Can anyone help interpret results

[weekitty]

Hi I've just had my thyroid levels checked. I had asked for thyroid antibodies to be checked but I'm not sure if that's been done yet. I will have to call the gp to check. I was having fertility treatment and had a chemical pregnancy last month. Not sure if this could have been a possible reason. TSH levels are high. I have only been told to repeat the blood test in 3-6months time. I'm not on any medication at the moment for thyroid. I have, also asked for full vitamin testing. Iron, folate etc. Should I be taking levothroxine for the high TSH. Any help/advice would be much Appreciated. TIA.

[SlowDragon Administrator]

Typically bloods should be retested 6-8 weeks after first abnormal thyroid results

As levothyroxine is often/usually lifelong treatment it’s important to get two blood tests 6 weeks apart before levothyroxine is prescribed

TSH should always be under 2.5 before considering pregnancy

Yes essential to test thyroid antibodies and vitamins too

Thyroid testing should be done as early as possible in morning for highest TSH

[weekitty in reply to SlowDragon]

Thank you for your reply. I will get the thyroid antibodies checked as well and take it from there. Thanks

[tattybogle]

If this is the first raised TSH you have had , then yes it's correct to wait 3 months to retest .. if TSH is still raised at next test, then you may be started on Levo at that point , depending on symptoms . Raised thyroid antibodies TPOab (thyroid peroxidase antibodies ) would help to convince GP to start treatment ,as it would show a reason for the reduced performance of the thyroid gland (autoimmune hypothyroidism) but GP won't be very interested until you had also got 2 over range TSH's ,3 months apart. Some GP's might not wait quite as long as 3 months , some are prepared to retest after a couple of months, but the guideline currently tell them to wait at least 3 months.

Sorry i don't know anything about chemical pregnancies , but hypothyroidism can be responsible for difficulty conceiving /maintaining a pregnancy.

Currently your results are what is called 'sub-clinical hypothyroidism'.. which means your TSH (thyroid stimulating Hormone ) is over range (ie, asking for more thyroid hormone to be produced) but your thyroid hormone (fT4) is still within range.

Sub-clinical hypothyroidism can be treated with Levo, even if fT4 is still within range, if symptoms of hypothyroidism are a problem.

but there can be many other causes of TSH to be raised temporarily, and so they have to wait long enough to see if it returns to normal levels by itself, before they start what is usually a life long replacement of thyroid hormone.

[weekitty in reply to tattybogle]

Hi thanks for your reply.I had the blood test first thing in the morning. Only had a bit of water before the blood test and hadn't eaten anything for about 12 hours before the blood test. I had the levels checked about a year ago and they were high then as well. Il need to get the thyroid antibodies checked as well. If I was put on levothroxine any idea what the dose would be and how long it would take to get level down to about 2.5?

[tattybogle in reply to weekitty]

If I was put on levothroxine any idea what the dose would be

If under 65 then Levo is usually started at 50mcg, with retests after 6/8 weeks , usually needing further increase and retest. Many people end up on somewhere between 75-150mcg, but it's hard to predict how much till you get there. A very rough guide might be 1.6mcg/kg bodyweight , but it's really just an estimate , the only way you'll know is to take a dose consistently for at least 6 weeks , and then test blood again.

If over 65 or with heart issues then they might be more comfortable starting your dose at 25mcg to allow body to get used to effects more gradually.

how long it would take to get level down to about 2.5?

TSH could well go down to 2.5 after 6 weeks on just 50mcg , but it might not stay there for long on that small a dose . And anyway TSH 2.5 might not be where you need it to feel well. often it needs to be lower than that ,at around 1 or under.

[weekitty in reply to tattybogle]

I'm 40 years old. I don't have any symptoms. Don't feel unwell.

[tattybogle in reply to weekitty]

Oh . i see , so just trying to get TSH to that level to improve chances of conception ?

I'm afraid there is still no easy answer to how long ? or what dose ? it's a complex natural regulation system with negative feedback loops, so how it reacts when we start adding extra hormone from outside is not very predictable.

it's (sadly) not as simple as add a little Levo (synthetic T4)and TSH will fall a certain amount and stay there.

When you add some T4 from outside the TSH level reacts , and then that alters how much of your own T4 your thyroid makes.

TSH needs to be allowed 6 weeks to settle after any Levo addition/change

[weekitty in reply to tattybogle]

I see. If I'm put on levothroxine. I would need to have blood tests every 6 weeks if dose is altered. Il just need to see how it goes when meds are started. X

[SlowDragon Administrator in reply to weekitty]

I had the levels checked about a year ago and they were high then as well

So this is second high TSH result

How high were blood test results a year ago

If this is the second high result you should be prescribed levothyroxine

They should also have advised against pregnancy until TSH is under 2.5

See flow chart on top of page 2 here

gp-update.co.uk/Latest-Upda...

Standard starter dose of levothyroxine is 50mcg. Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Many people find different brands levothyroxine are not interchangeable

Obviously EXTREMELY important to test vitamin levels if considering pregnancy

Low B12 and folate are very common when hypothyroid and you need correct levels of both for a baby’s neurological development. Not too little and not too much either

What vitamin supplements are you currently taking?

Have you had cholesterol levels tested. High cholesterol is linked to being hypothyroid

Before considering TTC levels need to be stable and TSH under 2.5

verywellhealth.com/infertil...

.

Pregnancy guidelines

thyroiduk.org/having-a-baby-2/

gp-update.co.uk/files/docs/...

IMPORTANT See pages 7&8

btf-thyroid.org/Handlers/Do...

thyroidpharmacist.com/artic...

[weekitty in reply to SlowDragon]

Hi thanks for your reply.I asked the gp to test for vitamin levels, folate, full blood count. Iron ferritin and ferritin. I will get the results on Tuesday for those blood tests. I'm currently taking pregnacare conception tablets. Methyl folate, vitamin D, N-acetyl cysteine. L-Arginine. Co enzymeq10. Omega 3 fish oil. I also take a liquid iron supplement. I stopped taking all of these 7 days before blood tests.

[weekitty in reply to SlowDragon]

I'm not sure what the level was a year ago. But I remember the gp saying it was high and to gave it checked in 6 months time. Then covid happened and my appointment was cancelled. I've only had the blood test done few days ago and tsh has came back high. I have a telephone appointment with the gp on Thursday so will ask her what the levels were 1 year ago and ask about the levothroxine as well.