* Author Topic: Thyroid Chat - Part 9  (Read 39836 times)

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Offline BabyBear1

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Thyroid Chat - Part 9
« Reply #130 on: 7/08/17, 20:54 »
Hi, not sure if this thread is still active but here's hoping!

I have just started at ARGC, hoping to do a FET soon. They want me to take humira which I am currently thinking about, talking to them on Thursday about possibly trying Intralipids first.
So I had my thyroid tested 2 weeks ago as part of the immunes and TSH was 0.02 and Free T4 22.8. I had it tested again today, so only 2 weeks later. I think I should have left it longer! Anyway today it was TSH 0.03 and Free T4 19.7. So it looks like I have an overacive thyroid? I had my TSH tested 3 times in the last 2 years and it has been fine. I'm not sure what is going on, do I need treatment for this? They just said talk to your GP and get referred to an endocrinologist. Does this mean my cycle will be delayed even more now? I've no idea what to expect, if anyone can give me any pointers?

Thanks! xx

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    Offline Amazone

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    Thyroid Chat - Part 9
    « Reply #131 on: 18/08/17, 19:09 »
    Dear nightingale,
    fT4 (and fT3) are of no use, if you don't indicate the reference range, as these vary extremely from lab to lab. So if you have your results, please look them up and post them.
    Just to make sure, you don't take any thyroid medication?
    If not on medication, your TSH is low and could indicate an overactive thyroid.
    I am more familiar with the underactive thyroid. In 90-95% of the cases, an underactive thyroid is caused be an autoimmune disease called Hashimoto's.
    There is another autoimmune disease, Graves, which can cause an overactive thyroid. So the first thing to do for you would be to get properly diagnosed. By a specialist, so try to consult an endocrinologist as soon as possible. Before you spend a lot of money on IVF, your thyroid issues should be taken care of, as it can make it more difficult to get and stay pregnant.
    Wishing you the best possible outcome!

    Offline Bagpuss87

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    Thyroid Chat - Part 9
    « Reply #132 on: 21/08/17, 09:55 »
    Hello just wondered if someone could advise...my surro has an underactive thyroid which is being treated with levothyroxine which seems to be helping it decrease...last tests was TSH 4.7, T4 17.1 however her thyroid antibodies are 1300 (hashi?) Ive seen some people take pred and asprin/clexane during cycle for these ? Is that normal procedure ? If so when is that started? Ive seen all different doses too...We are waiting to do fet so trying to get everything in range and under control before transfer.

    Bag xx

    Offline Pv7882

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    Thyroid Chat - Part 9
    « Reply #133 on: 13/09/17, 16:46 »
    Hi Bagpus, just saw ur msg in this thread. Not sure whether u ve already got an answer for this..
    I have been tested with high thyroid antibodies too, my gynae advised to take prednisolone from two days before FET along with intralipid infusions..
    Aspirin/Clexane s to thin ur blood, so dont think its anything to do with thyroid..

    Offline Bagpuss87

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    Thyroid Chat - Part 9
    « Reply #134 on: 18/09/17, 12:22 »
    Hi Pv

    Thank you, yes i did wonder whether steroids may be needed...next bloods the antibodies had dropped from 1300 to 400 so they think she had a bug ? Although 400 is still way over the range : / x

    Offline Laquinn

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    Thyroid Chat - Part 9
    « Reply #135 on: 23/09/17, 15:04 »
    Hi All. I just found this thread! I was wondering if anyone could give me some advice...

    Just started ttc last year at 43 yrs old; sadly had an early miscarriage at 5wks followed by a stillbirth at 26wks and 4days. No reason for our loss could be found with post-mortem but I became thyrotoxic early this year. Ob said this had nothing to do with our loss (?) TSH was 0.01. I was put on 8 tablets of PTU. Now my TSH is 1.35 and T4 11.2 but no sniff of a bfp. I have a thyroid nodule which was tested for cancer which came back negative and I've been given a two year reprieve from potential surgery to remove it to ttc. The doctor suspects I have Graves Disease (loads of it in my family). I am TRab negative but tested postive for TPO anti-bodies last November (493.9) (range <6.0).

    We are considering IVF at Serum. I have an appointment with my Endocrinologist in October and wondered if I should have an initial consultation with Serum to see what they propose then run it past the Endo? From what I've read on this thread IVF can really mess with your thyroid, this being my first time I would really appreciate any insights/ advice. At 45 I don't have time to mess around! xx

    Offline Amazone

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    Thyroid Chat - Part 9
    « Reply #136 on: 24/09/17, 23:06 »
    Hi Laquinn
    So sorry for your losses... Unfortunately, an untreated thyroid condition can cause miscarriages.
    The first thing to do would be to get the suspected diagnosis Graves confirmed. And a treatment plan, the medication you had received might not be enough and you might need to take thyroid medication constantly.
    I can fully understand you don't want to lose time (we are the same age, and I haven't been successful yet). But first you have to take care of your thyroid issues. So the appointment with the endocrinologist should be first priority.
    As to your test results, TSH is one indicator, but much more important are fT4 AND fT3, both should be tested (and with these two you have to indicate the lab's reference range, otherwise the result does not mean anything).
    The problem with autoimmune thyroid diseases (Grave's, Hashimoto's) is that there are two aspect, one is hormonal, and the other is the immune system. With thyroid medication you "correct" the hormonal problem, but not the immune problem. Unfortunately there isn't any established therapy for this second aspect, which is especially important when TTC or doing IVF. Some doctors prescribe steroids (prednisone), but there is no agreement on if it really helps, when to start taking it and which dosage. Others prescribe intralipids infusions, but as they are made of soy, it could cause problems to patients with thyroid issues (I have been told to avoid it).
    I cycled with Serum in the past, and as much as I appreciated them for eg. their caring ways and excellent communication, they are NOT specialized in thyroid or immune issues. Their approach in these matters is experimental, which might be ok for somebody who still has a lot of time. But in your case I would advise to consult an endocrinologist and an immunes specialist, and then have Serum design a protocol, based on the recommendations of the endo. and the immunologist.
    Of course this would mean spending more money (sigh), but in my case I regret not having consulted the specialists earlier.
    I really hope you can make your dream come true soon
    @Bagpuss: the bug theory does not sound very convincing to me. If you have a "positive" thyroid antibodies result once, it means you have an autoimmune thyroid disease. And you will have it for the rest of your life, regardless if the antibodies decrease. If she has been a surro before, it is possible that Hashimoto's has been activated in her last pregnancy.
    As I mentioned above, there is no agreement on steroid therapy... In my case, after extensive immunes testing, my immunologist wants me to start with a low dose of prednisone (5 mg) 10 days before transfer. 2-4 days before transfer I will repeat some of the blood tests and he will adjust the dosage according to the results. Same thing 2-4 days after transfer.
    Wishing you the best possible outcome

    Offline Laquinn

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    Thyroid Chat - Part 9
    « Reply #137 on: 24/09/17, 23:32 »
    Hi Amazone. Thank you so much for your reply - I really appreciate the clarity. Can you recommend a fertility immunologist? I am based in Glasgow...


    Offline Pizzicato45

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    Thyroid Chat - Part 9
    « Reply #138 on: 15/12/17, 12:26 »
    Hi all,

    It's been a long time since I posted here but about to jump back into fertility treatment and things aren't quite right.

    Wondering if anyone can recommend a private doctor by PM who is flexible in their approach to thyroid treatment and has experience of working alongside IVF? I have Hashimoto's and have been on levothyroxine for several years. My FT3 started falling slowly the moment I started treatment and is now in the bottom quarter of the range - I feel wiped out. But as TSH and FT4 are okay, my current doctor is not too helpful. I have experimented with NDT (my last doctor was amazing, sadly now retired) but the ratio of T3:T4 is not for me. I think adding T3 to my meds would help enormously as I'm obviously not able to convert T4 to T3 too well, but getting T3 on the NHS with the current cost is impossible when you're still in range. I am waiting for results of adrenal testing as I know this could be a factor too.

    I adjusted my diet (gluten and soya free, with very little dairy) several years ago and keep a close eye on vitamin and mineral levels for my supplements (Vits B, C. D, calcium, chromium, iron, selenium, zinc, ubiquinol, pycnogenol, curcumin, Omega 3, l-lysine), so have done as much as possible to make my body thyroid friendly. 

    I will be cycling with Serum next year so anxious to get all my ducks in a row. Would be interested to see if anyone else has had this problem?

    Any help or advice really, really appreciated.

    Cx

    Offline Amazone

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    Thyroid Chat - Part 9
    « Reply #139 on: 20/12/17, 10:20 »
    Dear C

    I canít recommend you a doctor unfortunately, as I donít live in the UK. But it is important that you find one, I was in a similar situation like you, I found a competent doctor after having had transfers, and regretted not having done so earlier.

    One thing is your current medication. Both ft3 and ft4 should ideally be in the upper third of the reference range, or, the very least in the upper half. If your values are so low that you have symptoms, it means that you probably donít have a sufficient level of thyroid hormones to get, and to remain, pregnant. So itís really really important you have a specialist adjust your medication and monitor you during your next ivf cycles.

    Because, the second thing is, if during the 2ww you have to take estrogen pills, this makes it more difficult for your body to absorb the thyroid medication, so you have to up the dosage! (For this reason also a higher dosage is needed during pregnancy). I normally take 150 levothyroxine, with my last fet I had to take 6 estrogen pills daily, my endocrinologist monitored me closely with weekly blood tests and I ended up upping the levothyroxine to 225... Unfortunately most fertility clinics are not aware of these things and Serum are not an exception, I used to cycle there. Another thing they didnít know about was that intralipids are not unproblematic for thyroid patients, as itís made out of soy.

    The third point is immunes. With Hashimotos your immune system attacks your thyroid, but unfortunately not only your thyroid... so there should also be immune treatment during an ivf cycle, if needed. Serum treat these things empirically, which means that if immune issues are suspected, you will follow an immunes protocol, which then was 5 mg Prednisone during the cycle and up it to 20 mg after transfer. This protocol might be adaquate for some, but it might not for others, you canít know without immunes tests. In my case I finally consulted an immunologist and have him monitor my cycles too. Unfortunately by the time I discovered all this it was probably too late, my cycles have been erratic for a year so I donít know if I will ever be able to try again with my eggs. And if I turn to donor eggs, it will be even more difficult for my immune system to accept, so probably more immune meds... Another thing fertility clinics donít tell you about when advising donor eggs.

    As to your supplements, you should stop the vitamin C. This was the first thing my immunologist told me. Your immune system is already overreacting because of Hashimotos, with vitamin C you reinforce this, which is exactly what you donít want. What is important for Hashimotos is good levels of iron, vitamin D, B12 and Selenium. Selenium supports the conversion of t4 to t3, the most effective form is Selenomethionine, so I would switch to that if you are not already taking this.
    Sorry this might all sound too complicated and discouraging. But Iíve come to believe that thyroid issues are a big important, but unfortunately underestimated factor when ttc. And unfortunately the problem is not solved with just taking a pill.

    I wish you the best possible outcome for your next cycle