Bloods explanation please

[Frankjones3373]

Hello, I have had a recent missed miscarriage after 15 months ttc and I’m desperate to get pregnant again. I had some bloods done in November prior to a referral to the fertility clinic however fell pregnant before an appointment with them and wondering if anyone could have a look at these results to explain if there is anything I need to discuss with the gp please. I already have an appointment booked in an attempt to continue my levothyroxine as my TSH increased further following this but not sure if I need anything else looking in to as I am unsure what most of them mean and not had the opportunity to discuss with a professional. Thank you for any help. I have put them in a list as they just present as individual screens on my app.

7th November:

Progesterone 31.4

Serum testosterone 0.7

Serum free T4 level 13.1

Serum TSH level 5.01

Serum prolactin level 287

Serum FSH 7

Serum LH 7

25th November:

Serum prolactin level 192

LH/FSH 11

thank you so much for any advice

[Endofitall]

the main issue here is the TSH being raised so that’s good your levothyroxine has been increased. It’s really important this is well controlled (usually below 2-2.5) to help fertility and reduce risk of miscarriages.

The rest look normal (though hard to judge exactly without your lab ranges and knowing day of cycle you did them - FSH, LH, testosterone should be done day 3 of your cycle i.e. first day of bleeding being day 1, and with SHBG (sex hormone binding globulin) or that the lab calculates free androgen index, as serum testosterone on its own provides limited info, but the results here don’t appear to suggest PCOS). The progesterone suggests it was done around a week before your period was due and this level would suggest ovulation is occurring.

[Frankjones3373 in reply to Endofitall]

Thank you for reply. I am currently fighting to stay on levothyroxine as they said they would no longer prescribe it following my loss. They believe that it was only needed whilst I was pregnant but do seem to take this seriously that it should be lower to conceive in the first place.

[Endofitall in reply to Frankjones3373]

No problem. Is the TSH of 5.01 above the reference range for your lab? Has it generally been slight high?

and have they tested for thyroid antibodies?

[Frankjones3373 in reply to Endofitall]

Yes it has usually sat at around 5 until I was pregnant and prescribed thyroxine. My last TSH following my miscarriage but whilst continuing medication was 2.8 which is why I want to continue it. Seems like it is working to me?

I had antibodies tested when I was pregnant, not sure if that is the norm as I have not had that tested any other time and was at 23.8. That was before I was prescribed thyroxine.

Thank you for any advice, I find this so confusing.

[Endofitall in reply to Frankjones3373]

No worries. Given TSH consistently been raised, then by definition you do have at least “ sub clinical hypothyroidism “ (so even if T3/4 normal it shows your thyroid is struggling to keep up) and given you’re trying to conceive perfectly good reason to be taking levothyroxine.

is that thyroid peroxidase antibody and is that level above the reference range for your lab? If so that just adds extra weight to fact you need it. Even without TTC/miscarriage factors if someone has persistent raised TSH and positive TPO antibodies then they class as sub clinical hypothyroidism and if they want to/have potential symptoms of under active thyroid can start levothyroxine.

[Frankjones3373 in reply to Endofitall]

Yes it stated thyroid per oxidase antibody when I was pregnant. Not had that result any other time and not sure what that means if I’m honest. Thank you so much. It’s really helpful having that information for when I visit my GP

[Endofitall in reply to Frankjones3373]

The thyroid peroxidase antibody being raised helps confirms there’s an autoimmune process affecting the thyroid. It’s the most common cause of under active thyroid in western world in women. Our immune systems just seem to take umbrage against the thyroid.

I hope your GP is helpful when you go armed with knowledge as well.