Hi there, I am trying to conceive and have uncovered that I have a under active thyroid. My TSH was originally 5.87 with T4 at 12. I was put on 50 mcg of thyroxine but at the next test my TSH had shot up to 8.75. It transpired a few days later that I was actually pregnant and that was the cause for the spike. Unfortunately I lost the pregnancy very early on and my GP and endo put me in 100 mcg is thyroxine. Now, 4 weeks later my TSH is 1.43 which I’m happy about as it should be below 2 to get pregnant but my T4 is only 13.1 (range 12-22) so it hasn’t really risen much. I aware that T4 should be in the upper part of the range for conceiving so what can I do? I think my GP will be reluctant to increase Levo as my TSH is under 2. Why would my TSH reduce so much with hardly any impact on my T4? Any recommendations?
All help is very much appreciated!
Thanks!
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Sherywood
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Do you know if you have Hashimoto's ? That's autoimmune thyroid disease diagnosed by high thyroid antibodies
If not had thyroid antibodies tested you need them tested
Also essential to test vitamin levels. Low vitamin levels are extremely common.
For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
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.
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. If also on T3, make sure to take last dose 12 hours prior to test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Suggest you see GP and request a 25mcg "trial" increase in Levothyroxine
And get vitamins and antibodies tested if not been done
Good levels of B12 and folate essential for baby's development
Thanks so much SlowDragon. I have TPO antibodies tested and they were 113.8 so, yes, I have hashimoto’s. Does that make s difference to treatment? Do you know why my TSH would decrease so much but will no resultant significant increase in T4? Thanks!
Many medics completely ignore the autoimmune thyroid aspect of Hashimoto's, but patients find there's much they can do to improve symptoms
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's
Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.
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)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
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Trying to conceive
Advice please
Hashimotos and Trying to Conceive 
Dose changes advice please 
Advice on blood test results 
