Fertility hypo - Am hypo or not?! Please help! - Thyroid UK

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Fertility hypo - Am hypo or not?! Please help!

Unimaginativename profile image

Hello everyone,

I’m hoping that some of you can help me please.

To cut a very long story short, my husband and I have been trying for a baby for 5.5 years. In that time we have got pregnant twice but sadly lost them both times. We had our first appointment at the fertility clinic in October 2018 and at our second appt in December, was told that all test results were fine except my thyroid which indicated an under active thyroid (TSH 2.99) and I’ve been prescribed Levothyroxine 25mcg which I’ve been taken for 3 weeks. I went to see the GP today because in those 3 weeks I have fainted once, felt unwell and even more tired than normal (still aware and acknowledging that it has been the festive season and have overindulged). GP is not worried about any symptoms and told me that my TSH of 2.99 is completely normal!

I did realise that it wasn’t very low but the consultant at the fertility clinic had said that it could explain the infertility and even the miscarriages and that she had had lots of successes from it. I’ve been really excited from that and the prospect of getting pregnant and keeping the baby but now I’ve seen the GP I feel really deflated. Also, when looking at symptoms of hypothyroidism it explains so much of how I’ve been feeling for the last night 3 to 4 years

Does anyone have any experience with similar levels and fertility issues?

Thank you 😊

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Unimaginativename profile image
Unimaginativename
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10 Replies
SeasideSusie profile image
SeasideSusieRemembering

Unimaginativename

I believe that for a successful conception and pregnancy, TSH should be below 2.5

A dose of 25mcg Levo will stop your own thyroid producing as much hormone, but the replacement dose wont be enough so you will very likely feel worse until you are on an increased dose.

There are other members who have more knowledge of thyroid and pregnancy than I do and I'm sure they will be along to help. In the meantime here are some links you can look through

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

btf-thyroid.org/projects/pr...

Unimaginativename profile image
Unimaginativename in reply toSeasideSusie

Thank you so much for responding :) It’s really reassuring alone to hear that I’m not imagining feeling worse over these last few weeks.

Thank you for the links too x

Duchy82 profile image
Duchy82

Go with what the fertility doctor has said as they are in fact right, your tsh should be below 2, if I remember correctly from a fertility point of view. When I went through ivf a study on this was being carried out at the clinic I went to and they were recruiting at the time for participants, that's about 3-4years ago now.

If you are feeling worse it may be worth contacting your consultant and having your bloods rechecked to see where things are at. Good luck!

Unimaginativename profile image
Unimaginativename in reply toDuchy82

Thank you 😊 It’s so reassuring to hear from people who have been there and back me up on the TSH levels as the GP made me feel a bit silly for questioning it and I wondered if I’d got it all wrong! Sounds like I may need a higher dose but I’ll definirely speak with the consultant again soon if I carry on feeling so rubbish!

Thanks again :)

SlowDragon profile image
SlowDragonAdministrator

Ridiculously GP's often think adding a small dose of Levothyroxine increases overall levels of thyroid hormones

It doesn't. It reduces output of your own Thyroid without offering enough replacement hormone

Unless over 50 years old standard starter is 50mcg Levothyroxine

Bloods should be retested 6-8 weeks after each dose increase

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Ask GP to test vitamins and supplements at retest of thyroid

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

Pregnancy guidelines

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

gp-update.co.uk/files/docs/...

thyroiduk.org.uk/tuk/guidel...

Thank you ☺️

Loads of stuff for me to research there and consider private testing too.

Really appreciate your response :)

SlowDragon profile image
SlowDragonAdministrator in reply toUnimaginativename

On Levothyroxine TSH should be under 1.5 and FT4 in top third of range and FT3 at least half way in range

Essential to test FT3, vitamins and antibodies

Unimaginativename profile image
Unimaginativename in reply toSlowDragon

I will! I’ll make sure I get it all tested

radd profile image
radd

Unimaginativename,

Welcome to our forum & sorry to hear of your losses. 😞

Good advice above regarding an inadequate dose of Levothyroxine risks reducing thyroid gland output.

Adequate thyroid hormone is imperative when trying to conceive or the resulting higher TSH (thyroid stimulating hormone) and TRH (thyrotropin releasing hormone) levels may encourage more prolactin which interferes with ovulation. Low thyroid hormone can also influence the luteal phase (time between ovulation and menstruation usually between 13 and 15 days).

Luteal phase issues can be due to too much oestrogen which will encourage elevated SHBG that can bind thyroid hormone making it unavailable for use. Elevated oestrogen can also interfere with developement of follicles and good FSH & LH surges needed for ovulation.

Side effects are common when introducing thyroid hormone replacement but not always recognised by GP's. Your side effects indicate your body is still acclimatising and you could have nutritional deficiencies that are discouraging good thyroid hormone synthesis. Low thyroid hormone may result in low iron, Vit D, Vit B12 and folate. Have you had these tested ? ? ...

If you are supplementing folic acid, many members have found methylfolate to be more beneficial.

.

NICE - preconception & hypothyroidism.

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

Thank you SO much. It’s been such a comfort reading all of the responses.

Whilst the most important thing for me is to have a successful and healthy baby, I just want to feel better too!

I haven’t had vit d tested but I was sure I had had b12 and folate and my GP told me it was fine, but then he told me my TSH was fine too so who knows what to believe.

Thank you again :)

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