Can anyone help me with links to recent research on hypo diagnosis / normal TSH?

[kayaktime]

I've just got my Blue Horizon blood tests back after some forum members recommended an early morning test.

TSH 4.73 (0.27 - 4.2)

T4 108 (59 - 154)

FT4 16.5 (12 - 22)

FT3 5.1 (3.1 - 6.8)

Thyroglobulin Antibody 124.3 (0 - 115)

Thyroid Peroxidase Antibodies 5 (0 - 34)

Given that I'm experiencing 2/3 of the symptoms of the TUK checklist for hypothyroid, I'm going to attempt to persuade my GP for a trial of medication.

I'm trying to track down an article I saw recently on re-thinking normal TSH levels but can't find it anywhere (from Norway I think?).

If anyone knows of any recent research articles re. TSH levels and planning pregnancy, I would be very grateful for the links. I brought this up at my last GP appointment (my last TSH was 3.5, two months ago) but was met with rolling eyes and "don't believe everything you read on the internet". Frustratingly, during my last two appointments, I've seen the doctor google hypoparathyroid and use the same sites as me...I'm supposed to be embarking on IVF soon (or would have by now, if I wasn't so achy, tired and mis-diagnosed with chronic fatigue), so I'm taking no chances with this.

Are the guidelines in Scotland the same as England? I see there are no SIGN factsheets so what do GPs use as guidelines up here?

Thanks for any help. I really hope I get somewhere with my GP, but want to go armed with research.

[Clutter]

Kayaktime, one would hope your GP would agree that your TSH over range qualifies a subclinical hypothyroid diagnosis and prescribes a full replacement dose of 75mcg/100mcg Levothyroxine.

Elevated TSH can make conception difficult and NICE recommend that TSH should be in the lower range 0.4-2.0 and Levothyroxine started immediately while awaiting referral to a specialist.

cks.nice.org.uk/hypothyroid...

hypothyroidmom.com has good info on pregnancy in hypothyroid women if you scroll down to the topic links.

Good luck with conceiving

[kayaktime in reply to Clutter]

Thank you, Clutter, for the info and links. Shall be printing out the appropriate NICE section : )

[eeng]

I read somewhere that your TSH should be at 2 or below if you want to conceive, so you definitely need to start on Thyroxine. If it was me and my doctor refused I would self treat. You only have one life. Once you are pregnant you will need to have your Thyroxine dose increased under the care of an endocrinologist.

[kayaktime in reply to eeng]

Thank you, eeng. A lot of fertility clinics automatically give thyroxine to women above 3, whether they have symptoms or not. Hoping my GP is helpful, as don't really want to self-medicate.

[Hidden]

It is very important to ensure that if hypothyroid, you are suitably medicated and well, before embarking on pregnancy. pregnancy.about.com/od/thyr...

Like Clutter says, I would hope that with your higher than desirable TSH, you will be offered levothyroxine as soon as possible.

Good luck

[kayaktime in reply to Hidden]

Thank you, Hypnoteq. High TSH = too much of a gamble - had no idea of the impact on pregnancy, just knew that it increased chance of miscarriage.

[Hidden in reply to kayaktime]

Everyone was very worried about my son as I hadn't been told to wait before pregnancy, to get my levels right, nor was my T4 increased during. He was whisked off to have tests done for cretinism which we had to wait a few days for, before being declared okay. However he does have severe Crohns. I would hate you to have a similar experience

[kayaktime in reply to Hidden]

Hynoteq, that must have been an awful experience with your son. Severe Crohns is a such a hard thing to live with - hope he's got a good doc and is coping with it okay.

[Ansteynomad]

Have a look at the NICE Guidelines and print them out for your GP.

cks.nice.org.uk/hypothyroid...

[kayaktime in reply to Ansteynomad]

Thanks, Ansteynomad. Will do.

[shaws]

Before going for IVF you have all your levels for your thyroid gland at optimum level for you. If they are you may get pregnant before IVF.

hypothyroidmom.com/hypothyr...

[kayaktime in reply to shaws]

Thanks, Shaws. Unfortunately not possible in my case, which is why I have to be in tip-top condition to maximise IVF chances. Hypothyroidmom is a great site.

[shaws in reply to kayaktime]

I wish you every success in your IVF.

[kayaktime]

Thanks all - there's so much knowledge on this forum.

One last question - if doc agrees to medicate, how long does it normally take to get TSH down and become a little less symptomatic? That's possibly like asking about the length of a piece of string, but any estimates would be really appreciated.

[Hidden in reply to kayaktime]

Generally tests are done 6weekly to track changes and alter meds if necessary, but if I remember correctly I noticed feeling better very quickly. I went around telling people I hadn't realised how ill I had felt until I started to feel better! ( the Endo had turned to his students to tell them I had one foot in the grave, though)

[kayaktime in reply to Hidden]

Feeling better quite quickly sounds very good to me. Today is one of those days where my head feels too heavy for my neck...