Looking for some help/guidance/support. Apologies in advance for the long post.
My husband and I, both 31 and healthy, have been trying to conceive for a year now with no success. We've both had a number of tests and through my own reading and persistent private re-testing have identified my thyroid could be a potential issue. Although I do have regular periods and ovulate.
My TSH levels have fluctuated in the last 6 months from 0.083 (March) to 4.71 (October), with a number of other results between 3 - 4 in the months between.
My T3 and T4 results have been tested a few times also (only when going private as NHS/GP won't) and they have been around 4 (T3) and 14 (T4). My most recent (October) T3 and T4 results were 4.4 (T3) and 14 (T4), this was with the above-mentioned October TSH of 4.71.
In September I tested positive for TG antibodies with a result of 106.
The lab reference ranges have been 3.1-6.8 (T3), 12-22 (T4), 0.27 - 4.20 (TSH) and <40 (TG antibodies).
I had my bloods taken just before 9am, fasted and had stopped taking vitamin supplements a few days prior.
In September i was also tested for a number of other vitamin deficiencies including B12, Serum Folate, Sodium, Potassium, Ferritin, Vitamin D etc and all were at very good levels (can share exact results/ranges if helpful). That said, I have very recently started taking Vitamin D, Iron, Iodine, broad range B vitamins, B12, Zinc, Vitamin C and Magnesium supplements (in additional to my daily folic acid).
I was also Coeliac screened in September which showed no issues, my result was 1.9 and the reference range was <20.
My father was diagnosed with hyperthyroidism around 20 years ago when he was 45 and heavily symptomatic, he ended up having his thyroid destroyed and has been on daily thyroxine ever since. He does not know/can't find medical records that confirmed the root cause of his.
Other than struggling to conceive, I have no identifiable symptoms.
Thankfully I have private medical insurance through work and have been able to have a number of these blood tests via a private endocrinologist who has diagnosed me with auto-immune thyroid disease and recognises optimum TSH levels for trying to conceive are lower (<3.5, possibly closer to 2.5) and based on my latest October blood results has started me on 50mg of Thyroxine. He has said that it is usual to see with Hashimotos the thyroid function jumping from under to over and back again before settling longer term as permanently underactive, but this could take a number of years still before it does this, therefore starting the medication now is sensible.
However my GP refuses point blank to continue the prescription, repeat blood tests or refer me to an NHS endocrinologist given my TSH levels are in their 'normal range', even though they know we have been struggling to conceive for a year (they were so condescending, rude and unhelpful to me at my appointment that I cried). I have taken many reference material in with me including from SAGE journals, Thyroid Association and Thyroid UK regarding TSH ranges for conception and healthy pregnancies but it made no difference. Therefore it looks like I will have to continue with a private prescription and testing, not ideal but something I am willing to do this if it results in a healthy pregnancy.
The last thing I want to add on this is that I have now had a pelvic ultrasound just after ovulation which has confirmed that my uterine lining is breaking down earlier than it should, most likely due to a lack of progesterone. I am ovulating (as confirmed by pelvic scan) but I typically ovulate around day 18-20, with cycles usually around 33 days. I've not yet had a progestrone blood test to confirm exact levels but the sonographer and gynecologist were very certain low levels of progestrone were to blame for my lining breaking down after ovualtion. They have therefore recommended mild letrozole for ovarian stimulation prior to ovulation and progestrone (cyclogest) pessaries post ovulation (and well into my pregnancy if I fall). I mentioned my thyroid issues to them and they said there is a link between thyroid disfunction and low progestrone levels but I could still take thyroxine and the drugs they have recommended together.
So really I think my questions are:
1. Does anyone have any experience with underactive thyroid/Hashimoto's and struggling to conceive, particularly with low progesterone/thin lining also being detected?
2. Given I have only just started on Thyroxine, should I give it 4-8 weeks and see if the Thyroxine alone results in the progesterone/lining improving or should I just go for it all at the same time?
3. Any other general guidance/support you think useful based on what I have said above. Similar stories and positive TTC outcomes particularly welcome !
Many thanks all. Sorry for the length, appreciate anyone taking the time to read and reply. Just feeling very lost and alone on this journey as am seeing different doctors on different issues and trying my best to piece it altogether and work out best next steps.
Written by
er2012
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I'm so sorry you're having these problems with a dumb, ignorant GP. It's so frustrating, isn't it! I'm afraid I can't answer any of your questions, but I would like to comment on your supplement routine because it's very important to get that right.
Vitamin D: should be taken four hours away from, with magnesium. How much are you taking? Important not to over-dose. It would be useful to post all your nutrient test results and ranges to make sure you're taking the right amount. Are you also taking vit K2-MK7? This is important because taking vit D increases absorption of calcium from food, and the K2 makes sure that the extra calcium goes into the bones and teeth, and doesn't build up in the soft tissues and arteries.
Iron: this should also be taken at least four hours away from thyroid hormone AND two hours away from everything else except vit C, which should be taken at the same time as iron.
Iodine: did you get iodine tested first before supplementing? Iodine should never be supplemented unless you are deficient. And even then only under the supervision of an experienced practitioner. Excess iodine is not a good thing, especially when hypo.
Broad range B vitamins: I take it you mean a B complex? Which one are you taking? They're not all good.
Zinc: did you get both zinc and copper tested before supplementing? The two should be balanced, but hypos often have one high and the other low, so best to know which is which in your personal case.
Folic acid: folic acid is synthetic folate, and not the best form to take. Methylfolate it better for most people.
I mentioned my thyroid issues to them and they said there is a link between thyroid disfunction and low progestrone levels but I could still take thyroxine and the drugs they have recommended together.
Well, not literally together - i.e. at the same time. Thyroid hormones should be taken on an empty stomach, one hour before, or two hours after eating, and at least two hours away from all other supplements/medication - except the ones mentioned above, which should be four hours away.
Thank you for your reply. It is much appreciated. See attached for my vitamin results my endoc tested for in September.
The information you have provided on the vitamins is very interesting and I will need to rethink how/when I take some of them. I will respond to each of your questions below.
Vitamin D: should be taken four hours away from, with magnesium. How much are you taking? Important not to over-dose.
I am taking 1,000 IU each day as recommended by my endoc. To clarify do you mean that Vitamin D should be taken hours away from Magnesium i.e. not together? If so I am not doing this so will start doing so.
It would be useful to post all your nutrient test results and ranges to make sure you're taking the right amount.
Results attached.
Are you also taking vit K2-MK7? This is important because taking vit D increases absorption of calcium from food, and the K2 makes sure that the extra calcium goes into the bones and teeth, and doesn't build up in the soft tissues and arteries.
No I am not taking K2-MK7. What is the recommended dose please?
Iron: this should also be taken at least four hours away from thyroid hormone AND two hours away from everything else except vit C, which should be taken at the same time as iron.
I take Iron and Vitamin C together (Iron-C) and hours away from Thyroxine. However I do take Iron-C with other supplements, such as Magnesium so I will look to start taking this on its own.
Iodine: did you get iodine tested first before supplementing? Iodine should never be supplemented unless you are deficient. And even then only under the supervision of an experienced practitioner. Excess iodine is not a good thing, especially when hypo.
Yes, was full vitamin tested by a Biochemist/Naturopath/Applied Kinesiologist who said I was Iodine deficient (along with Iron, B12 and zinc). I now take 225ug per day.
Broad range B vitamins: I take it you mean a B complex? Which one are you taking? They're not all good.
Yes, as a magnesium powder supplement. See all that is included below. In addition I also take a standalone B12 methylcobalamin (1000 ug per day).
Zinc: did you get both zinc and copper tested before supplementing? The two should be balanced, but hypos often have one high and the other low, so best to know which is which in your personal case.
Yes, via the biochemist I mentioned above. Copper I was fine but Zinc I was deficient.
Folic acid: folic acid is synthetic folate, and not the best form to take. Methylfolate it better for most people.
Noted. I will look into this.
I mentioned my thyroid issues to them and they said there is a link between thyroid disfunction and low progestrone levels but I could still take thyroxine and the drugs they have recommended together.
Well, not literally together - i.e. at the same time. Thyroid hormones should be taken on an empty stomach, one hour before, or two hours after eating, and at least two hours away from all other supplements/medication - except the ones mentioned above, which should be four hours away.
Noted. I take Thyroxine just before bed on its own. The progesterone drugs they have recommended would be internal pessaries that I use in the morning.
To clarify do you mean that Vitamin D should be taken hours away from Magnesium i.e. not together?
Sorry if that was a bit vague: they should be taken at the same time.
No I am not taking K2-MK7. What is the recommended dose please?
About 150 mcg a day.
Broad range B vitamins: That is not a good supplement. It contains calcium. I cannot see any result for calcium testing in your results, and it's somewhat doubtful that you actually need to take it. Excess calcium is not a good thing, and calcium supplements are difficult to absorb and tend to build up in the arteries.
Also, it contaisn vit C which will negatively affect how your body uses B12 - no point in taking masses of B12 if your body cannot use it.
Are you taking selenium with your iodine? The two work together. I can't see any iodine level in your results. Nor vit D or iron, come to that. We do have to be so careful not to over-dose on these things.
Did you know that you will be getting about 33 mcg iodine from your levo every day? Have you taken that into account when calculating your dose of iodine?
Vitamin D is in the attached, the result is 95 but the endoc has still advised I take a daily supplement.
The other results (Iron, Iodine, B12 and Zinc) came from testing from a biochemist which I don't have a copy of the full results, will try and obtain and post. However this was all before I started Thyroxine. Do you think it is best to stop all supplements for now and go for full re-testing in 4 weeks once the Thyroxine kicks in and see what I may / may not need?
Yes, was full vitamin tested by a Biochemist/Naturopath/Applied Kinesiologist who said I was Iodine deficient (along with Iron, B12 and zinc). I now take 225ug per day.
Click on "Read the list of available tests" and on page 3 of the pdf you'll see
Urine Iodine Test:
Specimen requirements: Urine
Cost: £71.00
Order Code: END25
Turnaround time: 5 - 10 days
Iodine is an essential trace element, vital for healthy thyroid function. Adequate levels are required to enable the production of T3 and T4 thyroid hormones, whilst also being required in other areas of health.
Deficiencies can lead to impaired heat and energy production, mental function and slow metabolism. Urine iodine is one of the best measures of iodine status. This test is not performed as a loading test, but can be used to establish existing levels or to monitor iodine supplementation.
thank you humanbean !! I have seen all of your replies on my other post. A lot of information that I am still trying to digest it all but thanks ever so much. You have a lot of knowledge and have made me feel so much better than my awful GP did.
I don’t have much advice with the technicalities of it all but can share my fertility journey ….
My first pregnancy resulted in miscarriage … I believe from seeing a GP that didn’t immediately up my levothyroxine.
Since then I am lucky to have conceived and carried 2 healthy babies … with the GP managing the levels straight away … both took over a year to conceive. Oh
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