Thyroid UK
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Diagnosis - finally! Will our fertility issues now be over?

Hi all!

FINALLY got my diagnosis from my GP. I took the results from Medicheck. Although she agreed that my TSH was high and has prescribed levothyroxine 50 mcg which I have started today, she said my thyroglobulin antibodies were borderline (they were 116 in a range of 0 - 115) and they would retest.

My fiancé and I have been trying to conceive for almost 3 years. Last year after some tests at a fertility clinic we were diagnosed with unexplained infertility. In the same timeframe, I have gained almost 4stone in weight which my Dr today said is most likely down to the Hypothyroidism.

Could the introduction of levothyroxine help us conceive naturally if I can get my TSH down? I believe it should be somewhere between 1 - 2 to optimise fertility. We were looking at IVF to start in January so wondered how quickly my TSH may drop and if it does drop, could we have a better chance of conceiving naturally?

I need to get my weight down so my BMI drops and hoping the medication will help that. Also gone gluten free too.

Thanks in advance for any advice!

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Fertility can be affected with hypothyroidism (infertility/miscarriages) etc. So it is important that you will soon reach an optimum dose, i.e. when TSH is around 2 for a healthy pregnancy.

As your dose of levothyroxine is increased, every six weeks after a blood test, with an incremental dose your TSH will lower. Weight gain is a clinical symptom of hypothyroidism and should reduce as levothyroxine is increased to an optimum.

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NeensB,

How high is your TSH? TSH >3 can certainly make conception difficult. It is recommended that the TSH of women planning conception should be in the low-normal range 0.4 - 2.5. When pregnancy is confirmed Levothyroxine dose is usually increased by 25-50mcg. NICE recommend hypothyroid patients planning conception should be referred to endocrinology. cks.nice.org.uk/hypothyroid...

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

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...

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_...

Thyroglobulin antibodies are mildly positive for autoimmune thyroid disease (Hashimoto's). 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_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

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My TSH is currently 7.35. It's jumped from 2 in a year.

My thyroglobulin antibodies is 116.

Hoping I can get that TSH down to the required levels by January.

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NeensB,

It's entirely likely 50mcg will get TSH down to the required level in 6-8 weeks but, if not, dose can be increased to 75mcg.

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NeensB,

I've edited my post to say that thyroglobulin antibodies are positive for Hashimoto's.

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Thank you - my GP said she wasn't going to jump to the immediate conclusion that my thyroglobulin antibodies meant Hashimotos. It was 116 and the range was between 0 - 115.

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NeensB,

Well, 116 is over range so it is positive for Hashimoto's. There's no point in retesting once you've had a positive result as antibody levels fluctuate.

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My thoughts exactly. But I think my GP was a bit miffed I paid to have bloods done elsewhere as there was an almost 3 week wait to have them done via my GP.

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NeensB,

GP practices usually test thyroid peroxidase antibodies. They rarely test thyroglobulin antibodies.

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She was pretty dismissive of it. I'm led to believe that the treatment however is the same and putting me on the Levothyroxin is how Hashimotos would be treated I believe...I may be wrong.

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NeensB,

Having a confirmed Hashimoto's diagnosis won't make any difference to your treatment. As I said above, there is no treatment for Hashimoto's, it's the low thyroid hormone it causes which is treated.

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Thank you so much for your advice. I believe and know it's Hashimotos. Just hoping that I can now work with my GP to get my TSH and BMI down in time for starting IVF in January.

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NeensB,

3 months is plenty of time to get TSH down to 0.4 -2.5. Good luck with the IVF.

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Thank you so much! Xx

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I ended up using Maca Herbs for infertility . Didn't take long and I was expecting !

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