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Thanks Cloudy. Just joking now.  :) :)
 

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Hi Ladies.

Looking for some advise please. I've tested positive for thyroid antibodies and had an elevated TSH that was classed as within normal levels but as we know not ideal for fertility! Only now after 3 failed cycles I am finally going for a FET where my consultant has prescribed thyroxine 50mg and Prednisolne 25mg, asprin and intralipids. My recent test results are TSH has reduced slightly from 2.56 to 1.91 (last test end april after a failed cycle) and my T4 is now 13 from 12 but my thyroid antibodies have increased from 179 to 207. I'm on thyroxine to hopefully bring down my TSH to 1 for my transfer planned mid September. The prednisolne is for the antibodies but my question is when did you take prednisolne in your cycle? I have been told to take it 4 weeks before treatment so start now. Then start my progynova around the 20th August in prep of my FET. Does this seem like a long time? By the time I get to transfer I will have been on prednisolne for 6 weeks? Can't find anyone on this thread that was on it that long?

Thanks  ^idiot^
 

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Hi ladies,

I'm looking for some advice. I've got loads of things wrong, and I really don't want to add to my troubles/stress.

I've emailed serum looking for a consultation. The response included that they recommend gluten free for 3 months due to my anti-thyroid anti-bodies. But I've had a test for coeliac disease, and the rest was negative (I forgotten to advise them, it seems like such a long time ago).

So just to confirm this result means that going gluten free wouldn't have any impact or should I go for it?

I'm confused when reading into it, and because of my lifestyle, weight, I think I'm going to find it harder than most.

Any idea? Am I being daft x
 

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Hi Wishing. The argument for going gluten free is that gluten contributes to increased intestinal permeability (leaky gut) so even if your immune system isn't reacting to the gluten itself, it may react to other proteins that 'leak' through. Leaky gut may be involved in the development of autoimmune disease. So it might be worth trying. There are loads of gluten free alternatives available these days so it's quite easy x

Dolly, I haven't heard of anyone starting that early but perhaps they are thinking it will help to get your thyroid antibodies down before you cycle x
 

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Hey ladies

Just wondering if anyone can help with my thyroid results, and let em know how it might affect my next IVF cycle?

TSH - 6.65 (high)
T4 - 12.6 (normal)
TPO - 332 (high)

The nurse at my GP suggested I am probably hypothyroid, and possibly have hashimoto's too. I am awaiting a call back from my clinic, and I am guessing I will have to delay my upcoming 5th cycle until my levels are normal. But does anyone know how long this might take? I will be having a double donor this time - so I won't be using my own eggs (will be using my partners) and donor sperm.

Thanks ladies

B x
 

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Hi bethannora

My TPO is also high at 257.  I have spoken to a nurse from argc today and she said that this is nothing to worry about at this point as  they will treat this with steroids once I start cycling. I was not aware that i had problems with my thyroid as my tsh came back normal at 3.63. Does this mean I have Hashimoto?
My T4 is 15.8 so also within range apparently.
Stupid question but what is t3 then?

Does anyone know how a high TPO affects ivf please?
 

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I have just read on the previous pages that tsh also needs to be below 1 for ivf? I am totally clueless and there seems to be a whole new world opening up  :-\
 

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Hi bethanora and Andrea

I had a high tsh of 5.16 but normal t4 levels.
And I have high thyroid antibodies. Tsh should be below 2.5 /2. It can take a couple of months to get it down. My immunes palava started in April and only now am I able to continue with fET. Thyroid is easy to sort out but thyroid a nobodies means steroid etc will be needed.
 

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Thanks for info Leenaj.  Argc actually told me that they will treat my thyroid issues with steroids during my cycle and that I should concentrate now on getting cytokines down with Humira. Are you with Argc? It seems you were advised to sort thyroid issues first before you could start? Did you take any medication to get your tsh down prior to your cycle? Do you know if antibodies respond well to treatment? Any advice I would be so grateful
 

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Thanks ladies :) I have taken 5mg of pred on previous cycles, but guessing thus should now be upped in light of my antibody results. Does anyone know what does we should be on?

Leenaj - good luck with your FET X
 

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hi andrea

im with a local clinic in manchester but i am seeing Dr G for immunes. i went to see DR G FOR consult in march and he initially turned me away as i had no real  need as far as he was concerned - no thyroid issues or other autoimmune issues and no hx of recurrent miscarriage ( actually hadn't even had a single transfer !), but i wanted to get everything ticked off whilst i was waiting 3 months for my cycle to return to normal after 1st ivf in jan .  I went to my GP instead and pestered him about some odd pre period spotting -so he did thyroid testing, vit D etc and it turned out i had a thyroid problem. so i was put on thyroxine straight away since then. So after that i went back to Dr G and he now said it fine to test immune issues - found i needed humira/LIt etc. So i was treated for thyroid before anything else because it just happened to be diagnosed before other issues .  I dont think the thyroid antibodies disappear with steroids but having them corresponds to inflammation which can negatively impact embryo implantation and development, so i guess steroids reduce inflammation by bringing down NK cells etc.
 

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So glad to have found this thread! and hoping someone could give me a bit of advice.
After much heartache and many cycles i am finally at 12 weeks and all looks good. But I have some thyorid medication questions and wondering if anyone out there might be able to help.  i ve reduced all my meds now but not sure what to do about my thyroid levaxin(25m a day) meds. it was a bit self medicated.  my tsh was good and under 2 till the cycle before my successful one in which it came out at 2.5.  thinking it was going up due to estrogen convinced my re here in norway to give me prescription for levaxin, gennet(my cliniic czech for donor cycle)didnt really have any comments either way. so , i ve been on it now but not sure if i continue or not as the level was never that high and i ve now stopped estrogen. last tsh 2 weeks ago wsa 1.1 and though up a bit my T4 and T3 normal range. with my luck my local re has moved and i m unable to contact him and gennet have said i m out of their hands. I will talk to my regualr doc here to try and get an apt with an endo specialist but just wondering if anyone has opinions.  thanks so so so much.
 

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Dear all
I have been struggling with my thyroid too. The clinics I have cycled with treat immunes empirically, this meant prednisolone. My main problem is age (44), but I wanted to have the other bases covered too. So I went to see an obstetrician in Germany, who is specialized in autoimmune thyroid disorders. And an immunologist, who cooperates with fertility clinics, also in Germany.
My medication has been adjusted, some months have passed and I would like to share my insights and experiences. (As an input, I am not a medical person. Reproductive immunology is a minefield is stated often in these forums and this is my experience too - on the same matter you get contradicting advice from experts in the field...) I will start with some general information and then thyroid + IVF related, so you can skip the first part if you like  ;):
-Hashimoto's is an autoimmune disease. You can have Hashimoto's with or without hypothyroidism. Especially in the beginning you have only the autoimmune aspect, then as it progresses, the thyroid gets inflamed, parts of it are destroyed and this leads to hypothyroidism.
-Hashimoto's is mainly diagnosed with the presence of thyroid antibodies. And with a scan of the thyroid, depending on the pattern of blood circulation, the doctor judges if the thyroid is inflamed
-If you have Hashimoto's + hypothyroidism, you have to treat both aspects. The immune problem + supplement the missing thyroid hormone. Without hypothyroidism the main goal is to fine tune the immune system. Plus, get your thyroid markers in an ideal range
-And here comes the main problem. Standard TSH reference ranges are too wide. For the general population, but especially when you're trying to get pregnant. So it's possible your GP tells you that your TSH is ok - and it's absolutely not. It has been mentioned already, when TTC, TSH should be between 1 and 2, ideally around 1. But, TSH should always be looked at in combination with T3 and T4. Especially with Hashimoto's, T3 and T4 should be in the upper third of your lab's reference range
-So the therapy for Hashimoto's would be as follows: 1. thyroid hormone therapy, with the goal of lowering the TSH and getting T3 and T4 in the ideal range. This can take weeks or even months and has to be monitored with blood tests. 2. The immune part. The goal is not to suppress your immune system (cortisone), but to support it so it functions the way it should and does not overreact. There is no generally accepted therapy, I have been advised the following: check iron, vitamin D and B12. If you are low in any of these, supplement. Supplement also with Omega 3 and Selenium. Then, keep inflammation low. Avoid stress (very easy...  ::) ), get enough sleep. Nutrition wise, there is the suggestion to go sugar free and glutene free.
-Thyroid and TTC/pregnancy: if your thyroid does not work the way it should, you will have difficulties getting pregnant. And, (untreated) not optimal thyroid function causes early pregnancy losses. If you are on thyroid medication and get a BFP, you should consult your endocrinologist, he has to adjust the dosage. You will possibly need 1.5 times the dosage you needed before getting pregnant. Throughout pregnancy, thyroid levels have to be monitored regularly and dosage adjusted if necessary. This is important also for the development of the foetus.
-IVF: Something very important, nobody at the fertility clinic told me when I had my first two transfers  :-\ estrogen pills, like HRT or the one they prescribe after embryo transfer (like Cyclacur) interacts with thyroid medication! Estrogen attaches to the same receptors, so if you take it, your body can't absorb enough of the thyroid hormone. So, you have to increase the thyroid medication. And, also important, don't take them at the same time. So, if you take your thyroid pill in the morning, you have to wait at least 4- 6 hours before taking the first Cyclacur pill.
-For everything they prescribe at the fertility clinic, you have to consult your endocrinologist, to make sure it doesn't affect your thyroid problem. Example: Intralipids infusions. Intralipids are made of soy - and soy should be avoided if you have Hashimoto's...
-Immune treatment: I am not in favour of experimental immune treatment. It might cover the majority of cases, without having to spend hundreds /thousands of Euros on immune tests. But if you belong to the other group, it can do more harm than good. I had my NKs tested and they are in range, in spite of my high thyroid antibodies. The immunologist explained to me what happens during implantation. From what I understood, if you take for example cortisone and you wouldn't really need it, you could be "too suppressed" and implantation would not take place. Instead, he suggested Omega 3-infusions (which are much more effective than intralipids in his point of view) before and after transfer. Then, if I get a BFP, blood monitoring and cortisone if needed.
I am still not sure about what I am going to do immune wise if / when I get to the stage of embryo transfer (I am doing natural cycle IVF, with embryo banking). But, since adjusting thyroid medication I feel a lot better and my cycles have become more regular.
So I want to encourage everybody with a thyroid issue to have it examined by a specialist and get adequate treatment before cycling. It's not just one of the secondary factors when TTC, but substantial, if your thyroid does not function the way it should, your hormonal system in general will be affected
 

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Thanks for the post Amazone.  I agree completely about making sure you talk it through with a specialist before starting any meds and making sure that person will be available throughtout the cycle and after should you succeed in conceiving. My re here locally was happy to prescribe me the levaxin, though he did not find it necessary as he held the belief that under 3.5- 4 was fine, and I was happy to start taking it but now find myself at 12 weeks with no guidance as what to do with dosages as he has moved and I m no longer able to contact him.  It has got me worried and I m not happy at all that I have no idea what to do and have placed myself and baby in the position.  The earliest apt i could get so far with a private endo specialist is not until the 7th of sept. I will ask my family doc tomorrow for a blood test for my tsh etc. Hoping to get a referral from him in the public health sector but that could take weeks as well.  Just keeping my fingers crossed that my bloods still come out fine tomorrow so to reduce my worries and feel relaxed till I can see someone-if they dont will probably just head to emergency with a big thick book for the wait till  I see someone:)
Amazone, I do have a question for you...my tsh was at 2.5 and ws why I requested the levaxin...and as you stated it should be lower that 2 and ideally close to 1---but for someone who had such a borderline tsh to begin with, do you think they d take it for the whole pregnancy? My fear now is that it s going to go too low and to be honest is really doing my head in and feeling quite anxious---trying to keep it calm till at least get the blood tests done but finding it hard. thanks.
 

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Dear B.
I really think you should ask a medical professional...
What I know is that thyroid medication is usually taken throughout pregnancy. And if Levaxin is the same as Euthyrox (Levothyroxine), which is what I have, 25mg is a really low dose.
Please stop worrying
 

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Hi Amazone, Thanks so much for sharing your experience. I have only found out that I have high Cytokines and high thyroid antibodies during my immune test as part of my monitoring cycle and clinic wants to focus on lowering my cytokines with Humira first before even starting a cycle. The thyroid issues will be dealt with during my cycle with medication. I do trust them however I am wondering if it would be worth to see my gp and show him my thyroid results to possibly initiate any further tests? Can you have Hashimoto or thyroid issues without any symptoms as this is the first time I have heard that I have thyroid issuesn
 

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Hi Andrea
Yes, it's possible to have issues without symptoms.
As it takes some time to get to the right dosage (plus, it takes some time for the medication to be fully effective), the ideal thing to do would be to start thyroid medication a couple of weeks before your IVF cycle. But, as you say you trust them and they know what they 're doing, I guess you are only slightly out of range. By starting the medication when you cycle, there would be part of the effect by the time you have your embryo transfer.
Another reason not to treat your thyroid beforehand could be your other issues. I don't know anything about Humira, but, if you treat your immune system, the thyroid could benefit from it too (if you have autoimmune thyroiditis), so that could create a different situation.
Your other option would be to have your GP refer you to an endocrinologist. This would be good in case of a pregnancy, so you don't find yourself in the situation of bubbalove, pregnant, not sure about medication, the clinic not responsible anymore and difficulty of getting appointment
 

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Hi ladies,

New to this thread, as I've just been told I have Hashimoto's disease...eek!

I previously had a failed cycle, at a UK clinic who did treat my TSH with thyroxine 25mcg which did lower my TSH, but since testing again in August, a new clinic thinks I have further issues with my thyroid and I should get a referral to see an Endocrinologist.  I told show my GP the initial result of 4.66 and he wasn't bothered, said that was within range and he would only be concerned if I got pregnant.  Here's my results to date, as you may know more about these than me:

Jan 2016: TSH 4.66 / Free T4 14.7 / Free T3 4.7
Mar 2016: TSH 3.37 (on thyroxine 25mcg) / Free T4 15.9
Aug 2016: TSH 5.61 / Free T3 4.7 / Free T4 16.5

Amazone, an interesting read on your experience, thank you.

So I'm now waiting for a letter so I can get a referral to see the specialist, but this will now delay my cycle til November for longer. 

Do you know what further tests will be done? 

I'm wondering whether all the drugs, and IVIG drip I did on the last cycle has made my TSH flare or start to working harder etc. 

Are you all on a gluten free diet?  Should I start this, any tips please would be greatly appreciated whilst I wait.


 

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Hi Juju, your TSH is too high, all of your 3 results.
As to fT3 and fT4, you have to indicate your lab's reference range, as these differ extremely. If the reference range is for example 3-9 and your doctor wants your fT3 to be in the upper third of the reference range, it should be above 7. If you go for blood to a different lab, you can't compare the two results, you will have to look at their reference range.
So a very general conclusion from your lab values (what is not clear to me, did you stop taking thyroxine after March? If yes:) TSH is like the signal of your brain to your thyroid, how hard it has to work. Comparing your January and August results, IF they were done at the same lab (!), the amount of fT3 in your blood is the same, but TSH is higher, so your thyroid has to work harder to achieve the same result. So the situation has worsened. Of course the analogy fT3 to fT4 is also important, but to give you a detailed analysis you have to see a specialist, forget about GPs, they have no idea.
And get this started some time before you cycle again. I started with 50 levothyroxine and increased by 12.5 every second week, blood test every 4 weeks. This has to be monitored by somebody who knows what he is doing.
Further tests... They might check your thyroid antibodies. The presence of these usually confirms you have Hashimoto's.
As to combination with the other meds while cycling, you will have to consult your endocrinologist about that too. What I know (now), when taking estrogen you will need more of the thyroid medication.
I did not go glutene free, as my doctor doesn't think this is necessary. I have reduced it to a minimum though.
This might all sound very intimidating and it's another obstacle on the difficult IVF journey... Unfortunately many thyroid problems start after 40 (I am the same age as you), it's the hormonal changes that initiate the process and if Hashimoto's runs in the family... Many of my female relatives have it so I was prepared. Of course IVF related stress does not help at all... So try to do something about this too, acupuncture, meditation, counseling...
 
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