Serum C reactive protein level <1 mg/L 0.00 - 5.00mg/L
Serum vitamin B12 252 ng/L 197.00 - 771.00ng/L
Serum folate >20.0 ug/L 1.90 - 25.00ug/L
Im taking supplements: folic acid (400 ug), magnesium citrate (300ug), zinc Cu complex (15mg), vit C (350mg), CoQ10 (120mg), vit E (330mg) and occasionally some drops of Vit D 1000iu. Normally all in the morning before breakfast
Doing these tests to prep for next IVF steps. Accupuncturist pointed out my TSH is above 2.5 and will probably need to take thyroxine. However results last Sept (4 months ago) showed significantly lower levels??
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mjsbee
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In Sept'19 last year I had tests done via a fertility clinic in Lisbon:
Free T4 1,4 ng/ dl (equiv to 16.7 pmol/L according to my conversion search)
TSH 1,3 mU/L
Ac Anti-Tg <10 ku/L
AC. Anti-TPO 11 ku/L
Don't worry about converting into a different unit of measurement, it's not necessary. As long as you give the reference ranges we can work out the percentage through range and compare that way.
We also need the ranges for the antibody tests please.
From your February results, your B12 is too low, it should be at least 550ng/L according to the book "Could it be B12" by Sally Pacholok.
Ferritin is so low and is recommended to be half way through range.
As you are taking Vit D, what's your current result?
No real need to work out percentage through range for TSH, the ranges are almost identical and you know you need TSH to be below 2.5 for pregnancy.
Sept 2019
TSH 1,3 mU/L range 0,4-4,2
Free T4 1,4 ng/ dl range 0.7-1.8 = 63.64% through range
February 2020
Serum TSH level 3.22 mu/L 0.27 - 4.20mu/L
Serum free T4 level 15.1 pmol/L 12.00 - 22.00pmol/L = 31% through range
Some countries diagnose hypothyroidism when TSH goes over 3, here in the UK we have to wait until it goes over 10.
As you are TTC you should discuss this with your GP pointing out that for a successful pregnancy TSh should be no more than 2.5
Ac Anti-Tg <10 ku/L range - up to 115
AC. Anti-TPO 11 ku/L range up to 34
Those antibody results didn't indicate autoimmune thyroid disease (Hashimoto's).
However, it's possible to have Hashi's without raised antibodies, and Hashi's causes fluctuations in test results.
Were the tests done under the exact same conditions, that's the only way they can be compared:
* Same time of day - no later than 9am to give the highest possible TSH
* Water only to drink before the test, no breakfast, no tea, coffee, etc.
* No Biotin or B Complex supplement for 7 days before the test (this can give false results if biotin is also used in the testing procedure, which most labs do)
The tests were not done under the same conditions. Sept was midday, Feb was before 10 am but after breakfast.
OK, the first graph in the picture in this post healthunlocked.com/thyroidu... shows the daily rhythm of TSH. It's highest at midnight, but as we can't get tested then the next highest is 9am. The TSH lowers throughout the day, lowest at 1pm then starts to rise again.
So your September test was done when TSH was almost at it's lowest level of the day.
February test done at 10am would be not far off the midday level, but you'd eaten so that may lower the level as well. If you'd done your February test at 9am and had nothing to eat or drink but water, it may well have been higher than 3.22
Folic acid wouldn't affect the results, it's only Biotin that does, whether as a stand alone supplement or within a B Complex.
How do I rule out Hashimotos?
Basically, you may not be able to.
Postive antibodies confirm Hashi's. Negative antibodies don't rule it out unless you have had many negative results over the years and have no fluctuations in symptoms or test results.
BTW - GP is totally un sympathetic bc infertility is not treated via NHS if you are over 40 and Im 46... so will have to find a private doctor to get any medication prescribed I assume
I haven't taken any medication or and the only change in supplements was an increase in CQ10 ubiquinol for last 4 days, not BC of thyroid but for baseline fertility health...
Tests have to be done under the same conditions to be comparable.
Were the new Medichecks done as advised
* No later than 9am to give the highest possible TSH
* Water only to drink before the test, no breakfast, no tea, coffee, etc.
* No Biotin or B Complex supplement for 7 days before the test (this can give false results if biotin is also used in the testing procedure, which most labs do)
Your latest results would be classed as euthyroid (normal) with those FT4/FT3 results and your TSH is below the 2.5 threshold for pregnancy.
You don't have a range for free t4 from Lisbon. The way to compare the 2 free t4 results is to work out the percentage through their ranges.
Different testing labs have different ranges so even though you converted the Lisbon result to the same measure, the Lisbon lab might have a different range.
Levels can change over a short period of time. If your free t4 is reducing then your tsh will be increasing if you have or are developing classic hypothyroid disease.
This might not be a good idea. Did you have your zinc and copper tested before starting it? Hypos - and you are hypo with a TSH over 3 - often have low zinc and high copper, so taking more copper is not a good idea. Best to have copper tested before taking any.
I have Hashimoto’s Thyroiditis for 32 years, I am about to turn 35. I am currently expecting our IVF baby in June. My TSH has been everything from .0002 to over 13 and my doctors have said anything from .1-4.5ish is fine. Even when we transferred our embryo (first round was successful), my TSH spiked to 12.8. I wouldn’t worry too much about your TSH level being slightly off. I am in my second trimester and I’m slightly out of “normal” range, but everyone’s normal is different. I would trust your reproductive team’s judgement. My Endocronologist is more concerned with T4.
Can you explain how your endocrinologist has approached it? Would love to understand why T4 is more important in your case. I'm certainly hesitant to start any medication without a proper doctor to oversee it, hopefully a thyroid savvy one!
I have been on thyroxine for fertility. My results also bounced around and done so years, never reaching levels where they would treat a tyroid issue.
I started on thyroxine and it took about 6 months to find the right dose but the month the tsh stabilised I became pregnant with my second child. I do feel that this was as a result of the tyroid management. With the first I took longer and required clomid to get pregnant.
So I would definitely recommend moving forward with thyroxine!
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