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Original poster

Optimal thyroid levels when TTC?

81 replies

Frazzlerock · 18/09/2019 14:31

I have an under-active thyroid which was diagnosed many years ago. I spoke to a fertility nurse who said I should aim to get my levels as close to 2 as possible. I was over-compensating so had my thyroxine reduced from 100 to 75, then to 50.
My most recent TSH has come back as 0.6. I'm told this is 'normal'. Is this okay for TTC though?

We've been TTC for 3.5 years and lost three babies so I'm desperately trying to do everything I can for a healthy outcome for our future rainbow baby.

OP posts:
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Teddybear45 · 18/09/2019 15:26

Yes thyroid problems can cause recurrent miscarriage. As you have PCOS get tested for a clotting disorder too - in a lot of races they can go hand in hand

itswhereitsat · 18/09/2019 15:22

Also note that being in range for Thyroid hormones is not enough., they need to be optimal.

For T3 and T4 this needs to be near the top of range. I'm not sure how this differs in pregnancy.

You will be amazed at the number of people how have say a TSH of around 1.0 and still feel unwell, only to find out that their other thyroid hormones are out of whack when they've taken it upon themselves to get a thorough hormone panel done.

Also bear in mind that for your Thyroid to work well you need to have optimal B12, Folate and Ferritin. May be worth getting these checked too and get all your ducks in a row.

itswhereitsat · 18/09/2019 15:16

I had both Endometriosis and PCOS as well. There is a strong link with both diseases and Autoimmune Thyroiditis (Hashimotos). I will warn you now that GP's are by no means the experts of this, also they will rarely if at all, get your T3 and Thyroid antibodies checked due to budgetary issues.
www.medichecks.com/thyroid-function-tests/thyroid-check-plus
This test is brilliant. It will give you the full picture of your thyroid, including whether you have autoimmune thyroiditis, I strongly recommend you get it done, it could open the key to the knowledge as to why you have experienced fertility issues. Autoimmunity is the most common reason for an Underactive thyroid so the odds are that you have it. This medical reports explains how Hashimotos (autoimmune thyroiditis) can affect the growing fetus, as can being undermedicated on your thyroid medications.

rarediseases.info.nih.gov/diseases/6570/hashimotos-syndrome/cases/52284#targetText=Hashimoto's%20syndrome%20that%20is%20untreated,woman%20and%20a%20developing%20fetus.&targetText=Potential%20complications%20of%20an%20underactive,%2C%20and%2For%20postpartum%20bleeding.
However, it's important if you do this test to put in the notes what Thyroid medications you are on otherwise they will comment as if you are a person not on medication.

KellyMarieTunstall2 · 18/09/2019 15:11

Tsh at 0.6 is good for TTC, there's wriggle room for it to creep up but still be safe. T4 should be in the upper range (top end). Once you are pregnant it needs to be checked monthly.
Have you have your thyroid antibodies checked? Tpo and ttg? If you are positive for antibodies, this is an indicator of auto immune thyroid disease and can be linked to miscarriage. I have it and had multiple miscarriages. I did go on to have 2 babies. I would raise this with your RMC consultant.

Original poster
Frazzlerock · 18/09/2019 15:02

Oh wow, thank you so much!

I knew there were other levels that should have been checked and I couldn't remember what they were. When I rang the surgery today, the receptionist said my results were 'normal'. I had to ask her what the actual results were and she said 0.6. Then I said I was expecting two further thyroid results but I couldn't remember what they were called (as you say, T3 and T4). she said she only had the TSH result.
I might call again and ask about T3 and T4. My GP knows full well I'm desperately TTC as she's been my GP since our first loss and I see her fairly regularly so I'm surprised she didn't ask for T3 and T4...

Do you think this would be something my RMC consultant would sort for me if the GP hasn't done so?

I also wonder if it was my thyroid that was causing our babies to die Sad. I know it was always slightly over compensating but I seemed to be comfortable on it so I never had my meds reduced until my consultant suggested it after our third loss.

I have no idea of the cause of my underactive thyroid, I didn't think I'd ever know. I have PCOS so my endo system is pretty shit TBH.

I have had two DC previously (11 and 14 now) with my ex husband and, apart from PCOS getting in the way of TTC, I had never had a miscarriage until 3.5 years ago. So I don't know if it is my thyroid or not. It's always been pretty stable (although very slightly over until recently )and I get it checked regularly. I guess I'll never know.

I might call my surgery again and if no joy, I will call my RMC team.

Out of interest, what should T3 and T4 be? Or is that completely dependent on TSH?

OP posts:
itswhereitsat · 18/09/2019 14:46

Frazzlerock - For pregnancy it needs to be less than 2.5 so yours is pretty good. They will need to monitor it throughout pregnancy.

When it comes to your thyroid it is important to know what your T3 and T4 levels are. You could have a TSH of 0.6 and ridiculously low T3 which would not be good. (I have Hashimotos Thyroiditis). Do you know the cause of your Underactive thyroid? Many UK doctors don't bother to find out however Autoimmunity is the most common cause. Knowing this could be useful to you TTC and also self-care during pregnancy. For this you need to have your Thyroid antibodies tested.

If I was in your position I would definitely get a private Thyroid check (perhaps through someone like medichecks) just to be sure that you T3 and T4 levels are optimal for pregnancy. GP's won't usually do these tests but it gives you a much better picture of what your Thyroid is up and gives you peace of mind.

I'm so sorry to hear that you have lost three little ones Flowers. It does make me wonder whether your thyroid was being properly managed at the time and whether this could have been a reason. I had my own pregnancy difficulties long before I discovered I had an underactive thyroid and I can't help but wonder if this was one of the problems.
So anyway, to summarise, your TSH is at a good level for TTC but fertility nurses are not experts on Thyroid conditions. T3 and T4 are really important, take control, get them checked, get optimal and hopefully, you will soon be holding your own little bundle. Sending you good wishes and hope it all works out for you.xx