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TTCing with TSH 40, antibodies 1500. Help!
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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TTCing with TSH 40, antibodies 1500. Help!

I have been trying to conceive for the past 4 years with no success. Recently been diagnosed with hypothyroid, autoimmune.

My TSH is very high at 40, antibodies also high at 1500, but my T4 and T3 are normal.

Any possibilities of me conceiving and giving birth safely? Would IVF help? Anyway to treat the high antibodies to minimise risk of miscarriage?

Pls help!
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97953_tn?1193367871
The high antibodies may well explain the difficulty conceiving.  It's quite possible you have had mild thyroid failure from Hashimotos (immune system attack on the thyroid) for several years and now it is in full bloom (labs undeniably abnormal).

The good news is that treatment can siginficantly improve fertility.  Would not consider IVF until your TSH is normal (about 1.0) for six months and you still have not conceived.

The antibodies are a marker of the immune system attack and will fall with treatment, but will likely never normalize - that's okay, most hashimoto patients do very well with pregnancy -- it is VERY important to keep the TSH around 1 throughout pregnancy - this usually requires about 25-40% increase in thyroid hormone dose compared to non-pregnant state.
16 Comments
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Avatar_n_tn
Hey Constellation. It is my understanding that a low free T4 and low free T3, EVEN if in range, can be problematic towards getting pregnant, besides those antibodies. Are you on thyroid meds to counter those high antibodies?

I remember three gals--two on one forum and one on another, who also couldn't get pregnant. They were on T4-only meds. They switched to dessicated pig thyroid, also called natural thyroid (Armour, for example), and they got pregnant! So, we think it was due to Armour having direct T3, which improved their free T3 levels, which being on T4-only meds like Synthroid or Levoxyl are NOT going to do. I've got to run...I'll add more later. But there are other folks here, in addition to Dr. Mark, who can give you good info.
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Avatar_n_tn
I have a similar story to doodlebugs...a gal got on Armour (desiccated thyroid extract) and got pregnant within a few months.  i just got pics of her Baby Jack at two months!  

Infertility is a known cause of infertility...and you probably are going to have to get that TSH down to about 2.

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Avatar_n_tn
you didn't mention whether those were FREE T4 and Free T3 tests.  Those will give you a better picture than the Total T4 and T3.  Free labs will show what is actually available for use...and if they are in the lower 1/3 of the range, that may be too low for you.
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Avatar_n_tn
I've been ttc #1 for 2 yrs (I'm 37) and recently fopund out my TSH was 6.3, then 4.99 a week later, and I have elevated antithyroid antibodies.  I just called the RE's office and they said my thyroglobulin (sp) antibodies were 105 and s/b under 20.  I think I've been hypothyroid for several years when I look back on my symptoms.  The first 8 mos I was ttc were useless b/c I had a parasitic infection also.  I didn't know anything about the thyroid til I saw the RE last month :c(  What a lot of precious time I wasted!  I'm on .1mg Synthroid for a month.  I'm looking into Armour but I'd like to wait til I go in for more tests to see if Synthroid is helping.  What stinks is that these meds don't make you magically better overnight :C(  It can take weeks to months to be 100%.  At 37 (38 in Jan.) I don't have a lot of ttc time!  
Anyway, I've been reading that in order to conceive your TSH s/b 1-2.  But, you have to make sure all your thyroid levels are correct and your whole immune system is in good working order.  I'm also working on cutting out the tons of sugar and flour I eat.  Hard!
Well, sorry I didn't have much info to give you.  
GL and babydust!
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Avatar_n_tn
obviously i still have some hypo brain fog:
so when I wrote:
Infertility is a known cause of infertility...

let's try HYPOTHYROIDISM is a known cause of infertility.

actually if you search those two words, you should get some good info.
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Avatar_n_tn
I've had brain fog for a long time and thought I was losing my mind...I guess in a way I have been.  It's embarrassing - I space out all the time - I forget what I'm saying in the middle of a sentence, I am in another world at the cash register, I miss things people say, just generally a space cadet.  I AM blonde but I wasn't like this a few yrs ago :c)
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I can totally relate to the brain fog, I am blonde too but I was never this spacey 8 months ago!  I find myself fogetting just about everything.  I am only 31, my memory shouldn't be this bad!
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Hi, I wondered if i could ask about the parasitic infection you mention in above post. I've had concern about this because I've had elevated Eosinophils on three consecutive CBCs but I do not have sinusitus symptoms at all! I've also read where parasites can cause the joint pain/fatigue. I feel it's not what I have but am eliminating all possibles.(I feel my problem is likely adrenal).
What signified the parasitic infection? Did they confirm with a specific test? I hear round works are common.
Thanks,
Jim
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Avatar_n_tn
Can I ask what is TTC and what symptoms does a parasitic infection cause?  Also I just wanted to mention that my Antibodies have always been high ever since I was diagnosed with Hasimoto's 19 years ago and I have two kids with no problems.  Once my TSH level became normal having kids was not a problem.  Antibodies will never go down if it's autoimmune.
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Avatar_n_tn
Hi. Antibodies DO go down if you find your optimal treatment! I've seen it numerous times on the large forum I'm on when the person is on Armour and is allowed to dose by symptoms, not the TSH!
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Hi all, thanks for all your comments.

My free T4 is low normal at 12.52pmol/L (1 ng/dl). Free T3 is 4.46 which is low mid normal range. As a start, I am given levoxyl 50mcg. I have just started the medication for less than a week, but will have a review in 6 weeks' time for another blood test. Will discuss with doctor then about getting Free T4 and Free T3 up as well.

Good to hear about "success" stories of conception by people with my condition. I have been so depressed after being diagnosed with this condition. Hopefully I can really bring my antibodies with treatment too.

Do any patients go on steroids or something to bring down the antibodies?
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97953_tn?1193367871
Attacking the antibodies with steroids or other immunosuppresants is not helpful and could cause additional problems.
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Avatar_n_tn
Hi constellation!! Yup, your free T3 and free T4 are the same ones I've seen in others who've said they were having trouble conceiving!! Typical, too, when you are on T4-only meds, by what I observe AND have experienced.

I never heard of anyone going on steriods to bring antibodies down!! Instead, when I see folks bringing them down, they are on Armour and getting their dose high enough to eliminate hypo symptoms.

And constellation, I do so understand depression. It was VERY depressing to go through the misery I did all those years on T4-only meds, only to be told over and over and over that it wasn't my thyroid and my TSH was "normal". It WAS my thyroid, and it was being on T4-only meds, and it was being held hostage to the TSH. I found out differently, and so can you. :o)
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Avatar_n_tn
I read that steroids suppress TSH.

The parasitic infection was a common one but usually it is transmitted sexually, although it can (rarely) be transmitted via stagnant water and wet towels, etc.  It was trichmoniasis - a parasite that inhabits the vagina and attacks sperm.  Men can harbor this also - genitourinary area or something...it can hang out for years and be a nuisance.  It was cleared up with a dose of Flagyl.  This parasite is identified on a wetslide.  Some people may not have symptoms (or they may pop up occasionally).
I also would like to be checked for h Pylori.  Aaaarrrggghhh -there are so many things that can go wrong!!!!!!!!!
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I think I may need some help....I am having every symptom you can think of...but the chest pain and arm pain are the most troubling...along with the  try to stand up straight and not look like a drunk walking..I had to give up walking the dog..weight is going up, vision off, fybromyalgia,osteo, several broken bones, feet, toes, back in a couple of places, if you can name it,  I have been to the doc for it...brain fog..omg...do not want to go there....I have forgotten my own kids names at times and repeat myself all the time.can not remember a damn thing and it might cost me my job.feel like a senile old woman..I am 54 and that is not old enough to feel like this....My tsh is now at a 22.486.....have been hypothyroid for years..this snuck up on me and slapped me hard...Synthroid has been upped from 100mcg. to 150, then 175 and now 200..but the feelings are not going away and neither is the weight...what is next?????????
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