Subclinical hyperthyroidism and fertility?

Hi Dr. Lupo,

After a total thyroidectomy due to papillary cancer five years ago, my TSH remains very suppressed at <0.02 with Free T4 at 1.2 (range being .7 - 1.9) and Free T3 at 4.5 (range being 2.8 - 5.3).  Since my Frees are within the normal range, I could be considered as being subclinical hyperthyroid.  I have no hyper symptoms at all.  My current dosage of meds is 100mcg Levothyroxine with 1 1/2 grains Armour.  I feel best on this combination.  
We have been trying to get pregnant for three years.  I have been pregnant twice, but miscarried both. I've also had three biochemical pregnancies. The general consensus among my ob/gyn and endo is that the difficulty with fertility is due to my age (age 40) not any thyroid issue.  I am very active with charting, BBT, etc. I have had every blood panel, fertility test/procedure possible and all come back fine.

My question to you:  Could subclinical hyperthyroidism cause fertility issues?  Do you suspect it is my age, not the thyroid issue at play here?  What are your overall thoughts?

Thank you!

[Devrapunzel]

Oops.  I realized that this is not the place to post for Dr. Lupo.  Do any of you have any thoughts or experience with this situation?

Thanks much!

[virgo2121]

Hi there,

My story is a little different to yours but may answer some of your questions. Sorry for the length of this!

I have been doing IVF (2 in UK and 5 here in Perth WA). My thyroid check always came back fine so no concerns were ever raised with that. My first attempt in Perth I unknowingly got pregnant and only found out when I was admitted to A&E for emergency ectopic removal :-(
I am 40. After the ectopic we decided to try and better our chances by seeking the help of a naturopath to support the IVF process, in other words to get the body in the healthiest state possible for the IVF cycle. My naturopath ran a number of tests and did not like the look of my thyroid reading being 2.47. Despite this being in the normal range which I think is below 5, this set alarm bells for her. She requested that i check my antibodies and they were sky high (hashimotos - hypothyroid - opposite to you I know). I was told this is auto immune and would greatly reduce my chances of becoming pregnant. I did explain that I had previously fallen pregnant but it was ectopic and was told by her that it can happen but my chances are vastly reduced :-(
On my next IVF cycle (before I commence natural eating habits) I got pregnant again but had a very early miscarriage - it would not have even been picked up if my bloods were not being monitored and appeared juts like a period. Thyroid V age - no one knows.
Healthy eating began and although I could have been treated naturally for thyroid, this may not have helped and in any case would take months to see any results. As a result I sought medical treatment and hashimotos was officially confirmed. Ordinarily they would not treat anyone with this until the thyroid started to pack up. I asked if I could be treated with thyroxin to at least try and help me to get pregnant. I was prescribed the smallest does 50mcg a day?? Not sure on units.

The healthy eating programme began (look up foresight UK as this is what it is based upon) and we were told it would take 4 months prior to attempting conception to have any effect.  Despite this we went ahead with IVF, hoping we would just get lucky.  We didn't and got a big fat negative.  Unfortunately we found solace in the bottle of wine and chocolate etc and the healthy eating took a backward step.  We then got all motivated again and had 6 weeks before our next IVF.  We stuck to the healthy eating and my cycle was looking optimistic.  Unfortunately I ovulated before egg collection so we will never know if that would have made a difference.  It was interesting though that despite all the drugs trying to stop me ovulating my body decided it would do it's own thing.  Could that have been the healthy eating kicking in?  Who knows?
Xmas was approaching and we took three months off as family were coming over to experience our new BBQ lifestyle down under. We still did two IVF's during that time but both were negative.

Having got rid of family and having re motivated ourselves we are now commencing the healthy eating programme again but this time we are not going to give up if the cycle fails but allow the adequate time advised to better our chances. Foresight have managed to get about 85% of couples pregnant purely by following this programme and it includes women up to 45 years old. It is correct that as you hit 35 your chances start to lessen (in the majority of cases) and I think they lessen even further at 37 then 40. It does not mean everyone will hit 40 and not be able to get pregnant but the chances are usually reduced somewhat. I know a 43 year old women who just did IVF and got pregnant first time with her own eggs - she produced about 18 eggs compared to my measly average of 3 :-( She is very fit and healthy so you never know!

The best way I had it explained to me was that imagine your eggs in a bowl. If you scooped it out with a ladle in your 20's most would be good fertile eggs. The older you get the more they diminish and the ladle will eventually have more poor quality eggs than good ones. But hey, you could get the lucky one! Has hubby or partner been checked too?

I know this may not help you much but having ridden the rollercoaster of emotional ups and downs for so long I now figure how stupid I must be to ignore the advice of what the foresight programme offers when the percentages are so high in success. I may have saved myself a fortune and by now may well have had a baby in my arms. I am day 4 of the healthy eating which is very strict. The most exciting my drinks get is a herbal tea and that’s what I have to look forward to on Friday night :-( - however I will not back down this time as I really need to know if this will make a difference. I am aware that my biological clock is ticking and as such I have to give this every ounce of effort and energy.

My thyroid did go hyper for a while when on tablets and my endo told me it is better to be hyper than hypo. I am not sure if anyone else can comment on this - if you have read this far.

Hope this helps and good luck with falling pregnant!
:-)

[Noel25]

Hi my doctor discover my hipothiroid a year ago and i was very slim at that moment with no medication then him give me levo 0.50 mc because my % it wa 0.3 anyways im stewardess and i been going up of my wait with non stop i got 10 k more and i feel really weack to do gym so i been taken fucus and l-carnitina.
Im thinking that im having a problem with my anxiety too
I' ll like to ask if any knows a way to loose wait with the change of time because basicly my big problem is the different time when im going to different countries what can i do with my medication i up it myselfe to feel better to 200 and im changing but im still dont know how to take care of this problem.
If any has a valanced diet or any page that i can get one pls help me.