Hello All
I have been diagnosed with Hashimotos- I have high thyroid antibody levels
I am waiting to see an endocrine consultant next month - however I am due to start my IVF soon- will the antibodies effect my IVF success ?
Hello All
I have been diagnosed with Hashimotos- I have high thyroid antibody levels
I am waiting to see an endocrine consultant next month - however I am due to start my IVF soon- will the antibodies effect my IVF success ?
Looking at previous post ….last TSH was much higher than 2 maximum recommended for anyone on Levo
TSH should be below 2.5 maximum before TTC
How much levothyroxine are you currently taking
How much do you weigh in kilo
On levothyroxine we always need TSH below 2, many (most?) with Hashimoto’s will need TSH below 1
Most important results are always Ft4 and Ft3, plus GOOD vitamin levels
ESSENTIAL to test Vitamin D, folate, B12 and Ferritin
What vitamin supplements are you taking
High TG antibodies will reduce as TSH drops below 1
High TPO antibodies often reduce slowly on strictly gluten free and/or dairy free diet
Recommended that all thyroid blood tests 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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Before TTC levels need to be stable
verywellhealth.com/infertil...
Pregnancy guidelines
NICE guidelines that if hypothyroid or subclinical you should see endocrinologist BEFORE TTC
cks.nice.org.uk/topics/hypo...
Important See pages 7&8
btf-thyroid.org/Handlers/Do...
Also here - dose increase in levothyroxine as soon as pregnancy test confirms conception
cuh.nhs.uk/patient-informat...
thyroidpharmacist.com/artic...
Low ferritin, low thyroid levels and miscarriage
preventmiscarriage.com/iron...
Low iron and hypothyroid
endocrineweb.com/news/thyro...
Folate and B12 and Neural tube defects and autism
healthunlocked.com/thyroidu...
ec.bioscientifica.com/view/...
Once thyroid levels are OPTIMUM often fertility issues resolve themselves
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here