Pregnancy and hyper

[Carebear92]

I am being treated for hyperthyroidism and am delaying original plans for pregnancy because of it not being controlled. Original plan was to start trying in September.

When I started treatment, I thought that it was my FT4 that I was waiting for to become stable. My appointment yesterday revealed that I’m actually waiting for my TSH to come into range. That has been suppressed since May and hasn’t shown any signs of changing since I started treatment.

I was so deflated after my appointment yesterday because it now feels like it’s pushing back our plans even further.

Can any of you wiser ones explain how the TSH level increases and how long it takes to respond to treatment? I don’t understand.

I don’t have Graves, they’re putting it down to subacute thyroiditis I think?

[SlowDragon Administrator]

Strongly recommend getting full thyroid and vitamin testing done

you have IBS and EDS and on gluten free diet

Strongly suggests autoimmune thyroid disease……possibly mix of both Hashimoto’s and Graves’ disease

Have you had thyroid antibodies tested

TSI or Trab antibodies tested for Graves’ disease (hyper)

TPO and TG antibodies for Hashimoto’s (hypo)

It’s possible to have both at same time

Low vitamin levels are highly likely with both

Heavy periods leads to low iron /ferritin

Low vitamin levels and especially low iron/ferritin can lower TSH

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 at least once year minimum

Recommended on here that all thyroid blood tests early morning, ideally just before 9am

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 and money off codes

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

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning.

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

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

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

Graves Disease antibodies test

medichecks.com/products/tsh...

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors 

[e-mail]

[Carebear92 in reply to SlowDragon]

Oh wow, this is so thorough, thank you! Endo said yesterday my TPO and TRAB were both normal, no mention of the other antibodies. Rheum is testing a few other autoimmune conditions, I’ll get results back at consultation in a few weeks.

All my bloods are booked for 8.30-9am so that’s good.

Will look into private testing. He’s ordering another HBa1C test with my next bloods but would be interested in another vitamin test as I don’t think they were complete.

Last ferritin, B12 and folate tests came back normal but can’t see vit D. I supplement with 2000IU vitD every day.

Will give these a read later, thank you

[SlowDragon Administrator in reply to Carebear92]

please add actual B12, folate and iron and ferritin results and ranges

Test vitamin D twice year when supplementing

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

You need ultrasound scan of thyroid - request via endocrinologist or GP

Or £100 privately

thyroiduk.org/help-and-supp...

[PurpleNails Administrator]

Hello Carebear

Was wondering how you were getting on, hope you are feeling better? 

Did you visit GP earlier in week? 

The TSH (thyroid stimulating hormone) is a pituitary hormone which signals the thyroid.  If thyroid levels are low it rises to further stimulate the thyroid & raise levels. Your thyroid levels have risen so the TSH has dropped.  

The medication, if managed right will bring your FT4 & FT3 into range.  Then in time the TSH should respond to levels and rise into normal range. 

Unfortunately that can take time.  Usually a matter a weeks, but after being hyper that can take longer.  If you were hyper for a prolonged time it does get to a stage where it doesn’t fully recover & its remains low.   

My TSH didn’t respond & my levels were kept borderline low for several months.  Doctors suggested I increase carbimazole further based on low TSH - but agreed to keep it the same after I pointed out the low FT4 & FT3.  That’s been 4 years. 

 So Doctors do tend to focus on the TSH, but if trying to force a response by keeping FT4 & FT3 very low long enough - you could feel very unwell with too low a thyroid level. 

Obtain actual results (for all results) and antibodies.  My guess is doctors has tested TPO and tGab but as they are negative not tested further. tRab should be been tested also. 

Good idea to test HbA1c and all nutrients.  Privately if Doctor won’t test everything.  Doctors usually suggest delaying TTC until anti thyroid is stopped & levels stable.   PTU is considered safer during pregnancy, so you are already on the best option.  

[Carebear92 in reply to PurpleNails]

Hiya,

I’m okay thanks. I spoke to the GP (at 10.25) who basically told me I should have gone to a&e for bloods but then found me an appointment (at 10.40) so I got them done and WBC is fine. So I went to the pharmacist as this GP also didn’t care about treating my symptoms. Pharmacist was wonderful, gave me anti fungal gel and all is improving finally!

That all makes sense, thank you! They have tested TPO and TRAB and doesnt sound like they will be doing any more antibodies. I don’t have the TRAB results on my record so can’t remember what he said the results were. He warned of going into hypo so I’m alert to it, but having bloods every 4-6 weeks for the foreseeable. Hoping that doesn’t happen and it’s smooth sailing… HA, likely.

Yeah, I requested the PTU for that reason. I’m just deflated because I’d expected to be stable by January and TTC in March but that doesn’t feel likely now at all and he didn’t seem to care, it was very black and white to him.