Underactive thyroid and ttc, help with GP

[Kai1977]

I am ttc. I saw an endo in summer last year and he got me to 2 TSH. It's crept back up to 2.75 now (although I suspect my levels fluctuate between summer and winter).

My GP didn't really seem bothered as I was within range. Are there any NHS sources I can show her to convince her the TSH should be lower for TTC (we have been trying for three months which is obviously not that long)!

Check the NICE guidelines for hypo and pregnancy - I can't do it on my phone but I think they'll be a good starting point.

Thank you! But there doesn't seem to be any reference specifically to being 2 (or is it 2.5) or under? It just says it should be at 'euthyroid' level?

This is my issue with the NHS having ranges. I've been within range many times and still felt crap. In this case the GP appears to consider that because I"m within range, I'll be fine to conceive?

cks.nice.org.uk/hypothyroidism#!scenario:3

They've updated the NICE guidelines for TTC so there are no figures now. Disgraceful. You're basically on your own with this.

Your best hope would be to try to get a referral to an end o on the grounds that you are TTC.

If you're on meds your TSH shouldn't be as high as 2.75 anyway. It should be nearer 1!

This link from the British thyroid foundation gives the recommendation of below 2: www.btf-thyroid.org/projects/pregnancy/202-thyroid-in-pregnancy-information

This one is much more detailed: www.thyroiduk.org.uk/tuk/guidelines/Lothian%20Guidance%20for%20Diagnosis%20and%20Management%20of%20thyroid%20function%20in%20pregnancy.pdf

Thank you! How easy is it to get referred to an endo without private health insurance and a 'serious' medical reason?

I don't know but I am watching with interest. I've just got BUPA coverage with work and am considering asking for a referral.

I am not on meds but TSH was 2.5 a while ago. I was told this was normal but I was concerned that it is too high, given the advice for those on medication. GP insistent this doesn't apply in my case and all is fine.

Since then I have had fertility issues (unexplained), a range of symptoms that could be thyroid related, and three miscarriages. My new FC also agree that my TSH is too high. I'm not sure what to do next.

They can't diagnosd by TSH. You need your FT3 and FT4 checked. You should aim for TSH of 1 and FT3 and FT4 in the upper range. 2.75 is a sign your thyroid is struggling. It's so frustrating.

You should also get your antibodies checkrd for Hashimotos and check ferritin, vitD, folate and B12 are all well tgrough range and not near the bottom. Blue horizons are good for private tests but there are others.

Thank you. So the NHS can't check for FT3 etc or Hashimotos? And what happens if the private test shows anything up, will the GP pay attention do you think?! It's so annoying!

I was within range for Vit D, B12, ferritin and folate, all within range but am taking etc iron and vit D anyway, plus folic acid.

Oh and my T4 is currently 17.2.

Gp can order test for ft4 and antibodies for Hashimotos. Thats wuite standard though you'll need to ask. Get a print of your results as ranges are set quite low so the bottom is far from optimal! For example B12 at under 500 should be supplemented. Take a look at healthunlocked/ thyroiduk

Thanks, FT4 is 17.2

Yep I went on that forum and they said take supplements for vit d and iron to get to higher point in range.

I think you should get tested for Hashimotos and FT3 before you start TTC so you are better informed. My FT4 was 17.1 but my FT3 was only 3.2. It turns out that i dont convert so i have to take t3 meds. If the iron doesnt improve your symptoms, go back to your GP. My GP referred me to an Endocrinologist who understands much more.
Are you taking thryoxine? If so, you should aim for a TSH of 1 or less.

Thank you, am getting a private test. And yep I am also on 75mcg levothyroxine. I have also been referred to a lipid specialist due to high cholesterol (39 years but otherwise healthy and active). I think this may be linked.

Good luck. You should definitely have your dose increased to get your TSH down after you've done the test. Remember to test before 9am and after 12 hours fasting and dont take your levo 24 hours before as it will affect results.

75mcg Levothyroxine is almost certainly not enough and yes, raised cholesterol is a diagnostic for underactive thyroid.

They shouldn't give you statins unless your cholesterol is still unacceptably high once your thyroid is optimally treated.