To want meds for thyroid to help me conceive

[ismythyroidok]

I know that the upper threshold for TSH before meds are prescribed is 4.2mIU/L but I've read some things online that it should be below 2 in order to conceive and keep a pregnancy. Mine is 3.5.
Anyone conceived with TSH at that level? If not, how exactly do I convince a doc to prescribe me meds when technically TSH is within the normal range?

now constantly feel like i have a lump in my throat.

Please go and see your doctor.

@Nolly1994

Reference ranges for normal (which you should be able to get from the NHS app where you view your results):
TSH - 0.27-4.2
FT4 - 12 - 22

You didn't mention your latest TSH. But you're diagnosed Hashimoto's and your FT4 is below normal reference. You should have started Levo by now.

As I mentioned I was TSH 4.9, FT4 12.6 and TPOAb 1300 at diagnosis. Like you I took private test results in to request a repeat and get diagnosis. I didn't have any issue/push back from my GP, I just tested privately due to my unusually short luteal phase and a bunch of medical research that indicated it can be caused by hypothyroidism. We also have other auto immune disorders in the family so it was a potential cause.

You could reference Cambridge University Hospital's Hypothyroidism page if you feel you need to back up your request to lower your TSH to 2.5 as you're planning to conceive. I would be careful not to mention infertility though. Whilst thyroid issues can impact fertility, the reason that they are advised to get you to 2.5 is as a protective measure for a potential pregnancy/baby, not to help you conceive the baby in the first place. So stick to that perspective and I would hope you'd find them receptive.

I did IVF a few years ago and I had a "normal" TSH level (I think it was around 3.2) but the doctor at the clinic wanted to lower it to under 2.5 (I think). She had to send a letter to my GP to ask them to prescribe me levothyroxine, which they did reluctantly, and were funny about my entire pregnancy. The levothyroxine did work well though.
I've moved doctors now and they're allowing me to stay on it even though my TSH is lower, as I'm doing another around of IVF this year.

Sorry, just double-checked in the app, the reference ranges I mentioned aren't NHS.

NHS are:
TSH 0.35 - 4.9
FT4 10 - 20

Which does make more sense because that's why the GP suggested I shouldn't need to start Levo cause I was TSH 4.9 and FT4 12.6 😊But I countered with TTC and started Levo that day.

Thanks so much for this - my NHS app has a completely different reference range for ft4 of 7.86-14.41. I'll definitely query all of this next week.

My FT4 has gone from 16.2 (2021) down to 9.40 (2023) - so definitely concerning!

My TSH has gone up, but not loads. 3.09 to 3.89.

I guess the reference range varies by NHS trust - very frustrating! I've just had a quick Google and have managed to find 2 different NHS ranges and a third one listed on the British Thyroid Foundation website. 😅

Good luck with it all. Your FT4 is trending down, TSH trending up (slowly) and you've got a constant lump feeling in your throat. Throw in that you're TTC (don't mention infertility) and I could definitely see a GP prescribing Levo for you if you mention the Cambridge Trust website.

After my GP referee me and the NHS denied us ivf even though we have no children, the consultant said my TSH was too high and said it should be below 2 will ttc although my GP had said I was fine at 3.9 and 4.5 or so. Tell you GP it should be 2 for ttc.

These are my results!
Is this indicative of thyroid issues or not really?

Personally I'd have no concerns about yours (but not a doctor). The slightly higher TSH reading (which is still well within normal) is paired with incredibly normal FT3 and FT4, which means that even if your thyroid was struggling a little bit, it's actually keeping up with demand perfectly. And from everything I have read, the most important thing is actually that you have enough T3 and T4. The symptoms of hypothyroidism are caused by inadequate levels of T3 and T4. Which you don't have right now.

I think from all the research I did the most common healthy TSH reading is more like 1.6-2.6. So perhaps you might want to keep an eye on your TSH over time to see if it trends up in a worrying way, then check FT3 and FT4 again if it does. Although TSH does naturally trend upwards as we age, and with higher BMIs, hence checking to see if you've still got enough T3 and T4 circulating if you see it going up.

My subclinical hypothyroidism was missed and I did 3 unsuccessful rounds of IVF before it was noticed (bloods had been done before the first round but nobody noticed as they were 'within normal range') and they were mainly concerned with my husband's low sperm count. After the 3rd failure i saw the clinic director for my WTF appointment and was told my egg quality was bad and they finally noticed my subclinical thyroid numbers and put me on thyroxin. Pregnant naturally 3 months later. After that baby I went off the meds for 2 years and after going on them for 6 months got pregnant naturally a second time.

You need to insist on getting it below 2.5 if you are having trouble TTC. I wish I'd known as I likely went through 3 invasive procedures for nothing and spent £10k when all I needed was levothyroxin.

@Curiosity101 thank you so much for looking at my results and the thorough response! Super helpful

@bluebird3 so you can stop and start levothyroxin? From what I've read (not a huge amount, v happy to be corrected) once you're on it you're on it for life

Out of interest @bluebird3, what were your numbers at the time?

I conceived with a TSH of 4.8. GP ‘wanted to check’ that I needed to start medication, even though the endocrinologist said in my outpatient letter than I should have a TSH kept below 2.5 in pregnancy with Hashimoto’s. She took two weeks to ‘check’ and get back to me- I did in fact need medicating (shock!). In the meantime I lost the pregnancy.

Pregnant again at almost 12 weeks with a TSH now at 1.7.

No way to prove that the thyroid caused the MC but was very frustrating and plays on your mind when you know your levels are sitting too high.

See if you can get a good GP and push for a small dose to get you under 2.5.
Good luck 🍀

If you need it to be under 2.5 for pregnancy you can come off it once you are not pregnant provided your levels are normal. A lot of IVF clinics will put women on a small dose if just over.

I think the ‘for life’ thing is because once you’ve got a shitty thyroid (above the cut off), you likely have thyroid disease which doesn’t get better.

Can I just say a giant thank you to everyone for sharing your stories and educating me ❤️so grateful for MN

As my numbers are within 'normal' range I didn't need to stay on it once not ttc

I don't remember exactly but I had two checks before starting IVF and one TSH was slightly over 4.2 and the next was slightly under. So think they assumed the slightly higher one was within margin of error. No idea why the fertility clinic didn't pick up that these were too high for ttc before all the IVF.

The clinic director looked through all my 3 failed rounds and said my egg quality was bad but I was 31 at the time so the only thing they could think maybe effecting the eggs was my TSH levels.

I’m so grateful to have found this thread and just wondered if anyone could give me any updates? Did medication help?

Im currently 38 weeks pregnant through IVF. I’d asked my GP for an MOT blood test a year ago and was told everything looked fine. I saw a consultant to be booked in for an induction last week and she asked me what treatment I’d had for my Thyroid (drum roll… absolutely none). My level was 4.7. T3 and T4 weren’t measured. Consultant felt sure I could conceive naturally and ordered another blood test… this has sent me spiralling a little bit, the thought that we had 5 years of infertility and then IVF for something that is such a easy fix?! I’m very grateful to be pregnant and am sure when I meet my baby I’ll have no regrets that things turned out the way they were meant to. But if we decided we wanted another, or if my thyroid is sluggish and there are things I can do to give me more energy, I’d like to know!

Many thanks!!

@Sep88 Id follow the same thought process of your consultant. If I were you I’d request a full Thyroid blood test from your GP and not accept any push back. You want a full one which includes antibodies just in case you have hashimotos.

I feel much better than I used to pre Levo. And my second pregnancy was straightforward with no bleeding unlike my first one.

Whether Levo helps you or not is hard to predict. But step 1 is getting a full blood test for it and discussing treatment with the GP

Don’t you basically just need a TPO blood test to confirm hashimotos. Not sure an endocrinologist is needed for that. They were useless with me and just suggested I get more sleep.

following as also in disagreement with GP over TSH and TTC