TSH levels pre-pregnancy with no diagnosed thyroid disorder.

[Yellowtulip96]

Hello,

I have recently had an advanced thyroid check which have all come back 'normal'.
TSH - 3.38
Range - 0.27 - 4.2

T4 - 21.5
Range - 12 - 22

T3 - 4.8
Range - 3.1 - 6.8

My doctor has said that there is no indication of a thyroid disorder and my antibodies have also come back negative. All in all, on the face of it, looking good. However, I have read multiple sources that say in order to conceive, your TSH should be less then 2.5. When I asked the doctor this, he agreed. I asked what I need to do in my situation then as I am TTC. He said 'good question' and told me to retest in a month for piece of mind but told me I shouldn't worry as my thyroid is behaving as it should. He seems to think that the <2.5 rule only applies to those ladies who already have an existing thyroid disorder as management as otherwise it would be a routine thing that all women would have a TSH check before and during pregnancy.

My question is, is there anybody who has had successful pregnancies and A) not known their TSH levels so is irrelevant or B) has had higher TSH levels then 2.5 in pregnancy with no existing thyroid issues and had a successful pregnancy?

This information about TSH is really not well known for pregnancy so I am struggling to understand if mine is an issue or not as I have no thyroid disorder.

Hi, I don't have a thyroid issue or know much about it, however, my TSH level recently came back as 3.3. I too queried this with my GP and had it retested a month later and it's now down to 2.3. I made sure I tested at the same time in my cycle, not sure if that can make a difference or not!

I am going to ring my GP to discuss next week anyway but I'm hoping it was a one off 🤷🏼‍♀️

Hello, I had no idea until I went to a consultation with an NHS IVF dr and he said it 3.2 which was a little high and needed to be 2.5. He wrote me a letter for Gp who since prescribed it. I feel pregnant the first month taking it (sadly resulted in a MMC)
annoyingly I had paid for private tests a year previous and they had mentioned nothing about it!

When I was TTC my first I went to the GP to have bloods done as an initial investigation into why we hadn't conceived, and they checked my thyroid levels at the same time. No previous history of thyroid issues. My TSH was 3.04 which I was told was higher than they'd like for TTC so they started me on a low dose of levothyroxine - when I conceived four months later my dose was upped slightly and my TSH was checked regularly through pregnancy to ensure it stayed below 2.5 and ideally close to 1 for the duration.

Post-pregnancy I had my thyroid monitored for a while and was told to wean off of the levothyroxine. They were in range when last checked last summer. I've this week had my implant taken out to TTC #2 and when I mentioned I'd been on levothyroxine last time round to the nurse she told me to check in for tests to check my levels again before we get deep into TTC.

I know experiences vary massively around this but my GP has always been incredibly helpful, and I'm sorry it sounds like yours has been less so...

I got extremely fixated on TSH levels when I was TTC for this same reason too (read about it needing to be below 2.5 and mine was 2.9). I was soooo stressed and found that doctors either didn't know anything about it really or I felt they were fobbing me off.
Eventually a doctor that I trusted to be thorough and helpful sat me down and really explained. Her explanation was basically what you have been told.
That it's only a concern if it is over 2.5 in women WITH a known thyroid issue, who are already receiving treatment (medication). Because it would suggest that their medication is not being effective at managing their existing thyroid condition. So it's not the slightly higher TSH that would be a problem (in itself) more what it would indicate about the health of that person and the management of their thyroid problem.

A TSH of >2.5 in women who are otherwise healthy and don't have a thyroid condition is not of concern. So long as it's within normal range (below 4 or something like that? I forget now !)
After this I wondered - couldn't my high TSH suggest that I DO have a thyroid problem though?? And the doctor said that in absence any other symptoms then no, it's fine and my TSH was within the healthy range.

This eventually put my mind at rest and I wished someone had explained it properly to me from the start. It was a big relief. I really hope this helps to give you some peace. TTC is stressful enough ❤️

As it happened I had my TSH levels retested shortly after and they had dropped to 1.9 anyways!

My first test was December I think and showed 2.9
My next was June and showed 1.9

They explained the difference saying that usually it's lower in summer?? Not sure!

In December I actually did get pregnant too but had a missed miscarriage. This was when I became fixated on TSH as I worried it was to blame :-( but really there's nothing to suggest it was linked at all in the end. I got pregnant again in the September and he is nearly 3

I really hope this helps!

Just read some other replies on here which suggests that slightly high TSH DOES need to be treated which isn't what I had heard in the end and obv goes against what I've said here. To reduce confusion, I would recommend looking online for some proper peer reviewed research articles regarding this. Things may have changed. I know when I was looking there was a distinct lack of anything confirming issues with TSH >2.5 which should have been my clue when I was stressing. If it was true/fact then there would have been more info. I could only find random things on American doctors websites (where they charge for patients everything so it's in their best interest to treat more things if you see what I mean!)
Hope I haven't contributed to anymore confusion and stress with my post!

I've just gone through this same discussion with my Dr, but my thyroid does get monitored yearly due to problems as a child.
My gp really didn't seem that worried but has sent a message to an endocrinologist to get a second opinion (I have had 2 miscarriages at thos point).
Although there is research out there NICE don't actually suggest treating unless a known thyroid problem is also present. So it all seems pretty grey

@Eatsleepbakerepeat that's interesting! I had a MMC in December and trying really hard to not put it down to this.
I'd be interested to know what the endocrinologist says in response! The fact that I don't have a thyroid disorder is making me question the whole <2.5 thing 🤔

@Yellowtulip96 You're in a similar situation to the one I was in.

Tsh fluctuated, all other t ranges were fine, so I have subclinical hypothyroidism and GP said tsh was in the 'normal range', but didn't think that it needed to be under 2.5 for ttc and pregnancy.

I ended up going to a private gynecologist for 3 recurrent miscarriages last year and he believes it was down to high tsh level. He asked the GP to prescribe thyroxine to keep tsh under 2.5 especially in first trimester of pregnancy.

Definitely push to get to a consultant, especially if you've had a mmc, as it could be causing issues. Hope you get sorted x

@T2024 thanks for your reply. Do you mind me asking what your TSH level was when it had fluctuated?

No problem at all @Yellowtulip96 I was anything from 3ish to 7/8 after a miscarriage last year. it also fluctuated from under 2.5 and upwards, so I went from over active to underactive over years.

If I remember correctly, they consider under 10 ok, they will treat for over 10 but I read up that's for non pregnant, non ttc people. Completely different for ttc and to sustain a pregnancy if you ask a fertility consultant or gynecologist. Definitely think my 3 miscarriages last year were down to tsh level, but getting treated now and under 2.5 thankfully.

They said it can take a few weeks. To get a reply but once I head I can update. We're going to carry on trying so who knows what the next few weeks will bring
I do have a DS who is 3 and when I concieved him it was 1.7, now its 2.8-3.7 hard to see it purely as a coincidence!

@Eatsleepbakerepeat have your T4 and T3 results been okay?

They are, but I always have deranged antibodies so at some point my thyroid will probably go one way or the other but not at the moment. My tSH fluctuates like mad though

I have a thyroid condition and successfully conceived twice with a tsh of 3. My endo likes tsh to be under 2 during pregnancy so I upped my thyroxine and it came down to under 2 within around three weeks. So, in my experience it didn't prevent conception but ideally during pregnancy it should be below 2 for the health of the fetus. The reference range for non-pregnancy is 0.4 - 4, but during pregnancy it should be below 2.5 for the first /second trimester and under 3 for the third trimester.

Have you been offered thyroxine?

Oh also, the thyroid is routinely checked at a woman's first midwife appointment, so around 6-8 weeks pregnant. By the time the results come back and treatment potentially started, this often misses the critical first trimester, so although better than nothing, it's still not ideal!

@DarlingClementine85 I haven't been offered any medication as everything was classed within range and have no existing thyroid disorders.