Thyroid UK

Potential thyroid problems and TTC

Hi all,

I'm new here and just wanted to give a bit of background first.

DH and I have been TTC since July. We had a early miscarriage/chemical pregnancy and 4w6d in October.

I'm aware that we haven't been trying for long, and that there is no need to be concerned. However, I'm worried that my thyroid could be impacting.

I was told that I was subclincally hypothyroid a few years back. Never treated, as my levels are always 'normal'. Despite this, I do have symptoms of an underactive thyroid (hypothyroidism), such as fatigue and sensitivity to cold

I've had my levels back last week. My TSH is 4.6 (range 0.5 - 6) and my t4 is 11.6. (don't know the range, sorry)

I've seen a number of times that TSH should ideally be between 1 and 2 when TTC.

I'm worried that this could affect us TTC. Even more so, I'm worried that this could be the reason for our early loss in October. I know it's probably not, and that early loss is very common, but I just wonder if the doctor should have mentioned this to me when I told her I was pregnant.

I saw my doctor today (a different doctor to the one I saw in October) and he told me that my levels are well within range and that there is nothing to be done basically. Even when I explained all the above he just repeated that they were in range.

I feel like I have a million questions. I don't quite understand how the ranges work, are they based on an average or is it more than that? I also don't understand why I keep reading that levels should be between 1 and 2 for ttc if my doctor disagrees - he said he'd never heard of that before!

If anyone could give me any advice around this I would be so grateful, thank you.

3 Replies

Welcome to the forum, Bumblingbee.

I'm sorry for your miscarriages.

I think it's very likely that your high TSH is the reason you have miscarried. NICE CKS recommend the TSH of women planning conception and newly pregnant should be in the low-normal range 0.4 - 2.5. Your GP should prescribe Levothyroxine to bring TSH <2.5 and dose should be increased by 25-50mcg when pregnancy is confirmed.

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Would be good idea to ask GP to check levels of vitamin d, b12, folate and ferratin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells

Also have you had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

If you have high antibodies, then guidelines recommend treating, even if TSH is above range (but below10)

ALWAYS Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to copies of your own results

If you can not get GP to do these tests, then like many of us, you can get them done privately

Blue Horizon - Thyroid plus eleven tests all these.

This is an easy to do fingerprick test you do at home, post back and they email results to you couple of days later.

Usual advice on ALL thyroid tests, (home one or on NHS) is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

If you have Hashimoto's then you may find adopting 100% gluten free diet can really help reduce symptoms, and lower antibodies too.

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I am sorry for your recent loss. I am currently on my 3rd pregnancy with an underactive thyroid.

I fear that you will find it difficult to conceive, and though no one can say for sure, your thyroid could well be the reason for your loss.

Take a look at the website, It has lots of great articles, (I have included some thyroid/pregnancy articles at the bottom) and advice you can take to your GP. (You GP will know very little about the thyroid in pregnancy, so it is very important for you to get as knowledgeable as you can. If you are lucky, you will have one like mine, who is very open minded and willing to read the articles and go with my suggestions.) Buy the book she wrote on pregnancy-it’s amazing! “Your Healthy Pregnancy with Thyroid Disease”, by Dana Trentini & Mary Shoman.

You need to be medicated, to bring your TSH down to below 2.5 and ideally, close to 0. Once you are there, you can start trying to conceive again. You also need to have your T3, B12 and Vit D levels checked and optimal before you start trying.

Once you are pregnant, then increase your Levo/thyroxinne (T4) by 30% . The demand increases as soon as 4-6 wks into pregnancy and we are trying to avoid miss carriage. Then go to your GP and let them know you need blood tests every 4weeks until 20weeks. The results of these tests, will likely show that you need further increases. (Don’t increase without the blood tests to tell you how much you need.) Your blood tests need to include T3 results. If your GP won’t do this, get private testing done through “Blue Horizon.” As always, get copies of all your blood tests, and post on here for advice. Do not accept your GP telling you that you are “normal” or “within range” as very few of them know what is healthy for pregnancy. At 20 wks, the demands usually plateau and you will need tests/increases less often. (The book tells you how often.)

The book I mentioned above, gives this advice about the TSH levels you need to have to have a healthy pregnancy. This is really helpful to take to your doctor.

Pre conception & First trimester: less than 2.5 with a range of 0.1-2.5

Second trimester: 0.2-3.0

Third trimester: 0.3-3.0.

TSH should be monitored every 4 weeks during the first 20 weeks of gestation, then once again between 26 and 32 weeks.

Keep an eye on your B12 levels, as pregnancy places a high demand on these and people with an underactive thyroid are usually deficient to begin with. (You can’t overdose on B12, anything you don’t need you will pee out. A bit of a waste of money, but not dangerous!)

Some articles, you may like to read:

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum

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