TTC with Hashimotos

[osannie]

Hey,

Just looking for some advice please. I'm based in Ireland, have a daughter who's nearly 2, and hoping to start trying for baba #2 in the new year.

In March 2017 I found out I had Hashimotos, only met with endo in September so only on eltroxin just under a month. 75mg. I had bloods done that day and. They only checked Tsh and T4.

Tsh is 4.5 and T4 is 14.1 no range given the receptionist didn't know the ranges. But said endo had note on to increase eltroxin to 100mg.

Back to my GP nx week for follow up bloods as I'll be a month on eltroxin.

What do I need to ask or know about trying to conceive in the new year. I'm aware of getting my Tsh lower, will an increase in eltroxin do this?

[osannie]

Don't know how pretty got in to the title. Can't seem to edit it.

[shaws in reply to osannie]

You press the down arrow along from Follow Post and select edit.

[osannie in reply to shaws]

Thanks shaws

[shaws]

Any blood tests for thyroid hormones have to be at the earliest possible, fasting (you can drink water) and allow a gap of 24 hours between your last dose of thyroid hormones and the test and take afterwards. This helps keep the TSH at its highest as that seems to be all the doctors take notice of.

We need the ranges along with the results as it makes it difficult to comment without them. Maybe phone the lab the surgery use who will give you the ranges. I find it incredible that they are not put on the print-out the surgery gets.

Increases in levo will reduce your TSH and I believe around 2 is good for pregnancy. Others will also respond. You should also have B12, Vit D, iron, ferritin and folate tested too.

[Clutter]

Osannie,

An increase in Eltroxin will raise FT4 and reduce TSH. Women planning conception should aim for TSH to be in the low-normal range 0.4 - 2.5. Eltroxin should be increased by 25-50mcg when pregnancy is confirmed to ensure good foetal development. NICE in the UK recommends hypothyroid women planning conception or newly pregnant are referred to endocrinology for management. cks.nice.org.uk/hypothyroid...

Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee

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...

[osannie in reply to Clutter]

Thanks clutter,

Should I ask GP to check t3 and antibodies again?

[Clutter in reply to osannie]

Osannie,

There's no point in retesting antibodies once they've been confirmed as positive as they will fluctuate.

FT3 is rarely tested in primary practice in the UK unless TSH is suppressed <0.1. Your FT3 is unlikely to be optimal as TSH and FT4 aren't but neither is FT3 likely to be over range which is why it is usually tested.

[SlowDragon Administrator]

Your antibodies are high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. When they are too low they stop Thyroid hormones working.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...