high free thyroxine and normal tsh.. difficulty to conceive

[Artemisiagent]

hi, I am tryjng to get pregnant for over 2 years. my thyroid tsh is on around 1.5 mU/L with 100 levothyroxine but my free thyroxine is high at 27 pmol/L. I read that for implantation free thyroxine should be in the middle range. what is your opinion on my results?

[Artemisiagent]

just to clarify that I checked all the vitamin and everything is within normal range

[SlowDragon Administrator in reply to Artemisiagent]

I checked all the vitamin and everything is within normal range

Can you add actual results

We need optimal vitamin levels

thyroid levels

You need TSH, Ft4 and Ft3 tested together

Most important result is FT3

Do you always test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

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

Also ESSENTIAL to test both TPO and TG thyroid antibodies at least once

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.

Looking at your previous post you said you had low iron/ferritin

Are you still taking iron supplements

It can take months to improve low ferritin

Any iron supplements should be at least 4 hours away from levothyroxine and 2 hours away from any other supplements

Retest FULL thyroid and vitamin levels 6-8 weeks after each dose change or brand change in levothyroxine or after starting any vitamin supplements (or stopping )

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.

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...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[HealthStarDust]

rcog.org.uk/media/4v3hsepc/...

You might find this helpful. Bear in mind it is only a draft at this stage.

[greygoose]

You probably don't convert very well, and that is why your FT4 is so high. You need your FT4 and FT3 tested at the same time to see how well you convert.

Are you sure it says that FT4 needs to be mid-range to conceive? Are you sure it didn't say at least mid-range? That would make more sense, especially as you're on thyroid hormone replacement.

[Artemisiagent in reply to greygoose]

thanks, ncbi.nlm.nih.gov/pmc/articl... from this artiche for example

[tattybogle in reply to Artemisiagent]

Interesting . Thanks for posting it .

However you must bear in mind that the study looks at people who are not taking levo .

once taking levo we have an altered ratio of T4 : T3 (and an alteration of TSH relative to T4/T3 levels).

Patients on levo (taking just T4 and not getting as much T3 from their own thyroid) will tend to have 'relatively' higher fT4 , 'relatively' lower fT3 , and 'relatively' lower TSH. than people who's thyroid is healthy and producing T4 and T3 for them.

So it's hard to disentangle 'which is causing what' , when so many things are different between patients with healthy thyroids and those taking thyroid hormone replacement.

eg. even of T4 is just as high, there is no way to account for the effect of having a relatively lower T3 than these unmedicated women .

However pregnancy and conception issues aside , there are other reasons to try and avoid an over range fT4 if possible .... recent research is starting to suggest there may be associations between higher fT4 levels and proliferation of (some kinds of) cancer cells.

[tattybogle in reply to tattybogle]

having looked again more carefully , it's not clear if any of them were on levo or not.

they excluded people with previous record of high T4/T3 / low TSH (hyperthyroid)

[greygoose in reply to Artemisiagent]

Well, I haven't read that word for word, but I can't see anywhere that it says the FT4 has to be mid-range for conception. And, when they talk about raised FT3 and FT4, they're talking about Graves'/hyperthyroidism, not high in range FT4 when on exogenous hormone.

Besides, I lost faith in this study when I read this:

Similarly, autoimmune thyroid disease causes antibodies production against thyroid gland and its products – Hashimoto’s disease.

Which isn't true. The TPO/Tg antibodies are not 'against' the thyroid gland. It's not the antibodies which attack and destroy the thyroid. So, if they can get that wrong, what else did they get wrong?