I have had 3 miscarriages in the past few years and have been trying to conceive since December with no luck. I was on levothyroxine during my last pregnancy but my doctor stopped this after the pregnancy ended.
I had my levels retested last week and the doctor says they’re fine and I don’t need treatment. They don’t look fine to me, I’m at the end of my tether with the whole thing.
I’ve posted a photo of my thyroid hormone tests but my thyroid antibodies are also at 66. The normal range on my paperwork is 0-34.
Any insight or advice would be appreciated.
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Cmch1
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Your high antibodies confirm you have autoimmune thyroid disease also called Hashimoto's
You also need vitamin D, folate, ferritin and B12 tested
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
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working and obviously very important to have good vitamins when TTC
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes 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
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thank you so much for all of this info. Unfortunately I’ve seen 2 GPs who have both agreed my levels are fine and said I don’t need treatment, do you know if it’s possible to go private and see an endocrinologist?
I have had the ceoliac test done and was told it was normal but thinking now I should maybe ask for a printout of my results and check for myself.
I will look into all of your other links too, thank you
Majority of us with Hashimoto's are not coeliac but gluten intolerant. The only way to know if you are gluten intolerant is to try strictly gluten free diet
Your TSH level is above range and your FT4 levels are too low.
Adequate thyroid hormone is required for conception because a low level encourages more TSH (thyroid stimulating hormone) and TRH (thyrotropin releasing hormone) to be secreted, but by doing this the body also creates 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 the development of follicles and good FSH & LH surges needed for ovulation.
Therefore, it is important to achieve a low TSH encouraging adequate thyroid hormones when trying to conceive to avoid the chance of obstetric and neonatal complications. In view of your previous miscarriages, ask your doctor for a dose of Levothyroxine that will bring your TSH down in range, in line with NICE guidelines. Print off a copy of NICE guidelines to pass onto your doctor.
Also, so that he knows to increase your Levothyroxine dose by 25mcg as soon as you conceive to keep TSH within low-normal range (0.4–2.0 mU/L) and FT4 concentration in upper reference range as stated in the NICE guidelines. Ensure he tests both TSH & FT4 and refers you to a specialist.
Your tsh clearly shows you’re under active thyroid. Any decent consultant will tell you that any patient with for example Hashimoto (under active thyroid) with raises thyroid anti bodies should have a TSH of 2 or under. I would suggest that you should be under the consultant if you have a history of underactive thyroid and you’re trying to get pregnant. It’s dangerous otherwise. Your GP is not, however competent, able to manage you through a successfull and safe pregnancy as they are not a specialist. You need to be referred to an endocrinologist before pregnancy and through the whole the pregnancy. My son was 5lbs because I had undiagnosed Hashimotos (under active) and he could of died or had learning difficulties. Your GP needs to recognised the important of their limitations. See another GP if your original GP won’t refer you. Or go private. £150 to see a consultant is worth every penny of you are to carry a baby (healthy baby) full term w/o complications. Good luck.
I've been told that the NHS will investigate causes after 3, so this might be worth pursuing.
I had health insurance and saw a private Endo with an interest in fertility, she advised getting my TSH as close to 1 as possible and also increasing my folic acid dose as well as a wealth of other bloods.
Great advice above on the vitamins etc. to ask to be tested.
I fear I've left it too late and at 43 have pretty much resigned myself to the fact that my daughter will be an only child. I don't know your age, but these things can take a while to get resolved, so start nagging your doctor now and make sure they know you are trying to conceive.
Many years ago before being diagnosed I had 9 miscarriages. I had one baby and miscarried after that - after 6 years of trying eventually my second daughter was born. I’m convinced that if I’d had the right tests - never even thought of thyroid ! Good luck x
Hi I have been struggling to conceive too and had TSH levels around 3 or 4. I paid to see a private endo who said that to conceive and have a healthy pregnancy my TSH needs to be under 2. I actually think it has to be under 1 but he wasn’t a very good endo, he specialised in diabetes not thyroid which I didn’t realise. Anyway, he increased my Levo and I had my bloods done a couple of months ago and my TSH was too low - like 0.13 or something however for the first time ever I found out I’m pregnant! Maybe just a coincidence or maybe it was always just that my TSH was too high. If you can afford it I would really suggest trying an endocrinologist because Gp’s don’t really understand. My GP had previously told me all sorts of rubbish, one thing was that an underactive thyroid doesn’t have anything to do with infertility!! Good luck with everything. And remember if you do get pregnant again, make sure you check your bloods after a few weeks - I used medichecks last week because when pregnant you need more Levothyroxine so it’s vital for the health of the baby that you check your bloods again at that point.
My TSH is 0.01 (0.300 - 4.200 uIU/mL). It's not too low. It is only "low" in terms of where it falls on the reference range. Here is a discussion of how the ranges are determined: academic.oup.com/ajcp/artic...
Most doctors don't know that if the patient's results fall outside the range, they need to look at other lab result to determine whether or not there is really a problem. In the first place, TSH is not even a thyroid hormone. It is produced by the pituitary gland.
TSH stands for "Thyroid STIMULATING Hormone" and as the name implies, its job is to stimulate the thyroid gland to get to work and create more thyroid hormones. If your body senses that it already has plenty thyroid hormones in circulation, the TSH level will go down or stay the same. If it senses your thyroid hormone levels are too low, the TSH will go up.
So the doctor needs to look at the thyroid hormones. T4 is produced by the thyroid gland. It is called T (for Thyroid) 4 because the molecule contains 4 iodine atoms. Some T3 is also produced by the Thyroid gland, but most of your circulating T3 hormone is made in the liver and elsewhere in the body through converting T4 to T3 by knocking off one of the iodine atoms. Most of these hormones are bound up and can't be used until they are "Free". So your doctor needs to look at where your "Free" hormones (FT4 and FT3) are within their ranges.
If your FT3 and FT4 levels are above their ranges THEN your TSH is too low. Your dose of thyroid medication may need to be reduced. If you are not taking any medication and your FT3 and/or FT4 levels are high, chances are that you have hyperthyroidism (over- instead of under-active) or you have an autoimmune disease (Hashimoto's) that drives thyroid hormones up and down seemingly at random. The doctor would need to check for antibodies to verify these guesses.
Thanks for all that, perhaps my TSH at 0.13 is okay then. Yes I have Hashimoto's and have my T4 & T3 tested regularly. I was only referring to TSH, as for me, that is what has changed recently and I am now pregnant. Anyway I definitely do not need to worry about my TSH being too low now, had my medichecks results back today because I am worried about this pregnancy, and unfortunately it has shot up to 9.52 I have just written a new post for help.
I’m afraid I don’t feel ‘qualified ‘ enough to help you here. I’m quite new to ‘thyroid world’ myself. But what I can say is that ‘slow dragon’ and others certainly have the knowledge and know how to help you and point you in the right direction. No wonder you are at your wits end. I really hope things improve for you soon Hun. Sending you a hug .
I have had this battle with my GP repeatedly but the TSH levels need to be below 2.25 to even consider a viable pregnancy. This is very well referenced now so there is no excuse but as you've already had miscarriages you should automatically referred to a specialist so insist that this happens. I see you've been provided with great links below - I literally used the info provided by this forum to school my GP!
I am now under a specialist fertility team who understand that TSH needs to be below 2.25 (and they won't even consider treating me if it goes above this until it's dealt with) but even they don't have any knowledge beyond that so it's very frustrating.
Feel free to email me directly if you want to discuss. Wishing you all the best!
Thank you everyone for all your help. You are all so knowledgable. I’m going to take the time to sit and read over all this as you all have provided lots of great info. Thanks.
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I have just written a new post for help. 
NDT and trying to conceive
Hashimotos and Trying to Conceive 
