* Author Topic: Thyroid Chat - Part 9  (Read 39832 times)

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Offline Amazone

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Thyroid Chat - Part 9
« Reply #40 on: 7/09/16, 19:14 »
@Canadablue:
There are lots of different opinions about "normal" TSH ranges. When trying to conceive it should be below 2.5, ideally closer to 1. If you have elevated thyroid antibodies, you possibly have a thyroid condition called Hashimoto's. In the beginning stage of Hashimoto's there are elevated thyroid antibodies, but not an underactive thyroid (= high TSH) - yet. However, the hormonal situation during a pregnancy can worsen Hashimoto's and cause early pregnancy losses. This is why you should have it treated by a specialist (not a GP). This is also the case with IVF, a qualified person should monitor your TSH, fT3 and fT4. And advise you about every aspect of the IVF process. For example estrogen patches or pills make the thyroid work harder, so somebody who is taking thyroid medication has to increase the dose. Or, as soy should be avoided if you have Hashimoto's, it's not a good idea to have intralipids. Fertility doctors might know a thing or two about the thyroid, like prescribe cortisone in the presence of antibodies, but they don't have the whole picture, so I wouldn't rely only on them to treat your thyroid condition.
@mmj:
I have been advised to have my thyroid tested every 4-6 weeks if/when pregnant

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    Offline GingerFold

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    Thyroid Chat - Part 9
    « Reply #41 on: 7/09/16, 22:26 »
    If it helps, I've been under the care on an endocrinologist for a wobbly thyroid all year (before I fell pregnant and now throughout). He said that it takes 6 weeks for any change in medication to have an effect enough to show in your thyroid blood tests, so getting it done any more often was a waste of time. This seems to to align with what Amazone has been told too.

    Offline Canadablue

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    Thyroid Chat - Part 9
    « Reply #42 on: 8/09/16, 07:03 »
    Thanks for responding mmj & amazone

    My tsh is just under 1 (for now) so thats a relief

    Ill keep my concerns in open discussion with the clinic in Spain im working with, throughout my treatment prog. We are on a refund prog so im sure they will be doing all they can to get & keep me preg asap

    Thanks again

    Canadablue

    Offline alittlenervous

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    Thyroid Chat - Part 9
    « Reply #43 on: 8/09/16, 17:37 »
    Hiya everyone, hope it's ok to join this thread and get some advice from you all  :)

    I saw my GP on Monday and took all the NICE guidelines on thyroid and levels for TSH to conceive.  According to NICE guidelines if I have a TSH between 4 and 10 I am subclinical and should be trialled on thyroxine if symptomatic (I am) or if trying to conceive.    I told the gp this as my TSH is 5.8.  She said they won't treat me till my TSH reaches 10 even if I was pregnant and a know hypothyroidism patient all they would do is monitor me!  She said with my levels I am fine and holds no risk to my fertility, unborn baby if I got pregnant etc.    Endo at the hospital said the same.   I get all the drs telling me it's fine but NICE guidelines saying they recommend a retest and if still in subclinical range to treat.   She is giving me a retest and she said unless comesback at 10 they'll mark as normal even though out of their range.    Why do they even have a range?!!

    I tried contacting a private endo and for a private consultation I would need GP referral and just for the consult alone 190 and that's before drugs.  With all my money saved for private sperm and probably clomid no way I can afford that too so looks like I'll have to try and get pregnant and trust gps and hospital endo correct

    Offline Orchid-1

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    Thyroid Chat - Part 9
    « Reply #44 on: 8/09/16, 22:03 »
    Nervous- I am sorry but yr GP does Not know what she is talking about. High TSH can cause miscarriages. Where r u based? Most private consults are self- referral. You don't have to give yr GP's contact details even.

    My ex GP also refused and I mistakenly accepted that for a long time.  I saw a private endocrinologist (self referral) who prescribed levothyroxine and it made me feel a lot better. Every IVF clinic I have been to recommended TSH between 1-2 for fertility.

    With regards your endo - medics like backing each other up and try not to go against eac other's diagnosis. Sorry if that sounds cynical.

    It all does adds up though in terms of expense but I guess my view is that there are certain crucial things which I have to correct in order not to waste the cost of an IVF cycle.

    Wishing you all the best. Listen to your gut instinct.  ^reiki^


    Offline Mrs.AT

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    Thyroid Chat - Part 9
    « Reply #45 on: 8/09/16, 23:06 »
    I have had a very similar frustrating conversation with my GP today. As my tsh is below 5 even though my antibodies are very high he won't prescribe me thyroxine or give me a referral. He didn't even listen to my arguments and just said that there is no evidence that tsh needs to be between 1-2. As far as he is concerned my tsh is within range and he just ignored the antibodies. Very frustrating however I just wanted to see if it would be worth starting to take thyroxine before my cycle but I know that argc is aware and will give me the meds closer to my cycle so I know it will be dealt with. Are you with an ivf clinic because they should be dealing with thyroid issues before/during your cycle and will probably put you on meds then? If you are trying naturally I think a private consultation is money well spent or try and really hassle the gp again to get to the bottom of this.

    Offline Amazone

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    Thyroid Chat - Part 9
    « Reply #46 on: 9/09/16, 10:07 »
    @nervous:
    I second Orchid, don't waste your money, get adequate treatment for your thyroid before cycling. I read the following which should make you understand how important the thyroid is: the heart is the motor of the body, the thyroid the gas pedal. In your case, your brain is sending signals to the thyroid (pushing down the gas pedal = TSH) but it's not enough to keep all your body functions working properly (as you said you have symptoms). So getting -and staying- pregnant will be very difficult for you.
    Go see a specialist, have a proper thyroid assessment (TSH is not enough), this means also fT3, fT4, antibodies, scan of the thyroid. You will be prescribed medication and monitored. It can take weeks or even months to get you in a range acceptable for IVF.
    I fully understand you that you want to trust your doctors. However, it is a sad fact that most GPs are not informed about the guidelines of the Endocrine Society ("If hypothyroidism has been diagnosed before pregnancy, thyroid hormone replacement medication dosage should be adjusted to reach a TSH level not higher than 2.5 mIU/L prior to pregnancy.")
    I am not in favour of Dr. Google or getting medical advice on the internet, but there is a very useful blog, just to give you some ideas why it is important to go for -qualified- professional help:
    http://hypothyroidmom.com/i-lost-my-unborn-baby-needlessly-what-i-want-other-women-to-know-about-thyroid-disease/#more-10100
    (not sure if FF allows links, if not, search "hypothyroid mom"). She mentions the interesting fact that experts estimate more people worldwide suffer from thyroid conditions than from diabetes. Also that in 2014 "Conservative estimates find that at minimum there are 27 million Americans with thyroid disease, but experts believe that the actual number is closer to 60 million at least half are undiagnosed". So it becomes clear why thyroid ranges are kept as wide as possible - imagine the expenses for the national health systems if the number of "officially recognised" thyroid patients would double...

    /links

    Offline alittlenervous

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    Thyroid Chat - Part 9
    « Reply #47 on: 9/09/16, 13:45 »
    Thank you for your advice  :)   I paid for private bloods to check my thyroid and these are my results from April

    TSH H 5.81 range 0.27 - 4.20 IU/L

    T4 Total 77.4 range 64.5 - 142.0 nmol/L

    Free T4 13.48 range 12 - 22 pmol/L

    Free T3 4.29 range 3.1 - 6.8 pmol/L

    Immunology

    Anti-Thyroidperoxidase abs 8.9 <34 kIU/L

    Anti-Thyroglobulin Abs <10.000 <115 kU/L


    My gp, endo and subfertility clinic all say I am fine!  I am in Blackpool and at the clinic which I was referred to as low progesterone and not ovulating you never get to see a specialist just a fertility nurse. 

    I am trying to get pregnant via a sperm donor via Cryos at around 800 a go and I don't have enough money for more than 5 goes.   I can't afford private endo so desperately been trying to get my GP to believe me by taking NICE guidelines in and fighting my reasons but she said at that we wouldn't treat you even if pregnant we would just monitor and she brushed my results back to me.

    I am going to have to get one private endo consultation but I couldn't afford monthly private prescriptions.  If my GP says I am fine if a private endo disagreed could he write to my GP to get me thyroxine on the NHS?

    Plus my egg reserve is 13 in American terms 1.9 and that concerns me time is running out too as I am 36

    Offline Juju44

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    Thyroid Chat - Part 9
    « Reply #48 on: 9/09/16, 15:08 »
    Hi Alittlenervous,

    I can only tell you of my recent experience with seeing an Endocrologist, which I paid 280.00 for 30 mins consultant.  He has written me a letter for my GP, which he said will help with getting thyroxine and bloods on the NHS.  I haven't been back to my GP yet to discuss this, as I've only got the letter today.  My GP did refer me to see a consultant, but the waitlist was 3 months, and I didn't want to wait that long, hence I paid to see Dr Gerard Conway (London), and was seen within a week.  He has given me a private prescription for 3 months supply of thyroxine which I haven't collected yet, as I ready had some.  This isn't an expensive drug and my local (non chain) pharmacy are really good and only charge me a small fee 6 for a month's supply, so I don't expect to be paying a lot.

    My TSH is 5.61, and the range for fertility is 2.5 or less, so I would try to address this before starting another cycle.

    Good luck, I hope you get the help you need.

    Offline alittlenervous

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    Thyroid Chat - Part 9
    « Reply #49 on: 9/09/16, 18:51 »
    Thank you so much for your reply JuJu.  I think I'm going to get my thyroid blood test next week and get the results then depending on what my GP says when they comeback I will have to find that 190 for a consultation with the private endo.   I don't want to waste all that money I don't have to waste in the first place just for it not to work or to work but lose the baby  :(

    Thank you again, I really appreciate your help xx