Thyroid follow up

My first appointment with the endocrinologist was early December. Last week I went back for a follow up to see how my body is reacting to the dosage. I got bloodwork done and the results just came back that my TSH is higher.  My initial test back in Dec had my TSH at 2.96; last week it tested just above 3.

I don't get it. I've been taking the dose as recommended for 8 weeks. Why would my numbers go up? My doc is recommending doubling the dose from 25 to 50 and retesting in six weeks. I told the tech relaying this message that I want to speak to the doc because I have questions. Am I supposed to delay a transfer for this? It's too precious and expensive to transfer before fixing this, but in the meantime I'm not waiting six weeks to find out if it worked. If she doubles my dose I want to be on it for a week and then retest. If it's still not good then the dose needs to go up again. I'm not being impatient, I just don't think the endo doc realizes my timeline.

My doc answered some of my questions. First she said the number is within normal variation range so she would interpret the results that the TSH didn't change, not necessarily that it "went up," and the dose needs to be increased. Second, she said it takes a minimum of 4 weeks to see the full effect of a dose so she doesn't recommend repeating labwork within a week but would cut it down from six.

She did say that since my "TSH is in the normal range now, it will not cause a miscarriage or fetal demise so it would be safe to continue with the FET." Do I trust that? I don't know if I believe her. Every single article I read says that TSH numbers above 2.5 have a greater chance of a miscarriage.
I don't want to take Google's word over that of the trained professional doctor who is paid to treat my specific case but it's hard to argue with a study like this: First Trimester TSH levels between 2.5 and 5.0 are associated with increased pregnancy loss

Do I loop in my RE? I can already imagine that his answer would be "it's up to you." On one hand I definitely don't want to delay. Four weeks to wait to test seems like a lifetime right now. And then what if it's still high? That's another increase with an additional four weeks of waiting. What if this is just my normal and no dosage will help? On the other hand I don't want to risk it. I don't want to have found an actual issue and then just plow forward and ignore it. I know I would be devastated if the FET doesn't take and I will feel like we could've done something... like wait for TSH levels to get to the ideal range. But at the same time if we're increasing the dose and then checking it again soon (and possibly increasing it again due to a pregnancy?) then isn't that enough? Some women get pregnant not knowing their TSH levels are up and only add on thyroid meds once they're already in their first trimester. Is that a risk I'm willing to take?

What to do??

Insurance hiccup

Called Freedom to fill my prescription for the upcoming cycle. There's a snaffu with my insurance in that no one can tell me if I have a yearly maximum on fertility medication or a lifetime maximum. It took four calls and waiting on hold for a combined total of 2 hours to get to this point. Until they figure it out they consider no coverage at all. Never a dull moment.

In follow up news, we finally found a therapist and have an appointment scheduled. It was an ordeal to find someone that met our criteria, which wasn't even that picky. Needed to take our insurance, have evening hours, and preferably have one or two good reviews online. I searched online for recommendations but anyone that came recommended didn't take insurance and the rates were beyond what I was willing to pay (i.e., $350 for first session and $200/hr beyond that). Then I searched through the insurance website, but anyone who had a few good reviews wasn't accepting new patients or if they were taking patients had no availability until March.

I expanded my search parameters up to 20 minutes away and just started calling and leaving messages. I finally got someone to pick up the phone. He took our insurance and had an evening appointment within the month - WIN! I scheduled the appointment. In the meantime I got a few calls back so if we don't like this guy we have a few backups.

The meeting with my supervisor regarding my position and expanding my role went well. I have a follow up meeting with my boss in a few weeks.

I just finished my latest show on Netflix, 3%. The show is in Spanish and while I'm not a fan of subtitles I thought the concept was interesting. I'm usually not a fan of shows that don't have more than one season but I made an exception and glad I did. While we're in between shows we're watching reruns of Seinfeld and Nature with fuzzy baby animals.

Meds

There is a national shortage of Delestrogen and I've been having a tough time trying to fill my prescriptions. I need to have the meds in hand in order to start the cycle with the baseline on Thursday.

The only pharmacy that has any left is in South Miami. Remember Hurricane Matthew? Everyone in Florida is busy trying to survive the storm and they're all closed.

My nurse and I have been researching pharmacies to see who still has an alternative to substitute. There's on in New Jersey who might. I've also been contacting my regular pharmacy, Freedom, and their hold music is literally the worst. The Worst. I don't know why there have been such long wait times but it's a minimum of 10 min on hold each time I called. I called several times throughout the day yesterday and stayed on hold as long as I could before needing to go back to work.

I finally got hold of someone in the evening. They offered an alternative where the dosage and concentration of the medication is different but essentially it's the same drug. They need to confirm with the doctor that it's an acceptable swap before shipping the order.