Hello Dr. Sher, I can only imagine how busy you are so I will try to make this question as brief and concise as possible. I just turned 39. Currently 5wks pregnant (naturally conceived–was told it was an impossibility by RE). I have Graves disease and Hashimotos. History of two miscarriages around 8wks (healthy heartbeats, good HCG, thyroid levels near optimal). I have two living children through fertility (2018 and 2020). My last loss was in May 2022; my first was in 2020 around the time I was diagnosed with Hashimotos. I strongly suspect my losses were due to my immune diseases. I also suspect I will need, at minimum, prednisone (potentially LDN?) to calm my immune response in order to prevent a subsequent loss. I realize I’m working against the clock as my pregnancy advances. I am learning that there are waiting lists everywhere (understandably) and lab results can take weeks. I’m looking for ANY advice here. I live in rural Johnson City TN where there are few specialists or drs who know much about immune diseases and particularly how they influence pregnancy. If you have any referral options, if you have an opening in your schedule, or know of any physicians who have a baseline knowledge of autoimmue responses I would LOVE any help I can get! THANK YOU for you time.