Need advice from endocrinologist or fertility specialist


Q: After having my first child in 2008, I was diagnosed with hyperthyroidism (grave's). I was treated with methimazole 5mg tid for a few months, but was noncompliant and came off the medication. I was symptomatic for about 1 year (no menstruation, hot flashes, tremors). Then, after 4 years of no therapy and being asymptomatic, I became pregnant but miscarried. My thyroid levels were checked and I was found to have subclinical hypothyroidism with a TSH of 5.2 and positive for antibodies. I remain asymptomatic. I was started on synthroid 25mcg daily and after 3-4 weeks of treatment I began to feel symptoms of hyperthyroidism (jitteriness, palpitations, hot flashes) in which I have not felt for almost 4 years since the prior diagnosis of hyperthyroidism back in 2009. My physician is recommending to continue the synthroid to acheive desired levels for conception to even be possible. However, the symptoms I am experiencing are making me wonder if I am becoming hyperthyroid again. I recently had a TSH level done and my physician wants to increase my Synthroid to 50mcg daily. Should I continue even though I am feeling symptoms of hyperthyroidism? Is it expected to feel these symptoms while trying to achieve desired levels of TSH 1-2?

Symptoms:  Hot flashes, increased appetite, jitteriness

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