Levothyroxine : Hi Ladies, Before I... - Fertility Network UK

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Levothyroxine

Natty80 profile image

Hi Ladies,

Before I started my first round of IVF in January 2020 it was delayed because of my thyroid level. I was then told to take 50mcg of Levo for six weeks. I then had my bloods done and my thyroid levels where in range of what it should be. Unfortunately my first transfer failed. I had a frozen embryo left and was due to go ahead in March but Covid delayed the transfer. Anyway..fast forward to July and I was told I could start treatment for my one remaining embryo..this also failed to implant resulting in a BFN. Anyway..I had follow up bloods at the clinic two weeks later and the consultant rang to say that my thyroid level was 9 and that I would need to increase my medication to 75mcg. I am just wondering if this could be the cause of my embryo not implanting as I’ve not had my levels checked since Jan.

I had bloods at the clinic this week and my thyroid level is now 1.9 I was told the ideal range for pregnancy is 0.2-5.0. .I am starting my second round of IVF when AF comes hopefully next week. I am wondering how often I should be having my bloods done to check my thyroid function as I wouldn’t want it to get to 9 again?

Also, I had my progesterone levels checked and it’s 33..is this good?

31 Replies

Hi Natty

So Sorry to hear about your bfn. I don’t have much to offer on the ivf front but I have been trying to manage a thyroid issue for the last year or so with a view to having ivf as a single mum. I am currently seeing a private endocrinologist to help with this.

The one thing I’d say is gps and some endocrinologists I’ve come across know very little about managing thyroid issues. The thyroid forum here is really excellent and can give you really detailed help if you post blood results. (Also maybe search posts there to get a feel for managing thyroid issues),

First of all ideally I’ve been told that your tsh level should be under 1 if you’re trying to conceive and if you’re on Levothyroxine 1.9 is probably too high generally (whether ttc or not) . 9 is very high although ideally need to know the range to confirm this.

I’d really recommend getting a full thyroid panel so you fully understand what’s going on. Do you have any other results? You’d need tsh, ft4, ft3, anti bodies if you’ve never had these so if you know if it’s auto immune and I think if very high these can affect fertility. It’s also quite common for vitamins to be low in people with thyroid issues so test vit d, b12 and folate. To give you an example the nhs gps will only really tell you vit d needs to be above 50 nmol/l. Two endocrinologists have told me it needs to be 100-150nmol/l. Tsh is not enough to figure out what is happening especially when trying to conceive but many doctors will only test tsh and sometimes ft4. You need it all! The full thyroid panel you can have done via at home tests from firms like Thriva or Medichecks. It’s around £79 for all the above and they use the same labs as the nhs.

Once you’ve got these results post them over on the thyroid forum and they will give you some help.

Most people with thyroid issues will end up on about 100mcg of Levothyroxine. 50 is just a starter dose. Some people suggest it should be based on your weight - around 1.6mcg per kg of weight (I think!!)

In terms of how often to test I am currently testing every three weeks with the endo as my levels are quite out of whack (expensive!!). After a dose change generally it’s recommended to test after six weeks. The vitamins you can test a bit less frequently and just the thyroid test is a bit cheaper.

Good luck, feel free to pm me. X

Natty80 profile image
Natty80 in reply to Arlie123

Hi.. thanks for the reply..my consultant said today that 1.9 is good enough level to start IVF? I’ll email the clinic on Monday just to double check..I’m funding my next rounds as a single person and want to make sure it works next time.

I am also under my GP, he was going to refer me to an endocrinologist when my level was 9 but has decided not to seeing as my levels are now in range. I will join the thyroid forum for more info. Thanks x

Arlie123 profile image
Arlie123 in reply to Natty80

Hi, sorry I'm not 100% sure in terms of starting IVF, I think you should be ok! Also I've just re-read my reply and realise that it might be a bit anxiety inducing! Just to say lots of people with thyroid problems are successful from what I've seen and it's a very manageable problem! You just might need to be a bit assertive with doctors, that's all. If your consultant says it's ok, I think it would be - the British Thyroid Association says under 2.5 for TTC and my endo only said ideally for under 1, i.e. a bit over is ok.

I would think it would be more important for the transfer part and as someone said below you must increase levo by 25mcg as soon as you know you're pregnant - maybe at implantation for IVF (I'm not sure, sorry). btf-thyroid.org/pregnancy-a...

The thyroid panels are very easy to do, if you buy the test tomorrow and do it on Monday you would probably have the results back by Friday, so less than a week. Just make sure you do the test first thing, before taking medication and fasted. I would really recommend doing these as you should check your thyroid antibodies. Vitamins can really help with thyroid function and a lot of people (even if you have a perfect diet) are low and that's very easy to fix.

What time of day did you take the test that gave you the 1.9 result? TSH decreases during the day so if you had the test in the afternoon your highest TSH might be higher than that.

There's quite a lot of good info on thyroid and fertility in 'It starts with the egg'. Worth a read if you can!

Hi there,

I'm sorry to hear about your failed transfer. It is poss that it may have been the cause but to be honest this will be impossible to prove and there are also lots of reasons why embryos don't implant so I wouldn't be too quick to blame the thyroid just in case it isn't that. I've been on 50mgs of levothyroxine for many years now and this controls my levels (which generally are under 1). I have been told that ideally the levels should be under 2.5 for IVF but since I have been on the meds I've always been on or around 1. As my levels are quite stable, I don't get them tested too often but do get them tested once you get a positive pregnancy result as you will need to up your meds most likely (I upped mine to 75mgs). I did this last time I got pregnant but sadly lost the baby.

I would be surprised if your levels go up to 9 again now you have upped your dose but you never know. Can you get them checked again next week before you start your next round?

x

Natty80 profile image
Natty80 in reply to hifer

Thanks for you reply..I know there could be other reasons for my embryo failing to implant. I am just trying to make sure that my thyroid, progesterone levels ect are in range before I start my next round. There’s only me funding it so I’ll do anything to try to make it work next time. I could try and get another blood test but I doubt it if I’m starting next week x

hifer profile image
hifer in reply to Natty80

I totally understand. I’d be doing exactly the same thing because any one of those things *could* be the cause so it’s so worth trying to get it right. It’s such a juggling act isn’t it?! Perhaps could you get one at the earliest opp so even if it’s not before you start it should be before you transfer just to check? X

Natty80 profile image
Natty80 in reply to hifer

It’s a tough process having to go through all this just for a small chance of it working. Thanks for the advice..I’ll request to have my bloods done before transfer also. Good luck on your journey xx

I also struggle with thyroid levels, last transfer the clinic didn’t even test the thyroid levels and I was too scared to say anything in case they cancel it again (previous to this I had one cancelled because of ovulation) and another one cancelled due to Covid. So I was really keen to get going, I think now it was a mistake as got BFN and this time round we did say we need to check this and it turns out my levels were at 9. Since then I have been taking 125 mcg every day and found out the FET is successful and I am 5 weeks pregnant . Of course I do think this is also because I am also taking steroids... now I’m waiting on my clinic to tell me if I should increase the dose of thyroxin.... I strongly recommend you bring the levels down to approx 1 ( this was my last results 4 weeks ago). Again my clinic says they test this every 4 weeks... I hope this helps somehow, I strongly believe the thyroid levels have a huge impact on implantation...

Natty80 profile image
Natty80 in reply to Raluca88

Thanks for your reply. I’ll email the clinic on Monday just to double check and see if needs to be 1 instead of 1.9. Congratulations on your BFP x

Natty80 profile image
Natty80 in reply to Natty80

Oh and thyroid levels should be tested before starting IVF...

Raluca88 profile image
Raluca88 in reply to Natty80

Thank you! Keeping everything crossed for you! Xx

Hi natty

Arlie replied you in detail but I can add my experience that I got my first miscarriage at 4 weeks of pregnancy I researched alot about miscarriage that why it happened when for next turn I meet with my Dr I told her that may it is due to thyroid although I never check it nor feel any problem at that moment she click and on the spot she took sample of blood and then I got a call that it is 4.means higher for conceiving or pregnancy so she prescribed 25mg daily and after that I m using that and then it 1.somthing...so your is very high when u start once thyroxine this is then life time pill... So check it with gp that how much u need for current circumstances.

One thing I forgot

Do all test etc before transfer bcos my Dr said that that medication take 3 weeks to level down so make sure start medicines 3 weeks before transfer and then retest before transfer...

Natty80 profile image
Natty80 in reply to Dorekhani

Thanks for your reply..my GP has been liaising with the clinic and both have have agreed that 75mcg is ok for now. I have been on this dose for around 7 weeks now x

Dorekhani profile image
Dorekhani in reply to Natty80

That's good

Praying for successful round🙏🙏

I had my thyroid checked with clinic last week. My TSH is 4.45, so consultant has started me on thyroxine.. When I asked if I should inform my gp, I got told that go won't treat as it's still technically within range. They will only treat if I have a diagnosis of underactive thyroid. I looked at GPs reference range for thyroid and its a max of 4, so should I speak to gp to see if they can monitor me? Xx

Yea you should consult with ur Dr because this is high for conceiving not high normally.. Google it and do research yourself so you will convince.... Your level will down in just 3 weeks of low dose but this is possible only if you convince your dr. Best of luck🤞🤞

Arlie123 profile image
Arlie123 in reply to Dorekhani

4.45 is too high for normal as well as trying to conceive! 'Normal ranges' here are a load of rubbish! Charlie - your consultant sounds like he knows what he's talking about so he should monitor you? I avoid GP where I can as they were no help at all. The consultant just writes to the GP and they then update my prescription accordingly.

Dorekhani profile image
Dorekhani in reply to Arlie123

Yes true... It is high range.. When my range was 4 they said that this normal but very high for conceiving... In every thing you have to monitor yourself no one will help u... I myself book a test after few months to check how is that level... They never say to book test to know that how is your level. So we have to care ourselves..

Arlie123 profile image
Arlie123 in reply to Dorekhani

You’re a sensible lady! x

Dorekhani profile image
Dorekhani in reply to Arlie123

Thanks arlie💖

Actually I always get my prescription through gp Becos my clinic had informed

My surgery about this... So I don't know what is protocol of your clinic...

Thank you, I will speak to gp Monday xx

Speak to them what they say... Gp will not monitor you but will do prescription monthly to you easily by ur call and if u want to book blood test for self monitoring they will arrange.... You have to monitor yourself

Hi, I developed Hashimotos disease after my first child which has resulted in me having to take Levo for the rest of my life. I’m only on 50mcg - they checked before I started my first FET in June and levels were ok I guess (I hadn’t had it checked since March I think) went through my first FET - failed. I started my second a month later and I’m now 5 weeks 3 days BFP. I still haven’t had my levels checked but am having bloods done in the next 2 weeks to make sure they’re ok for me and to sustain growing baby. I was told my egg was defective and nothing to do with thyroid. I hope that gives you some reassurance. Good luck with your next try I’ll be keeping everything crossed for you xxx

Natty80 profile image
Natty80 in reply to Pittuck23

Thanks for your reply! And congratulations on your BFP xx

Just on the progesterone point, my clinic likes it to be over 50 on the day of transfer. They added in an extra dose of lubion last time for me because it was slightly under. Most NHS clinics won’t test for progesterone levels but I would push any clinic to check as it’s super important and often not quite high enough xxx

Natty80 profile image
Natty80 in reply to Millbanks

Thanks for your reply..I’m assuming that 33 is ok then plus I’ll be given extra progesterone during treatment which will hopefully make it rise higher..if that makes sense..xx

Millbanks profile image
Millbanks in reply to Natty80

I would ask them to do a test on the day, just to check xx

I am so sorry you got a bfn, I am dealing with thyroid as well, my Dr. mention that I should be under 2.5 before starting the process. I usually check every two months and if I see something odd I visit the specialist for an adjustment. Right now i am at 75 Levo.

Natty80 profile image
Natty80 in reply to GaJo

Hi..I’ve been on 75 for the past seven weeks. My clinic said it should be under 2.5..I’ll double check with my clinic. Mine is 1.9 and someone said it needs to be lower than that..x

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