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Hypothyroidism, regular ovulation, PCOS. Had 2 miscarriages. Abnormal thyroid peroxide ab. How can I prevent miscarriages?

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I am 26/f with hypothyroidsm and I take 127 mcg of levothyroxine daily. My TSH value is under control. I ovulate regularly and have a cycle length of 37 days. I had 2 miscarriages before.
I had the following tests and results to find the reason for miscarriages:
Glucose Fasting - 96 mg/dl
2 hr glucose - 89 mg/dl
Insulin Level - 72 uIU/mL
Testo Total - 33 ng/dL
Testo Free - 6.5 pg/mL
Thyroid Peroxide AB - > 1000 IU/mL

I was asked to take metformin 500 mg daily for insulin resistance and said that I may have light PCOS. The ultrasound for ovaries came back normal. The blood tests to find blood clotting issues was normal. The saline ultrasound was normal. Karyotyping for me and my husband was normal.

What I am more worried about is the Thyroid Peroxide AB. My doctor says that there is no medication to reduce the antibodies and she is not sure if this is causing miscarriage. She says she doesn't know. She is asking me to continue taking levothyroxine.

I want to know if these antibodies are causing miscarriage and is there a way that I can reduce these antibodies so that I don't have any more miscarriages.
Posted Fri, 20 Apr 2012 in Pregnancy
Answered by Dr. Rakhi Tayal 2 hours later

Thanks for posting your query.

Thyroid peroxidase antibodies are not usually the cause of recurrent abortions that you are having.
These antibody levels do decrease with regular treatment of levothyroxine for one to one and a half year which you are already taking.

You can get your levels re tested after one and a half years of treatment to confirm the same.

Levothyroxine treatment at doses keeping TSH at low-normal levels is effective not only in decreasing the autoantibody levels but also in the goiter size, which could ultimately prevent progression to overt autoimmune hypothyroidism.

Hope this answers your query. I will be glad to answer the follow up queries that you have.

Please accept my answer in case you do not have further queries.

Wishing you good health.


Above answer was peer-reviewed by
Follow-up: Hypothyroidism, regular ovulation, PCOS. Had 2 miscarriages. Abnormal thyroid peroxide ab. How can I prevent miscarriages? 1 hour later
I have been diagnosed with hypothyroidism around 6 yrs ago and I have been keeping my thyroid under control since then, except for one or two times when TSH increased to around 11. This increase happened around 2 yrs ago. I am worried why even after so many years of taking levothyroxine my TPO Ab is still high. I do have a little enlarged thyroid, but the ultrasound showed no nodules.
Answered by Dr. Rakhi Tayal 6 hours later

Thanks for writing again.

Levothyroxine treatment is keeping your TPO (Thyroid peroxidase) antibody levels at a comparatively lower level than it would have been without the treatment. There is no other way to keep these antibodies in check.

You need to concentrate more on your female hormones like FSH (follicle stimulating hormone) and LH (Luteinizing hormone) to identify the cause of recurrent abortions.

Hope my answer is helpful. Write back if you have further queries. Please accept my answer in case you do not have further queries.

Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by
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