How long after fertility medication can I undertake private full thyroid and vitamin test?

[Robins53]

Hello,

New to posting here but being following for a while. I’ve been trying to get investigated for thyroid problems for over a year now since I was diagnosed with stage 4 endometriosis and infertility in 2018.

I thought my GP was providing reasonable support but realised recently despite having thyroid function tests done at several points over the last year, and referring me (after serious pressure) to an endocrinologist, I’ve never had my T3 tested. I can see from posts on here that it’s critical to get this tested as part of TFT and vitamin tests too.

I’ve got the Medichecks Thyroid Check Ultra Vit blood test to do at home. (Could not wait or bear any more GP tests and not sure they would do T3)

Here’s the thing - I’ve just finished my ivf medication (yesterday) for this cycle and want to know when I can undertake the thyroid testing without any impact form ivf medication which may still be in my system?

If anyone can share their advice it would be much appreciated.

For some background - Because I’ve read the thyroid is so important for fertility, due to higher risk of miscarriage and implantation failure, I am desperately trying to get everything checked out before I transfer any embryos. I’m due to do this later in the year after my third cycle of hormone stimulation and egg collection in May. As far as I know I’ve never been pregnant (trying to conceive for over 3 years) and I have very low chances due to only producing a small number of viable embryos. (I’m 39 with low ovarian reserve). I would like to make sure my thyroid is fully investigated to give me the best possible chance. I have a range of symptoms and despite highly supplementing I still have low vit D (last checked Dec 2019) and low calcium.

I would like to do the thyroid test and and get results before my follow up endocrinology appointment on 18 March.

Any help appreciated, thanks, Susan.

[HowCome]

Hi Robins53,

I feel your pain... i recall begging for an on-the-day phleb, when we twigged that my TSH had shot up and well out of range for pregnancy, after a m/c [‘silent’ at 5wks, found out at 10wks, at early private scan] and no-one had noticed TSH, until appointment to start first cycle.

Not sure i can help... but someone might... first qu in my mind...

What ivf meds have you just finished? Stims of some sort?

(Sorry, i can guess what you might have just been thru, and i know its likely to be a world of pain... happy to chat via PM if you prefer., and can put up with a few hours delay at times...)

Very best wishes. (And babydust, as they say.)

[Robins53 in reply to HowCome]

Thanks for getting back to me 😊 I may post on fertility site too.

Yes - finished ivf stimulation drugs. I’m on a natural modified cycle so low-medium dose drugs. Taken Bemfola for 8 days 225 with cetrotide for 5 days of that and ended with double ovitrelle ‘trigger shot’. Thanks for your kind words. Keeping my mind off tomorrow’s egg collection by obsessing over thyroid 😂 best wishes to you

[SlowDragon Administrator]

How low is your vitamin D?

How much have you been supplementing and for how long?

Are you also supplementing magnesium?

Are you on any levothyroxine?

Can you add most recent test results

Sorry can’t answer you question re when to test in relation to ivf meds

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

Do you have Hashimoto’s confirmed?

Research suggests Endometriosis and hashimoto’s may be linked

Ask GP to test vitamin levels

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)

Is this how you do your tests?

Always do the test on a Monday, Tuesday or Wednesday morning as early as possible in morning before eating or drinking anything other than water

[Robins53 in reply to SlowDragon]

Thanks for getting back to me ! Most recent results Dec 2019 (fasted but not early in the morning)

TSH - 0.69

T4 - 18.2

Vit D - 62

Calcium - 2.10

I’ve been supplementing with vitamin D daily since 2017 (part of prepregnancy supplements. Then taking 4000 IU daily dose of vitamin D since January 2019 (Better You spray).

I am taking a magnesium supplement with my calcium supplement.

I’ve got the Medichecks test to do at home for thyroid and vitamins and will do test early in the morning fasting as per advice thanks. I will drop Medichecks a note to see if they can advise about any overlap with ivf stimms medication.

Not been diagnosed with Hashimotos or any thyroid disorders. My second ever appointment with endocrinology is in 2 weeks. After the first appointment he checked my cortisol and ACTH test but I’ve been waiting since December for my follow up to discuss results. I also have slightly raised cortisol 702 (am range 150-600).

I am interested in the link between endometriosis and Hashimotos too.

I thought I’d been tested for antibodies but can’t access a result so to get on with the Medichecks test.

As a precaution to support my fertility I have pretty much eliminated gluten Andy dairy (as well cut out all caffeine alcohol etc)

Thanks a lot for your help.

[HowCome in reply to Robins53]

Well done, especially the dietary mods. And coping without caffeine & wine!!

And great distraction technique!! Make a change from lots of time in the Fertility forum😉

Good idea to ask Medichecks.👍😎

[HowCome]

Hi again...

Have you had a laparoscopy?

I read Robert Winston’s book.... he advocates this strongly.... says clinicians are far to keen to start fertility treatments without completing investigations....

I had my laparoscopy after my last cycle of ivf!

(And my secondary infertility remained “unexplained”. But age, & virtual age from stress, were probably my source issues.)

Or is that how they identified stage 4?

(I had my bit of endometriosis ablated away... may not be possible, or effective, if extensive?.)

Guessing you’re looking at nutrition generally...?. you could check out Sandra Greenbank..., “nutritional therapist”, specialising in fertility, seems genuinely well-meaning, though they all need to make a living... she has a closed/secret fb group you can join, where she usually answers questions quite quickly, and will reference research/sources.

Worth looking at Omegas re hormonal balance. Western processed diet, uses alot of seed oils in attempt to be healthier.... so we are often very very high in Omega6, relative to the Omega3.... (like 45:1, instead of 6:1) and carious hormone systems can be impacted. Marilyn Glenville writes alit about this, in her nutrition books.... be aware, bit more of a marketing m/c than Sandra!

Good luck!

[Robins53]

Hello,

Yes - had a laparoscopy in Dec 2018 where they diagnosed stage 4 endometriosis and removed a 7cm endometrioma cyst from my right ovary. That ovary isn’t really in the game anymore - I just get one follicle. I still have a small cyst on my left ovary but get about 4 follicles and seems to be small enough to carry on..

I am sorry that you didn’t get a proper investigation until after your treatment. My NHS fertility consultant was keen to sort with laparoscopy before treatment started - they were good in that regard.

Thanks so much for the extra sources of information. I’ll take a look - anything to make sure I am not disrupting my hormones with eating habits is good! Very interesting about the oil too. I’ve been taking a flaxseed supplement most days..

Thanks for your help!

[HowCome in reply to Robins53]

Hi Robins53, sounds like you ate on a good track.... flaxseed being a good one for omega3 (for readers following in later!......whereas, my non-trained understanding is that some of the common vegetable oils are very high in Omega6’s...).

[HowCome in reply to HowCome]

Oh my goodness, I just went to refresh my memory on rapeseed(=canola) oil, etc....

en.m.wikipedia.org/wiki/Fat...

(Making do with Wiki in haste today... lots of citations to follow, for proper reading -up/ research.)

Looks like i might need to review my butter habit.

And find out what corn oil is....! Is that being used in the UK? Never seen it on the supermarket shelf, but that’s not definitive, given my food struggles!!!

[Robins53 in reply to HowCome]

I must admit I’m not that up on oils and haven’t heard of corn oil at all!

We try to stick to organic olive oil and coconut oil and occasional sunflower oil... so many modifications but all in a good cause.

[HowCome in reply to Robins53]

Great that you got investigated properly.

My backwards investigate after ivf probably had no impact, but was a stressful issue for me.... who really wants unnecessary ivf?!?

(Following readers: my private fertility consultant (who was also my NHS consultant.... the money side of this I still find abhorrent) referred me to back into NHS for laparoscopy - we had already sunk alot of cash.

4 month wait was extended to 7 or 8months, because of strikes. But we took the decision to press on with the final fresh cycle, due to my age.)

Soldier bravely on with nutrition tweaks... admirable, when under this stress, and you just want chocolate, easy dinners, and comfort!!

Tweaks is good... be kind to yourself!

BD for this week and beyond....🤞🤞🤞

[Robins53]

Thank you xx sounds awful for you! The NHS is amazingly brilliant in so many ways. Managing individual fertility challenges with other issues thrown in is not one of the NHS’s strengths 😊