I’m new to this group and wondering if anyone can help. I’m currently having IVF treatment and due to have embryo transfer this wed. I am currently on 75mcgs of Levothyroxine. I have had results back today (shown below). My consultant seems to think this level is ok. I’ve read that TSH levels during IVF/pregnancy should be below 2.5. My last embryo transfer failed in July and my follow up bloods showed my thyroid level was 9. I hadn’t had bloods taken before this transfer. Advice needed please X
you are correct before considering TTC TSH should be under 2.5
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
75mcg levothyroxine is only one step up from starter dose
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. About 90% of primary hypothyroidism is due to autoimmune thyroid disease
Do you have Hashimoto’s?
What vitamin supplements are you currently taking
When were vitamin levels last tested
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Hi SlowDragon, thanks for your reply. The blood test was taken early morning and I hadn’t had anything to eat or drink. I had my tablet about 7.30 that morning. I will definitely look at having the tests you have recommended. Do you think I should postpone my transfer on wed or would it be better to start taking 100mcg? I would obviously speak to my doctor first.
What vitamin supplements are you currently taking?
Hi SlowDragon, thanks for your reply. I had the blood test at 8.30 in the morning and I hadn’t had anything to eat or drink. I had my Levothyroxine tablet at 7.30 the same morning. I will definitely have the above tests you have recommended. As I am due for embryo transfer on Wednesday would it be better to delay it?
Hi, I’ve not had my vitamins levels tested yet..did you say I could request this from my GP? I’m currently on 5mg folic acid and vitamin D tablets.
So, would you advise to increase the dose as soon as possible? Also, do you know how long it would take for an increased dose to take effect? You also point out that the result is a false high would I still need to increase the dose now or when I find out I’m pregnant?
Apologies for all the questions. The link is very helpfully the way.
Ideally you would have got your TSH level down into that lower range before attempting normal conception and it must follow that the same reasons apply with embryo transfer. If going ahead with transfer on Wednesday increase now. Given having had your blood test an hour after taking your medication an increase of 50 mcg the first day and 25 mcg the second day and so on alternating may be more appropriate as a cautious increase rather than 25 mcg Levothyroxine daily.
Your consultant or GP
may be concerned over you doing this but explain you made a mistake taking your Levo so soon before the test and that anyway your TSH is nowhere near becoming suppressed (below range) and there is leeway within your Levo/FT4 range for increasing your T4/Levo meds. Obviously further frequent testing is needed as pregnancy progresses and with further dose
adjustments if necessary to keep your TSH low enough & your FT4 level up.
Thanks for your reply. I have had 100mcg this morning. I have a telephone appointment with the GP tomorrow morning so will discuss it then. I’m also having my progesterone levels checked at the GP early tomorrow morning. I will see if I can have the Thyroid function blood test as well. This time I will not take my medication until after the blood test.
Yes, your FT4 level should be increased (which will also lower your TSH) before conception & would apply to IVF as well.
Discuss the increase with your doctor but given where your levels were with testing shortly after taking your T4 meds you could ask about increasing by 50 mcg the first day and 25 mcg the next & continue alternating until
the next test after4 weeks rather than 6-8 weeks and rather than starting on 25 mcg daily. Then ask suggested monitored 4 weekly with
This article says that methyfolate may be better to take thsn folic acid
Methylfolate Supplement May be Superior
Taking a prenatal or multivitamin with methylfolate may be more beneficial than taking one with folic acid. Remember, methylfolate is the most active form of folate in the body. It is well absorbed and can effectively raise folate levels in your blood (3).21 Jul 2019
rootfunctionalmedicine.com › folic-...
Folic Acid vs. Folate: what's the difference? - Root Functional ...
Might be an idea to get folate, B12, Vitamin D Ferritin (iron) full iron panel, TPO, tgab antibodies checked. You could ask your doc to check these levels especially Vitamin D, but he may refuse due to cost. If not you could do a home finger prick test if you can afford it. These Vitamins need to be optimal but docs dont know this or are not trained in them.
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