Ttc with Hashimotos?

[Aeiou90]

Good evening all- I've just found out I have a thyroid disorder- TSH is 6, TPO 900. We've been ttc for 2 years so this maybe explains it.

Has anyone with hashimotos got any advice for ttc?
I've read I need to get levels in order- which levels are these?
I suspect my GP is not on the ball- he has refused to medicate saying I don't need it even though he knows our ttc issues, but he has referred us to endow and reproductive health clinics. Which both have waiting list of months and months.
Thanks for any advice x

I was diagnosed with Hashimotos about 6 months after my first child was born. It took me 8/9 months to fall pregnant with him. Since I began treatment, I began TTC #2 and have fallen pregnant a further three times, each time taking no more than 2 cycles. (Unfortunately the first and second ended in MC but I'm hopeful the third is going to stick) This could of course be a complete coincidence.

I am fortunate in that I live overseas with great medical insurance and so was very quickly referred to an endocrinologist who keeps a very close eye on me, especially now I am pregnant again (I'm currently having blood tests every three weeks) It's great that you've been referred - I think it could be worth the long wait in the long run.

My understanding is that TSH should ideally be below 2 when TTC and for me personally, when it goes above 2-2.5, I start to feel like shit quite quickly. So in my totally non-medical opinion, 6 is quite high when TTC BUT once treated, it should come down very quickly.

I have my fingers crossed for you!

You must be medicated, I’m at work but will dig out my paperwork when I get home.
You should actually be at an increased level of meds in the early weeks of pregnancy so you need to get this right first.

It’s totally possible to conceive easily with hashis so don’t worry about that.

Like I say, I will post back later with all the technical information

Thank you, really appreciate your replies. I'm beginning to see things clicking together and realise I feel pretty crap in comparison to a few years ago... really want to feel like me again! x

I think you will find the difference in how you feel once you are correctly medicated will be huge.

Before I was diagnosed, I gained a LOT of weight, my skin and hair and nails were so dry and weak, I had ZERO energy, every part of my body ached especially my hands and wrists, my mood was so low, even my face changed (everyone kept telling me I looked 'different' and I could tell they didn't mean in a good way)

Combined with the fact that I had an exclusively breastfed newborn baby who was a shit sleeper and I went back to work full time when he was 4 months old, I honestly thought I was dying at one point. I cried with relief when I was diagnosed.

Fingers crossed you get referred quickly and the rest of your TTC journey is a short one!

Hi @Aeiou90 ,

I work as a gp and have an underactive thyroid and have been trying to conceive for some time so have researched this a lot!!

Tsh needs to be between 0.3-2.5 when trying to conceive - you may well get pregnant with other levels but there is a higher rate of miscarriage with a high tsh. Personally I also feel much better when my tsh is in this range - it recently went up to 3.6 and god did I notice!!!

Also if you get a positive pregnancy test your levels need checking again asap and your thyroxine should normally be increased.

Lots of gp's aren't great at managing this - just a gap in their knowledge. I often have to tell my own gp what to do

Here's a reliable source of info on it : www.btf-thyroid.org/information/leaflets/38-pregnancy-and-fertility-guide

Says tsh should be in lower reference range. Normal is 0.3-5 so you are borderline at 6 (as I was) ideally should be

Thanks everybody- that's especially reassuring you are all advising a similar approach, and I'm usually very reluctant to go 'against' my GP but on this one it just doesn't sit right- everything I've read and your opinions too say I will need medication to get TSH lower than that to even have a chance at successful pregnancy...

Claire- are GPS allowed to prescribe for me or does it have to come from the endocrine clinic? I got the impression GPS can do it, I just want to check before I start ploughing through the list of GPS at my surgery, best wishes to you too xxx

Gp's prescribe it. Usually start at 25mcg and then check your TSH level again in 6-8 weeks and go from there. Even if it's then ok I'd check again every couple of months if your trying to conceive as it can change when you're in the early stages of starting medication.

I went several months without checking and regretted it as my TSH went too low and my periods almost disappeared - I'm now on alternating doses between 75mcg and 100mcg to get it in range which is very annoying!

Best of luck - you could email/write a letter to the gp saying your concerned as you've read x, y, z then it gives the gp time to look up guidelines and call you about it? Just a thought.

And if you get pregnant you should be referred to obstetrics endocrine clinic x

Thank you very much!

I have one more question- my husband has read up about this too- specifically how diet can improve things... he is keen for us to try vegan specifically. I have to admit I've read success stories about hashimotos and gluten free- is there anything in this in your opinion? I'm assuming the diet is alongside medication, could it ever lead to coming off medication or is it more that the thyroid damage is done and the diet can just slow down further damage? Or is it all a load of rubbish?! x

I'm afraid I've never heard of that! Hashimotos is an autoimmune disease meaning your body has inappropriately attacked its own thyroid gland . It often runs in families along with other autoimmune diseases.

I've never been told or tell anyone that diet impacts on it x

A wife of my husband's friend has Hashimotos. They have 2 failed IVF-s and is considering IVF DE now, as she is 42. A doc also recommends undergoing IVF DE with PGS NGS xx

Hi @fififa , what's PGS NGS?

Thank you all- that is so helpful, i really appreciate you taking the time to reply, think I feel more confident now saying to (a different ) GP that I want to take the treatment path and try to get levels under control for ttc. Thanks for the idea of emailing gp first- I hadn't thought of that! xxx

I have had Hashimotos for 13 years and I am now 29 weeks pregnant with my third child.

Your TSH of 6 is a little high but you seem to have caught this early as usually it would be a lot worse. Did you have the blood test first thing in the morning? That is the most accurate time to do it.

I have not had trouble conceiving or maintaining a pregnancy but I made sure I knew a lot about what I needed to do. My endocrinologist said my TSH should be maintained within a level of 1-2 when TTC and pregnant. Once you conceive you need to increase your dose of thyroxine and have regular blood tests. My thyroxine dose has increased from 150 to 200 in all my pregnancies.

The baby does not have a working thyroid until after 12 weeks so getting your thyroxine dose right at the start is key. Ask for a blood test as soon as you find out you’re pregnant. Have it in the morning and do not take thyroxine before the test.

Thyroxine is best taken in the morning on an empty stomach. Avoid milk for an hour after taking it. I take it as soon as I wake.

You will be referred to an obstetrics endocrinologist but in my experience you don’t see them until after your 12 week scan. So don’t wait to see them before doing anything.

You could take the NICE guidelines to your GP or advice from the British Thyroid Foundation. Good luck!