TTC or Pregnant with an under-active Thyroid.

[hippychick66]

Hi,

We were talking about this a lot on the charting thread and thought it would be good to start a separate thread.

There's about 3 of us at the moment but please do join us too if you are TTC with this added probem.

My results were 9.07 and then a few weeks later 5.5. I'm due another blood test in 5 weeks and hopefully my GP should be starting me on Thyroxin soon.

Quite worried cos the NHS guidelines say your numbers should be a lot lower when pregnant. still i haven't got that BFP yet so I guess I'll worry then.

ladygonegaga and Bessie26 - hurry up and join me here .

I really hope so iggi I lost my 1st at 24 weeks so I have another couple of months to go till I feel a bit safer, trying to be positive though and keep telling myself that this is a different pregnancy and I am getting better care etc. Feeling movement so that is lovely and I am trying to concentrate on that. Can't believe you have had 4 miscarriages, it's so tough, we both more than deserve our fair share of luck this time x

Just back from the consultant, he was very helpful.

He has ordered all sorts of blood tests for Dh and I and an ultra sound.
He said he does not need to test DH's sperm as they are clearly getting to the egg but he wants to check us for chromosonal abnormalities.

He thinks the problem could be my thyroid as my TSH is at 3.9 which he said is within the normal range but in his experience needs to be at 2.5 for conception purposes. He thinks I would be a good candidate to take progesterone from 2 days past ovulation but that he wants to rule everything else out first.
I asked about progesterone extending a doomed pregnancy and he said he would by a week or 2 but not much more than that.

He was totally dimissive of the NK theory and the use of steroids. I think the jury is out on that though as so many women seem to have had success on that front.

One thing I wanted to pass on was that he mentioned 'hyper fertility' as I am getting pregnant reasonably quickly. There is a theory that in some women the uterus is 'unfussy' and allows embryos to implant outside the usual window and that this can lead to miscarriage/chemical pregnancies. He said despite the fact that many women get preggers quickly he said the normal range is 6-9 months.

Hi farfalla that's great news, sounds like there is a lot they can do to help you get a sticky bean. Some interesting theories there, it seems fitting that with a low progesterone level that progesterone supplements may help. Also interesting about the unfussy uterus, I have fell pregnant fairly quickly 3 times now but then again I have friends who have fell quickly and not had any trouble.
The Nk cell one is tough, I know a lot of people have had sucess with treatment but I think sometimes steroids are used a bit too much and all other possibilities should be ruled out first. I went to see a consultant about NK cells and he advised me not to get tested for them. He said they might be high but he would be uncomfortable prescribing steroid treatment after 1mc and 1 stillbirth that he feels were totally unrelated. He said that treatment is not without risk and he just thinks I need a bit of luck.
Lot's of luck with things and I hope you get your results back quickly x

Yes he said there was no evidence it worked and that the steroids cross the placenta etc
However I know st mary's were very anti progesterone a few years ago and they have changed their stance on that seemingly.

I am a bit concerned about going onto Thyroxene (sp) for borderline results as I understand you then have to take it forever. It is interesting that he brought it up before I mentioned it though. hmmmmm.
I am assuming he will do more tests on the thyroid i,e, t3, t4, antibodies.
Is there anything else I should be looking out for?

So sorry to hear about your still birth :(

I know what you mean, it's a bit of a lifetime commitment if you are not even sure you are underactive. Maybe you should just see what he says when you get your results back. If your antibodies are positive then it would indicate that your results are likely to get worse rather than better on their own so you may feel more comfortable taking meds then. The only other thing I can suggest in the meantime is to eat 2 brazil nuts a day. They contain high selenium which has been found to reduce antibody levels and they can't do any harm even if you don't have high antibodies. There are no other thyroid tests I can think of, I always just get tsh and t4 checked now.

That is very helpful thank you!

I have emailed him to check the full thyroid screen will be done, antibodies and all (he already thinks I am a bit of a nutter I am sure!)

Hi! sadly I m/c again :( I'm doing ok tho.

I have leant so much since my m/c thanks to my endo, he is super thorough he scan my thyroid all the way from my breast bone to my chin and the sides of my neck as your thyroid can growth away from where it should be, and explain what he was seeing. He also stood behind me and felt my neck checking for lumps, size etc.

My endo stressed to me the TSH needs to be between 0.5-1.5 for the whole of your pregnancy and you should not TTC until your TSH has been stable at this level for at least 10-12 months (I know this seems like an eternity when ttc but your health and the babies is so important) I am taking this advice and i will try ttc again in 10-12 months.

He told my he would prescribe me 200mg selenium daily as i have hashimoto's and it will help the antibodies.

Also my specialist told me when TTC because I have an underactive thyroid I also need a pregnancy vitamin with Iodine as it is important for the baby to get iodine as women with thyroid problems are lacking this vitamin, my dr recommended Femibion, I checked it is also available in the uk. It is expensive though. Hope this helps.

bebe I am so so sorry to hear that, do you know what caused it this time?
Big hugs

Very interesting about the selenium and Iodine. The Zita West preconception vits have both iodine and selenium (150g) in them. It is pricey though and you have to remember to take them 3 times a day.

thanks ffr, not yet.

Totally forgot before, I also suffer from low progesterone very low :( I have always had v.short cycles because of this. I also have heard there is a link between thyroid and low progesterone.

Wow, you have email access to your specialist?
When I get a panel done nowadays they do TSH, FT3 & FT4 (they don't bother with my antibodies anymore). It is a commitment taking the tablets, but your prescriptions will be free and it's a like-for-like replacement; i.e. you're not pumping yourself full of side-effect inducing drugs, just literally replacing the thyroxine your body should be making, but isn't, with tablets of thyroxine.

What's an NK theory?

popcorn yes in theory, he has not replied yet though! I am seeing him privately though

Thanks for the test bits.

Natural Killer Cells theory as a reason for recurrent miscarriage or indeed infertility. Still quite controversial but lots of ladies on teh recurrent buns thread have been treated with steroids and gone onto have successful pregnancies.

bebe I have also read about low progesterone and thyroid being linked. Were you on any progesterone supplements? The consultant suggested this to me as a potential treatment but he wanted to wait until all the other results come back.

Iodine is about the only thing I'm not on, off to look for some in the shop! (I've a feeling my veggie/junk food diet won't be rich in it!)

Hi, I'm new to this thread. I also have a underactive thyroid and take 75mg of Thyroxine daily.

I have been TTC since June. I didn't know TSH levels could affect conceiving. If my TSH levels are above 2 how does that stop me from conceiving?

I think I need to arrange for a blood test!

bebemad Just read your post. So if I am TTC my TSH level should not be higher than 1.5 or is that just once you have got pregnant?

Hi nappy, I don;t know about the science of it all (although I have just bought a couple of books)
The gist seems to be that the thyroid controls a whole host of other hormones so any problems with that can affect ovulation from delaying it to stopping it altogether.

Are you under the care of an endo?

No, just the GP but haven't told them that I am trying to TTC as I didn't realise an underactive thyroid could be an issue til now.

hi nappyaddict your TSH should not be above 1.5 even when ttc i know the nhs will not agree with this. I go to a private doctor in a country were they are very thorough and strict and dr's say your TSH should be stable for 10-12 months at this level. I know waiting is hard (i'm waiting at the minute 9 months to go!!) but i also know waiting is the best thing, i am doing everything i can to make sure everything will go well in the future, its not worth ttc until everything is 100% right as believe me you will constantly worry is the baby getting enough thyroxine? are you? how is this effecting everything.

Someone higher up said it should be 1.0?

If I waited for 12 months I would be too old to keep trying.
I think it is ideal to keep the tsh quite low and to be regularly monitored - but it is only one of many things that can go right/wrong in pregnancy and I do worry if we get too obsessed with a particular number it could be counterproductive - especially as you will struggle to find a doctor who agrees with the numbers!

Hello ladies. I am new to this thread but wondered if anybody might have some advice or reassurance. I have underactive thyroid and have been on thyroxine for four years. I am currently 8.5 weeks pregnant and just had my thyroid blood results back at my first midwife appintment today. TSH 3.80, T4 16.6. I told her this sounded high but she said it's within the normal range. I wont get to see an endocrinologist for at least three or four weeks but I'm really worried i should be upping my dose. Neither the midwife or the GP seem to have any clue about thyroid problems in pregnancy or any sense of urgency.
I had a successful pregnancy before and my thyroid levels stayed constant throughout so I was a bit shocked to see they have gone up so quickly (TSH was 2.46 at my last reading six months ago). Any thoughts?

It is common for GPs to up your thyroxine dose by about 25mg when you become pregnant. That is what mine always does. If you were on the "right" dose before pregnancy, that won't be right anymore as there is definitely a higher demand on your thyroid in early pregnancy.
TBH I would just increase it myself if I were you - or return to a different gp and say you've heard it should be under 2 in pregnancy (you could google NHS clinical knowledge summaries and take that with you!)
I am speaking from a background of recurrent miscarriage, you might not be quite so worried/paranoid about it all

Thanks Iggi999. I emailed the endocrinologist that I used to see when I was first diagnosed about booking a private appointment as I was in such a panic. He very kindly replied and just said to up my dose by 25mg right away and get my bloods done again in a few weeks time. So fingers crossed that should do the trick....though I have been feeling a bit dizzy since I went up to 100mg but that could just be a pregnancy related thing...

Hi There

This is a great thread. Been following Hippychick, but you have disappeared are you ok? I find your comments really witty and spot on. I am 40 and a bit and trying for number 3 too. Problems with TSH etc please read. Really pd off.

I've been on 100micrograms for the last 20 years, and and fortunately managed to get pregnant straight away twice, and gone on to have two successsful pregnancies (having 150micrograms during these periods).

My health and weight have been ok (althought it is harder with hormone conditions to lose weight) and I took up running and completed a 5k in June of this year.

I've had regular check ups with my Endrocrinology unit at the local hospital all this time, and each time I've been kept at the 100microgram dose.

When I went to see the Endo unit this April for a regular check up I was told that my levels were too high T4 was 22.0, which is the high end of the clinical range, and that I must go on to 75micrograms. I was a bit taken a back by this and I said to the doc that I've been on 100 for the last twenty years. The up shot is that I started to gain weight (all the weight I had lost with running) and became a bit lethargic.

I went to my GP in June,as I felt something wasn't right. Had blood test, results came back as - TSH 25.4 (normal clinical range 0.27-4.20) was sky high and my T4 11.2 (12.0-22.0), so my instinct was right. The fact at this point I wasn't due to see the Endocrine unit until the middle of October, heaven knows what would have happened if I hadn't listened to myself. Needless to say I've been back on the 100 dose since the 1st of September.

The thing is that my DH and I have been trying for a third baby since June and have had no success. I'm sure it is due to my change in dosage. I feel angry at the Doc at the hospital (whom I had never met before, I usually see the Prof who is head of the unit or his deputy). I'm hoping now that I am back to my 100 dose that I'll get pregnant soon.

I feel I don't know my body anymore, and each month I'm hoping to get pregnant, and I don't feel motivated to lose weight as I figure, that if my thyroid is out of whack, why should I bother!

I know this sounds a bit selfish, as my heart goes out to the couples who are ttc their first child, but I badly want this third child as much as I wanted my first. I feel I've been robbed because of the change in my dosage.

I'm due for my regular check up this Tue at the hospital. So hope to get some answers then. I'm hoping to find out soon if my levels are back to the normal range too. My GP mentioned that I could be super sensitive to the change in dose. I just hope that I haven't become infertile while my TSH was so high due to the lack of T4 in my blood serum. So I am going to ask for a FSH and LH bloods to be taken.

Just wondering if anyone else has any experience of this kind. Would be good to share experiences. I have a history of Prolactinoma too, just to add to the mix!

mary I am new to all this but I would say TSH looks high!

Good luck with your appointment, hopefully once the levels are stabilised you should be able to conceive again?

I have a question too:
Got a full thyroid profile

TSH 2.72
Free Thyroxine 13.6
Free t3 4

My TSH has improved in a month from 3.9 on its own (could this be the Brazil nuts and B Vits??)

Have an appoinment in November to discuss with the consultant (obs./gynae) but I wanted to see if it was possible for the hormone to fluxuate?

Hiya

Farfall Saw the Specialist ( a different one from who I saw at my last appointment) today, and he has taken more bloods to check all my levels and Prolactin too.

He said that having my TSH high for a few weeks wouldn't have affected my fertility. I forgot to ask him to take my Follicle Stimulating hormone levels, but maybe ask my GP to do this.

I asked him why was my dosage decreased, when in fact it could have just stayed at 100ug, (my T4 level at the time was 0.22, which is the top-end of the accepted clinical range) and he said that sometimes it can be a difficult call, as he said the level can fluctuate according to outside stimuli, ie. stress etc.

He was really nice and helpful, and said he would call me in 2-3 days with the results, and he is going to book me in for an MRI to check my Pituitary gland (as I had a benign tumour called a Prolactinoma three 20 years ago, and they monitor it yearly). The tumour was what probably put my thyroid gland out of whack, way back then in the first place, as it all happened at the same time in 1990 ish !!