Ttc #2 and under active thyroid

[AppleMum29]

Hi all, just joined up as me and the OH are ttc number 2! I had #1 in 2010 after one month of trying after the pill no problems but a c-section birth due to complications. Found out two years ago I had under active thyroid so commenced on levothyroxine 100mg and 50mg every day!

We have started ttc and I have been taking pregnacare conception also it's early days. I am just concerned about the thyroid and haven't been to the doctor as yet to speak about thyroid and ttc. Anyone else here that has the same problems with under active thyroid and ttc?

Hi applemum, I'm in the same position as you although I was diagnosed with my under active thyroid before I had dd. I was only on 25mcg a day but am now up to 50mcg a day.

We've been trying for 6 months for number two and nothing yet. Feeling a bit disheartened as I conceived dd first month of trying! I need to see my doctor as my last TSH result was 2.9 and I've read that is should ideally be below 2 when ttc or pregnant, even if your current medication makes you feel fine. Do you know what your levels are?

It's just another thing to worry about!

make sure you have a low tsh (50mg is a v low dose of meds, do you feel ok on it) before conceiving and once pregnant, immediately increase the dose. if your gp doesnt know how much by, get them to find out now while ttc - i think it is by 50 usually but i dont know for sure and i guess it depends on your initial dose too). it is importnt to increase straight away when pregnant

also, while ttc, it is a good time to test all other main things thst can be low when hypothyroid: folates, b12, vit d, ferritin. check the results on here as, for instance, ferritin should really be over 70, not 12 as your gp may say

I don't know my levels unfortunately I am on 150mg a day so it's a very high dose and I feel fine! I maybe should make an appointment with the doctor to talk it out and check my levels. I have a funeral to go to next week after working all this week so be the following week before I can get. Now. This is a little disheartening as when I asked about ttc when I was diagnosed the doctor said at the time there should be no problems when I want to start and to do as normal as I did with my first baby!

Hullo! I've had a diagnosed underactive thyroid for around 18 months and have steadily increased from 25mcg to my current stable dose of 150mcg. I've spoken to my GP about conceiving and being pregnant on levothyroxine and she advised me to continue taking it but that I would need more frequent blood tests to keep an eye on my levels - I guess this means every month/six weeks as opposed to two/three months. I wasn't advised to expect any difficulty conceiving due to my thyroid though; I imagine it's more to do with how your thyroid affects your menstruation. I know that when I increase my thyroxine I tend to skip a period, but it always settles down again.
Don't worry

Well with ttc #2 I just realised my AF was due 12th but nothing as yet! Don't want to get hopes up due to having no cramping what so ever and it's only been month (although first one only took that) can't be that lucky second time around! Will just have to hang on in there and give it another weel and if AF hasn't shown attempt POAS but there's been no signs of cramping/spot bleeding or anything! Very confusing this.

exciting! fingers crossed

i think if you are feeling well and tsh is good eg well below 2 then your body is supposed to be working as normal, as though you were not hypothyroid, but the immediate increase in meds is important

i have got a copy of 'understanding thyroid disorders' and it says as soon as you are pregnant visit gp who will probably immediately increase dose by 25mcg and do a blood test. the ave increase needed is 50mcg.

i would not rely on my gp knowing that and if ttc it is the perfect opportunity to tell them in advance so they can read up about it.

I agree, if your TSH is stable and under 2 you should not have any trouble conceiving and maintaining a pregnancy. But in the first trimester the baby needs your thyroid hormones, until it makes a thyroid of its own, and that is why you need to be regularly checked during your pregnancy. My GPs are aware of this, so hopefully most are. It's really important, because if your TSH is too high in pregnancy you have a higher chance of miscarriage, or when the baby is born it could have a lower IQ.

Well I now have pushed for an appointment tomorrow so a blood check and inform them about ttc so hopefully all my levels are normal :-)

Good luck Applemum! My next thyroid blood test is on 27th so I'm hoping I'll have a BFP by then!

I have had an under active thyroid since the age of 18. 150 mg per day of thyroxine.

Conceived 3DC with no problems and pregnancies went well. Having regular checks on your levels is good practice and this includes post birth.
Breastfed all 3 too.
Hope this helps. Good luck

Thank you for all the positive information ladies :-)

Well had my bloods done it has been a long time I asked the nurse to check it was last may :-o I was very unhappy when I realised how long they have left me! Results tomorrow, still no AF as yet so plucking up the courage to POAS possibly tomorrow! Don't want to get my hopes up in case it's just irregular at the moment but that's AF 5 days late. Here's hoping for a BFP tomorrow and all levels come back fine

Apple I have to arrange my own blood tests every 2 months!! Were you stable back in May? Hopefully the results don't show anything you don't expect :)

leezl, your 2 month tests followed by dose change doenst usually continue once you are stable. when the right dose is reached you just test yearly or if you feel the meds are not working. 18 months is an incredibly long time to take to go from 25 to 150 mg. it is possible to go straight to 150, and some gps do this, or to start on 50 and take it from there. only where heart problems/the elderly are issues is it necessary to take 18 months to get to 150! or have you been on 150 for a while but still feel unwell? or is it because you are ttc? if you are happy with 2 month blood tests, thats fine, just wanted to let you know you dont need them if stable!

Thanks merci! I was just told by the GP that we should test every 3 months and increase if necessary, but only by 25mcg as she was concerned about increasing too much. My last blood test showed that I was stable, so it was the first time I haven't increased and stuck with 150mcg (so I've been on that dose for 4 months). I feel very well at this dose and am finally able to lose weight with diet and exercise.
When I went in to ask about taking the meds while TTC and pregnant she told me I'd need more frequent blood tests to make sure the levels are healthy. She told me to come back for a blood test that week, and to have them every two months instead of three, so since I'm TTC now and it's been two months since my last test I figured I might as well have one now! When I said I had to arrange my own tests I meant that I didn't get "called in" when they were due, and I have to make the appointments myself and keep track of when I'm due a check. It's no bother for me really!
It's a confusing business! Thanks for the advice though : )

It's a very long time but everything was fine last blood test they have never told me my levels just that its fine and continue taking my original dose if 150mg a day :-/ so I assume its at the level it should be from all tests as I was started on 150mg and its never been changes for me?

lol, sounds like every gp does their own thing! at least, leezl, altho it took ages to get up to 150, your gp sounds very keen on keeping your levels monitored while ttc.

its good, applemum, that you started on 150mcg, saves lots of time, some gps dont like to go straight in at replacement dose level. i am on 100, started at 25 and increased every 4-6 weeks. i still think i could go up higher but my tsh is as low as it can go and i feel fine. now i just go once a year, but, yes, like leezl, i have to arrange the test myself.

i know i mentioned it before, but if ttc, get your vits tested at the same time: vit d, ferritin , b12. with thyroid issues there is usually deficiency in one at least and better to start pregnancy with good levels of all of them

Well sorry I have not replied for so long had a death in the family so was away for a week! Well I POAS and alas it's negative :-( still no AF yet either :-/ my levels are fine just on the lower side but soon as I get my BFP I have to go back for tests and likely up my levothyroxine

I am in a good position to advise here as I'm underactive and TTC, and went to see a consultant Endocrinologist about this four weeks ago. My own GP said I could start TTC straightaway, and that as soon I got a BFP, I should go back to see him and he'd refer me to a consultant. However, I did some online research and I wasn't convinced that this was good advice (I was right).

The consultant wrote up the notes and posted them to me as well as my GP. I'll quote parts and paraphrase others.

He explained that in the first trimester, the mental and physical development of the foetus relies on maternal thyroid hormones. If you have an underactive thyroid, even if it currently regulated with thyroxine, this can quickly become off kilter as the foetus draws on supplies, so this is why you should have blood tested every 4-6 weeks.

After the first trimester, the foetus's/ throid gland is fully functioning and not as dependent on the mother. At this point, low thyroid hormone levels will be very tiring for the mother, but not harmful to the baby.

The key point that I really did want to alert you all to is that he said that- and I quote- 'the current recommendation is to keep the TSH just under 1 to ensure adequate replacement' throughout pregnancy and also that you should 'get the TSH to around 1 before planning pregnancy and theoughout the first and early second trimester'. The consultant puts this twice and draws attention to it. So, those of you who have been told TSH 2 should get a second opinion from an Endocrinologist (not your GP) as this is at odds with what I was told. I was on a dose of 75 when I saw him, and he put me on 100 immediately, even though my TSH was 1.82.

He explained that if your hormone levels are too high it increases the risk of miscarriage, and if they are too low, it results in impaired foetal development. This may just be slightly reduced intelligence, and you may not know there was ever a problem, but the foetus will not reach its potential.

I really hope that this helps someone, and if anyone wants to ask anything else, please do and I'll check the letter and see if he covered it. The main thing though is not to go on the TSH 2 recommendation- that is not what current research is suggesting and I would definitely get a second opinion from a consultant Endocrinologist if that is what your GP is saying.

Thanks for the info Louise! I had my blood test this morning so when they telephone with the results next week I will advise them that we are actively TTC and see what they suggest. I'm expecting my results to be around 3 or below as I'm quite stable atm so we'll see!

The GP never actually said what I was just that it was fine if a little low and to go back in three weeks to get another blood test and soon as I get a BFP to make appointment and they will up my dose of levothyroxine then :-/ it's so hard to know what is right and wrong and you trust your GP to know and advise what is safe and best but its not always the case either. I am back in three weeks so shall keep this info and mention it all when there see what response I receive then :-) thank you so much for that information :-)

Louise, thanks for your detailed explanation. What I still don't know is what time to get my TSH tested. The last time I tested was in the afternoon, which gave me a result of under 1. The time before that, on the same dose and 3 months earlier, I tested in the morning and got a result just over 2. Research has shown that TSH can differ more than 2 points during the day.

It's not only frustrating different doctors tell you different things, but also that no one seems to know about how TSH levels differ and which one you should go for (or the average?).

Good point Blue, I always have mine tested first thing in the morning but I never considered that a different time of day (or after eating etc) might give a different result.

morning is best and dont get any annual tests done in spring as tsh is lowest that time of year

great info from the endocrinologist

now i want to know why specialists can see our fertility is best when tsh is under 1 but think the rest of our bodies work just fine with ths 4,5

Wow why spring Merci??