I recently suffered a miscarriage (through IVF) and soon after that I've got my thyroid blood test taken. I am not on any medication at the moment as I am still trying to figure out what to do with my results.
TSH - 5.26 mU/L
Free T3 - 4.41 pmol/L
Free T4 - 17.8 pmol/L
Thyroglobulin antibodies - 30.2 IU/mL
Thyroid Peroxide antibodies - 9.2 IU/mL
Should I take LDN and thyroid medication together or is LDN sufficient? I would really like to lower down my TSH and thyroid antibodies before my next FET next month. Does anyone know how long does it take to lower the levels down with medication?
Thanks everyone.
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Thanks for your reply radd. I'm sorry, here are the ranges:
TSH - 5.26 mU/L (0.27 to 4.2)
Free T3 - 4.41 pmol/L (3.1 to 6.8)
Free T4 - 17.8 pmol/L (12 to 22)
Thyroglobulin antibodies - 30.2 IU/mL (0 to 115)
Thyroid Peroxide antibodies - 9.2 IU/mL (0 to 34)
My GP has just taken bloodworks and I am hoping they would offer me some medication (Levothyroxine?) I read that if you're trying to get pregnant, thyroid antibodies should be 0 so I am hoping LDN could help?
FT4 is 58% through range, & FT3 - 35% which is fine if you aren’t symptomatic. However, with a TSH over-range it may be pointing towards early onset hypothyroidism and you should be offered Levothyroxine anyway given you are on an IVF program. Do you feel symptomatic? ie tired, gaining weight, etc. Does your thyroid gland look/feel more noticeably larger?
TRH & TSH correlate with prolactin levels, so during conception it is important to keep TSH low to avoid prolactin elevating which can interfere with ovulation (less release of LH, lower progesterone receptor site sensitivity, loss of sensitivity to FSH in the follicle, etc.)
A low TSH is also more likely to ensure adequate FT4 levels needed for baby’s healthy development, so used as the guide for dosing increments of Levothyroxine during pregnancy. Expect between 30-50% increase. As Levothyroxine will reduce thyroid activity it is thought to deter Hashi attacks should thyroid antibodies rise.
Regarding LDN, some have great success in modulating the immune system, reducing antibodies & so the likely hood of immune attacks, but not everyone as it's dependant upon how your immune system works. Your antibodies aren’t over-range so you won’t get a Hashi diagnosis on those results and many people live happily with a few antibodies. However, they fluctuate and could flare at some point (or not), and unless (sub-clinical) hypothyroidism has been recognised flares can be difficult to identify as mimic flu-like symptoms.
LDN can be taken throughout pregnancy, usually stopped for the final few weeks in case opioid pain relief is required during labour, but I would have thought given the immense immune changes the body makes during pregnancy you would have needed to have stabilised long before ttc. Also, unless your specialist is functional you may have difficulties in getting an LDN prescription.
If you read books such as ‘Your Healthy Pregnancy With Thyroid Disease’ by Dana Trentini and Mary Shomon, and view websites such as ‘hypothyroidmom’ you will see the general consensus is to keep antibodies as low as possible through means such as eliminating cross-reactive foods, avoiding sugar spikes, supplementing selenium, fish oils, Vit D etc, that helps calm an over active immune response.
Radd, thanks again for your valuable input. Regarding symptoms, I am having abit of weigh gain and some hair loss but thyroid gland doesn't seem to look noticeably larger.
I forgot to mention that I was diagnosed with lupus 9 years ago but has been in remission for 5 years now and unmedicated. I had a blood test for Anti Nuclear Antibody taken before my last FET and it showed negative.
My IVF doctor has previously recommended prednisolone (as a precaution) but I am relunctant because of its side effects and so I was wondering if LDN could be a better option if it can modulate my immune system (if necessary) and reduce thyroid antibodies (however based on your reply my antibodies do not seem to be in the danger zone)?
Well, in that case if you have no liver/kidney issues I would definitely be considering LDN which is far preferable to prednisolone as a preventative measure.
Having one autoimmune disease often predisposes us to others and as pregnancy is a time of hormonal flux, it often invites underlying/dormant conditions to exposure/reoccurrence. Hasn't your IVF specialist offered LDN? You will need someone to monitor you for a few months because it doesn’t agree with everyone and there can be strong side effects for those it doesn’t suit.
I would also be aiming to get Levothyroxine started asap just because any hormonal change can take several months for full benefits to be felt and symptoms often lag behind good biochemistry. A Low TSH is absolutely essential for not only conception but in retaining the foetus. A GP might delay prescribing until thyroid hormones further reduce but a specialist is likely to start Levothyroxine straight away because as soon as conception occurs you are will need much higher levels of T4.
As disappointing as it is I would delay any more IVF for at least 6-12 months to allow time for LDN hiccups & Levothyroxine to stabilise, as you want to start IVF in top form to offer best chance of a healthy pregnancy.
Vit D is a good immune modulator, selenium reduces TPOAb's and helps in the manufacture and processing of thyroid hormones. Folate protects baby against brain & spine birth defects (methyl-forms are better). Are you taking pre-natal supplements? Have you had Vit B12, folate, Vit D and iron checked?
'My Vitamin D, Folate and B12 are within normal range but my Ferritin is on the lower side 26.9 ug/l ( range 13 to 150). I am trying to bring the level up through iron supplement and food and I am on 90% vegetarian diet'.
These nutrients need to be optimal and not just within range. Can you post recent results complete with ranges (numbers in brackets) for members to comment.
Your ferritin is only 10% through range. This indicates iron deficiency and possible anemia. It is very important to ask your GP for an iron panel which will allow him to prescribe more appropriate iron supplements and to then monitor your levels. Unfortunately some members experience difficulties in introducing Levothyroxine when ferritin levels are so low.
Yes, these look good. Weird your ferritin is so dire. It must be your diet?
Yes, optimising iron levels first would be preferable than introducing Levo with this level of ferritin but iron can take months to raise. Your other nutrient levels appear to eliminate any absorption issues but you can’t raise iron quickly because of the bodies safely mechanisms in place that prevent iron toxicity. It just doesn’t work.
Even with low iron Levo will reduce TSH but sometimes members experience a worsening of their symptoms. As metabolism is increased so breathlessness & heart palps may increase, and jittery feelings until iron levels raise enough.
These symptoms can be frightening & dangerous, and your worst scenario would be for these symptoms to prevent a necessary Levo dose increase should you fall pregnant.
radd, your input are invaluable to me! I do not have kidney/liver issues but just skin issues from lupus. I was first introduced to LDN through my functional doctor early this year but I wasn´t keen on it till my recent miscarriage - I am thinking there could be no harm in having it despite the fact that we will never know the real cause the miscarriage.
During the initial stage of my IVF journey, I've asked my IVF doctors about LDN but they seem to have no idea about it and have always been an advocate for predisolone. That was another reason why I have never stated LDN. I've managed to find a pharmacist here that can prescribe LDN so hopefully I can get it soon.
You're right, it is dissapointing to have to delay our next IVF but I certainly understand where you're coming from and the benefits of doing so. With so much money, time and effort involve in an IVF journey, we definitely do not want to risk it.
My reply to SlowDragon: At the moment I´m not taking a prenatal multivitamin but the individual vitamins like DHA EPA oil, Vitamin C, D, E, Selenium, Folate, B Complex, Iron, Magnesium. Should I just be taking a good prenatal multivitamin?
Obviously I don’t know your background or the whole picture but from where I’m standing the reason for your miscarriage was most likely too high TSH. It is common on the forum and something GP’s don’t always advise women ttc about because the thyroid problem may be not yet discovered.
Your sups are good. Separate or multivits combos are choice. Just don’t take a multi with iron or calcium because they can impair absorption of other nutrients. And a multi needs to be geared towards ‘prenatal’ (as opposed to general) because nutrients such as Vit A can be harmful to baby.
Vit D is better combined with Vit K2. And iron needs to be supplemented separately anyway to address your deficiency, and 4 hours away from thyroid meds when you start. Speak to your GP about iron supplements and monitoring because you will need regular labs to keep an eye on levels as you don’t appear to have absorption issues.
I recommend you read the book I suggested above ‘Your Healthy Pregnancy With Thyroid Disease’ by Dana Trentini and Mary Shomon which deals with all autoimmune conditions and details the use of LDN. They are both thyroid experts in their own right but their source re using LDN is fertility expert Dr Phil Boyle who practices in Ireland.
You may read negative literature regarding high dose naltrexone in pregnancy. Don’t mix it with LDN because as you are probably aware high & low dose work very differently, ie HDN blocks opioid activity & LDN promotes optimal opioid activity resulting in beneficial immune system changes for some.
I haven’t watched these exact videos (advocated) by Dr Boyle but you may like to glean as much info as possible 😊
radd, I strongly believe my diet has contributed to my low iron/ferritin. I'm going to change it by having liver and red meat more frequently now. It's sad to know that iron can take months to raise but hey ho it is what it is. ~
On the contrary, my husband would like me TRY having a consult with a naturopath to heal things the natural way by getting to the root cause as he does not really believe in taking drugs such as Levo or LDN but we´ll need to weigh in the pros and cons and consider the best option for us. Do you have any experience in this or heard stories where problems like mine could be solved naturally without taking any drugs?
By the way, you´re right, the reason for my miscarriage at 5 weeks could be too high TSH level as that is by far the most obvious reason. I am really annoyed thyroid test was not offered by my IVF clinic before transferring our embryo.
Regarding the book, I've just ordered it! I'm going to check out Dr Boyle's videos as well through the links
Levothyroxine isn't a drug but a synthetic thyroid hormone just replacing what has become deficient through hypothyroidism. LDN is a drug.
I would say you know your root causes - a history of Lupus and possible hypothyroidism caused maybe by iron deficiency (we need adequate iron to manufacture and process thyroid hormone) or possible early onset Hashimotos (antibodies fluctuate).
Another great read for your husband which is very aptly named is 'The Root Cause' by Isabella Wentz which goes into detail about immune issues mainly thyroid but also others. I wish my husband took more interest in my immune issues 😁
radd - ah, I always thought Levothyroxine is a drug. Good to know it's not!
I suppose you're right about my root cause that could have caused my TSH level to be elevated. My TSH level over the years has never really been lower than 2.75 anyway (must be from Lupus like you said) so I guess I really need to take Levothyroxine to lower it down when my iron level has increased. Do you know what is the recommended lowest iron value safe for me to begin taking Levothyroxine?
Thanks for the book recommendation, my husband surely need to read it I guess he is interested as he is worried about spending alot more on future medication But thanks to amazing people like you, we can be our own health advocate based on history, symptoms experienced, bloodworks etc
The results were taken around 2 weeks after my 5 weeks miscarriage. Could this be contributing to the rise of my TSH level? I suppose we can't be certain as my TSH was not tested before my failed FET?
My Vitamin D, Folate and B12 are within normal range but my Ferritin is on the lower side 26.9 ug/l ( range 13 to 150). I am trying to bring the level up through iron supplement and food and I am on 90% vegetarian diet.
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
SlowDragon, you're so knowledgable and thanks for all the articles! It make sense now why I am experiencing the symptoms such as hair loss (over the years) and difficulty in losing weight. My ranges are:
Folate - 16.9 ug/L (range 3.89 to 19.45)
Vitamin B12 - Active »150 pmol/L (range 37.5 to 188)
Vitamin D - 199 nmol/L (range 50 to 200)
Do they look alright?
I'll definitely be taking liver, red meat plus the other iron rich food from now on. I'll also be purchasing the full iron panel test from Medichecks and will post my results here once I have it in hope that all you kind souls will be able to advise further.
SlowDragon, you're so knowledgable and thanks for all the articles! It make sense now why I am experiencing the symptoms such as hair loss (over the years) and difficulty in losing weight. My ranges are:
Folate - 16.9 ug/L (range 3.89 to 19.45)
Vitamin B12 - Active »150 pmol/L (range 37.5 to 188)
Vitamin D - 199 nmol/L (range 50 to 200)
Do they look alright?
I'll definitely be taking liver, red meat plus the other iron rich food from now on. I'll also be purchasing the full iron panel test from Medichecks and will post my results here once I have it in hope that all you kind souls will be able to advise further.
SlowDragon, At the moment I´m not taking a prenatal multivitamin but the individual vitamins like DHA EPA oil, Vitamin C, D, E, Selenium, Folate, B Complex, Iron, Magnesium. Should I just be taking a good prenatal multivitamin?
Please do not try to conceive until your TSH is under at least 2. (NICE guidelines). It is likely to lead to miscarriage and no one wants you to go through that again. Insist on talking to your GP and take the guidelines with you (if you search this site you'll find a link). Good luck
Thanks mistydog, now that I know how important it is in getting my TSH under range before conceiving I will make sure it gets to at least 2 before we try again.
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I'm going to check out Dr Boyle's videos as well through the links 
But thanks to amazing people like you, we can be our own health advocate based on history, symptoms experienced, bloodworks etc 
Hyper/Mania after starting Levothyroxine
Suitable thyroxine dose before pregnancy 
Hyperthyroid with Pregnancy
Positive pregnancy test and levothyroxine!
