Higher TSH level and difficultly conceiving?

[Holmcross]

Hi!

I had a blood test a few years ago which showed serum TSH level as 5.1. They said not clinically relevant unless symptomatic and to repeat in 12 months. Unfortunately I forgot. I had a recent blood test which showed 4.16 which is only just under the upper limit of normal, 4.2.

I know that from googling studies, for best chances of conceiving it should be under 2.5. Has anyone had experience of this? I have doctors appointment for early April but I’m not really sure if they’ll do anything as it’s not classed as hypothyroidism even though it’s likely to affect chances of conceiving?

Thank you!

It's standard practice to put women on Levothyroxine if they are trying to conceive and TSH is >3.0

Oh really! Is that in NHS guidance online? I couldn’t find anywhere online unless diagnosed with hypothyroidism.

I was on thyroxine, had to increase dose when ttc go get tsh <2.5

Sorry @Teacup19 meant to tag you!

So did you already have hypothyroidism or similar condition anyway?

Docs don’t usually do bloods for everyone before TTC unless testing for something else do they? Great if they do

Did they test your other thyroid levels too? Would be useful to know what T3 and T4 look like too.

No they didn’t, I assume as my TSH wasn’t over the threshold of abnormal?

@Holmcross end of Pg 1

www.btf-thyroid.org/Handlers/Download.ashx?IDMF=941f817e-a8da-4ea9-8ee9-83772477c280

Thanks, it looks like this is for people already diagnosed with under or over active thyroids though? Mine is just within normal though over 3…

just a bump in case anyone else has experience of this?

I'm a GP and I have started a low dose of thyroxine for a patient in this situation - she conceived a couple of months later. So I would treat you! Not sure if there's any formal guidance and am rushing out of the house so can't check - sorry.

@CakeIsNotAvailable Thank you that’s so helpful! Would you diagnose as hypothyroidism as it’s under the 4.2 threshold, or outside of this just to assist with conception? Had your patient already been trying to conceive for quite a while?

My T3 and T4 wasn’t tested in latest blood tests (I assume as it’s just under abnormal threshold) - if that matters.

If you’re able to see if there’s any formal guidance you’re able to track down later that would be so helpful as unsure whether or not my GP will do much!

cks.nice.org.uk/topics/hypothyroidism/management/preconception-or-pregnant

Try this

Thank you, I’m not in UK at the moment & it says not viewable outside of the UK so will have a look at that later this week!

Acupuncture was really helpful for me. My levels evened out and I conceived quite quickly. Could be worth a look.

That’s interesting thank you!

@CakeIsNotAvailable hello…. Sorry to pester, if you have any advice about this I’d be so grateful! Worried the GP will just dismiss and say it’s not technically outside 4.2 threshold so they’d only review after trying to conceive for 12 months (which is the time period for fertility help in my area)

I have experience with this. Had similar numbers and it wasnt picked up. Had trouble conceiving. After 3 years infertility and 3 failed rounds of IVF, I was seen by a lead consultant and was asked if I'd ever been treated for my subclinical hypothyroidism. I said no. She said that the way my IVF was failing it looked like I had bad eggs which is unusual at 32 so that was the only thing standing out to her. She put me on levothyroxin and I got pregnant naturally 3 months later. And then had a second baby, also naturally while on levothyroxin.

I feel really let down that it wasn't picked up sooner by the NHS fertility clinic. I went through three really invasive rounds of IVF, including some adverse reactions to procedures and suffered a lot of pain - physical and emotional. Had they just tried levothyroxin first, I likely wouldn't have needed any of it.

GPs can be awful when it comes to thyroid & fertility. Show them the NICE guidelines if they try to fob you off. TSH definitely needs to be below 2.5 while TTC, they need to test full TFTs (not just TSH), and once you’re pregnant, you need regular monitoring as TSH rises in pregnancy and can negatively impact the foetus. Many women go through infertility for this reason- it definitely deserves to be taken seriously.

Thank you, sorry to hear of the difficulties you had, that's so frustrating and you must have felt so let down... glad you did conceive after the medication. Do you remember what your TSH were/ if it was under the upper limit? My most recent 4.16 and threshold for normal is up to 4.2, so high enough to affect fertility but not high enough for doctors to medicate, from what I've read..

They may not medicate if you’re not TTC with a TSH of 4.2, but you ARE TTC, and so the guidelines are different. It’s not a matter of having trouble conceiving/ an infertility treatment - it’s just a healthy guideline for you and your baby. Even if you were to get pregnant now, with your TSH at or above 4.2 (I did), it could be unhealthy for your baby. So they really must help you get it down, which is very easily done. PS- thyroxine is much more easily absorbed on an empty stomach, so take it first thing in the morning. If you take it during the day/ with food, it doesn’t work as well.

@Pupsandturtles thanks for your reply that’s helpful. I couldn’t really find any guidelines online to back that up (and show GP if needed) the only guidelines within TTC and prescribing thyroxine until TSH was under 2.5 was for those who are already diagnosed with hypothyroidism. So I’m confused!

So are you symptomatic OP? If you are (imagine you would be in some way with a TSH at that level) then you should try to convince your doctor to diagnose and treat based on symptoms. Might be a struggle but keep at it. Also see if your GP will test your thyroid antibodies (TPO and TPa). If they are high it will be having an impact.

I struggled to conceive with a TSH similar to yours. I tried for a year, had further tests done and discovered I also had endometriosis. I then went on the Endo Resolved diet and conceived 3 months later. The Endo Resolved diet is similar to Dr Isabella Wentz's Hashimotos Protocol. I think going on the Endo Resolved diet was the key for me. I've never felt so good as I did on it and think that was because it addressed my Hashimotos as well as the endo.

As others have said above, being hypo in pregnancy means there is a risk of things like low birth weight, cleft palates and tongue ties, neurodevelopmental issues, etc. It's really wise to accept now that if you do conceive you're going to need much more support with your hypothyroidism than others, and to start pushing and questioning why you aren't being treated now rather than later.

I had 2 miscarriages at roughly that level. I was fortunate enough that my local hospital was part of a study looking at recurrent miscarriage and thyroid levels. Turned out I have Hashimotos. I had all the symptoms but my levels were never considered high enough to treat until I took part in that study and the consultant advised me to start on levo ASAP. She thought that my previous successful pregnancy had caused it as post pregnancy your thyroid can go "off". Also once you are pregnant it's important to increase your dose of levo to compensate

Thanks for your reply it’s really helpfully

In terms of symptoms for the last few years I definitely tick the boxes of poor memory and brain fog/lack of concentration, that’s been documented with doctors for a while and I’ve actually been looking at ADHD as a lot of my symptoms are around struggling with executive function though could also fit with this as definitely seen more in last few years which does coincide with higher TSH results. I carry a lot more weight around my stomach but then I think that’s just my body shape..

I’d also say I get tired and generally can feel quite lethargic but then I don’t know if that’s just anxiety/depression I also have. My periods have been getting very short and light and cycles shorter over the last year but unsure if connected as symptoms for hypothyroidism say heavier and irregular.

I’ll ask about testing thyroid antibodies thank you. Really interesting about the different diets thank you I will look up. Glad you were able to conceive.