Thyroid and fertility

[Flanger90]

Good afternoon

I'm hoping someone will be able to help me as I'm after some advice from those who are knowledgeable on thyroids after not getting very far with the GP. Sorry for the long post, I'm just giving my history.

Back in 2020 we had been trying to conceive for well over a year, we had been referred to fertility specialists but my GP arranged other bloods and my husbands analysis whilst waiting for a referral. I had long, irregular cycles (around 32-38 days) with heavy periods and short luteal phases. All my bloods came back ok apart from my TSH was 3.7, so my amazing GP put me on 50mcg of levothyroxine as he said any fertility clinic would want my levels to be at least below 2.5. Soon after starting levo my ovulation happened a week earlier than all previous cycles (I had been tracking properly for about 12 months), and I conceived and had a healthy pregnancy and now have a son who is 16 months old. My consultant during pregnancy said they like it to be nearer to 1 for fertility and agreed the thyroxine likely helped conceive.

I had a blood test about 3 months after having my son, and my TSH was 2.9 and the GP stopped thyroxine, saying it was no longer necessary and to get tested again when trying for number 2. (I had changed GP surgeries). We are now trying for number 2 and my recent results were TSH 2.4 and FT4 15.9 (this I know absolutely nothing about), so both are in the normal range and the GP wouldn't enter into any discussions about it.

Can I ask if anyone thinks I should look into this further? My cycles are still very irregular (although I know they take ages to settle after breastfeeding), but my last cycle was also long and luteal phase was only 7 days (so very little chance of conceiving).

I know 2.4 is under the 2.5 threshold for fertility, but I would need it checking in early pregnancy anyway wouldn't I?

I am just anxious to avoid another 18 months of struggling to get pregnant if it could be as simple as taking a low dose of levothyroxine, I truly believe this is what gave me our son.

Any advice is much appreciated!

[SlowDragon Administrator]

Definitely

Get FULL thyroid and vitamin testing

Vitamin levels are as important as thyroid

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

plus both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

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...

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 Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

come back with new post once you get results