Hi there I was diagnosed with an underactive thyroid in September after trying to conceive for about 12 months after a miscarriage it came as a bit of a surprise obviously! My periods were very short and still are.
It's only since doing my own research that I've started to have a clue about the numbers and what they mean. I've been told by my GP that my number are borderline for being treated at all (??) however everything I'm reading online seems to be saying that they are too high and not at all optimum for trying to conceive!
T4 14
TSH 4.54
I was recently upped to 50mg of Levothryoxine and the numbers have come down to those (no idea what they were before!)
My cycles are still only 19-21 days long. I've no idea if I'm even ovulating but I would probably guess not I gave up tempting and testing months ago as it was just getting me too depressed and seemed pointless! !
After my latest results above of the receptionist told me to make an appointment with my GP if I was still planning to conceive so I have that on Tuesday and I'm just on here really to see if anybody could please give me some advice for the sort of questions I should be asking at my appointment and what if anything they may be able to do about my short Cycles.
Feeling totally down in the dumps and like this is never ever going to happen for us 😔😔
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mitchellrose54
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Suggest you get hold of results from BEFORE starting on levothyroxine to see EXACTLY what has been tested and how high TSH was before starting on levothyroxine
How long have you been on 50mcg ?
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
See GP for 25mcg dose increase in levothyroxine
Blood will need retesting 6-8 weeks later
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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels NOW if not been tested
Plus BOTH TPO and TG Thyroid antibodies if these haven’t been tested
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood 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)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
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 you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
So sorry for your loss and sorry you’re feeling so rubbish x
Your doctor is talking rubbish! You should be referred to an endocrinologist if you have sub-clinical hypothyroidism and are TTC according to the nice guidelines here: cks.nice.org.uk/hypothyroid... but in the meantime try and persuade your GP to help you get your TSH lower. If you do get a referral, come back here to get a recommendation for an endo that is a thyroid specialist rather than a diabetes specialist. Consultants can be a bit hit or miss.
My endocrinologist who also looks at sub-fertility has told me that my TSH should be one or lower if TTC and that’s what we’re aiming for. My levels are similar to yours - I’ve only been on levo for one week (50mcg too but am expecting this to go up in increments to get tsh to where it needs to be).
I am currently reading the book ‘it starts with the egg’ - it’s really good and has info on thyroid issues and fertility. You might already know this but worth checking PCOS too as thyroid issues and PCOS seem to commonly appear together.
I’m sure someone else more knowledgable will come along and fill you in but it’s also important to check vitamin levels.
Also when you post results try and include the ranges otherwise it’s difficult to for people to interpret properly. Hth and good luck xx
I agree with you, yes - you might not be referred, whatever the guidelines say. I too have never been referred to an endo, not when TTC or when pregnant, after 5 years of being hypo.
When I got pregnant I was (wrongly) advised to reduce my thyroxine dose, but I read the NICE guidelines and ignored the advice.
I’m in the UK too and NICE are UK guidelines. I think you should definitely ask for a referral - whether they give it to you or not I don’t know! Definitely print out the info above so you’re armed when you see your doc. My GP was utterly useless, consultant is much much better, but I have paid privately to do it quicker.
I’m sorry I don’t know anything about short cycles as mine are pretty regular and 28 days even though I don’t think I ovulate. You could post your question over on the Fertility UK board here, someone might be able to help. There is also good info in ‘it starts with the egg’ on supplements to help with ovulation. But if there are no other reasons for it (e.g. PCOS) you might find once thyroid levels are optimal your cycles sort themselves out.
It’s a lot of info and can be a bit overwhelming when you’re first getting your head around it. Personally if I were you I would prioritise:
1. Getting your b vitamins, d Vits, folate and iron checked and optimised. GP might do some of these but most people here use at home tests - you can try Medichecks, Thriva, blue horizon
2. Asking GP to increase levo in suitable increments to get your TSH under control. This might take a bit of time as you can’t up the dose too quickly. Point out to your gp for those ttc it should be at least 2.5 or less. Print out evidence.
3. Asking for a referral
4. Looking at other fertility optimisations
I am a newbie here though and you will pick up lots of good general info from reading posts from people that are much more knowledgeable and have been reading up for a lot longer than me! One thing I’m sure though is that your TSH needs to be low and Ft4/3 optimal for you, in order to maximise your chance of conceiving and carrying the pregnancy. Sending you lots of good baby vibes! X
My menstrual cycles were short. It wasn't until I was in my 50s that I realised with hindsight that the length of my cycle had been strongly influenced by how good or bad my iron levels were. When my iron was low my cycle was short. I remember that when I was a teenager my menstrual cycles were only 16 days long. I was prescribed some iron tablets because it was discovered that I was anaemic and my cycles got longer. I don't think the doctor realised that the iron was probably the reason for my cycle getting longer - he was just treating my anaemia, not my menstrual problems.
I would suggest that anyone trying to conceive should ask for the basic nutrient levels to be tested because deficiency of any of them will make it harder to conceive, will make it more likely that you will miscarry if you do get pregnant, and increases the risk of birth defects or just makes the pregnancy harder on the mother.
The basic nutrients are vitamin B12, folate, ferritin, iron and vitamin D. Note that doctors consider any result to be "normal" or "fine" if it is within range. But people with low in range nutrients are not going to feel nearly as good as someone with optimal nutrient levels.
Nutrients can be tested along with thyroid hormone levels in a test bundle from Medichecks or Blue Horizon - or you can ask your doctor to test nutrients - but be aware that they are so strapped for cash that they often refuse these days.
Women with known thyroid dysfunction who are taking levothyroxine may need the dose increased by 30–50% from as early as 4–6 weeks gestation [De Groot et al, 2012].
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