I have Hashimoto according to my endocrinologist with slightly elevated antibodies (although GP is not convinced). I Have now TSH around 2 on 75mg levothyroxine. I am doing IVF and had multiple miscarriage which could have been related to TSH above 5 at the time (2 years ago, before starting levothyroxine).
I asked my IVF doc about being prescribed Low Dose Naltrexone because I saw that ladies who have Hashimoto in the US often take 4.5mg of LDN.
My doc is unsure. she says it could destabilise my TSH level. I thought it would actually help, ie I might be able to take less levothyroxine if on LDN? Also, if I start months before the IVF, it should have stabilised?
I would like to hear your thoughts on whether or not trying LDN would be a good option in my case?
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Lilly12255
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Isabella Wentz recommends LDN for Hashi sufferers during pregnancy for the exact reasons you want it for. It also stabilisers thyroid markers (TSH, T4,T3).
75mcg levothyroxine is only one step up from starter dose, unless very petite, it’s likely too low a dose
Essential to test Ft4 and Ft3
What were latest results
Also dose levothyroxine it typically increased as soon as conception is confirmed
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
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