Hashimoto and amenorrhea when trying to conceive

[plokmijnuby]

Hi all been reading this forum and others and gathered some information on how amenorrhea may be caused by Hashimotos. However what I’ve read implies this is normally by untreated hashimotos and should be fixed by proper treatment.

Personally I have been treated with levothyroxine for 3+ years (on 100 mcg) and came of the mini pill hormonal contraception at the end of January. Whilst I appreciate this isn’t 3 months (yet) for amenorrhea I have not seen any hint of ovulation or period (currently tracking with a basal thermometer - although I think this is being affected by my hashimotos too!)

- does anyone have experience with this

- is it worth going back to the doctor to ask for a broader blood test (my last when unwell in November was tsh c. 2.4 which is quite high compared to previous measurements around 0.4)

- any other advice for women trying to conceive with hashimotos?

Thanks in advance

[SlowDragon Administrator]

TSH is likely too high

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and retest thyroid including Ft4 and Ft3

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)

What vitamin supplements are you currently taking

[plokmijnuby in reply to SlowDragon]

Thank you Slowdragon. I do have my tests fasted and 24 hours. I discussed the higher result with my doc and as I wasn’t having more brain fog and other symptoms than usual we considered it might have been a consequence of being unwell at the time.

I thought that TSH too low would cause long heavy periods, whereas hyper / too high might cause amenorrhea?

Vitamins wise I’m taking folic acid with vitamin d.

[SlowDragon Administrator in reply to plokmijnuby]

Usually when more hypothyroid and TSH is higher periods get heavier and low TSH periods are lighter

But with thyroid issues not everyone follows same symptoms

Eg majority tend to gain weight, but some lose weight

How low was vitamin D

How much vitamin D are you taking

When were levels last tested?

Important to retest folate, B12 and vitamin D, especially before TTC

[plokmijnuby in reply to SlowDragon]

Vitamin d is 10 mu.

I worry that the doctors will a) think it’s too soon to be worried about amenorrhea. And b) think I’m over dosed as no periods

Not sure I’ve had those levels tested for a while (and patient access is currently down so can’t see my history). What are their impact on TTC? Fertility issues or miscarriage risks?

I read about prolactin. Should that also be tested?

Thanks again!

[SlowDragon Administrator in reply to plokmijnuby]

Sorry don’t understand the vitamin D

How low was vitamin D?

Do you mean vitamin D supplement is 1000iu?

GP will only prescribe to bring levels to 50nmol.

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

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

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently 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 vitamins

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Bone pain

easy-immune-health.com/pain...

naturalnews.com/038286_magn...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[plokmijnuby in reply to SlowDragon]

Thanks so much slow dragon. I will read through those links. The supplement is included in the folic acid so likely not enough.

I will try to get more data and tests sorted

[SlowDragon Administrator in reply to plokmijnuby]

If your vitamin D was under 50nmol you will need minimum of 1600iu per day for 6 months

If under 25nmol GP should be prescribing 300,000iu over 6-8 weeks....that’s 5000iu per day over 8 weeks or 7000iu per day for 6 weeks

[sazzle2680]

Hi plokmijnuby

I have Hashis and have been struggling to conceive now for over 4 years and currently having IVF with donor eggs. I had amenorrhea before I was ready to conceive and was told by GP not to worry. It wouldn’t affect my fertility. I waited and it’s my biggest regret.

My strongest advice would be to look at your AMH (Anti-Müllerian hormone - egg reserve). I didn’t and ended up waiting too long before getting fertility support and now having to go to the extremes if the really invasive IVF procedures and having to use donor.

GPs generally won’t do AMH until you’ve been trying to conceive for at least a year but you can get test kits online for around £40-50. Having your AMH results will help you plan your next steps.

Good luck!x

[plokmijnuby in reply to sazzle2680]

Hi Sazzle. Thank you. Good to know you can test those things easily and privately. Being 27 I may have had false confidence, but this lack of period after 10 years on the poll is scaring me!

Will look into the test today as knowing can only help. Xx

[mistydog]

When conceiving your TSH needs to be below 2,preferably less. And maintained throughout pregnancy with regular testing.

Check out NHS guidelines as they changed over the past few years and not all GPs will be aware. Take a copy with you. Good luck

[plokmijnuby in reply to mistydog]

Thanks. Normally my tsh is <1 but I was poorly on my last blood panel so think that may have skewed things.

Think I will be going back when it’s officially 3 months without a period and asking for a full test on hormones for conceiving and thyroid plus all the vitamin levels mentioned!

I’m lucky I have a specialists doctor note on file saying I should always be below 2.5 and ideally below 2 when pregnant. So I have a batch of 25mcg levothyroxine ready for when I am pregnant!