Levothyroxine and FSH (fertility)

[Noworries105]

Hi,

So started levothyroxine on advice of my ivf clinic who said my TSH of 3.5 was high as they aim for <1.5 anyway since October been on Levothyroxine, and now on 25mg and 50mg on alternate days. Over these past 3-4 months, my FSH has risen from 6.5 avg to december of 9.5 and then today January to 20!

I have never had FSH anywhere near these levels, clinic says it’s not related but I am 100% sure it is. I basically want to stop the levothyroxine as I can’t now start my cycle until it drops to <10.

Please can anyone give me some tips on how to do so, as frankly I was fine before and never wanted to take it in the first place.

I have high Anti-TG antibodies appx 125 and normal Anti-TPO.

Not sure but I believe it’s Hashimoto’s.

Thanks guys.

[SlowDragon Administrator]

You need to continue levothyroxine to maintain TSH below 2.5

Thyroid levels should be retested 6-8 weeks after each dose change or brand change in levothyroxine

What are your most recent thyroid results

TSH, Ft4 and Ft3

If you have high TG antibodies this suggests autoimmune thyroid disease

Have you had vitamin D, folate, ferritin and B12 tested

Presumably you are taking pre-natal vitamin supplements

[Noworries105 in reply to SlowDragon]

Awesome! Thank you SlowDragon for your help once again.

I’m going to find an endocrinologist as my body seems to be totally out of sync between my thyroid and my FSH.

[SlowDragon Administrator in reply to Noworries105]

Recommend getting FULL thyroid and vitamins tested BEFORE booking any consultation with thyroid specialist endocrinologist

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine

Exactly what vitamin supplements are you currently taking

Remember to stop taking any supplements that contain biotin a week before blood test

Vast majority of endocrinologists are diabetes specialists

Email Thyroid UK for list of recommended thyroid specialist endocrinologists...NHS and Private

[e-mail]

[Miss81 in reply to Noworries105]

I am experiencing the same as you! Ever since they put me on levothyroxin 50mcg I have not been able to get my fsh to be below 20!!! What is going on here?!! Someone help! How can we fix this high fsh now? What do we do?

[Noworries105 in reply to Miss81]

Hey, so basically it looks like we’re going to reduce our dose right down as to be honest had enough. Either we have good TSH and high FSH or vice versa. Going to go back to 25mg and just see how it goes as we can’t do IVF if FSH is >10.

Looks like will need some immune treatment for the Hashimotos too during a cycle.

[Miss81 in reply to Noworries105]

I am taking T3 now in combo with T4. To see what that does. Hope it will help.

[radd]

Noworries105,

I am surprised your clinic says its not related because typically FSH lowers in hypothyroidism so increasing thyroid levels can initially higher FSH just until levels balance out.

Thyroid hormones and TSH work in an inverse correlation so thyroid hormones need to higher to ensure a low TSH. TSH works in correlation with prolactin and they both commonly raise at the same time, and high prolactin can interfere with ovulation.

Oestrogen highers in the early part of pregnancy and the corresponding increase in transport proteins can bind a small proportion of thyroid hormone meaning we need to be mindful regarding adequate levels.

Therefore, a low TSH is not only essential in ensuring enough thyroid hormone for conception & retention of the foetus but because it also ensures prolactin remains normalised until it naturally rises a bit later in pregnancy in preparation for breast feeding. Therefore, it is important to continue in medicating your Levothyroxine.

Some pre-natal combo supplements are including iodine now as there has been quite a substantial number of pregnant women in England who are iodine deficient which risks being damaging to both mother & baby. As you are taking Levothyroxine which already contains iodine it might be prudent to ask your specialist what type of prenatal supplement would be most suited to you.

Thyroid antibodies may reduce with optimal thyroid hormone meds and nutrients, and may reduce further with a gluten free diet. SlowDragon has given good advice re the rest.

[Noworries105 in reply to radd]

🙂 thank you for this excellent advice. You and SlowDragon are really well versed in this topic, that is clear and really helpful for people in my situation.

I know this sounds risky but I want to come off the levothyroxine for a while and then get back to pherhaps 25mg. Basically our RE put us on Levothyroxine, we took a Medichecks at home fingerprick test about a month later where they upped the dose based on the levels. It’s all been a bit shambolic so I haven’t actually been on a steady dose for 6-8 weeks and my supplements contain biotin so god only knows how my body is is actually doing.

I do know I think pherhaps 25mg alternate days for 8 weeks is a good start, but I need it to reset first if that makes sense as my FSH has doubled in a month and that’s scary.

Any tips would be appreciated.

[radd in reply to Noworries105]

Noworries105,

When it comes to hormones you must give time for levels to rebalance. My synopsis above was a simplified example of how one hormone change causes a whole cascade of change in others.

I can’t comment on the Levo dose reduction without seeing your TFT’s, but lots of switching doses isn’t good, often extending the time until all levels finally settle and your issues are compounded by Hashimotos. Even without ranges your TGAb's don't look massively elevated (some are in the thousands!) but there are immense immune changes during pregnancy & managing Hashi beforehand is likely to help your pregnancy.

I recommend you read a book called ‘Your Healthy Pregnancy With Thyroid Disease’ by Dana Trentini and Mary Shomon, whose 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. Thyroid hormone levels will influence pregnancy hormones and vice versa but the response can be positively altered in women with elevated TGAb's.