TSH & Conceiving - Doctor's Appointment

[hairymclarey]

First post as I'm looking for some advice before I speak to my GP!

We've been trying to conceive since August 2024 with no luck. Conceived daughter first time in 2020. Regular periods, have been tested for progesterone which shows I am ovulating.

Underactive thyroid runs in the family (mum's side) and my brother who is in his early 30s has just be diagnosed too...I've started to think this could be an issue for me too. I have symptoms of underactive thyroid including dry skin and brain fog.

I had some bloods taken Jan 2024 for an unrelated issue in which I've just found out (via NHS app) my TSH was 3.36. Now, from what I can see online the optimum TSH for TTC is below 2.5. I have a phone appointment with the Dr next Thursday and want to be armed with the correct info. What blood tests do I need to ask for and if TSH is still above 2.5 can I push for levothyroxine?

I'm mid-30s and worried time is ticking by!

[Buddy195 Administrator]

Welcome to the forum hairymclarey

So we can offer better advice, can you share blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)

In the first instance, do ask your GP for the above tests. We don’t recommend supplementing key vitamins without testing first (and sharing results with us).

If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:

thyroiduk.org/help-and-supp...

[SlowDragon Administrator]

welcome to the forum

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

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

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

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

NHS only tests TG antibodies if TPO are high

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 that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and 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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/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...

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

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

If you’re taking any vitamin supplements that contain biotin stop these 3-5 days before ALL tests

[hairymclarey in reply to SlowDragon]

Thanks for this! So helpful! The blood test from Jan 2024 only included TSH so I will make sure I ask for full thyroid evaluation. I think my mother's hypothyroidism is Hashimoto's but I will ask her for some advice too.