HELP! Trying to get pregnant for 4 years. hormonal imbalance?

[LeoFB]

I have hashimitos, I tried the aip diet for 4 months, it helped with getting my period cycle on track for last 6 months, but I'm not conceiving . I think I have hormonal imbalance. I feel ill 2 weeks into my cycle and get cramps and a lot of discharge for a couple days that fully soaks my underwear. I get sore tender breasts for a full 2 weeks a before my period. Can anyone give me advice what to do. I'm nearly 26 years old and feel doctors don't take me seriously. But I've never had children and been married over 4 years I'm scared I'm infertile.

[SlowDragon Administrator]

Welcome to the forum

First thing is, do you have any actual blood test results?

if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 as you have autoimmune thyroid disease (Hashimoto's)

Ask GP to test vitamin levels if not been tested recently

How much levothyroxine are you currently taking and do you always get same brand of levothyroxine

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?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Are you on strictly gluten free diet?

Have you had prolactin levels tested?

medscape.com/answers/120937...

[LeoFB in reply to SlowDragon]

Once this lockdown is over I'll go through this with my GP, my recent blood results I got from a couple weeks ago. TSH 2.3 they told me it's I'm normal range over a quick phone call

[SlowDragon Administrator in reply to LeoFB]

Far too high

Absolutely essential to test Ft4 and Ft3

Plus vitamins

Ask for 25mcg dose increase in levothyroxine

Or get full test privately asap

Medichecks kit now includes tracked post return as standard post is too slow

[SlowDragon Administrator in reply to LeoFB]

iodine and hashimoto's

drknews.com/iodine-and-hash...

[SeasideSusie Remembering]

LeoFB

Can anyone give me advice what to do.

There are no medical professionals on this forum to give advice, it is a patient to patient forum to share experiences. However, we do know that for conception and a successful pregnancy TSH needs to be below 2.5 - do you have your current thyroid test results?

Have you tried any of the fertility communities linked to HealthUnlocked who might have more people who are, or have been, in a similar situation to yourself and be able to point you in the right direction:

healthunlocked.com/search/c...

[LeoFB in reply to SeasideSusie]

Thank you I will look into that. My recent test results from 2 weeks ago. TSH 2.3 , they said it's in normal range. I tried all sorts of conception supplements. While I was doing my aip diet I took pregnacare before conception but the iodine was very high and it interfered with my thyroid levels so I changed to a different supplement called Procieve, the iodine level is much lower Only 50ug... I have stopped taking them now as I took them for about 4 months... Giving my body a break... Do u think 50ug iodine is ok to have if I'm also taking 75mcg of Levothyroxine?

[SeasideSusie Remembering in reply to LeoFB]

LeoPB

Do u think 50ug iodine is ok to have if I'm also taking 75mcg of Levothyroxine?

I really can't comment on pregnancy supplements, they weren't around when I had my babies. As for whether it's OK to take 50mcg iodine would depend on your current iodine level. Has this been tested?

I also don't know anything about iodine levels during pregnancy so I have had a quick Google and found this on the NHS website:

nhs.uk/news/pregnancy-and-c...

There is no current recommendation in the UK to take iodine supplements during pregnancy, and you should be able to get all the iodine you need by eating a varied diet.

Probably best to read the whole article.

I can tell you that normally (and by that I mean not necessarily for pregnant women) the RDA of iodine is 150mcg daily. This is easily available from diet in the form of milk, yogurt, white fish, etc - see

bda.uk.com/uploads/assets/4...

However, that article does say that during pregnancy the RDA of iodine is 200mcg.

TSH 2.3 , they said it's in normal range.

Yes, it is in range but what about FT4 and FT3? For a treated Hypo patient your TSH is too high, most people feel better when it's down to around 1 or below with FT4 and FT3 in the upper part of their ranges.

[LeoFB in reply to SeasideSusie]

My doctor's never mention T3 or T4. Is there anything I can do at home to make my TSH levels lower? Maybe diet or supplements? Thank you for your responses I really appreciate it.

[greygoose in reply to LeoFB]

Lowering your TSH won't make your T3 and T4 higher. That's not the way it works. In fact, it's the other way round: optimal levels of T3 and T4 lower the TSH.

But, it's not the TSH itself that is the problem. TSH is just a chemical messenger from the pituitary to the thyroid. It doesn't do much else. It doesn't affect anything outside the thyroid.

Diet is very important, of course. But even the perfect diet can leave you short of important nutrients, because hypos tend to have low stomach acid, making it difficult for them to digest food and absorb nutrients. That is why it's essential to get vit D, vit B12, folate and ferritin tested, and supplement where necessary.

But, the important thing to do to optimise your thyroid hormone levels, is to get an increase in levo to raise your FT4 and FT3, and thereby reduce your TSH.

[LeoFB in reply to greygoose]

Thank you for your detailed explanation, I've been trying to figure it all out myself and trying different things... First time I heard about low stomach acid... But I've had stomach infections in the past and since then I get discomfort and cramps in my stomach, sometimes it's a sharp stinging feeling. Could this be from low stomach acid?

[greygoose in reply to LeoFB]

It could certainly be, yes. Have a look at this article, and try the home test at the end:

healthygut.com/articles/3-t...

[SlowDragon Administrator]

Levothyroxine contains iodine so you are very unlikely to need any extra even if vegan

Hashimoto's patients not recommended to take iodine

Can make hashimoto's worse

Important to test vitamin levels and only supplement what is deficient

Vitamin D, folate, B12 and ferritin

[DogLover518]

I would see a reproductive specialist or reproductive endocrinologist. This was my situation. We finally had to to IVF to conceive.