Pre-conception care with Hashimoto's

[Haveaquestion]

Hi. I've just moved to the UK and I'm not quite sure how the health system works here for patients with Hashimoto's ttc. My GP tested my TSH without T4 (or T3 and TPO abs for that matter) and told me that my TSH was 'normal' at 2.68 when ttc. She didn't think my dosage needs to be increased nor that I should be referred with urgency to the pre-conception clinic of endocrinology to evaluate/adjust my dose. I was advised that I had to wait 25 weeks to see the endocrinologist here? I worry I may end up miscarrying if I should fall pregnant on that TSH level, from not having access to an endocrinologist. What can I do if I should learn I'm pregnant - would visiting the A&E to get my levels checked be a viable option? I can never get through my GP, and even if I did, I would have to wait about a month for an appointment to get my blood work. Any advice would be appreciated, thank you.

[shaws Administrator]

Unfortunately, for many of us, the GPs (General Practitioners) don't seem to be very knowledgeable about how best to treat patients who're hypothyroid.

The A&E only deal with emergencies and GPs with 'normal' illnesses.

I shall give you a link which I hope is helpful and it is from our 'mother' website. and links within may be helpful.

thyroiduk.org/having-a-baby/

Members who've have hypo and also through their pregnancy will respond when they read your post.

[SeasideSusie Remembering]

Hi Haveaquestion

It would seem that your GP is ignorant of the guidelines for conception/pregnancy in hypothyroid patients, so I'll give you the details you can pass on to her and hopefully you will get the care you need:

cks.nice.org.uk/topics/hypo...

Arrange a referral to an endocrinology specialist for all women with overt or subclinical hypothyroidism who are:

Planning a pregnancy

Check thyroid function tests (TFTs) before conception if possible.

(read the rest of it as well )

Then there is the advice from the British Thyroid Foundation for patients here which recommends TSH below 2.5 in the first trimester:

btf-thyroid.org/pregnancy-a...

and one for your GP here:

btf-thyroid.org/pregnancy-a...

Good luck.

[SlowDragon Administrator]

Recommend getting Full thyroid and vitamin testing done yourself

Do you already know if you have Hashimoto’s.

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

EXTREMELY important to test vitamin D, folate, ferritin and B12, especially before TTC

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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)

Is this how you do your tests?

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

List of private testing options

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

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

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[Haveaquestion]

Thank you all so much for those useful links and suggestions!