Trying to conceive

[Alliec1992]

Hi new here will having elevated thyroid antibodies mean I will pass them on to baby thank you

TSH 44.9 (0.2 - 4.2)

FREE T4 10.7 (12 - 22)

FREE T3 3.8 (3.1 - 6.8)

THYROID PEROXIDASE ANTIBODY 647.3 (<34)

THYROGLOBULIN ANTIBODY 905.5 (<115)

[Clutter]

Welcome to the forum, AllieC1992.

You need to see your GP as a matter of urgency, today or tomorrow, to start Levothyroxine or, if you are already taking Levothyroxine, to have dose increased and you should be referred to endocrinology.

TSH 44.2 is very high and FT4 is below range which means your baby's development may be impaired and you are at high risk of miscarriage.

Show your GP the NICE CKS recommendations on pregnancy and hypothyroidism cks.nice.org.uk/hypothyroid... and Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee extract

13. The serum TSH reference range in pregnancy is 0·4–2·5 mU/l in the first trimester and 0·4–3·0 mU/l in the second and third trimesters or should be based on the trimester-specific reference range for the population if available. These reference ranges should be achieved where possible with appropriate doses of L-T4 preconception and most importantly in the first trimester (1/++0). L-T4/L-T3 combination therapy is not recommended in pregnancy (1/+00).

onlinelibrary.wiley.com/doi...

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroiditis (Hashimoto's) which can be passed on to the baby but won't necessarily be passed on. Even if they are it may be decades before they cause hypothyroidism in your baby. Babies are given a heelprick blood test before they are discharged from hospital so any thyroid abnormalities are usually picked up then.

There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/diagno...

thyroiduk.org.uk/tuk/about_...

[Alliec1992 in reply to Clutter]

Thank you I am not yet receiving treatment due to symptoms of adrenal insufficiency but I will go back to doctor tonight

[humanbean in reply to Alliec1992]

What are the doctors doing about your suspected adrenal insufficiency? Have they actually tested to confirm it?

Do you have hyperpigmentation?

mayoclinic.org/diseases-con...

All the symptoms of adrenal insufficiency, apart from hyperpigmentation, can occur with low thyroid function and low nutrient levels. It needs to be tested for, confirmed, and treated if necessary, not just suspected.

I really think you need to delay trying to conceive for a year. With your current thyroid levels and nutrient levels your chances of conceiving are slight. But if you do manage to conceive your risk of miscarriage is high and the risk of neural tube defects is also high because your B12 and folate are low in range and below range respectively.

Sorry for being so blunt about it, but to avoid heartbreak and a lifetime of regret you really need to get your health sorted out before you attempt to conceive, for your good and for the sake of any offspring you have.

[Alliec1992 in reply to humanbean]

Hi I have hyperpigmentation but nothing been done about the adrenal insufficiency

[humanbean in reply to Alliec1992]

Go and see your doctor and talk about the suspected adrenal insufficiency. Ask to be properly tested as an emergency, and treated for it if necessary.

If you have Addison's Disease it could kill you if it isn't properly treated, and you shouldn't just be left to rot.

en.wikipedia.org/wiki/Addis...

If you do have Addison's and it is untreated or inadequately treated then you could have an adrenal crisis. You need to learn about the symptoms of this, and if it ever happens you should go to A&E / the ER immediately.

en.wikipedia.org/wiki/Adren...

If you do get tested you should know how tests should be prepared for, the ideal timing, what to expect and how results are interpreted. When you know the name of any tests you are having, read up about it in this document :

imperialendo.co.uk/Bible201...

I simply don't understand your situation to be honest. Your doctor isn't testing and treating you for Addison's Disease for some unknown reason, and because he/she hasn't done that, he/she also hasn't treated you for thyroid disease properly.

Is he trying to kill you?

[SlowDragon Administrator]

Make sure GP tests vitamin D, folate, ferritin and B12 too

You may need to supplement these to help thyroid hormones to work.

[Alliec1992]

FERRITIN 8 (15 - 150)

FOLATE 4.1 (4.6 - 18.7)

B12 196 (180 - 900)

VITAMIN D 33.8 (25 - 50 deficiency. Supplementation is indicated) taking 800iu vit D only

[SeasideSusie Remembering in reply to Alliec1992]

What's been said about your below range ferritin?

Have you had full blood count and iron panel carried out and diagnosed with iron deficiency anaemia?

What's been said about your folate deficiency?

VITAMIN D 33.8 (25 - 50 deficiency. Supplementation is indicated) taking 800iu vit D only

You need far more than 800iu, it will never raise your level, it's barely a maintenance dose for someone with a decent level to start with.

You are just 3.8 above the level where you'd be given loading doses. Discuss the following with your GP and say that as you are so close to that level will he prescribe the loading doses

NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar.

If you can't have loading doses then my suggestion would be to buy some D3 softgels like these bodykind.com/product/2463-b... and take 10,000 daily for 4 weeks then reduce to 5000iu daily. Retest 3 months after starting them. When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - then you'll need a maintenance dose which may be 2000iu daily (not the paltry 800iu prescribed), it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

[Alliec1992 in reply to SeasideSusie]

Hi nothing been done about folate deficiency and complete blood count and iron panel showed

MCV 78.2 (80 - 98)

MCHC 388 (310 - 350)

Haemoglobin 124 (120 - 150)

Haematocrit 0.41 (0.37 - 0.47)

RBC count 4.44 (3.80 - 5.80)

WBC count 6.15 (4.0 - 11.0)

MCH 28.2 (28 - 32)

Iron 9.0 (6.0 - 26.0)

Transferrin 14 (10 - 30)

I will ask doctor about the vit D and folate

[SeasideSusie Remembering in reply to Alliec1992]

Alliec1992

FERRITIN 8 (15 - 150)

MCV 78.2 (80 - 98)

MCHC 388 (310 - 350)

Point out to your GP that your ferritin is well below range and all this suggests iron deficiency anaemia and you wish to be treated appropriately (you can also ask him why he's ignored these results).

NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines) cks.nice.org.uk/anaemia-iro...

Have a read through but this is the treatment:

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. Ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

**

FOLATE 4.1 (4.6 - 18.7)

B12 196 (180 - 900)

As well as folate deficiency your B12 is very low in range. Do you have any signs of B12 deficiency b12deficiency.info/signs-an...

Please post on the Pernicious Anaemia Society forum for further advice. You probably need testing for Pernicious Anaemia and may need B12 injections.

Folate should be at least half way through it's range and as far as B12 is concerned I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Whatever the PA forum advise, discuss with your GP and ask why he has ignored your folate deficiency.