Doctor won't refer me to see anyone pre. trying for a baby

[TillyP]

I was diagnosed with hashimoto's when i was 5. I feel fairly well in myself now and generally don't have any problems on 100mg Levothyroxine, however myself and my husband are considering trying for a baby and I would like to speak to someone for some advise/answer questions we have etc before hand.

My doctor cannot help, and won't refer me to anyone - What's my best options? Happy to pay for private consultation if anyone has any recommendations.

Thanks!

[SlowDragon Administrator]

First thing is to get full blood tests

You need TSH, FT4 and FT3, TT4 and both TPO and TG antibodies, plus vitamin D, folate, ferritin and B12

Always get actual results and ranges

If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Once you have results come back here on new post with the results for advice

Meanwhile also email Louise at Thyroid Uk for list of recommended thyroid specialists

[e-mail]

[SeasideSusie Remembering]

TillyP My doctor cannot help, and won't refer me to anyone

That's disgusting, I think she needs reminding of the NICE guidelines regarding hypothyroidism and pregnancy.

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

Refer to an endocrinology specialist all women with overt or subclinical hypothyroidism who are:

◦ Planning a pregnancy

◾Check thyroid function tests (TFTs) before conception if possible.

◾If TFTs are not within the euthyroid range, advise delaying conception, until stabilised on levothyroxine (LT4) treatment — discuss with an endocrinologist if there is any uncertainty about initiation of treatment or what dose to prescribe while waiting for review.

◾Check that the woman understands that her dose of LT4 must be adjusted as early as possible in pregnancy to reduce the chance of obstetric and neonatal complications.

◾Advise the woman to seek medical advice immediately if pregnancy is suspected or a menstrual period is missed.

◦ Pregnant

◾Check TFTs immediately once pregnancy is confirmed.

◾Discuss urgently with an endocrinologist regarding initiation of, or changes to, dosage of LT4 and TFT monitoring while waiting for review — trimester-specific TFT reference ranges may vary locally.

Good luck and I wish you all the best with your pregnancy when it happens.

[Clutter]

TillyP,

It's recommended the TSH of women planning conception should be in the low-normal range 0.4-2.5. Levothyroxine dose is usually increased by 25-50mcg when pregnancy is confirmed to ensure good foetal development.

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...