Hi All, my daughter has auto immune hypothyroidism. She is struggling to conceive. Could these be related?
many thanks
trying to get pregnant : Hi All, my daughter has... - Thyroid UK
trying to get pregnant
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BRITT1DENMARK
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SlowDragonAdministrator
Very likely
Ask her to join the forum
Does she always get same brand of levothyroxine
She needs FULL thyroid and vitamin testing
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
Essential to test vitamin D, folate, ferritin and B12
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements is she taking
Also VERY important to test TSH, Ft4 and Ft3 together
What is reason for her hypothyroidism
Autoimmune?
assuming autoimmune…is she on gluten free or dairy free diet
There's every chance, fertility is affected by thyroid issues. As she has a diagnosed problem then as Slow Dragon says she needs everything checking. A friend of mine's daughter got to her 40s struggling to become pregnant. By sheer luck she was invited to join a new research project where they discovered she was hypothyroid, treated her and she had a son.
Thank you for your reply
SlowDragonAdministrator
sorry should have read previous post first
Suggest you retest thyroid and vitamin levels
healthunlocked.com/thyroidu...
Her ferritin was extremely low
Folate low
Aiming for ferritin at least over 70 and nearer 100 may be better
Is she now on Gluten Free diet
Hi thank you, we’ve just retested. Waiting for results. No she isn’t gluten free. Do you think she should?
I’ll upload results when they come. Thanks for your reply
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
Some members who were TTC have found success in conception after cutting gluten out
gluten intolerance has no test available
leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Trying gluten free diet for at least 3-6 months.
If no noticeable improvement then reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
pubmed.ncbi.nlm.nih.gov/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Post discussing gluten
healthunlocked.com/thyroidu...
Recent research in China into food intolerances with Hashimoto’s
healthunlocked.com/thyroidu...
More interesting Chinese research on Hashimoto’s and leaky gut
nature.com/articles/s41598-...
Why gluten intolerance can upset cortisol levels
kalishinstitute.com/blog/gl...
Thank you so much for your in-depth reply. These are her results
TSH 2.86. 0.27-4.2
Thyroxine 16.30. 12-22
Triiodothyronine 4.6. 3.1-6.8
Vit D. 179
Ferritin 27
Active B12 94
Folate 7
Ferritin is deficient as under 30
Folate low
Vitamin D a bit high
What vitamin supplements is she taking
Hi she takes folic, iron, b12, Vit d and zinc
She’s on 150mg levo and weighs 72kg
Is she taking iron at least 4 hours away from Levo and 2 hours away from other supplements
Vitamin D tablets or gels need to also be four hours away from Levo
Vitamin. D mouth spray only needs be approx an hour away
Rather than taking just B12 and folic acid…look at adding Vitamin B complex instead of folic acid
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
In-depth article on different forms of B12
perniciousanemia.org/b12/fo...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
perniciousanemia.org/b12/le...
And why aiming to keep B12 over 500 recommended
perniciousanemia.org/b12/le...
Great reply by @humanbean on B12 here
healthunlocked.com/thyroidu...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
what iron supplements is she taking and how long has she been taking them
Are they prescribed by GP
retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 3-4 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
monitormyhealth.org.uk/anae...
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Ferrodyn supplement
healthunlocked.com/thyroidu...
Iron patches
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue
healthunlocked.com/thyroidu...
Hi, the iron and Vit D is prescribed by the doctor. She takes all her supplements at the end of the day, her meds in the morning. She didn’t know she should leave 2 hours between iron and other supplements. Also didn’t realise about biotin affecting tests.
Many thanks for your in-depth reply.
She’s going to call GP with these results. As her TSH isn’t below 2.5 which I believe is needed for fertility and also high Vit D levels. Fingers crossed she’ll get referred to an endocrinologist.
Once again thank you so much
she’s currently on significantly higher dose than guidelines of 1.6mcg per kilo of your weight per day
Yet her thyroid levels are low
Unless she’s not taking levothyroxine consistently, this suggests malabsorption issues
She needs investigation for
Coeliac, SIBO, H Plori etc etc
academic.oup.com/edrv/artic...
And paper discussing Levothyroxine malabsorption or pseudomalabsorption? A question in the management of refractory hypothyroidism
pmc.ncbi.nlm.nih.gov/articl...
Thank you, I will have a read
was test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
Free T4 (fT4) 16.3 pmol/L (12 - 22)
Ft4 only 43.0% through range
Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8)
Ft3 similar at 40.5% through range
Her results are on low side
How much levothyroxine is she taking
How much does she weigh in kilo
She did the test as recommended
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