TSH results for fertility treatment

[On_a_mission]

My TSH results are 3.05 mU/L. I had this test done by my NHS miscarriage Dr. The NHS considers the standard range as 0.35 - 5.50 mU/L. The Dr said we should keep an eye on it but no need to medicate for now. To give some context, this Dr has been excellent and I trust her judgment. My private fertility clinic Dr has not given me the same confidence however. Upon sharing my TSH results the fertility Dr was concerned and recommended medication. I protested and asked for some supporting evidence. They simply said it is clinic policy that it should be less than 2.5mU/L, and that different institutions can have different policies. They didn’t understand why I was upset with the conflicting advice I had been given about starting life long medication and it’s relevance to a successful pregnancy. I’m conscious that the clinic probably profits from a private prescription and that an NHS prescription probably costs the NHS. The clinic did offer me an appointment with the medical director to discuss this further. Does anyone know about TSH and fertility treatment??

[greygoose]

The TSH itself has no bearing on fertility. It's just an indication of thyroid status. And, a TSH of over 3 indicates low thyroid hormones, and therefore hypothyroidism causing infertility. Even 2.5 is too high, in my opinion, because it indicates that the thyroid is struggling and could start to fail at any time. Even if you weren't trying to conceive, with a TSH over 3 you should be on thyroid hormone replacement for your own health and well-being.

Just my opinion. I know some people would disagree.

[On_a_mission in reply to greygoose]

Thank you, I will look into how optimal ranges are determined more.

[greygoose in reply to On_a_mission]

On that subject, this article might interest you;

pmj.bmj.com/content/94/1117...

Where thyroid hormones are concerned, there's no such thing as an 'optimal range'. Optimal is where you feel well and your symptoms are gone, it's not a number. Blood tests are just a rough guide. We're all different, and all need different levels. Once, your TSH gets down to 1, the test is no-longer very useful. It's how you feel that counts.

[SlowDragon Administrator]

If you were already on levothyroxine then TSH should always be under 2.5, but especially before TTC

Some medics therefore say everyone should have TSH under 2.5 before TTC

Others say your not “sub clinical “ until TSH is over 5

All thyroid tests should be done early morning

Was this test done early morning

Have you had thyroid antibodies, Ft4 and Ft3 and vitamin levels tested

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

Low vitamin levels are extremely common, especially with autoimmune thyroid disease usually diagnosed by high thyroid antibodies

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

graph of healthy population showing median TSH is 1-1.5

healthunlocked.com/thyroidu...

[On_a_mission in reply to SlowDragon]

Thank you. I was not advised to do the test first thing but did it mid morning. TSH was tested alongside all the other tests the miscarriage clinic does as standard. Unsure if a full thyroid evaluation was done. My vitamin D is low so I’m taking supplements now.

[SlowDragon Administrator in reply to On_a_mission]

So TSH would have been higher if tested at 9am

How low is vitamin D

How much vitamin D are you now taking

What about folate, ferritin and B12 results

[SlowDragon Administrator in reply to On_a_mission]

Essential to test iron and ferritin levels

Good article explaining the link between low thyroid levels and low ferritin

preventmiscarriage.com/iron...

What’s your diet like….are you vegetarian or vegan?

[humanbean]

Personal anecdote :

I was referred to an IVF Clinic back in the 90s. I was told during my first round of treatment that my thyroid was "borderline underactive" but that they decided I didn't need treatment.

I ended up over several years getting pregnant three times via IVF and losing all three at an early stage. I am convinced that my under-performing thyroid had something to do with the losses. I am also convinced that my nutrient levels, particularly iron and ferritin, were poor, and this probably contributed to my losses too.

If you want to get pregnant then I would suggest that you optimise as many things as you can, and that includes your thyroid hormone levels, your nutrient levels, and your gut health (which is often poor in people with poor thyroid health).

[Delgor in reply to humanbean]

I just couldn't bring myself to click on the like button after hearing such a sad story - hope so much that things worked out for you eventually and that you had a happy ending after so much anguish!

[On_a_mission in reply to humanbean]

Thank you for sharing your story x

[1Cazza]

The NHS keeps us alive but not optimal, join some more groups for other nutrients you will soon find a huge trend of people trying to find answers to why they are not feeling good yet their NHS serum blood tests say otherwise. In range is not optimal and a lot of the people on here and the other sites have struggled for years trying to find out what is wrong when it was there all along in the NHS huge one size fits all range. Of course its up to you no one can make you do anything you do not want to. I have hypot. B12d. both undertreated on NHS and now have to supplement the meagre amount the NHS allow B12 and I buy my thyroid meds as NHS ones do not suite me and they will not fund what i need.

[On_a_mission]

Yes I agree the NHS keeps us alive not optimised, and the fertility clinics will clutch at any straw! It’s frustrating being the patient in the middle.