hypothyroidism - TSH and TTC

[harrietm87]

Hi all. I have had hypothyroidism since I was 16 and have been stable on 150mcg since i was about 21 (now 28). I had no idea of the possible related fertility issues until I started thinking about TTC.
I've recently had my TSH checked and it was 3.90, which is within the normal range (under 4.5) but much higher than is recommended for pregnancy (2.5). My GP is not concerned and said my dose doesn't need to be increased unless I conceive. Does anyone have any experience of this? I'm wondering whether I should get a second opinion and also don't want to delay starting TTC too much longer.

There is very clear guidance that your TSH should be under 2.5 when TTC or pregnant, and your levothyroxine needs to be increased by 25% as soon as you get your BFP.

High TSH has been linked with failure to implant and miscarriage, and women undergoing fertility treatment aren't allowed to start until their TSH is under 2.5, because it can be so detrimental if it is higher.

How often do you have your TSH checked? In your shoes, I'd be inclined to print off the guidance and take it into your GP and ask if they can up your dose (and tell them you've been unsuccessful ttc so far if needs be). If they refuse, I'd up it anyway, although they might flag up you needing repeat prescriptions more often

Thanks for your response. I usually have it checked every year but don't know what my last numbers were because I was told it was normal and my thyroxine dose didn't change so I didn't question it further. I'm annoyed by my gps response because as you say the guidance looks very clear. I'd be wary of self-medicating though because I wouldn't know how much more I need to take!
Once my TSH is in the normal range is there any further impact on fertility/miscarriage likelihood?
I've just made an appointment for next week so will raise it again then.

Be very wary of Self medicating as it could affect your heart, which if this happened would be dangerous

I got pregnant first try with a TSH of almost 4. They immediately increased my dose and my TSH is now 1.9. I'm 34 weeks and everything has been fine. I got so worked up aout being infertile, my TSH levels etc and in the end it was all fine. Everyone is different. I feel a damn site better with a lower TSH level though!

They check it every year?!
I have to have mine checked every 3 months. They won't give me a repeat prescription unless my blood tests are up to date.
Can you ask to be referred to an endo? It sounds like your GP isn't particularly up to date on the management of thyroid issues

Thanks all. It is definitely true that my gp is not up to date on this. She told me there were no NICE guidelines on it so I had to show them to her! It's so frustrating. She has referred me to an endocrinologist though so at least there's that. I'm looking forward to feeling myself again!

I have congenital hypothyroidism so I have taken thyroxine from birth. I have been on 150mcg as an adult and stayed on the same dose throughout two pregnancies. I did query if the dose should change during pregnancy and was referred to a consultant and they said no I was fine on 150 and tests proved that.