TSH and IVF FET

[StressedIRIS]

Hello! I am currently undergoing FET medication just stopped noretheristone and i am on buseralin. I am starting oestrogen and progesterone next week. I had a TSH test on the 12th august and came back as 2.1 mU/L. My clinic didnt do anything about it and i saw the results yesterday and when i asked them they said that we dont need to do anything about this as its below 2.5. But as inread oestrogen and progesterone increase the TSH and i also didint have the test in the morning. I had private online consultation with an endocrinologist and he suggested to start thyroxine as my levels should be below 2 and closer to 1. With regular testing of course. Does anyone know how i should get it? Would the GP prescribe it? And my embryo transfer is in 3 weeks so i am not sure if there would be enough time to take effect!he recommended 50mgc per day. Any advice would be greatly appreciate it

[NWA6]

Oh hun what a stressful time for you 😞 can you put off your embryo transfer? You really need to get full thyroid testing. FT4, FT3. And testing for antibodies to show if you have Hashimotos or not, Tpoab and TGab

Only when you have those results can you determine if you need thyroxine replacement and a starter dose of 50mcg and at least 6wks before testing again and perhaps add more after that and then 6wjs on that dose before testing again. Repeat until numbers or symptoms are optimal.

All in all you need to allow about 3mths to get ready for growing babies 😞

[NWA6 in reply to NWA6]

And Ofcourse Vits and minerals need to be optimal. If they’re not optimal then this might be the cause of higher TSH. Or autoimmune is making Vits and minerals low. It’s always a circle.

[StressedIRIS]

Thank you NWA6 but postponing is not an option currently as i am already on the meds. Will try and see what happens.

[SlowDragon Administrator in reply to StressedIRIS]

Presumably you have had vitamins tested recently?

Recommend getting FULL thyroid and vitamin testing privately ASAP BEFORE Starting levothyroxine

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

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/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

[StressedIRIS in reply to SlowDragon]

Thank you, yes i have tested all the others and vitamins as well and there are in normal range. But i didnt do the tsh early in the morning.

I will go and do the all the test tmr and talk to my gp and send the recommendation of the ivf endo. Thank you its extremely helpful.

[SlowDragon Administrator in reply to StressedIRIS]

What were actual vitamin results and ranges?

[StressedIRIS in reply to SlowDragon]

Ferritin 23 ng/ML (10-120)

Vitamin d 30 (9.5 -555) i had a deficiency before and i am taking vitamin d supplements 100 ug per day for the last 2 years.

B12 450 (190-959 pg/ML)

And i dont have the folate but i am taking 800 mg per day for the last month and 400 mg for the last two years while TTc.

I am going to repeat them

[SlowDragon Administrator in reply to StressedIRIS]

Vitamin D - are the units nmol or ng/ml?

If in the uk Vitamin D is usually measured in nmol

Standard range is under 25nmol is deficient

Under 50nmol is insufficient

Around 75nmol is a good level

If ng/ml around 40ng/ml

[StressedIRIS in reply to SlowDragon]

Vitamin is ng/ml i had it in cyprus.

[SlowDragon Administrator in reply to StressedIRIS]

So ferritin range may be different too

[StressedIRIS in reply to SlowDragon]

Is also in ng/ml

[SlowDragon Administrator in reply to StressedIRIS]

Ferritin looks low.

humanbean may pop along to comment

Ask GP for full iron panel test for anaemia

cdn.mdedge.com/files/s3fs-p...

Some experts believe that in pregnant women who are not anemic, a serum ferritin level between 15 and 30 ng/mL may also indicate iron deficiency. If the pregnant woman is anemic and does not have another cause of the anemia, a serum ferritin level less than 40 ng/mL is indicative of iron deficiency.

[StressedIRIS in reply to SlowDragon]

Will do! Thank you so much

[StressedIRIS in reply to StressedIRIS]

I will talk with my GP first thing in the morning and ask for all the tests to be done if they refuse i will do them privately as my transfer is the week 23rd and in 3 weeks and i need to address this. Thank you so much for all the advice. Its massively appreciated

[StressedIRIS]

Well my Gp was very helpful and they ate happy to prescribe thyroxine only if my IVF CLINIC advices this. However they dont do anything if TSH is below 2.5. Hence i can start taking aNything and i can not take a private prescription as i need to be monitored and its against the advice of my ivf clinic.

I am having all the tests done again next monday including vitamins and iron panel.

[StressedIRIS]

I think it might be late for this transfer as it appears as even if my levels are above 2.5 by end of next week and they start thyroxine i am having the transfer 10 days later and dont know if its enough time to make a difference

[katiehopeful81]

Hi StressedIRIS what happened with your TSH and FET if you don’t mind me asking? I’m having problems with mine after starting the oestrogen. TSH has risen by 1.5 in 3 days!

[StressedIRIS in reply to katiehopeful81]

Hello! I was put on thyroxine lower dose (50mcg) and my endo adjusted the dose with an increase of 25 mcg as the TSH increased with oestrogen. Your TSH should be below 2 ideally closer to 1. You should measure the TSH 5 days before embryo transfer to see that all is well and ideally 8-10 days after! I hope that helps.

[katiehopeful81]

Hi StressedIRIS thanks. My transfer is supposed to be this thurs so in 2 days and it’s doubled again and is now 5. I really don’t know what to do. My consultant didn’t reply back to me after I contacted him this afternoon x

[StressedIRIS in reply to katiehopeful81]

I am so so sorry! This is slightly weird for your TSH to double and increase so much. Is there anyone reviewing your results? TSH of 5 is slightly inhibiting for transfer. It should be below 2.5. What about your clinic? Can they increase your dose?