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Thyroid and ttc

(27 Posts)
BumblingBee89 Wed 04-Jan-17 12:42:07

Hi all,
I seem to be posting on this part of the forum a lot recently!

Some background:
DH and I have been TTC since July. We had a early miscarriage/chemical pregnancy and 4w6d in October. Since coming off the pill in July, my cycles have been between 28 and 31 days, however, last month I had a cycle of 41 days, which was frustrating (and expensive, I've never POAS so much in my life)

I'm aware that we haven't been trying for long, and that there is no need to be concerned. However, I'm worried that my thyroid could be impacting.

I have been subclincally hypothyroid for years. Never treated, as my levels are always 'normal'. Despite this, I do have symptoms of an underactive thyroid (hypothyroidism), such as fatigue and extreme sensitivity to cold (I'm currently in work with my scarf and a thick cardigan on...apparently it's really warm in the building today!)

I've had my levels back today. My TSH is 4.6 and my t4 is 11.6.

I've seen a number of time that TSH should ideally be between 1 and 2 when TTC.

I'm worried that this could affect us TTC. Even more so, I'm worried that this could be the reason for our early loss in October. I know it's probably not, and that early loss is very common, but I just wonder if the doctor should have mentioned this to me when I told her I was pregnant.

I'm going to make an appointment to see my doctor tomorrow, but does anyone have any experience of this or any knowledge they could share? I don't want to completely overreact, but DH and I are so ready to have a child of our own, and I want to be sure that this isn't being affected by something that could be fixed.

I hope that all makes sense. I'm typing fast because I'm on my lunch break! Many thanks for reading.

johendy Wed 04-Jan-17 13:35:52

Hi Bee. During private ivf I found out my thyroid TSH was 3.9 and I was put in thyroxine before treatment which took it down between 0.5-2. The ivf worked. And my health and energy has been unrecognisable since. I had more energy at the end of my pregnancy, even with a toddler than I did in the days before I had kids.
The trouble you might find is that your levels are 'normal' within the NHS guidelines so your gp might not be keen to prescribe thyroxine. You may have to see different GPs or even go private to get treatment. The research is clear that a lower tsh level greatly helps with conception and pregnancy, so it's worth pushing to get treatment.

Emz01 Wed 04-Jan-17 14:40:05

Hey Bumblingbee, I myself was born without a thyroid so know how difficult it can be to manage it especially when TTC. You're definitely right your TSH should be ideally around 2 and your T4 could ideally be a little lower too. I think especially if you're experiencing symptoms you should definitely be speaking to your doctor and just explain your concerns.

Unfortunately if your levels are wrong they can cause problems with fertility and pregnancy, your gp should explain.

I'm currently TTC#2 so rest assured once your levels are correct you can have a successful pregnancy it just might take a couple of months to rectify.

Pitapotamus Wed 04-Jan-17 14:58:03

They might put you on thyroxine given those blood results. I don't know why but the GPs seem so reluctant to prescribe levothyroxine. I basically had the same problem with similar levels to you and they wouldn't treat it but I did manage to conceive and they put me on levothyroxine straight away once I was pregnant. Read the NICE guidelines as that has a section on TTC and Pregnancy with subclinical hypothyroidism. If those guidelines support giving levothyroxine a go it might be worth mentioning it to your GP.

countingdown2gin Wed 04-Jan-17 15:33:01

Hiya, I have also had a history of subclinicaly hypothyroidism but also hyper and Graves' disease as a teenager. My consultant in this pregnancy also said that a level of 1-2 is optimal. When trying to conceive I was around the 3.8 mark so my doctor put me on a very low dose of thyroxine (25mcg) and then my levels were checked again but they still weren't normal range for pregnancy so I was given alternating 25 and 50 doses. I conceived when I wasn't quite in that optimal range (2.4) and am now about the 1.8 mark.

I would go back to your doc and speak to them about putting you on a low level dose, if they are unsure ask if you can speak to a consultant who I'm sure will agree it's best to put you on something.

Good luck! I know how worrying and stressful it is x

BumblingBee89 Wed 04-Jan-17 18:08:53

Thank you so much everyone. I've just got home and read through your replies. I feel much better knowing I'm not overreacting, thank you.

I've had a look at the NICE guidelines and they're very clear that if a woman is subclincally hypothyroid and is TTC or is pregnant, they should be referred to an endo.

I've also ready that having a high tsh can have an impact on implantation. I know that I had an early loss because implantation didn't happen, and although it could have happened for a number of reasons, and was probably just 'one of those things', it's quite painful to think it could have been avoided.

Again, thank you so much for your replies. I feel much more confident going to my doctor now.

Snoopysimaginaryfriend Wed 04-Jan-17 18:47:47

Hi bumblingbee I'm hypothyroid and I've had problems which aren't related to my thyroid. I've always found the NHS to be very hit and miss with the thyroid problem. The advice I got was to print off the nice guidelines and actually take them with you to the GP.

Hope you get the answers you need. Good luck!

physicskate Wed 04-Jan-17 19:25:30

Have just had my bloods for this! I used to take thyroxine for subclinical hypothyroidism and have been ttc for 9 month with no luck... so a bit of research showed there might be a link?? Clutching at straws....

Stopped taking the thyroxine because I moved countries and then kept moving house. Didn't see a GP for a few years! Stupid, I know... but when I was tested here, they said my results were 'normal' and then gave me massive eye rolls when I wanted the numbers. My numbers were normal because I was medicated at the time!!! Made me not overly enamored with the NHS...

Will be very interesting to see what happens during my appointment next Tuesday!

PrimeraVez Thu 05-Jan-17 09:53:28

Just another one adding my experience - it took me 9 months to conceive my DS and then when I was 5 months post partum, a routine blood test (I went to see my GP complaining of severe fatigue) showed that I was incredibly hypothyroid. It took approx 6 months for my TSH to stabilise (and I had to try several different dosages of thyroxine to get it just right) but at my latest blood test just before Xmas, my TSH was at 1.6 and my endocrinologist told me that I could go ahead and TTC#2. She also told me that my levels should ideally be less than 2 if I was to successfully conceive and have a healthy pregnancy.

Good luck!

BumblingBee89 Fri 06-Jan-17 09:24:25

Thank you so much for adding your experiences. I've got a doctors appointment for later on today and I feel more confident going into it reading your replies.

I'm worried they are going to dismiss my concerns. I've printed off the relevant NICE guidelines, and I don't see how they can disagree with them. But I'm concerned because my TSH is less than ten they might think there's no reason to be worried. Fingers crossed I get a nice, understanding doctor!

Thanks everyone flowers

yellowpostitnote Sun 08-Jan-17 17:28:15

Hi I've just seen this. Ask to be referred to an endocrinologist (you have this right) and maybe take the nice guidelines if you feel you need back up! You do need to be under tsh 2 (or 2.5, can't remember) to conceive and will need monitoring during pregnancy.

physicskate Mon 09-Jan-17 13:52:53

Absolutely gutted. Just got my results. TSH 2.3 and ft4 15. Was hoping this was the source of a number of issues! GP appointment tomorrow. I reckon no thyroxine for me! Ttc 10 months...

yellowpostitnote Mon 09-Jan-17 14:04:49

I would stoop ask for referral - they have wavered higher. When was the tsh 4 result? Why this second test?

yellowpostitnote Mon 09-Jan-17 14:05:01

*still

BumblingBee89 Mon 09-Jan-17 15:09:02

Thank you for replying yellowpostit. I'm still trying to get an appointment with my gp (not the easiest thing in the world!) Really appreciate your advice.

physicskate really sorry. It's so hard isn't it. Is it worth still making an appointment with your gp to see if there's anything else they can explore that could be having an impact?

BumblingBee89 Tue 10-Jan-17 17:24:35

I'm so upset. I've just come out of my appointment. I explained everything the best I could. I was told by my doctor that my thyroid is well within the normal range, the cut of point is 6, and that he's never heard of tsh needing to be between 1 and 2 to have a good chance of conceiving. He refused to refer me and said I need to stop focusing on it. He recommended that I relax by doing things I enjoy and that I take some aspiran. I have no idea why he wants me to take aspiran. I'm so upset. Is he right that I need to stop focusing on it or do I need to push this? I just feel devastated that this could be stopping me from conceiving a much wanted child and there's nothing I can do

PinkHippo1 Tue 10-Jan-17 17:50:24

Hi Bumblingbee. I have been a fairly long time lurker on here but this is my first ever posting. I felt I had to reply to your last post. Really sorry that your GP has been so hopeless. He is wrong on both counts. The upper limit of normal is 5 not 6, and TSH definitely should to be 2 or below to support conception. Can you speak to a different GP at your surgery? I know all this because I am severely hypothyroid following radio iodine treatment and on daily thyroxine. I started TTC six months ago when my TSH was nicely at 1.2. Nothing has happened yet so went for blood test in December and TSH has crept up to 7. GP has increased my thyroxine so I'm hoping that's what's been holding things up. Good luck!

PinkHippo1 Tue 10-Jan-17 17:51:41

Ps I have no idea what the aspirin is all about...

physicskate Tue 10-Jan-17 18:35:56

Bumbling bee- I think we go to the same GP! Had the appointment booked and told him I was disappointed that my TSH came back at 2.3. He told me to stop fixating and gave me anti-depressants... He was nice about it though.

Womble75 Tue 10-Jan-17 18:51:06

Hi. I'm hypothyroid - always been "borderline" but it went crazy after my first pregnancy and resulted in 4 mc's until it was tested.
Please try and see another GP. My GP is managing my thyroid through this pregnancy (currently 30 weeks) and has been brilliant. Until I found him I had one after another who did not have a clue.
I was 9.5 after my last miscarriage - currently on 200mg and my levels are consistently kept under 2 which is the upper of the optimum range to ttc and a successful pregnancy. Last test I was 0.95. I'm tested every 2 weeks to ensure the level is kept below 2 as my levels did go crazy in thr first trimester and given my history I was very anxious about it.
Sadly a lot of GP's are not clued up on it. You have to educate yourself a lot I've found so you can argue your corner and not be fobbed off. I would seriously see if you could get to another GP in your practice and do your homework before you go. You don't necessarily need to see an endo if your GP is on the ball.

BumblingBee89 Tue 10-Jan-17 20:02:11

I honestly can't thank you all enough for you replies.

Could I ask, does anyone understand at all how the references ranges work? Because I've Googled and Googled and I just don't understand it. Is it just worked out by an average or is there more to it than that?

I really don't want to make a mountain out of molehill. But I don't want to miss a potential problem if something can be done about it

johendy Tue 10-Jan-17 21:25:14

You are not making a mountain out of a molehill. It is a researched threshold for conception that you ideally TSH should be under 2. Private fertility treatment won't stay without having these results, which is how I learnt about it Absolutely go to another GP. Or go private if you have to. Obviously conception is your driver, but bringing your levels down could have many other benefits for you as it has for me. Good luck.

sparechange Tue 10-Jan-17 21:32:52

OP, how infuriating

Your GP is talking absolute bollocks, and all endos I've seen said they are tearing their hair out at the ignorance of thyroid problems by GPs

Despite being on medication and having regular blood tests and endo appointments, my TSH spiked to 3.5 during my last pregnancy and I miscarried at 10 weeks
My endo told me that when tsh is 3.5, over 70% of pregnancies will end in miscarriage.

So it is really imperative that you get this seen to as soon as possible.
Can you make an appointment to seen someone privately? You'll probably only need one appointment with them, if you take all your recent bloods.
They should then write a letter to your GP stressing the advice around TTC and TSH
A letter from a private endo asking them to prescribe me TSH and confirming a diagnosis was the only thing that would get my GP to listen

sparechange Tue 10-Jan-17 21:35:25

There is a reference here about TSH levels needing to be in the lower half of the range while TTC
www.btf-thyroid.org/information/leaflets/38-pregnancy-and-fertility-guide

Cwtchythings Tue 10-Jan-17 21:35:35

Hi Bumbling, I'm another one that would agree with getting to see another GP. I'm hypothyroid and I've found some GPs don't want to know. My TSH was 5 when I miscarried earlier this year, I'll never know if it had anything to do with it or not but I saw a great GP who put me on a trial dose increase before I got pregnant again...all ok so far at 30 weeks. Best of luck to you flowers

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