thyroid issues

[Negrita82]

I currently have a tsh level of 0.19. is this level ok to get pregnant and sustain a pregnancy?

[goolarra]

I'm sorry, I don't really have any suggestions for you.  "A watched pot never boils..."  Perhaps watching everything so closely is throwing your cycle off psychologically.  

Since there's been a new development (not ovulating), you might want to start a new thread asking that question.

[Negrita82]

Hi good morning. I flew back from Puerto Rico on the day I was supposed to ovulate. That was the 17th. So far im still waiting to ovulate. I now know that my cycle is off for this month. Normally I have been ovulating at 14-15 days every month. Any insight on what could be wrong now? We  are ttc and im using clear blue to track my most fertile days.  

[goolarra]

Your FT4 is a little bit high, and your TSH is a little low (TSH isn't a problem).  However, if you feel well, there is nothing in your labs that would indicate you shouldn't try.  Just be sure to monitor FT3 and FT4 levels closely during pregnancy as it may change your thyroid hormone requirements.  

[Negrita82]

Hi.  I was diagnosed with graves disease and i had to make the decision to  take the radioactive iodine.  currently im on 125mcg of synthroid daily and those were my current level.  my endo said that we are ok to start trying.  I was just wondering if its possible for me to get pregnant with my current levels. im not scheduled to see my endo for another two months.

[goolarra]

TSH has been taught in med schools for years as the "gold standard" of thyroid assessment.  This goes back to before FT3 and FT4 were as cheap and as reliable as they are now.  Doctors are very slow to change.

In a perfect world (the one without patients in it), TSH is the ultimate indicator of thyroid status.  The system is beautiful.  The pituitary checks thyroid hormone levels.  If they're too low, it sends out more TSH.  If they're too high, it doesn't put out any.  TSH reflects accurately thyroid hormone levels.

So, that's the fairy tale...in practice (the world with patients in it), any number of factors can make that beautiful feedback mechanism go awry.  Pituitary issues are often involved.  Thyroid meds can drive TSH almost to zero with people still feeling very hypo.

TSH causes no symptoms.  If FT3 and FT4 are good, it can be ignored.  I have a pituitary issue, and my TSH hovers around 20.0 all the time.  My endo and I just ignore it.  My FT3 and FT4 are good, and I'm asymptomatic.

If she's euthyroid (neither hypo nor hyper), she should have no trouble getting pregnant or sustaining a pregnancy (from a thyroid point of view).  

[thethinme]

Thanks goolarra. So why is TSH even mentioned? I mean, if someone's TSH is super low, as for example that's the only way for her not to have symptoms and get ideal FT4 and FT3 levels, can she get pregnant and maintain a pregnancy?

[goolarra]

FT3 and FT4 are always more important.  TSH can be influenced by so many factors other than thyroid hormone levels.  FT3 and FT4 are a direct measure of the actual thyroid hormones in the blood.  Those two tests and symptoms should always overrule TSH.  TSH's only function is as a messenger from the pituitary to the thyroid.  It causes no symptoms.  

[thethinme]

As I am also concerned about future pregnancy, I am curious to know: what numbers are more important for pregnancy? As everyone seems to state TSH is not the main thing, does that number really matter for pregnancy? Or are FT3 and FT4 more important / less important in this case?

[goolarra]

Your FT4 is very close to the top of the range, which, like your TSH, indicates that you might be hyper or heading in that direction.

She should have run FT3 to see where that is, too.

I'd ask the doctor to order a TSI (thyroid stimulating immunoglobulin) test to see if you have Graves' disease, and, if so, how active it is.  

Do you have hyper symptoms?  Weight loss?  Intolerance to heat?  Insomnia?  Hand tremors?  You can google a more extensive list.

[Negrita82]

range is (0.89-1.76) on my report.

[Negrita82]

currently my doctor did a thyroxine free which had a level of 1.72  is the range.This time she did not have a free T3 or T4 analysis done.

[Barb135]

Do you have Free T3 and Free T4 levels that you could post, along with reference ranges, which vary lab to lab, so must come from your own report?

What, if any symptoms do you have?

[goolarra]

Your TSH is a little on the low side, which might indicate that you are somewhat hyperthyroid.

Are you taking thyroid meds?