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Conception

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TTC and subclinical hypothyroidism

392 replies

Owl86 · 20/05/2021 18:19

Hi all

I'm 34, and my husband and I have been TTC our first baby since January. We've had no luck yet, but realise it's still quite early days.

However, I recently had a blood test after an ultrasound found a polycystic ovary. This came back negative for PCOS, but showed my thyroid function was out of whack. My TSH is 4.93, higher than the reference range, and my free T4 is on the lower (but normal) side at 14.7. So my GP told me I'm subclinically hypothyroid.

Not really knowing anything about thyroid issues, I asked what this meant for fertility and pregnancy. The GP said some fertility specialists like TSH to be under 2.5 when TTC, but it's more about optimising the body for conception than anything else. They didn't suggest medication right now, but said if I'm still not pregnant within the next 2-3 months they'd repeat the tests (with an extra check for thyroid antibodies/Hashimoto's disease) and refer me to the fertility clinic for advice if my TSH is still high. But if I do become pregnant, nothing further needs to be done.

I've since done my research and it doesn't seem to tally with what the GP said. As I understand it, for a healthy baby and pregnancy TSH levels should be below 2.5 and T4 ideally on the higher end of the normal range. And the NICE guidelines seem to suggest we should delay TTC
until I'm medicated and my levels have normalised and stabilised: cks.nice.org.uk/topics/hypothyroidism/management/preconception-or-pregnant/

I'm not sure how far I'll get with the GP, as they admitted they're not totally clued up on these matters. So I've ordered an advanced thyroid self-test kit to get a full picture of what's going on. I'm then thinking about seeing a specialist privately for advice on whether I should be taking thyroxine or not.

For anyone who's been through similar, my questions are:

  1. What sort of specialist would be best to see? An endocrinologist or fertility specialist/reproductive endocrinologist?
  1. Once on medication, how long did it take to get your thyroid hormones to the right level for TTC and pregnancy?
  1. Do you have any suggestions or advice? I'm feeling rather unsure and overwhelmed by the whole thing.

Thanks so much in advance. :)

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FlyingGiraffe · 29/10/2021 18:10

@Owl86 sorry to hear you're on to the next cycle too. Hope your bloods come back in the right range next week. Let us know!

I had my private fertility scan this week along with AMH bloods. I'll get the results at our consultation in a couple of weeks time. The nurse talked me through everything and seemed happy with the scan. She was happy I had my thyroid within the correct range for ttc and thinks they might suggest progesterone to support the luteal phase as I start spotting so early. Fingers crossed anyway 🤞 It was £225 for the scan, amh, SA and consultation so I'm pleased we've gone ahead with the private investigations now.

Songbird50 · 28/10/2021 21:52

Hi @Owl86 my certificate/ card arrived this morning just after I read your message, we must have been in the same batch! Nice to have that sorted. Hope your test results hit the sweet spot next week.

Owl86 · 28/10/2021 09:30

Hi @Songbird50, just to say I got my medical exemption certificate though the post yesterday. Has yours arrived yet?

@SimpleStuff27 Thank you for the luck and encouragement. 😊

As expected, my period arrived bang on schedule on Saturday so onto Cycle 9 we go. CD6 now so I'll be in my fertile window next week.

Just been down to the hospital for my 4-weekly blood test, so hopefully I'll get my results on Monday if I'm lucky. Really hoping I'm now out of the hyperthyroid zone since reducing my levothyroxine dose. 🤞

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SimpleStuff27 · 22/10/2021 11:55

Thanks everyone. I have spent a lot of time reading through these feeds over the last 14 months or so. Seeing stories that show that conceiving is possible helped me stay positive so I’m hoping it does the same for you.

Hi @Everythingcrossed2021 - I cut caffeine straight from diagnosis in July/August last year and did drop my alcohol intake quite early on. I still had a few drinks on special occasions. I’ve always suffered with really bad hangovers, probably related to my thyroid, so limiting the quantity did make me feel a lot better. I feel like the medication, taking it easy and the vitamins (particularly vit D) made the most difference ultimately though. But ‘taking it easy’ is easier said than done if you’ve got a stressful job or home life. I think that’s where walking, yoga or swimming helps. Something quite relaxing. Good luck!

Hi @nellyinthegarden - There’s a fair amount of research on selenium benefits so hopefully that helps. Just don’t eat too many as you can quickly get too much! I think one per day is probably the maximum. Good luck!

Hi @Owl86 - the 2ww is so stressful. I’m nearly 34 so a similar age. It’s a double worry when another year passes and everyone keeps reminding you about your ‘biological clock’ 🙄. The social pressure makes everything 100 times worse I found. I kept my struggles largely a secret because I didn’t want to be talking about it all the time with friends and family or them feeling sorry for me. It doesn’t stop people making random ‘baby time’ comments though. People should be more careful about these things. Good luck!

nellyinthegarden · 22/10/2021 11:33

Oh and welcome @TTCThyroid2021 too - sorry I missed you!

nellyinthegarden · 22/10/2021 11:29

Welcome @mrsmacmc! It's so nice to have people to talk to who understand what the numbers mean without needing a long explanation about the differences between TSH and FT4, so I hope you find this little group useful when you get your results in.

And have just added Brazil nuts to the shopping list, thanks for the tip and the hopeful story @SimpleStuff27 😀 I hope we're all in your position soon, and that the next few months go well for you!

I've been taking pregnacare conception and extra vitamin d since the spring, and definitely noticed a big difference in energy levels and generally feeling well as a result (much more noticeable than when I started on the thyroxine) - I was permanently anaemic and vitamin d deficient before then, and think I must have been for years!

Hope your weekend is ok @Owl86. I was feeling really crappy when my period arrived on Wednesday (not helped since it came with cramp, headaches, nausea and sore boobs, as if to taunt me!). But feeling much more cheerful and positive today. Also took my temperature for the first time this morning (but will remember the warnings from you and @FlyingGiraffe not to obsess over it too much!)

Owl86 · 22/10/2021 10:13

@mrsmacmc Of course! Feel free to join in when you've got your results. 😊

@SimpleStuff27 I don't seem to have Hashimoto's (very low levels of TPOAb and TgAb antibodies), but to be on the safe side I've been taking a Brazil nut every other day for the last several months plus increasing my Vit D intake as recent tests showed I was nearly deficient. I've always drunk very minimal alcohol and caffeine (extremely boring, I know), but it's clearly making no difference in my case anyway! 😂 Thank you again and wishing you all the very best for the rest of your pregnancy. 😊

@Songbird50 Glad to hear you're making progress and have had your dose increased, but so sorry to hear you've been struck down with a stomach bug - that's blimmin' typical! Hope you feel much better soon. And thanks so much for sharing that link - just checked and I'm registered too, phew! My understanding was that we were supposed to get a physical certificate within 10 working days of the application being received. If it doesn't arrive soon, I'll ask the surgery about it when I call for my next set of blood test results.

13DPO today. Not tested but I just know I'm not pregnant, so just waiting for my period to arrive sometime over the weekend so we can take Cycle 9 by the horns. Having really been pretty chilled this cycle, I woke up at 4am this morning worrying about TTC (and the fact I'm turning 35 soon). D'oh! 🙄🤣

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Songbird50 · 22/10/2021 08:40

Lovely to hear your experience @SimpleStuff27 and happy news, congratulations! And I love Brazil nuts, that will be a nice new daily treat, great tip!

My TSH is down to 5 now so making progress and I've been increased to 75mcg of levo daily on the back of that result. This month is our first proper month of trying after all our hiccups, but I've caught a stomach bug, it's crazy how frustrating these things are...like work trips that are suddenly at the wrong time. Never would have thought twice about the timing of these things before. Talking of temping, I've been using the free app Femometer as my cycles have been irregular and I wanted to check I was indeed ovulating. I like the app a lot, but I too can get obsessive and what I thought was a super temperature rise this month turned out to be the stomach bug arriving. Oh dear!

@Owl86 My gp surgery lost power and closed for a week, delaying my exemption submission but it's in now. You suddenly got me thinking...do we get a physical certificate...so I googled and found this: services.nhsbsa.nhs.uk/check-my-nhs-exemption/start
Turns out mine's been registered after about a week, hope yours is on there too?

Everythingcrossed2021 · 22/10/2021 07:54

Thank you for sharing your story @SimpleStuff27! It’s so important to keep the hope alive, and stories like that do help! Can I ask how long you changed your lifestyle habits like caffeine free and booze free before you got your BFP? It’s something I’ve been considering too but like you say, it’s hard to give simple pleasures up when this is going on for longer than I had anticipated…

SimpleStuff27 · 22/10/2021 07:38

Thank you both 😊 I forgot to mention that I also went caffeine-free, drank minimal alcohol (glass of wine every couple of weeks) and have been eating one Brazil nut most days to supplement selenium. Apparently that and vitamin D are good at reducing the thyroid antibodies. Doing something different to hopefully help the situation made a difference to how I felt mentally. I felt like I was taking more control of the situation. But I appreciate that some of these sacrifices may push people over the edge of a happy lifestyle. Go with what works for you. It’s been a long journey for me and I’m still very worried about the future but I’m doing my best. You’ll all get your time eventually. Stay strong and focus on you xx

mrsmacmc · 21/10/2021 23:30

Hi waves place marking as awaiting results from my 🩸 hope that's ok 💕

Owl86 · 21/10/2021 22:50

Thanks so much for sharing your story @SimpleStuff27, and congratulations on your pregnancy - I'm so glad you got there in the end! 😊 And welcome to the gang, @TTCThyroid2021.

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TTCThyroid2021 · 21/10/2021 21:39

Hi! Thank you for the message, this has given me hope :) Just reading all the above messages now.
To jump in i've recently been diagnosed with under active thryoid, 2 months taking levo and levels are now nearly where they need to be so hoping it wont be too much longer (almost 1 year TTC) but grateful i found out about my thryoid relatively early.. anyway, back to reading all the above! x

SimpleStuff27 · 21/10/2021 21:14

Hi all,
I just wanted to offer a bit of hope and share some advice I’ve received along the way.
I was diagnosed with hashimoto’s in August 2020 after coming off the pill and my cycles not returning. Luckily I have private healthcare cover that allowed me to see an endocrinologist straight away. It took about 6 months to get things stable and another 4 months for my cycles to return. Even then they weren’t regular. During this time I’d had ultrasounds showing cysts on my ovaries and was really starting to panic. My endocrinologist was great though. Kept my TSH under 2, advised to avoid/reduce gluten and processed food and eat plenty of good fats and protein. She recommended taking a pregnancy vitamin from the outset to get my vitamins in check and I took a bit more vitamin D because I was very deficient. She also recommended gentle exercise, like walking/yoga, reducing stress and getting plenty of sleep. After a year of trying to prepare my body for pregnancy I was starting to lose hope but she reassured me that if I relax and look after myself I would get there. 5 months after my cycles returned, whilst on holiday, I managed to conceive and I’ve just had my first scan at 12+2 weeks pregnant. Everything seemed fine which was a huge relief! What I have found since then, now that my private cover has ended because this is a ‘chronic condition’ 🙄, is that the GP and midwife don’t seem to be aware of the maximum 2-2.5 TSH level during pregnancy. Thankfully they’ve referred me to an NHS endocrinologist now. When my levels go above this I feel incredibly tired and bloated so it definitely makes a difference to me. I’d recommend pushing to see an endocrinologist if you’re in this position or trying to see one privately (although I appreciate the cost makes this option much less accessible). Alternatively, just keep asking questions until they get fed up and refer you! I’m also having to push for 4 weekly blood tests myself but thankfully my GP is going along with it.
Moral of the long story is don’t give up hope, see the wait as preparatory time where you get your body in the best position you can for your baby and don’t be afraid to question your GP on your blood results and frequency of tests. Good luck everyone! I’m keeping my fingers tightly crossed that I can keep this little one growing.

FlyingGiraffe · 21/10/2021 18:23

Hi all :)
@Owl86 I managed to get booked in for the private appointment and DH has already had his SA come back as normal/above average so that's a positive. I have AMH bloods and a scan next week then a consultation about the results two weeks or so after that so I feel like we might know a little more by this time next month. Good to hear you're feeling zen! Fingers crossed for you!

@Everythingcrossed2021 Sorry AF came for you too :( Now AF has almost stopped I feel a bit more positive again, but it does suck doesn't it?!

@nellyinthegarden I used to temp and used Fertility Friend to chart it on. It reassured me that I do get the temperature rise after ovulation (I was using ovulation sticks too) but I decided to take a step back and stop because I was getting obsessed or upset by it! Now I know like @owl86 that I ovulate around cd12-cd16 I'm fairly confident without it. I think I'm going to go without tracking anything this month and just try to dtd every other day instead :)

Owl86 · 20/10/2021 16:49

@nellyinthegarden So sorry your period came today. I know what you mean about not being sure whether seeing your period is any better than seeing a negative test!

I'm feeling OK, thank you. Obviously very bummed to still be playing the TTC game, but trying to shift my focus back onto other parts of my life and not let it consume me. This TWW is the most zen I've ever been in a TWW, so that's progress!

I'm only looking at having a HyCoSy scan in the near term, as I don't want to jump into having too many investigations too soon. I don't know what an NK cell test is, I'll have to Google that.

I did look into temping a few years ago, but decided it's not for me. My cycles are regular and I'm confident I nearly always ovulate between CD13-15 based on OPKs, CM and other signs, so I'm not sure what useful extra info it'll really give me. And as a big worrier with obsessive tendencies, I just think it'll be another source of stress. I'd 100% start overanalysing the data and looking for possible implantation dips or something. 😂

But that's just me, obviously a lot of people like your friend do find temping helpful so why not give it a shot? I don't know if thyroid issues would have an impact, I can't see how it would though. Let us know how you go!

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nellyinthegarden · 20/10/2021 15:19

I managed to resist the urge to test over the weekend, but my period arrived today right on schedule. Not sure whether that's better or worse than seeing the negative test to be honest! Generally feeling a bit miserable but I know the hormones are mostly driving that. And given my numbers are all in the good ranges I'm going to stick on 25mcg for now, but will probably try and increase if I get pregnant again.

How are you feeling @Owl86 ? Hope your next round of blood tests show things going back to normal! And how are you deciding what other tests to look at? I'm considering tests for NK cells (partly because the treatment would be similar to trying to treat for thyroid antibodies, which I know I have), but put off by the price / limited number of places that offer it.

On the advice of a friend I've also just signed up for Natural Cycles and am going to see if charting my temperature works for me in any way. The friend who recommended it isn't currently trying to conceive (at least as far as I know) but is obsessed with all the data it gives her, and more information about your cycle can only be a good thing, right?

Has anybody else tried it? And do thyroid issues have an impact?

Owl86 · 20/10/2021 10:53

@nellyinthegarden How did you get on this cycle? I'm glad your results have improved since your GP upped you to 25mcg, that's great news. Do you think your GP might be willing to increase your dose bit more, or do you think you've reached their limit?

@FlyingGiraffe Any luck with finding out about private tests?

@Songbird50 Did you manage to get your medical exemption certificate in the end? If so, how long did it take? It's been 3 weeks for me and nothing yet, but I'm probably being a bit impatient.

@Everythingcrossed2021 I'm really sorry you had no luck last cycle, but fingers crossed you get some good news from your second blood test.

No real news here. Around 11DPO today and I feel the same as I always do, so I reckon we'll be starting Cycle 9 at the weekend. Sigh. I turn 35 next month so I think I'll be investigating a private HyCoSy in the new year if we've still had no luck by then.

Got my next blood test next week so I'm really hoping my thyroxine levels have come back down into range after going hyperthyroid!

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Everythingcrossed2021 · 16/10/2021 08:23

Morning all. Another cycle bites the dust for me over here! Don’t really know how to feel anymore, definitely getting more used to this disappointing result so maybe feeling more numb - not really sure. Everything crossed for the rest of you in your tww!! Onwards and upwards for me into this next cycle. I have my second blood test on the 1st Nov so will be interesting to see if the 50mg has helped things - clearly hasn’t helped things very much this month!

nellyinthegarden · 15/10/2021 13:18

Hi all! Hope everyone is doing ok.

I'm also in the TWW - 9dpo today on my third cycle after miscarriage and determined not to test until Sunday at the absolute earliest. Finding it really tough since for both of the two unsuccessful pregnancies I got pregnant the second cycle, but trying to remind myself it's totally normal to take longer than that too (and that it's no bad thing if things are different this time!).

Definitely got the symptom-spotting mania, but my body is making it really difficult since I've had nausea, sore boobs and fatigue every month so far and lots of BFNs - apparently it's fairly common for your symptoms to 'reset' post-miscarriage, but wondering if normalising Thyroid levels has something to do with it too, perhaps impacting other hormone levels?

More positively, 4 weeks after my GP moved me up to 25mcg Thyroxine a day my TSH has dropped to 2.3ish and my FT4 is the highest it's ever been at 15 - hoping it all just stays there 🤞🏻

Good luck for your next steps @FlyingGiraffe and @Everythingcrossed2021, and hope you're back in ideal ranges soon @Owl86

Owl86 · 14/10/2021 15:19

@FlyingGiraffe Sorry, I just realised I told you all that in my previous message which I'd forgotten about... I'm going mad! 😂

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Owl86 · 14/10/2021 15:15

@FlyingGiraffe, so sorry to hear about the spotting. I've been getting pre-AF spotting since the end of last year, and my GP sent me for two ultrasounds (abdominal and transvaginal) to investigate. Could you try asking your GP about if they'd be happy to do the same? Would help you rule out some of the more common causes without having to wait for your fertility clinic appointment or go private x

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FlyingGiraffe · 14/10/2021 13:11

@Owl86 @Everythingcrossed2021 I'm 8dpo today and still spotting (since 5dpo) so I'm out. I have had this for a week before AF starts properly in previous cycles so I know what it is unfortunately. I haven't ever been scanned and have always been told not to worry about it but it's not good to be bleeding so early. I contacted the hospital regarding my referral and they said they cant advise on a timeline and that they are prioritising on a case by case basis. So I've been in touch with a private fertility clinic about tests and am waiting to hear back. It really is tough isnt it? ☹ I hope yours turns out to be a bfp still though @everythingcrossed2021 xx

Everythingcrossed2021 · 14/10/2021 07:52

How’s your tww going @FlyingGiraffe? I think I’m about 11DPO so caved and did a test - BFN. It wasn’t one of those highly sensitive ones though, but I feel periody now so preparing for that outcome. Gosh this ttc is tough at times. Sending you strength for your final push in your tww!

Owl86 · 11/10/2021 19:56

@FlyingGiraffe At the end of last year I started getting pre-AF spotting too, usually for 2 days before my full flow starts. Just a bit of light pink discharge when I wipe, on and off throughout the day. Sometimes it even stops for 12 hours and then starts up again, just to really mess with my head.

It's super annoying! My GP ran a hormone blood test (hence how I found out about the subclinical hypothyroidism) and I've had a couple of ultrasounds which showed no obvious cause. So unless it's my thyroid, I really don't know what's going on. I might ask the GP whether she thinks it could be cervical ectropion, but I think that would've been picked up at my smear in January.

Hope you get an answer about the fertility clinic wait times soon! And as @Everythingcrossed2021 says, you're not out yet. 😊

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