Thyroid levels and ttc

[Waggamamma]

I've been having a few health issues recently so asked for my thryoid to be checked. I had full bloods taken and everything came back as 'satisfactory. '

TSH levels were 3.68. Can anyone tell me what this means and the implications for ttc? From what I've read it need to be under 2 to sustain a pregnancy? Should I be pressing the doc for meds or more tests.

I had a miscarriage in June at 9 weeks (pregnancy measured 6), and wondering if it could be linked.

[mawinter]

Yes, it needs to be 2 and under to sustain a pregnancy. I recently had a level around yours and then it went down a bit, but not much and my doctor put me on L-Thyroxine to help get it lowered. Within a week I felt great and now my level is down to 1.77 at my last check. If I were you i would push for meds.

[Waggamamma]

Thanks. that's what I thought. I will make a docs appt next week. I hope they give me meds and it's not a battle because I'm still within the normal range.

[blamber]

It's not a definite 'if your levels are under 2 you won't sustain a pregnancy'. What is important is how you feel. Look up the symptoms of underactive thyroid and see if you recognise any. If you do, then go back to the GP and he might put you on a low dose of levothyroxine to see if it improves.

The thing is, this level might just be fine. It's borderline normal, so for some people it will not cause any symptoms, but for some it might. Everyone is different. I would not worry about your level at the moment, and I wouldn't link your miscarriage to it, this could have been for any reason. Only if you think you have other symptoms go back to the GP. If you take levothyroxine without needing it, you might get hyper, which can give you bad symptoms.

[mawinter]

blamber while it is not a definite and may be borderline for some people, having a level of over 2 when trying to conceive can actually cause a whole host of issues, which is why it is generally recommended to have this level under 2.

natural-fertility-info.com/solve-thyroid-problems-before-conceiving-a-baby.html
thyroid.about.com/b/2009/02/26/pregnant-thyroid-fertilityhtm.htm

[Waggamamma]

Thanks, I do have other symtoms, that's why I asked for a test. Mainly lethargy and complete lack of energy but I'm also contantly cold, gained a weight in the last year, heavy periods.

I also suffer from stomach pain which doctor thinks may be endometriosis.

I'm going to phone for a docs appointment on Monday to discuss the results.

[DearDinah]

Can I ask how you got on? I think I have thyroid problems but don't have a blood test until the 30th

[cosysocks]

My doc has repeated my tests as she said they vary quite often therefore it's important to have more than one test. Could you ask to be tested again?

[Waggamamma]

I've just been to gp to discuss my results. She said with a level of 3.68 they definitely wouldn't look at taking any action. She tried to reassure me and said that many women get pregnant with levels over 2 and because it's not a routine test we just don't know how many . She wouldn't prescribe unless levels are around or over 5.

I think she thought I'm a wee biy crazy with ttc as I've been woth various things over past few months. First gp I feel is taking me seriously though.

[DearDinah]

Could you look at a change in diet to help? I've been seeing a nutritionist to try to level out my hormones through diet (40+ cycles, crazy mood swings, acne) the doctors said they wouldn't do anything until it's been a year of trying (June) but times not on my side (MIL terminal cancer) so took things into my own hands. The diet is hell, I won't lie! No sugar, dairy, yeast, lots of good fats, protein, veg, veg, veg! No alc

[DearDinah]

Oops, no alcohol, mostly water & green tea. I'm oil cleansing using sweet almond oil & tea tree and today I think for the first time in months my skin is looking better, I'm not as tired as I was, jury's out on my cycle length, currently CD20, but had a couple of high fertility days on CBFM, just waiting to see it turn into peak (fingers crossed).
It's not for the faint hearted this way, but without the support from a GP at a time I most need it, I'm doing the best I can myself. Don't give up!

[Waggamamma]

Thanks for the advice deardinah I definitely plan to eat better and exercise more after xmas is over, I'm doing bits just now but could be better!

[Eletheomel]

Just come accross this thread. Wagamamma, you might want to read this: www.british-thyroid-association.org/info-for-patients/Docs/TFT_guideline_final_version_July_2006.pdf then discuss it with your GP again. Did she tell you your free T4 reading as well as your TSH? If it was me, I'd ask for a second opinion.

[Waggamamma]

I think my t4 was taken but I don't know the number. I will call and ask for it tomorrow.

I have scan read that link. Thank you. It didn't give reference to optimum levels or ranges?

I'm not really sure where to go from here. This is the first gp I feel has taken me seriously and I don't want to question her judgement too much. I have a lot of abdominal pain and gynae symptoms which she is taking seriously and I would rather get to the bottom of that first iyswim? She said it would be quite unusual to see someone with a tsh of under 2.

Maybe I'm searching for answers to a problem that doesn't exist for me?

As I've been ttc for under a year (since feb and a mc in that time), have had a successful pregnancy before and am 'young and healthy' she seems quite convinced I will be pregnant soon. I hope she is right.

[Eletheomel]

Waggamamma, agree that as you've only been ttc-ing for under a year and your young, you're no way near the 'worry' stage yet (most couples (about 95%) will conceive within 3 years of ttc-ing, and as you've already fallen pregnant, its very early doors for you). I would say though, that not having your thyroid working properly does increase the rate of early miscarraiges (which is why it's important to get your thyroid levels checked as soon as you discover your pregnant, if you know you have hypothyroidism or are sublinical)

Read pages 39-40 of the document I sent, you'll see they recommend a TSH level of 0.4 - 2 in pregnancy, and that T4 should be at the top of the range.

I was diagnosed with an underactive thyroid (although technically subclinical) when ttc for No1, I've been through 2 pregnancies (under consultant care) and my TSH was kept to beneath 2 throughout my pregnancies.

My first GP (who was great) told me that in woman ttc, subclinical hypothyroidism is a factor and that studies have shown that thyroxine therapy in subclinical women ttc - does improve the rates of pregnancy.

A lot of GPs are clueless about thyroxine and pregnancy or ttc - I've had to refer GPs to the guidelines and advice my consultant gave me, as they were unaware of it.

However, this all depends on what your T4 reading is, if that's at the top of the range already, that may be why your GP is loathe to go down that path (given that once you're on thyroxine, its a lifelong condition and you're on it for life).

[Waggamamma]

Thanks for the info eletheomel.

I called docs today and they didn't have a result for the t4, only tsh.

how can I point my gp to the guidelines without sounding patronising?

[Eletheomel]

Waggamamma, I think waiting's approach to the guidelines is a good one.

One thing I would say though is that they would have taken your T4 result (they need it as the TSH on its own is worthless) but they probably haven't left that for you to get via the phone.

I know at my practice they only have the TSH when I phone up for my results, however the full results are there in my medical records so if I don't get it, I ask for a telephone consultation with my doc (or get an actual appointment).

I'd be beyond shocked if they've sent your bloods to the lab and the lab hasn't sent them your T4 levels, more the case they think patients are too dumb to know what any of it all means so they don't bother getting the receptionists to tell you...

[naty1]

Did you manage to get treated for hypothyroidism?
If not you could consider visiting a fertility clinic privately.
My tsh was 3.7 for this round and they have asked my gp to get it below 2.5
I will have to see on next round if that has worked.
Tbh I don't feel any warmer, have actually gained weight etc so not sure if it would fix these issues for you but might help ttc

[Worrieddd]

This is a really interesting thread.

I've been feeling really tired recently, been to the GP, my TSH came back as 2.25. Doctor said definetly no action. Would you consider this figure as high or borderline?

I'm TTC 5th month after late miscarriage

[angelgabe]

I had my levels check a week ago....my TSH is 13.6 but GP has said no action. As it turns out my T4 is within normal range which makes me sub-clinical and I have no symptoms. I have had a very good talk with my GO and gone equipped with medical papers I found on Medline but she has told me she cannot give me any meds. She and my acupuncturist have said they both believe my miscarriage in December was not as a result of my TSH as baby wouldn't be making such demands on me that early. I've been referred to a fertility clinic and they have both also said they will probably put me straight on levothyroxine. I asked my GP to put me on it straight away (don't get me wrong do'nt want to be on medication for the rest of my life!) but she wouldn't.
Hope my referral comes through quickly!

[naty1]

Worried
Do you have any hypothyroid symptoms?
Short lp?
The baby doesnt make own thyroid stuff until second trimester so until then it uses yours.
You could try taking your body temp first thing in morning at start of cycle . It would be low.
Angel
Really that seems very high. Could you get a printout. On mine that would have shown as abnormal as the lab use tsh of up to 4.
The fertility clinic if they put you on thyroxine will then probably want it to take effect before you do anything else.
If you are on thyroxine they usually up the dose at the start of pregnancy I believe as the demands are higher.

[Worrieddd]

Thanks for replying naty

My only 'symptom' would be feeling cold lately and dry ish skin. My luteal phase is bang on 14 but sometimes I do spot up to 3 days before AF, which would still make my luteal phase 11 days.

It's just so confusing. I have been referred to a fertility clinic through a lot of pushing so I might just wait for that... The appointment is in 3 weeks time.

[naty1]

Did you do any day 21 tests for progesterone?

[Worrieddd]

I have had two sets of day 21 tests, all showing ovulation, I have regular 33-34 days cycles!