Subclinical hypothyroidism

[Scheepy18]

Hiya, I’m trying to convince & lose weight to help with this. I have PCOS and have been told I have the above - I don’t have periods which makes trying to get pregnant very difficult. I’m not sure which problem to try tackle first!! I’m 31 and have been TTC for 10months! Would love to hear from anyone who is in a similar situation. Thanks xx

[shaws Administrator]

Have you had a Full Thyroid Function Test? If not I would advise you to and it consists of TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. the most important are the Frees (rarely tested) and antibodies.

All blood tests have to be at the very earliest, fasting (you can drink water) and allow 24 hours gap between last dose of levothyroxine and the test. I shall give you a list of clinical symptoms:

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

Get a print-out of your results with the ranges and put them on a new post for comments.

[shaws Administrator]

I don't know what TCC means. There is an interconnection between hypo and PCOS . I don't have a link but this is a copy which will interest you :-

"

a Major Symptom of Hypothyroidism

The case I describe below is of importance to women with polycystic ovaries. If

they have evidence, such as a high TSH, that conventional clinicians accept as evidence

of hypothyroidism, they may fair well. But the TSH is not a valid gauge of a woman's

tissue thyroid status. Because of this, she may fair best by adopting self-directed

care. At any rate, for women with ovarian cysts, this case is one of extreme importance.

In 2008, doctors at the gynecology department in Gunma, Japan reported the case

of a 21-year-old women with primary hypothyroidism. Her doctor referred her to the

gynecology department because she had abdominal pain and her abdomen was distended up to the level of her navel.

At the gynecology clinic she underwent an abdominal ultrasound and CT scan. These

imaging procedures showed multiple cysts on both her right and her left ovary.

The woman's cholesterol level and liver function were increased. She also had a

high level of the muscle enzyme (creatine phosphokinase) that's often high in hypothyroidism. Blood testing also showed that the woman had primary hypothyroidism from autoimmune thyroiditis.

It is noteworthy that the young woman's ovarian cysts completely disappeared soon

after she began thyroid hormone therapy. Other researchers have reported girls with

primary hypothyroidism whose main health problems were ovarian cysts or precocious

puberty. But this appears to be the first case in which a young adult female had

ovarian cysts that resulted from autoimmune-induced hypothyroidism.

The researchers cautioned clinicians: "To avoid inadvertent surgery to remove an

ovarian tumor, it is essential that a patient with multiple ovarian cysts and hypothyroidism

be properly managed, as the simple replacement of a thyroid hormone could resolve

the ovarian cysts."[1]

Reference:

1. Kubota, K., Itho, M., Kishi, H., et al.: Primary hypothyroidism presenting as

multiple ovarian cysts in an adult woman: a case report. Gynecol. Endocrinol.,

24(10):586-589, 2008.

So I think (and am not medically qualified) that they should start giving your thyroid hormones.

Reference:

1. Kubota, K., Itho, M., Kishi, H., et al.: Primary hypothyroidism presenting as

multiple ovarian cysts in an adult woman: a case report. Gynecol. Endocrinol.,

24(10):586-589, 2008.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Scheepy18 in reply to shaws]

Hiya, thanks for this!

Sorry, TTC is trying to conceive

[humanbean]

PCOS is often mentioned on the DietDoctor website. Apparently a Low Carb, High Fat (LCHF) diet is very good at reversing some or all of the symptoms of PCOS and, apparently, it helps people trying to conceive.

dietdoctor.com/

dietdoctor.com/low-carb/ben...

Personally, I'm way beyond worrying about conception, so this has no relevance to me and I have no experience of trying this in relation to conceiving, but I thought it might be of interest to a PCOS sufferer.

[humanbean in reply to humanbean]

Hypothyroidism makes it harder to conceive at all, and increases the risk of pregnancy loss if you do conceive.

A common effect of hypothyroidism is for sufferers to become nutrient deficient. People are often found to be very low or deficient in vitamin B12, folate, ferritin, iron, and vitamin D. If you could get these levels tested by your doctor, or privately if your doctor is no help, then you can buy supplements online that will help you to optimise your levels of nutrients. It will improve your health and may help your future offspring to be healthy before birth.

For private testing :

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

Ask for advice if you are interested in private testing for anything thyroid-related.

[Tracilynholland in reply to humanbean]

“They” generally say the low carb way because when you eat carbs (especially high energy carbs ie potatoes, rice, pasta etc) you hold 3g of water with every gram of carb, so its not “fat” you gain (unless you’re also in a calorie surplus) but it’s water weight. Which is why its best to judge your weight based on measurements not scales xx

[humanbean in reply to Tracilynholland]

I don't think the weight gain is the main issue in this case. It is the fact that the OP wants to conceive but is not having periods. If a LCHF diet can get her periods going again (as it does with some sufferers) then it would be worth trying.

[Tracilynholland in reply to humanbean]

And a miracle

[Jazzw in reply to Tracilynholland]

Actually, it’s about PCOS often being caused by insulin resistance. And a low carb diet increases insulin sensitivity which can reset other hormones. It’s not so much about weight loss. If I had PCOS I’d definitely try a low carb diet, especially if I was trying to conceive.

[SlowDragon Administrator]

Having PCOS increases likelyhood of having autoimmune thyroid disease (Hashimoto's) diagnosed by high thyroid antibodies

pcosdiva.com/2017/03/pcos-a...

endocrineweb.com/profession...

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

add results and ranges if you have them already

Ask GP to test thyroid antibodies and vitamins if not already done, plus TSH, FT3 and FT4 obviously

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

[Tracilynholland]

Hi, I had PCOS when I was trying to fall pregnant with my first daughter 23 yrs ago and was put on 6 cycles of Clomid.... eventually falling pregnant with quads! The most important thing is, to reduce your weight and that will reduce your symptoms. You’ll need to go into a calorie deficit to lose the weight. Don’t worry too much on what to eat but just count the calories. If you’re on Facebook / Instagram check out James Smith PT Academy. Watch his videos too. Best of luck (I went onto have another daughter and conceived her first try with no meds... PCOS was gone, normally does after your first pregnancy) xx

[Scheepy18 in reply to Tracilynholland]

Thanks so much for this 🙂 x

[greygoose in reply to Scheepy18]

You should be aware that low-calorie diets are not recommended for hypos. If you don't ingest enough calories it will negatively affect your conversion, making you more hypo. And, if your weight is water-weight, low-calorie will not make you lose it, optimal T3 will help you lose it.

[Scheepy18 in reply to greygoose]

This is what I mean when I say I’m not sure which to tackle first without something aggravating the other 😣 my doctor said they wouldn’t treat my subclinical hypothyroidism- but it would be monitored if I fell pregnant. They haven’t been very helpful really 😔 thanks for your responses though- good to hear all the suggestions and nuggets of info you all bring x

[greygoose in reply to Scheepy18]

Do you have the actual numbers of this 'subclinical' hypo? 'Subclinical' is often a misnomer, but most doctors need a dictionary, anyway. Giving us the numbers - results and ranges - will give us a better idea of what is going on. Did the doctor say why he wouldn't treat you?

[Scheepy18 in reply to greygoose]

I will post the actual results when I get back home this afternoon, they said they wouldn’t treat it as it wouldn’t make much difference to me, because I don’t have a list of symptoms (apart from struggling to shift extra weight) they said once I’m on the tablets I’m on them for life so they don’t want to rush me into them or something.

[greygoose in reply to Scheepy18]

Oh, that stupid old chestnut! Of course you're on them for life, because your thyroid is going to be incapacitated for life! Dumbos! Of course, should there be a miracle healing, you would be able to come off them. But, that's hardly likely to happen, and in the meantime, you're at risk of all sorts of other problems from low thyroid hormone. I really don't know where they keep their brains, but they certainly don't use them!

Thyroid hormone replacement is not drugs. So, there's absolutely no reason why the shouldn't 'rush' you into taking them - and every reason why they should because it would probably make you feel better. You probably have lots of little symptoms that you don't even associate with thyroid. Have you read the list? There's over 300 known symptoms!

hypothyroidmom.com/300-hypo...

So, the sooner you start, the better. Doctors don't know anything about symptoms, anyway. They make me so cross!

[Scheepy18 in reply to greygoose]

Maybe they don’t want another patient to have to constantly monitor- I’m not sure 😔 my results are...

Free T4 12.2

TSH 6.9

FSH 7.6

LH 12.4

This means nothing to me lol and the doctor didn’t really explain what it meant except that it shows subclinical hypothyroidism

[greygoose in reply to Scheepy18]

You're probably right! Because, given that you are hypo when your TSH hits 3 - and in some countries you would be treated at that level - at 6.9 you are very hypo. And it looks like your FT4 is bottom of the range - although difficult to tell without the range. I'm afraid that one doctor's subclinical is another doctor's - in another country - full-blown hypo.

Did you have your antibodies tested? Although doctors don't realise it, testing antibodies is very important. But, with results like these, I would be tempted to start self-treating - especially given your other problems, which aren't helped by low thyroid hormone levels.

[Scheepy18 in reply to greygoose]

Really?! That’s worrying 😧 no they didn’t test my antibodies but I’m thinking I will go back to the doctors and have a full thyroid function test as this has me worried now! Thanks for the information

[greygoose in reply to Scheepy18]

Sorry, but which particular bit worried you? I wasn't intending to do that.

[Scheepy18 in reply to greygoose]

No no it’s ok, just that at TSH 3 it’s classed as hypothyroidism and mine is 6.9 so very hypo - I cant believe there are so many different diagnoses on this when it can be detrimental to health 🤨

I appreciate your information though as it sounds like you have struggled with this too and done a lot of research so it’s good to hear your advice, thank you x

[greygoose in reply to Scheepy18]

Well, that's the NHS for you. Hypos cost them money, so they don't like diagnosing them. I haven't had that particular problem, because I live in France, and when I had my first test my TSH was 11. So, no argument. My beef is that I'm pretty certain I've been hypo since I was about 8 years old, with lots of symptoms, but no-one, either in the UK or France, ever thought of testing my thyroid until I was 55! Despite me continually going to the doctor with said symptoms. And didn't even know what a thyroid was, so couldn't have suggested it. They are just so reluctant to test, when it should be the first thing they do. But, once I was diagnosed - with antibodies as well - I had to do a lot of research because I couldn't find a doctor capable of treating me. So, now I treat myself. I've encountered some pretty breath-taking ignorance in the last 20 years!

[Scheepy18]

These are all great to read thanks so much for all the info, I think I’m struggling with which issue I should try and combat first, PCOS, subclinical hypothyroidism, weight loss, I know they all tie in together - it’s just getting my head around which way is best to try help them all 🙂 thanks again guys x