TTC with Subclinical Hypothyroidism- can someone explain this to me?

[AngeloMysterioso]

I saw my GP this morning for a sort of check up as my DH and I plan(ned) to begin TTC for our first DC during my next cycle (been pregnant once before, had a termination). All seemed positive, he said to start taking folic acid, there's no reason why I shouldn't conceive straight away etc etc.

He noticed as our conversation was finishing though that I'd had a blood test for my thyroid levels recently which I have to repeat in 6 weeks, and the results suggest I have subclinical hypothyroidism. He then said I should put TTC on hold until I've had the second blood test and he has consulted with an endocrinologist. Hasn't put me on thyroxine or anything in the meantime though. I asked if I should start taking folic acid regardless and he said something along the lines off "well, it might be useful to get into the habit."

I've done a bit of googling but it's making my head spin so I was hoping someone with a bit of knowledge could explain the numbers for me and what it might mean? Apparently my TSH level was 7.77 and my free T4 was 14.8.

Also freaking out a bit because AF was due yesterday. Taken a test just to see, BFN. But that's happened before and been wrong and I've got sore boobs which was the giveaway last time!

I have hyperthyroidism so not an expert in hypo but as I understand it, your TSH (thyroid stimulating hormone) is a little high and your free T4 is at the low end of normal. So you have the hormone that is telling your thyroid to work harder, but the thyroid is not responding as much as it should.

There is an increased risk of miscarriage with an underactive thyroid, which is why they've told you to hold off conceiving for now. But there's no need to panic if you are pregnant, you'll be referred to an endocrinologist who will monitor your thyroid levels and treat if needed.

Hope that helps

I'd also suggest you get a test for anti-thyroid antibodies.

My guess is they will try you on some meds, which might take time to get your levels better for ttc.

They should be aiming for t4 on the higher end of normal. Tsh ideally below 2.5.

Keep pushing. Many gps are rubbish with thyroid (not saying yours is), so I'd suggest you start educating yourself to become your own advocate. Thyroid uk is useful. There are also a few threads that you might want to search for that have links to research. Search for 'thyroid' in the conception board.

Hi, I have hypothyroidism which was originally diagnosed as sub clinical, ie TSH is too high but T4 is within range. I was put on thyroxine as I was really tired.

The reference range for TSH is normally around 0.5 to 4.5 or 5, but for TTC it should be under 2.5. Not all GPs know this, but it is in line with the NHS guidelines and the endocrinologist will be aware, but if a GP ever tries to tell you this isn't the case then be prepared to print out information from the british thyroid foundation to back yourself up! One thing I have learned about thyroid problems is that some GPs are knowledgable but some are very dismissive so you should be prepared to advocate for yourself sometimes.

I have a DS conceived before I had any thyroid issues, and in April decided to TTC #2, unaware that TSH should be below 2.5 for TTC. My TSH was around 5 at the time. We conceived on the second cycle of trying so no problems there, but unfortunately had a missed miscarriage discovered at 10 weeks. My GP had increased my thyroxine when I found out I was pregnant but I believe this may have been too little too late and possibly contributed towards the miscarriage. Obviously there is no way to prove this was the cause, but there is a link between hypothyroidism and miscarriage and the guidelines for TSH levels when TTC and in each trimester are there for a reason.

The GP I saw after my miscarriage said my TSH was fine as it was then around 3.5 but I insisted she increase my dose anyway - she said she'd never heard it should be below 2.5 but she didn't doubt I'd done my research and was happy to increase the dose anyway. We've just started TTC again so hopefully this time my thyroid levels are in a better place, but I feel like I could have potentially avoided some heartache by getting them in order last time round.

I don't mean to worry you unnecessarily, but I definitely think it's wise to wait to TTC until your TSH has come down. It's positive that he is going to consult with an endo - I know it's ages to wait until you get another blood test but he probably wants to compare the two results before going onto thyroxine. I know it's frustrating to wait to TTC but I'd say anything you can do to put yourself in the best position for a healthy pregnancy is worth it. Good luck