Questions and Considerations for Preconception Endocrinologist (NHS)

[HealthStarDust]

*For anyone planning a pregnancy it is worth repeating that any woman with hypothyroidism including subclinical hypothyroidism should be referred for an endocrinologist preconception appointment. It’s not mentioned at all in the NICE Guidelines but can be found here on the CKS cks.nice.org.uk/topics/hypo... (so, don’t be surprised if your GP hasn’t heard of this).*

Hello Lovely Folks,

It was the circumstances of my last pregnancy that had brought me to this website. And, since then, I have had to learn fast from the wealth of knowledge on here. And, I’d like to pick your brains once again in view of my upcoming appointment with an endocrinologist for preconception advise.

Despite researching, I have no idea what to expect. The best I have found is some USA based YouTube videos, but I doubt these are the best comparisons.

To make the most of the appointment, as I believe it is a one-off appointment, I’d like your input on how best to approach it and what questions or considerations I should have for them.

I have read numerous mentions of trimesters specific ranges in pregnancy, but, I have been unable to find what these are. So, I’d be very grateful if you could share these.

FYI currently on Levothyroxine only, and increasingly slowly to optimum dose. Awaiting latest TFT and other results. Previous results on TFT and others can be found previous posts if needed (the April posts).

Finally, wishing you well in your journeys.

[SlowDragon Administrator]

Really useful link

Thank you for posting

[HealthStarDust in reply to SlowDragon]

Your welcome.

[humanbean]

I would suggest that you get as many of your vitamin and mineral levels tested and optimise as many of your levels as possible before conceiving.

Lots of people are aware that low folate in the mother can cause Neural Tube Defects (NTDs) in the offspring. Women are usually treated with folic acid to reduce the risk of NTDs. But in women with MTHFR (methylation) problems folic acid should be avoided and women should take methylfolate instead. Bear in mind that folic acid wasn't developed until 1943, so humans were reproducing successfully without it before then using the folate found in food i.e. methylfolate.

It isn't so well known that low B12 can also increase the risk of NTDs and hydrocephalus.

Source : obgyn.onlinelibrary.wiley.c...

Low vitamin D in the mother increases the risk of problems for both mother and child.

Adverse health outcomes such as preeclampsia, low birthweight, neonatal hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases have been linked to low vitamin D levels during pregnancy and infancy.

Source : sciencedirect.com/science/a...

Low levels of iodine can reduce IQ and increase the risk of hypothyroidism in the fetus.

hindawi.com/journals/jtr/20...

Low levels of selenium can cause problems too. I think there is a relationship between selenium and iodine. People who need more iodine need selenium to process the iodine - but take that info with a pinch of salt, I can't remember where I read that.

pubmed.ncbi.nlm.nih.gov/251...

Low levels of iron make pregnancy harder for the mother and increase the risk of low birthweight in the baby, plus other problems :

onlinelibrary.wiley.com/doi...

Vitamin C is important too :

scholar.google.co.uk/schola...

Use these sites to find research papers on conception and pregnancy :

scholar.google.co.uk/schhp?...

pubmed.ncbi.nlm.nih.gov/

...

I could probably go on a bit longer and suggest taking vitamin C, the other fat soluble vitamins, and other minerals but I haven't done the research. You could do it!

Here is a list of all the vitamins and minerals the human body needs. How relevant they all are to conception and pregnancy, and how likely it is for people to be low in them, I couldn't say.

en.wikipedia.org/wiki/Vitamin

en.wikipedia.org/wiki/Miner...

Good luck.

[HealthStarDust in reply to humanbean]

THANK YOU SO MUCH!

Similar minds. I’ve arranged for full TFT and key nutrients test ahead of the appointment.

I’ll also discuss with the Endocrinologist.