouldn't worry. Sorry, I've been around the block a few times. If you aren't even going to acknowledge my research, then you obviously have no interest in breaking out of your mundane daily appointments and actually listening to someone else. I pushed enough to get her to order another thyroid panel and a beta pregnancy test that I already knew would be negative.
She called me back that morning, the TSH had risen to 4.33 which is above my lab's normal max value of 3.74. Now I got the MRI ordered that I had wanted in the first place. The MRI report said "evaluation of the pituitary gland demonstrates a very subtle region of non-enhancement measuring approximately 4 mm within the rightward aspect of the pituitary without evidence of mass effect." That made me think about playing Mass Effect on my xbox for about 5 seconds. Hehe. The impression reads, "very subtle region of non-enhancement within the rightward anterior pituitary without mass effect. Cannot definitively exclude occult pituitary microadenoma."
I saw my regular provider before getting that MRI done, and he agreed to look into my research about the TSH, and subsequently said he would consider me as subclinical hypothyroid and agreed to put me on Synthroid 25mcg daily for now. After getting the MRI, he wasn't really sure what to make of it and deferred it to the reproductive endocrinologist I'm going to be seeing in August. I'm also getting thyroid panel and prolactin ran again the end of this month so I have something to take with me to see if the Synthroid is doing anything yet. I'm still able to express a small amount of milk. I don't do it often, as I know the stimulation can increase prolactin levels but I have to check every now and then to see if it's still there.
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