Had results back since dose increase to 125mcg 6weeks ago.
TSH at 3 and TTC. Fertile window in approx 1 week.
Increased dose last night after speaking with gp. Now on 150 mcg.
Is it safe to try to conceive in a week’s time? Also if I did get pregnant I know the advice it to immediately increase dose by 25mcg but as I’ve just done this would it be too soon to do that (after approx 4weeks of a 25mcg increase)?
I tested first thing in morning before food, didn’t take any supplements containing biotin for a week beforehand and didn’t take my levo the night before the blood test (I’ve started taking it before bed).
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hashihol
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Does your doctor only test TSH? Because with pregnancy and conception, it's not the TSH itself that is important, it's the T4 - thyroid hormone. The level of the TSH is just a rough guide to where the FT4 might possibly lie. But, it's only a rough guide, so you do need full testing.
I tested first thing in morning before food, didn’t take any supplements containing biotin for a week beforehand and didn’t take my levo the night before the blood test (I’ve started taking it before bed).
So, if I'm understanding this correctly, you left a gap of about 36 hours between your last dose of levo and the blood draw? That is too long, and would give a false low FT4, were it to be tested. You should arrange things so that you leave a gap of only 24 hours if you want an accurate result.
However, if your doctor doesn't even test the FT4 - as a lot of them don't - it wouldn't make much difference to your TSH when you take the last dose, because the TSH doesn't move that fast.
I don't think, if it were me, that I would try and conceive next week, having only been on the increased dose for four weeks. But, if you do decide to go ahead, and do conceive, I think it would be fine to increase your dose at that point.
Agh, so annoying, I wasn't sure how to time taking my dose and having the blood test. As I mentioned I've started taking it at night-time around 12AM before I go to sleep. So yes, you're right, it would have been a gap of around 32 hours between my last dose and the blood test so maybe the TSH reading has shown as higher than it actually is right now. Maybe I should get re-tested with Medichecks now, or wait until this added 25mcg has had time to start levelling out? I'd have to get a Medichecks done as my GP certainly won't re-test before another 6 weeks has passed, even if I explain that I messed up with the timings.
I'm not sure what to do next time I test to make it accurate. Should I book the blood test for the evening so that it's approximately 16hrs since my last dose ? Or should I still test in the morning and just take my usual dose the night before? So tricky working out the correct time to do things!
And sorry I thought I'd added the screenshot of my results but hadn't. I've added it now in the replies to my message. My GP does test T4 too (never T3 or reverse T3 of course). T4 level was 16.2
so maybe the TSH reading has shown as higher than it actually is right now.
No, as I said, leaving 32 hours between your last dose of levo and the blood draw will not have affected your TSH, because the TSH doesn't move that fast. It will only have affected the FT4.
The TSH is affected by the time of day you have the blood draw. If you had it done early morning, then you will have got the TSH pretty much at its highest.
Maybe I should get re-tested with Medichecks now, or wait until this added 25mcg has had time to start levelling out?
Best to wait the full six weeks before retesting.
No point in trying to explain to a doctor the importance of timing when testing, because they just do not understand.
I'm not sure what to do next time I test to make it accurate. Should I book the blood test for the evening so that it's approximately 16hrs since my last dose ?
No. 16 hours is not long enough. You need a 24 hour gap between your last dose of levo and the blood draw. And, the blood draw is best done early morning to catch the TSH at its highest. So, you'd have to count 24 hours back from when you intend to take the blood, and take your levo then. That would mean taking your levo in the morning again, for just that one day. It's a storage hormone, so won't make much difference to anything.
My GP does test T4 too (never T3 or reverse T3 of course). T4 level was 16.2
Absolutely no point in testing rT3, it doesn't give you any useful information. But, it would be nice if doctors tested FT3 because that's normally the most important number.
Your FT4 is pretty low, only 40.71% through the range. So, you really did need that 25 mcg increase, and will need another in the near future. Perhaps not the right time to try and conceive.
Yes, it's crazy, the GP tried to give me an afternoon appointment for the blood draw and I asked if it could be taken first thing in the morning as results are more reliable. She said 'it doesn't matter what time you do the blood test'. I did manage to get it at the time I wanted, but so frustrating there was no knowledge of the factors affecting results!
The average doctor knows nothing about thyroid - they pretend they know everything - maybe they even believe that - but in reality, they know nothing because they just didn't learn about it in med school. And, the factors affecting blood test results wouldn't have been touched on at all in the half hour they spent of the whole endocrin system. So, we just have to learn it all for ourselves and over-ride them as best we can. I've been self-treating for years because I just couldn't stand the ignorance anymore.
I´m no expert on thyroid hormone replacement and conception, but a TSH of 3 is too high, especially if on 150 mcg of levo. As greygoose points out, you need to have your FT4 levels tested as well (24 h after taking levo). But, generally, when people are on a high enough dose of levo, their TSH is closer to 1 or even a bit lower, and never above 2. During pregnancy, you will need more levo during the first trimester before the baby´s thyroid starts producing its own hormones. Unfortunately, not all doctors seem aware of that.
Thank you. Yes, I've read about how you should immediately increase your dose by 25mcg as soon as you have a positive pregnancy test and I'm ready to do that regardless of what the GP says. I had a miscarriage last time and didn't realise I should've been monitoring my levels so much more closely and then it was too late, so fingers crossed I'm more prepared this time. I've got very good and phoning and hassling them to get me tested. Still haven't been successful at being referred to an endo despite the miscarriage!
Are you working on improving ferritin by increasing iron rich foods in your diet
Eating iron rich foods like red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
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.
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