Hypothyroidism, No Periods, No Pregnancy

[ishamathur12]

I have always had irregular periods. Thyroid was discovered in my early twenties and is under control ( TSH - 1.07). Taking 50 mcg throxine for the past 8-9 years, but periods are still irregular. I usually have gap of 3-4 months between my periods. Doctors give me progesterone to get periods. It helps for a few months and then I am again back to square one. PCOS is ruled out. All tests always come normal. What to do as I wish to start a family soon?

[SlowDragon Administrator]

Just testing TSH is completely inadequate

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

Essential to test both TPO and TG thyroid antibodies to see if hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's

About 80-90% of primary hypothyroidism is due to Hashimoto's

Prolactin needs testing to see if this is causing lack if periods

High prolactin is relatively common with Hashimoto's

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Is this how you do your tests?

Ask GO to test vitamins, thyroid antibodies and prolactin

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

[ishamathur12 in reply to SlowDragon]

Thank you. Yes, I always get checked early morning ( 14-15 hrs gap from the last meal) Will ask my doctor to get me tested for the vitamins and antibodies as well. However, got checked for Prolactin and it was fine. I lead a very stress free lifestyle as of now. Can't understand what is stopping my periods to come.

[ishamathur12 in reply to SlowDragon]

Hell yeah. My Vitamin D and B12 levels are really low. B12 - 151 ( 211- 911), Vitamin D - 26.13 ( 75 - 250 )

[SlowDragon Administrator in reply to ishamathur12]

See your GP URGENTLY

B12 is extremely low. You need full testing for Pernicious Anaemia before starting loading dose B12 injections (several injections over next few weeks)

Also ask advice on PAS healthunlocked

Vitamin D requires LOADING dose prescription from GP - 300,000iu over 6-8 weeks

Bloods retested at end if course

Local CCG guidelines

clinox.info/clinical-suppor...

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better




Once you Improve level, very likely you will need on going maintenance dose to keep it there.




Retesting twice yearly via vitamindtest.org.uk




Vitamin D mouth spray by Better You is good as avoids poor gut function.




It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...




Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

healthy-holistic-living.com...

sciencedaily.com/releases/2...

articles.mercola.com/sites/...


betterbones.com/bone-nutrit...

This article explains should discuss with specialists before taking any vitamin K if you take any blood thinning medication

drsinatra.com/vitamin-k2-su...

You need FOLATE and FERRITIN tested

[ishamathur12 in reply to SlowDragon]

Ferritin - 25.46 ( 10 - 290). Doctor is suggesting to get injections for B12 and Vit D. However, I am planning to take oral Vit D For 3 months and get B12 levels in check through diet as they are not excessively low. Is it okay ?

[SlowDragon Administrator in reply to ishamathur12]

Vitamin B12 is extremely low

If GP offered B12 injections you should accept

Low B12 can cause permanent damage

Vitamin D you can self supplement

But if GP offered loading doses again would recommend accepting

With Hashimoto’s we struggle to absorb nutrients however good diet is

[ishamathur12 in reply to SlowDragon]

Right ! Will go for injections. Thank you

[SlowDragon Administrator in reply to ishamathur12]

Gambit62 can advise on your extremely low B12

You should have several loading doses close together over several days/ weeks

Ferritin is also too low

GP should do full iron panel to test for Anaemia

All vitamins are likely too low because you were left on far to small a dose of levothyroxine

[Gambit62 in reply to ishamathur12]

Unless your diet is completely devoid of animal products its unlikely, with a level that low and the likelihood that your hypothyroidism is autoimmune, that you actually have a B12 absorption problem - this means that changing your diet to include more B12 is unlikely to work. Most likely absorption problem is PA (an auto-immune gastritis) which really needs to be treated with B12 shots.

Low B12 is linked to fertility problems and a false menopause is a symptom of B12 deficiency - though quite probably that your GP isn't aware of this.

Suggest you take a look at the PAS forum.

healthunlocked.com/pasoc

Please also note the following:

B12 deficiency leads to a type of anaemia in which red blood cells are larger and rounder than normal. Iron deficiency leads to a type of anaemia in which red bloods cells are smaller than normal. This means that interpreting the results of a full blood count can be very difficult if you have both going on at the same time.

The normal test for the most common form of absorption problem, PA, is notoriously insensitive and gives false negatives about 50% of the time, which means that a negative result is a long way from ruling out PA as the cause.

[SlowDragon Administrator in reply to ishamathur12]

Vitamin D GP will only prescribe to bring vitamin D up to 50nmol.

How low was vitamin D?

Dose guidelines

Local CCG guidelines

clinox.info/clinical-suppor...

Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .







Once you Improve level, very likely you will need on going maintenance dose to keep it there.




Retesting twice yearly via vitamindtest.org.uk




Vitamin D mouth spray by Better You is good as avoids poor gut function.




It's trial and error what dose each person needs.

Frequently with hypothyroidism we need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...




Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

healthy-holistic-living.com...

sciencedaily.com/releases/2...

articles.mercola.com/sites/...


betterbones.com/bone-nutrit...

This article explains should discuss with specialists before taking any vitamin K if you take any blood thinning medication

drsinatra.com/vitamin-k2-su...

[SlowDragon Administrator in reply to ishamathur12]

You also need folate tested

Likely to be low as well

[ishamathur12 in reply to SlowDragon]

Oh. Will get Folate tested and share results

[SlowDragon Administrator in reply to ishamathur12]

It's highly likely your vitamins are so terribly low because you have been left on tiny dose of Levothyroxine for years

Levothyroxine does not "top up" our own thyroid production. It almost always turns our own thyroid production off, hence low TSH

But a full daily dose of Levothyroxine is as a minimum 100mcg. Many need higher dose than this.

Your thyroid has been turned off, yet your left only on starter dose of Levothyroxine. Result is poor gut function and low vitamins

List of hypothyroid symptoms

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

NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NICE guidelines

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

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

[ishamathur12]

Thank you. Yeah, I haven't tested for antibodies but I believe thyroid problem is inherited. Hypothyroidism runs in my maternal family. FT3 and FT4 are 3.23 pg/ml and 1.38 ng/ml respectively. Doctor says 50 mg is fine for me

[SlowDragon Administrator in reply to ishamathur12]

If thyroid runs in family then it's highly likely you have autoimmune thyroid disease

Low vitamin levels are EXTREMELY common as result

Then TSH stays low, even if very hypothyroid

Just testing TSH is completely inadequate.

50mcg is only a starter dose. Most patients eventually need somewhere between 100mcg and 200mcg

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

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

* This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

Getting vitamins, FT4 and FT3 and antibodies tested is next step

Vitamin levels need to be optimal

Vitamin D at least around 80nmol and around 100nmol may be better

Folate and B12 often need to be near top of range

Ferritin at least half way in range

[ishamathur12 in reply to SlowDragon]

Thank you. Getting myself tested for Vitmin D , Ferratin and B12 this weekend. Will share the results. Please do respond like you do everytime.

[SlowDragon Administrator in reply to ishamathur12]

And antibodies?

[SlowDragon Administrator in reply to ishamathur12]

What are the rages on these FT3 and FT4 results?

TSH is completely unreliable on thyroud hormone replacement

TSH over one is often too high. Many with Hashimoto's need TSH well under one, or suppressed

[ishamathur12 in reply to SlowDragon]

FT3 and FT4 are 3.23 and 1.38 respectively

[SlowDragon Administrator in reply to ishamathur12]

Need the ranges on these results

Figures in brackets after each result

Eg

FT4 14 (12-22)

[ishamathur12 in reply to SlowDragon]

FT3 and FT4 are 3.23 ( 2.3 - 4.2) and 1.38 ( .89 - 1.76) respectively