I have been trying to conceive for 8 months. I was concerned something was wrong and requested blood tests from GP. I received my results which indicate my TSH Is 5.5 and T4 is 13.2.
My GP advised my TSH is slightly elevated and spoke to a consultant who advised they wouldn't treat and that it shouldn't stop me getting pregnant.
After doing some reading the British Thyroid Association and other websites they state TSH should be 2.5 or lower when trying to conceive and when pregnant to avoid complications.
I am considering going private to see a endocrinologist as i just don't feel comfortable trying to get pregnant and putting myself at risk.
Does Anyone have any experience/thoughts?
Thanks
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Nat2021
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After doing some reading the British Thyroid Association and other websites they state TSH should be 2.5 or lower when trying to conceive and when pregnant to avoid complications.
Before going to the expense of seeing a private endo, print out everything you can find about where TSH should be for conception and pregnancy, including the above, and ask your GP why he is not following this guidance and why the consultant he spoke to is also ignoring it and risking you suffering a miscarriage if you did manage to get pregnant.
There is some information on ThyroidUK's main website which you may find useful:
Extremely important to test thyroid antibodies and vitamin levels too
Is there any autoimmune disease in your close family
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
So first step is to get full thyroid and vitamin testing done before considering booking any consultation with thyroid specialist endocrinologist
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.
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)
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
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests both antibodies, Ft3 or all relevant vitamins
I have ordered full thyroid test from medicheck hopefully arrive tomorrow.
I am at the point now where i just want to go private and get it sorted asap! I really don't want to wait round for a referral and have to fight my corner i would rather just pay and be seen next week.
After 8 months of ttc and at the age of 34 i just want to have a family.
Only do test early on Monday or Tuesday morning and then post back via tracked postal service
Don’t test if weather is freezing or snowy
If taking any supplements that contain biotin (eg vitamin B complex) stop these a week before test as biotin can falsely affect test results (it’s used in some labs testing kits)
Spoke to a different GP this morning and he advised that the GP i spoke to on Wednesday had spoke to an endo consultant who advised for another blood test in 3 months and that my TSH at 5.5 was only slightly over?
Am i over analysing? Everything i read online is very clear that TSH should be below 2.5 and how a higher TSH can impair fertility and increase risk of miscarriage.
I dont really want to wait round another 3 months for next blood test nor do i want to risk a miscarriage if i am lucky enough to fall pregnant.
I have booked a private endo appointment week after next to get to bottom of things.
My medicheck testing kit came today so i will do it Tuesday morning and send Tuesday afternoon.
I understand i may not be put on medication straight away but it will be good to have a conversation with a specialist about cause of action moving forward.
Nat2021, you might also want to note that NICE guidelines recommend Levothyroxine trial after 2 (6-8 weeks apart I believe) results have elevated TSH while TTC.
I’d recommend repeating the private test and see how the TSH can be lowered to 2.5 or less.
It usually improves chances of conception (if no other impediments are present) once TSH is closer to Euthyroid of 1.
In the event of your Medichecks kit arriving tomorrow, please don't do your test on Monday 3rd January, Royal Mail aren't collecting on Monday as it's officially a bank holiday due to New Year's Day falling on Saturday.
The advice for TSH < 2.5 in the first trimester and < 3.0 for second and third trimester applies to those with diagnosed primary hypothyroidism. This is different for women with a healthy thyroid which will be able to respond to slightly elevated TSH and maintain healthy T3, T4 levels. The research that underlies these recommendations is carried out in women who have known thyroid failure. The BTA advice applies to women with diagnosed hypothyroidism btf-thyroid.org/thyroid-dis... which they define as a low fT4 or TSH > 10. So, your GP is following guidance.
However, I have heard of a number of women (I'm not a doctor) who have become pregnant after treating numbers like yours. If I were female and pregnant I would at least keep a very close eye on my fT4 during the early stages of pregnancy. I'm assuming your fT4 is borderline although you don't give the reference intervals for your blood test.
I would get TSH, fT3 and fT4 measured just to see whether fT3 is also low normal. This blood test may by chance show a lower fT4 and let you jump through the hoop. If you still don't get pregnant with similar TSH, fT4 it makes perfect sense to trial some levothyroxine to bring your TSH down - this would be far simpler and cheaper than extensive investigations into why you do not achieve pregnancy.
Your levels MIGHT be OK, they might not. It makes sense to have another blood test as levels can change. It also makes sense to trial some levothyroxine as it is safe and cheap. You could trial slowly coming off the levothyroxine a few months after delivery.
It is difficult to get doctors to prescribe levothyroxine - not least because a diagnosis of hypothyroidism entitles you to free prescriptions. However, there is a study that showed that TSH is much higher mid-cycle frontiersin.org/articles/10... . So, you do a cheap private blood test and time it so that you get the best chance of having a high TSH. (You don't need to read the research study, I just include it for reference).
The body acts to defend serum fT3 levels so an fT4 like yours would be OK if your fT£ was around mid-interval. However, I don't know of any research which has been done to establish appropriate fT3, fT4, TSH for 'healthy' women planning pregnancy. There are cases of women with numbers like yours who fail to achieve pregnancy for a long time and only become pregnant with some levothyroxine. It makes sense to give it a try, but I'd get a cheap private test done first.
Spoke to a different GP this morning and he advised that the GP i spoke to on Wednesday had spoke to an endo consultant who advised for another blood test in 3 months and that my TSH at 5.5 was only slightly over?
Am i over analysing? Everything i read online is very clear that TSH should be below 2.5 and how a higher TSH can impair fertility and increase risk of miscarriage.
I dont really want to wait round another 3 months for next blood test nor do i want to risk a miscarriage if i am lucky enough to fall pregnant.
I have booked a private endo appointment week after next to get to bottom of things.
I've only glanced at studies and they have inconclusive results, some suggest levothyroxine helps and some conclude it can make it worse. It seems reasonable to try levothyroxine if you haven't succeeded without it
Hi Nat, we’re TTC too but not having any luck. My blood tests showed an elevated TSH, it was in the 20s! The Dr started me on levothyroxine to bring it down as he said it can cause miscarriage. They tested my anti bodies too and these are really high, as far as I’m aware this can lead to issues with pregnancy too.
We’re under an IVF clinic at the moment and they won’t start treatment under my thyroid is stable and between 1 and 2. Xx
Its so frustrating isnt it, i just want it sorting as i feel hopeless and each month gets harder. Im glad i got things checked rather than waiting until the 12 month mark.
I have ordered an at home test to measure full thyroid panel and will be booking a private appointment tomorrow.
You’re so right for checking things out early. We waited for years until talking to our doctor and then waited for months to see a fertility consultant and then months and months of tests!!!
The medication bought it down quickly. My TSH was 24 in May 2021 and after starting meds, 6-8 weeks later it was 2.7. The GP said that 2.7 was within range however on being tested at the IVF clinic they said this was too high for conception.
So the IVF clinic wrote to my doctors to tell them to increase my dose!
So my GP upped my meds and 6-8 weeks later I was retested and now my TSH is 0.1 which is now too low!
It takes a bit of tweaking to get the level right I think but it’ll all be worth it in the end! Xx
Oh wow that brought it down drastically! This is all so new to me and i have a lot to learn.
I know my levels dont seem drastically high but i cant help but worry its impacting my chances and i am fixer by nature so need to know how/if it can be improved. I am hoping a private consultant will see my results and prescribe me meds and its just a matter of that, if not least i know my levels are normal and its one less thing it could be.
Really hope you get things sorted soon. If the clinic are saying levels need to be lower than 2.7 then surely mine arent in the place they should be whilst TTC!
I did have a few symptoms but didn’t realise at the time. I was, and still am, often tired but I thought that was just a normal way to feel. My hands and feet are always cold and I have a really bad memory. I didn’t know anything about hypothyroidism until I started reading into it. This forum is really good for info and advice.
Wishing you all the best with your thyroid / fertility journey! If there’s any other questions feel free to PM me anytime xxx
No recent vitamin tests, I must order a test! I’ve seen the links above.
I haven’t had a gluten test either actually. I will do this before I change my diet. Thanks for the recommendations. I have found this group so useful! 😊
Hi NatI had my daughter 18, eventually after much heartache.
With Hashimoto's I was just not conceiving.
I should’ve been offered IVF on NHS but GP cocked that up and then I was 40, which was too old. I went for private IVF which happily worked first time at 42!
It never worked again though, despite, numerous attempts and spending a fortune.
Vitamins, D3 and B12 I’d recommend are by Better You - in liquid form they’re supposed to be more easily absorbed.
If you’re seeing an endocrinologist look for one that specialises in fertility. As we know there are endos and endos and not all are equally sympathetic or competent. Good luck🍀🍀🍀
Do you know much about TSH and Free T4? I am reading that DRS arent really to concerned if TSH is elevated but T4 is in normal range, however my T4 is normal range but on lower end.
I was on levothyroxine at the time. Not sure my numbers sorry.I never really got on with though I think. Took it for years then more recently got prescribed T3 which I prefer.
All I can say is I’m sure there’s more knowledge now. No web then!!!
Do gluten free, dairy free and cut sugar. But don’t go onto diet stuff because that’s much worse saccharine, aspartame really not good for you at all.
Read up The Thyroid Pharmacist - she is super informative. 👍🍀👍
Only extra info I can add that might be useful re conceiving is the following…
I dont really take much notice of my numbers unless I don’t feel well. (Super down or manic and cannot sleep) with Hashimotos your thyroid can be under or overactive.
As I take T3 my TSH is suppressed I think? But that’s normal with T3. Anyway after giving up on Levo I take 25 mcg of T3 which seems to do me fine.
Re conceiving, any probs I’d try and get referred to a endo specialising in fertility.
I had probs and had IVF at 42 and it worked first time. Previous to that I tried so much stuff (getting hair tested for toxins, cutting out so many foods)
They will usually bump up your Levo if you’re pregnant. Not sure if they increase it for trying to conceive.
That’s all I can think of for now
Let me know how you get on. Fingers crossed you’re already expecting🐣Happy Easter
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