Trying to conceive advice please! : Hi there, I... - Thyroid UK

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Trying to conceive advice please!

Sherywood profile image
6 Replies

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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SlowDragon profile image
SlowDragonAdministrator

Yes FT4 should be near top of range.

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

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.

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

Sherywood profile image
Sherywood in reply to SlowDragon

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!

SlowDragon profile image
SlowDragonAdministrator in reply to Sherywood

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

Ideally ask GP for coeliac blood test first

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

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

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

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

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

100mcg dose is simply likely not enough. See GP and request further 25mcg dose increase in Levothyroxine

Sherywood profile image
Sherywood in reply to SlowDragon

Thanks so much SlowDragon.

SlowDragon profile image
SlowDragonAdministrator in reply to Sherywood

You will see literally thousands of posts about Hashimoto's on here

Read as much as possible about Hashimoto's.

Sherywood profile image
Sherywood in reply to SlowDragon

Much appreciated SlowDragon

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