Hi All,
Hoping you can offer some advice.
Recently been told I have sub clinical hypothyroidism (TSH 4.3 and TPO 99.5).
I've been prescribed 25mg of levothyroxine, the GP was resistant but we want to try for a baby soon and so they did prescribe.
Has anyone had any experience with this? Slightly concerned about the effect raised TSH levels and antibodies have on conception, and GPs don't seem very knowledgable...
Any help or guidance would be amazing.
Thanks so much
What was your FT4 & FT3 level? Your previous post says you were hypEr thyroid was that a misunderstanding?
25mCg is half the standard starter dose. Assuming you don’t have underlying heart issue. It eventually replaces level not top up low levels. Retest in 6 weeks to see if further increases are necessary.
TSH should be under 2 nearer 1 and FT4 higher in range, this will support conception and pregnancy.
Did you discuss testing the nutrients which was advised in previous posts - also important if planning pregnancy.
One research studies show high TPO levels do not adversely affect pregnancy if levels are well managed & euthyroid.
Thank you for your quick response!
Yes I had misunderstood before, I am new to all of this and have really found the GPs very unhelpful and hard to get information out of.
They only gave me results for TSH and TPO, I have booked the earliest appointment I can with them to ask for more tests and info (thank you for that help) but the earliest in end of next week... three weeks since booking. Crazy! Hence looking for help in the meantime as I am driving myself crazy 
Their main concern seemed to be with the TPO rather than TSH though? They said my TSH of 4.3 is normal, but antibodies of 99.5 is 3x what they should be.
It's all very confusing!!
Well positive TPO confirmed under-active autoimmune and it is evidence that your thyroid will continue to not produce sufficient levels, it will deteriorate and doesn’t improve.
Your TSH may be in range but at 3 or over your thyroid is struggling. Levels FT4 & FT3 may also be in range but if they are low you will have symptoms and conception & pregnancy not as healthy as you need.
Sorry your GP doesn’t give you much information and help. You might have to be proactive to make sure your taken care of. Learning lots and viewing your own results.
Thanks so much. I have a list of questions for my GP when I can eventually speak to them, including asking for T3/4 and everything else you mentioned getting tested.
It's really frustrating. They weren't even going to treat me until I mentioned that we want a family soon. I'm just worried the TPO levels are too high to ovulate and might mean we struggle to conceive.
Fingers crossed I get more answers from them next week
Free T4 (thyroxine) & Free T3 (triiodothyronine). Free levels are the unbound levels available to the body & more useful information. There’s is also a Total level but you don’t need that measured.
Check out the links ThyroidUK give for conception/pregnancy here:
Make a note of any that say TSH should be below 2.5 for successful pregnancy and give to your GP.
Thank you!
Also request GP test prolactin levels, especially if your periods are irregular
High prolactin can be linked to autoimmune thyroid disease
So you have high antibodies, this is known by medics here in UK as autoimmune thyroid disease.
Technically it’s Hashimoto's (with goitre) or Ord’s thyroiditis (no goitre). Both variants are autoimmune and more commonly just called Hashimoto’s
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
Ask GP for coeliac blood test
lloydspharmacy.com/products...
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Bloating and digestive issues very common when hypothyroid
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
Standard starter dose of levothyroxine is 50mcg unless over 65 years old
Dose levothyroxine is increased slowly upwards in 25mcg steps until TSH is always below 2
Likely to need further increases in levothyroxine over coming months
Pregnancy guidelines
thyroiduk.org/having-a-baby-2/
gp-update.co.uk/files/docs/...
IMPORTANT See pages 7&8 re dose increase in levothyroxine as soon as conception is confirmed
Hello,
I can't help with the information about conception but there will be other people who can.
However when I was first diagnosed as hypothyroid, my TSH was similar to yours i.e. just outside the range and my GP, who I realised didn't know what she was doing with thyroid, was intending to keep my on 25 mcg because she felt that would keep TSH low enough. 25 mcg is not going to help in the long run - I know my dosage had to be gradually increased to a level which would actually affect my thyroid function. She disagreed and I then changed to another practice where I was lucky enough to find a GP who knew what he was doing. Just bear that in mind.
Good luck with your plans for a baby.
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