Optimal thyroid levels when TTC?

I had 3 early miscarriages.

My doctor said thyroid should be under 3.5 with 1-2 optimal.

My highest ever TSH was 4 so went on 75mg levothyroxine.

Tested TSH every 3 months.

I also got tested for APS and was borderline.

Ideal IgM anticardiolipin antibodies should be 1-10 MPL U/ml

So took low daily aspirin and heparin during pregnancy along with low dose steroids.

Did IVF and now have a very beautiful 15 month old.

@Frazzlerock
It might even be nothing to do with you Thyroid that is causing the MCs, it could be some other factor. Although as this is a known condition its obviously going to be beneficial to your all-round health to make sure your thyroid is optimal.

Just one other thing. Have you had your B12 checked in recent years? There are also strong links with low thyroid and low B12.Apparently people with low thyroids often have low stomach acid making it more difficult to absorb certain nutrients. One of the symptoms is tiredness, may be worth an up to date check if never been done.

Yes, the same old 'normal'. Honestly, the way Thyroid patients are treated is appalling.

I wouldn't bother with the Express, as the normal one is a really quick turnaround anyway. I'm really interested to see what your results are.

Hashimoto's is very common if you have something like Psoriasis. Doctors don't bother testing for antibodies as they say the treatment is the same either way (levothyroxine) The thing is, there are lifestyle adjustments you can make if you have Hashimotos to improve your health, which you can't do if you don't even know that you have it.

It makes me so angry and I am making it my mission to share the knowledge that I now have. We all deserve better.

@itswhereitsat thank you so much for the information and the attached pictures. I feel like I’ve been lazy and just trusted my doctor.

I think the root cause of my thyroid issues is autoimmune as I also have psoriasis.

I even called my doctor a few months ago to say I was starting ttc and could I have my bloods done to make sure all was ok beforehand. The results were ‘normal’.

I’m going to order medichecks today. Do I want to order express reporting without a doctors comments?

You know it’s funny as well because both my sisters have thyroid issues too. 1 has had no trouble conceiving but the other has. Both within normal range.

I just thought I would add that it is FT4 test (Free T4) and FT3 (Free T3) that you need. Sometimes I've referred to it as just T4 and T3 and that's a bit misleading.

@Happythoughts123

You would not believe the number of people who get told their results are 'normal'. Normal isn't optimal. The range for TSH for example if 0.5-4.5. But for someone with Hypothyroidism, they say you should have around 1.0 on medication. If for example a person has say, a TSH of 3.0 this would indicate that their thyroid is beginning to fail, even though its still in range at this point. Many GP's are useless when it comes to Thyroid conditions. You get your blood test, the results come back, they look at the sheet of paper and see it in range and tell you it is 'normal' because it is in range. Also, you will never see the full picture of your Thyroid condition without FT4 and FT3 and GP's aren't allowed to ask for FT3 to be tested, I believe it has to be a consultant that does it.
When you said you are on 50mcg my first reaction is that you've been put on a starter dose and left there. I would almost put money on it that your results will come back, probably within range, so even Medichecks may not highlight it as a 'red' but that they are NOT optimal.
I feel really sorry for many of the people in the UK (I was diagnosed overseas), they are left undermedicated and often have no clue with their Doctors just telling them there results are 'normal.
The picture I've attached really shows how being within 'normal' range isn't enough. I just attached a second as the first one uses US measurements
Try and get the medichecks done and let us know how you get on xx

For those asking what the levels should be my latest results say the normal range is 0.35-5.5 for TSH and 10-19.4 for free t4. However my consultant prefers it to be under 2 and over 17 to be optimal. I haven't got my T3. Maybe I should get that checked too!

Just wanted to add (having just gone through pregnancy with an under active thyroid) that when you don conceive (I really hope you do!) that you will have to put your dose up slightly immediately. I was told to put mine up 25mg straight away then make and appointment. I have been lucky enough tho to be under consultant care. Also I had an issue that I was throwing up so much I wasn't getting enough thyroxine so I had to increase my dose massively. It's therefore so important to get checked very regularly.

Fingers crossed for some good news op.

So sorry to jump on this thread. Does anyone know what the issues are with TTC and thyroid? My TSH is 3 and more worryingly, FT4 is 12!

I only found this out a few weeks ago and so have self prescribed 25mcg of levothyroxine (yes, I know the dangers of self medicating). I also had a test for antibodies but I don't have them.

Thanks

I’ve been on 50mg since I was diagnosed 6 years ago. Have it checked yearly and it always comes back normal. I think I was borderline when first diagnosed.

I have never enquired about t3 and t4. So ideally my tag should be 2? I hat should my t3 and 4 be?

I’m definitely going to look into medichecks thank you so much x

@Happythoughts.
How long have you been on 50mcg of Levothyroxine? Also do you know what is causing your Hypothyroidism? If the Doctor has never bothered to do the tests or tested your T3 he is failing you. I always get a full panel done myself, I know my hormone levels off the top of my head and I also know what they should be to be optimal. Definitely check out the link for medichecks Thyroid tests that I posted above. Good luck in your TTC journey xx

Less than 2.5 when TTC and throughout pregnancy is fine

@Happythoughts

It's not the Levothyroxine that's the problem (its part of the solution). The problem is doctors not doing full thyroid panels and trying for 'within' range, not optimal. 50mcg is only a starter dose. Do you know what your levels are?

This thread has utterly amazed me. I have hypothyroidism and have just started ttc. I’m only on a really low dose of thyroxine (50mg daily) so assumed/hoped it wouldn’t affect me too much but so glad I stumbled across this thread. Thank you for all the info.

Ps just another thought. Being hypothyroid affects iron levels, and it's also closely linked to coeliac disease. I found I was coeliac too. Having a GF diet reduced my thyroid antibodies.

I took low dose steroids for 12 weeks, heparin for the entire pregnancy (I didn't have a clotting issue but as Teddy said it's linked to antibodies) and progesterone. Plus regular scans. This worked for me for 2 pregnancies. Prior to that I had 6 miscarriages. My GP fobbed me off told me I was unlucky and it was my age.

@Frazzlerock If you do the medichecks bloodtest, let us know how you get on x

@Teddybear45
Your input is very interesting in regards to how the antibodies can impact the developing embryo and you had to have steroids - I didn't know that.

If you find that you have Autoimmune thyroiditis as long as your Thyroid levels are optimal (TSH, T3 and T4 - keeping remembering, optimal, not normal) then these are the factors that will reduce your chance of miscarriage the most.

Basically, if you have Hashimotos your immune system is attacking and killing your thyroid tissue which COULD be why you were diagnosed with an underactive thyroid in the first place (basically part of you thyroid tissue has been killed by your immune system).

Thyroid hormones in medication will never stop the autoimmune attacks, they just replace the thyroid hormones that your thyroid can't make. The antibodies can impact the way I feel and I often feel more tired and get sore throats when my antibodies are high usually due to stress. I find that stress, coffee and alcohol make my antibodies go through the roof for other people it is things like soy and gluten.

I think knowing that you have autoimmune disease helps you to understand your body better, for me it was a light bulb moment. It helped me understand why sometimes I get severe fatigue and I suffer when I take on to much. It makes me pace myself and I think if you find out you have it ,it may encourage you to take extra special care to manage stress better, get lots of rest and clean up your diet. These are all things that can help you feel healthier. But in regards to fertility, it's my understanding that the biggest factor is making sure your hormones (TSH,, FT4 and FT3) are optimal.

Clotting disorders would be something you always have - but some of the rare ones can get worse as you get older. I have one that gets worse as your blood inflammation levels get higher (which often happens normally with age). So it’s worth checking. Also, while aspirin is a blood thinner it often isn’t enough to stop the formation of microclots in the placenta (assuming your pregnancies have gotten this far) - for that heparin is provided too.

It would depend on the antibody results. Thyroxine does reduce my antibody results marginally but my IVF clinic recommended an aggressive steroid / lipids protocol for me as thyroid antibodies can often destroy the developing embryo. That along with blood thinners for my clotting disorder resulted in a BFP - as the pregnancy has progressed by consultant has kept a really close eye on my thyroid antibody results and has also filed a baby alert as my antibodies may have harmed the baby’s thyroid so the heel prick test etc needs to be performed immediately.