TTC with hypothyroidism

[Suzywuk]

I have been TTC with no success for 16 cycles now and was diagnosed with hypothyroidism 10 years ago (take 100mcg thyroxine daily).  I have my TSH levels tested yearly and until recently accepted the response that my levels were normal.  Because of my difficulties TTC, this year I asked what my TSH level actually was, I was told it was 3.67 and that this was normal.  After reading research papers and info on various websites I believe that this TSH is too high when being treated with thyroxine.  Considering my problems conceiving and menstrual irregularites (pre menstrual spotting) I requested that my dose of thyroxine be increased to take me closer to a TSH of 1 or 2.   My GP refused on the grounds that my THS is in the normal range, I'm not sure where to go from here.  If I wasn't experiencing problems conceiving I wouldn't be too concerned, could a TSH of this level be a factor in my TTC problems?

(btw my infertiliy has been classed as unexplained)
Thanks

[Mark Lupo, M.D.]

Particularly if the thyroid antibodies are positive, I agree that a TSH of 0.5-2.0 is preferable in women TTC.  This is consistent with the AACE positition statement on hypo treatment.  If the GP won't do it, ask your OBGYN or go see an endocrinologist.

[lumley801]

Are you in a medical plan that allows you to get a second opinion?  I would do that.  3.67 sounds too high to be TTC...yeah, to some doctors, that's "normal"...but it's also harder to conceive and maintain a pregnancy with higher TSH levels.

Best wishes.

[ancientmariner]

Have you considered switching to Armour Thyroid? It's a natural alternative to the synthetic thyroid hormones, and contains everything your own thyroid produces. I have heard many stories from people who were unable to conceive, sometimes for several years, on the synthetics, but after switching to Armour, they became pregnant within a couple of months.

[megaloo]

I am in the same situation as you (almost). I have been TTC for 8 months and after some testing when nothing was happening, I found out I had Hashimoto's and a TSH of 11.1, I went on Synthroid (0.05) and 6 wks later had a TSH of 5.06. My doctor doubled my Synthroid dose (2 weeks ago) and I hope that brings me under 2 as I have read all the same things as you about having to be under 2 to conceive. I agree with the others, having a TSH under 2 to TTC is well-documented from several sources on the Internet (however reliable that might be) so I would get a second opinion. Perhaps ask for a referral to an Endocrinologist?  Good luck!

[megaloo]

Oh and if you want to find a good thyroid doctor trying looking on Mary Shomon's site, thyroid.about.com and she maintains a list of the "best" doctors in your area, as recommended by members. One of those doctors might be willing to increase your dose, worth a try!

[Suzywuk]

Thanks everyone for your responses.  I forgot to say that I am from the UK so the health system is slightly different over here.  I have a follow up appointment with a consultant gynae in December and will definately bring these issues up with him then.  I think that health professionals in the UK are definately behind with regards to normal TSH levels :-(

[casablancas]

I agree that doctors in the UK are **** at dealing with thyroid issues. I was referred to an endocrinologist and he was really horrible, so now I just self-prescribe my own dose of thyroxine, I make an appointment with the nurse at the practice every 8 weeks for my TSH/T4 blood test and just call up the receptionist for the results, I always make sure my TSH is under 2 and that my T4 is within normal range. My GP wanted me to take 100mcg thyroxine when my TSH was 4.9 but I thought that was way too high so I take 200mcg and my TSH is now 1.8. I also feel a lot better on the higher dose but I still can't lose weight.
My GP also told me to lower my thyroxine dose when I was pregnant and I lost the baby at 10 weeks, I wont listen to my GP again. I also have positive antibodies and I know they play a role when trying to conceive/maintain a pregnancy.
When I get pregnant again I'm going to ask for my blood test to be done every 4 weeks so I can monitor my levels myself, I have been recommended to increase thryoxine by 25-50mcg per trimester.
When there are no decent doctors out there who know what they are doing regarding pregnancy and thyroid problems self-prescribing is the only other option available, I just wish the national health service was better and my doc would look after me!