TTC and higher TSH (Thyroid Stimulating Hormone) levels? Did you get your TSH checked before TTC?

[babybee]

Hi Ladies, I just got my Thyroid lab results. It looks like my TSH has increased since April of this year. It was 1,04 and now it is 4.28. I am panicking since my OBGYN mentioned that they have to keep an eye on my thyroid nodule and it can become an issue if I can't get pregnant. However they told me that 4.28 is still within normal range , but I read everywhere that's it's harder to get preggo with higher TSH. I think I did ovulate this month and my other blood work for Esradiol and FSH came normal, so should I be discouraged or take it easy? What are your experiences and /or if you had thyroid checked what do your doctors think about higher/lower TSH and TTCing? Should I be on meds to lower TSH? Please share. Thank you.

[Gwenn]

My RE tested my TSH and it came back 4.25. He put me on thyroid hormone immediately. Most REs want TSH to be between 1.0 and 2.0 for pregnancy.

[AllieA]

I am hypothyroid and take medication daily. I have been dealing with it now for about 3 years. Most doctors still follow older guidelines in which 4.28 is still considered normal. New standards indicate that "normal" range is 0.3 to 3.0 (with over 3.0 being considered hypothyroid). As pp said a TSH of 2.0 or less is what you want to see. It is also very important after you acheive pregnancy. Medications generally have to be increased by 50 mcg/daily. Did you go to a general practicioner for your blood tests? When I went to my family doctor, I wasn't getting results and I ended up going to an endocrinologist. They increased my medication right away and I started to "feel better". Last time I had my blood checked my TSH was 0.53. I recommend the book "Living Well with Hypothyroidism". It discusses the thyroid and fertility issues briefly, but in a whole it is a good book. Hope this helps! GL

[ootus973]

I'm also hypothyroid, and my levels were around 3 when we conceived. Once I was pregnant, I was sent to an endocrinologist who monitors my levels and has raised my medication twice so far during my pregnancy. I'd only been on meds for 4 months when we conceived DD, and they hadn't tested my thyroid yet when we conceived DS. When i finally did have my thyroid checked 6 years ago, my TSH was over 7! I have a hereditary auto-immune condition that effects the thyroid, and also leads to increased miscarriages and other issues.

[kellyowens]

Wow, that's a big jump!! Your TSH shouldn't fluctuate that much!

I have autoimmune thyroid disease. I've been on meds for 7yrs and through 3 term babies. I had 6 m/c prior to treatment and then another one during early treatment (I was hyperT because of the meds I was on)...I also had 2 consecutive losses while on meds but I was slightly hyerT (my thyroid fluctuates on occasion).

I started treatment when my TSH was close to 4 (TSH was rising like yours has, I tested positive for antibodies, and I have a strong family hx of thyroid disease). I would not feel comfortable ttc with a TSH like yours. Are you seeing a regular endo/RE or just the OB?

If you were to get pg it's not necessarily doomed, you would just need to get on meds asap (your TSH goes up during pg).

[livliv]

As others have said, I came back with a TSH of 4.33 and I am on a nature thyroid (1 grain). I re-tested and I am down to 2.33, my dr. said she wants me to be around a 2.0. Good luck to you. I am hoping this helps me to get my BFP as well!!

[babybee]

Thank you ladies for your input. My Obgyn mentioned that my thyroid nodule can become an issue, however they haven't called me in with the latest high TSH levels. I brought it back to their attention , especially the increase, they can look back and see it in my chart since they ordered the first screening in April . I am so upset they did not...and just told me the labs came normal... , . I am waiting for the response from the practice now. I am glad to hear your feedbacks, so I can be pro-active and not loose the time if I have to be on meds and it will help me to concieve. I've been to the endocrinologist in April but they didn't find any concerns back then and I guess if the OBGYN is not the one to prescribe me thyroid meds I will make sure to see endocrinologist soon and take care of my concern. I wish good luck to you all and positive thoughts for soon results!

[NHKate]

Try reading this article (just don't stop after the first short paragraph): http://thyroid.about.com/od/getteste...altshlevel.htm It talks about what is considered normal, and "the recommendation in January 2003, by the American Association of Clinical Endocrinologists, that doctors "consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0." They said that the people at the higher end of what was considered normal were actually people with mild or developing thyroid disease, and were skewing the curve.

[Consensus]

My "normal" is between 0.7 and 1.0, and I only know this because every.single.time I get my thyroid levels checked I call and record them in my personal records. I asked my OB to run my thyroid levels every single month this pregnancy so I've gotten lots of recent data points, but I've known from the time of my diagnosis with the autoimmune thyroid disorder (four years ago) that I was symptomatic with TSH ~1.4.

My last gyn said ideal for conceiving is ~1.0, but the OB and endo I'm seeing now want to see me below 2.0; however that being said my endocrinologist will adjust my meds if I vocalize being symptomatic even when he's happy with the way my blood levels look; my last TSH was 1.3, normal for some, high for me and I was getting my physical signs of hypothyroidism. It is a very, very difficult condition to wrap around, and it takes a strong doctor patient relationship to work together to get the patient well, because like pp's pointed out, the range of "normal" is so large. If your labs come back "normal", the doctors don't necessarily know there may still be an underlying issue if you aren't a strong advocate for yourself. To be honest, it may take some time for you to figure out your baseline and best medication combination to help get your TSH under control, and it may change over time and even my hypothyroid symptoms aren't always constant. I just had my third dosage increase this pregnancy and a few times had random stuff go on that I thought were weird pregnancy symptoms that cleared up within weeks of changing my medication levels. Being knowledgeable about you, figuringout what your clue symptoms are and your "happy" place will help your doctor be successful in figuring out the best treatments for you.

The best thyroid resource I have found is "The thyroid solution" by endocrinologist Ridha Arem; and I found it helpful to go to the medical "establishment" with questions that occurred to me as a result from reading this book by someone who is a well credentialed source in the field. He spends quite a bit of time talking about the full endocrine system, how the thyroid affects fertility and also menopause, which seems far off, but is a very related subject.

I wish you luck!

[kellyowens]

Thank you ladies for your input. My Obgyn mentioned that my thyroid nodule can become an issue, however they haven't called me in with the latest high TSH levels. I brought it back to their attention , especially the increase, they can look back and see it in my chart since they ordered the first screening in April . I am so upset they did not...and just told me the labs came normal... , . I am waiting for the response from the practice now. I am glad to hear your feedbacks, so I can be pro-active and not loose the time if I have to be on meds and it will help me to concieve. I've been to the endocrinologist in April but they didn't find any concerns back then and I guess if the OBGYN is not the one to prescribe me thyroid meds I will make sure to see endocrinologist soon and take care of my concern. I wish good luck to you all and positive thoughts for soon results!

Have them fax your results to the endo with a note that you are ttc . Also, if the endo doesn't see a need to medicate print out the article from the pp and show it to them (I gave my dr similar articles when my TSH was over 3.0).

My meds are usually increased twice during pg and lowered once early pp. My endo adjusts my meds to keep my TSH less than 2.0.

I plan on ttc around Feb (depends on when I get my cycles back...I'm currently bfing) and am having my TSH checked this week, again in 3months, and if I get pg they'll be tested early in each trimester .

KUP!

[Oliveland]

I found out I was hypo before TTC, and am still not ovulating even though my levels have been regulated for a while. No one's said anything about my infertility being linked to my thyroid but I reckon it is.

[Rae_1478]

"Normal" depends on your doctor. Non-pregnant, my endocrinologist keeps me between 1 and 5. During pregnancy, she wanted me between 1 and 2. I think part of the reason they want it on the lower end if you are trying to get pregnant is that the moment you DO get pregnant, it messes with the thyroid (and if you're on a supplement, you usually need more before you even know your pregnant and can have it tested). However, WHEN you do get pregnant, don't let your TSH number freak you out. Mine was up at 17 and everything turned out just fine. I stressed about it and I'd like you to not stress like I did!

[mrs.waddle]

I have a hypothryoid that was untreated until after my 3rd pregnancy. First let me say I have had 4 healthy pregnancies and 4 healthy babies :-) and never had a problem getting pregnant.
But it is common to have problems. When I first found out my tsh was off the charts, the lab only goes to 150...mine was >150...suspected that I had an underactive thyroid for years. The lowest mine ever was was 1.50 during my third trimester of pregnancy and they told me it was where it should be, I know there are different levels for each trimester. My dr likes my level to be somewhere between 1-5, but never wanted anything different when ttc. I must say tho, i feel like crap when my level is more towards 5.

[babybee]

Try reading this article (just don't stop after the first short paragraph): http://thyroid.about.com/od/getteste...altshlevel.htm It talks about what is considered normal, and "the recommendation in January 2003, by the American Association of Clinical Endocrinologists, that doctors "consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0." They said that the people at the higher end of what was considered normal were actually people with mild or developing thyroid disease, and were skewing the curve.

Thank you NHKate for the article. Good to know when I will talk to my endocrinologist. I am going to see the endocrinologist next week , so hopefully I'll find out what does the picture looks like for my case. I am reading about other symptoms of hypothyrodism and it seems I have some minor symptoms, however it is good to catch things before they become a big issue, right?Hopefully I'll get some answers for the peace of mind and soon BPF.

[babybee]

My "normal" is between 0.7 and 1.0, and I only know this because every.single.time I get my thyroid levels checked I call and record them in my personal records. I asked my OB to run my thyroid levels every single month this pregnancy so I've gotten lots of recent data points, but I've known from the time of my diagnosis with the autoimmune thyroid disorder (four years ago) that I was symptomatic with TSH ~1.4.

My last gyn said ideal for conceiving is ~1.0, but the OB and endo I'm seeing now want to see me below 2.0; however that being said my endocrinologist will adjust my meds if I vocalize being symptomatic even when he's happy with the way my blood levels look; my last TSH was 1.3, normal for some, high for me and I was getting my physical signs of hypothyroidism. It is a very, very difficult condition to wrap around, and it takes a strong doctor patient relationship to work together to get the patient well, because like pp's pointed out, the range of "normal" is so large. If your labs come back "normal", the doctors don't necessarily know there may still be an underlying issue if you aren't a strong advocate for yourself. To be honest, it may take some time for you to figure out your baseline and best medication combination to help get your TSH under control, and it may change over time and even my hypothyroid symptoms aren't always constant. I just had my third dosage increase this pregnancy and a few times had random stuff go on that I thought were weird pregnancy symptoms that cleared up within weeks of changing my medication levels. Being knowledgeable about you, figuringout what your clue symptoms are and your "happy" place will help your doctor be successful in figuring out the best treatments for you.

The best thyroid resource I have found is "The thyroid solution" by endocrinologist Ridha Arem; and I found it helpful to go to the medical "establishment" with questions that occurred to me as a result from reading this book by someone who is a well credentialed source in the field. He spends quite a bit of time talking about the full endocrine system, how the thyroid affects fertility and also menopause, which seems far off, but is a very related subject.

I wish you luck!

Thank you for sharing your story. I agree, being an advocate for yourself always helps, as you are the only one to know your body in its good and bad shapes. I'll try to read more before I go to endo, so I can l feel more knowledgeable discussing my problem.

[babybee]

I have a hypothryoid that was untreated until after my 3rd pregnancy. First let me say I have had 4 healthy pregnancies and 4 healthy babies :-) and never had a problem getting pregnant.
But it is common to have problems. When I first found out my tsh was off the charts, the lab only goes to 150...mine was >150...suspected that I had an underactive thyroid for years. The lowest mine ever was was 1.50 during my third trimester of pregnancy and they told me it was where it should be, I know there are different levels for each trimester. My dr likes my level to be somewhere between 1-5, but never wanted anything different when ttc. I must say tho, i feel like crap when my level is more towards 5.

Thank you for sharing mrs. Waddle. Good to know that it wasn't an issue for you to get pregnant and have healthy babies. It gives me hope that mine is not that bad and when it gets attention I'll be more optimistic than scared!!

[babybee]

"Normal" depends on your doctor. Non-pregnant, my endocrinologist keeps me between 1 and 5. During pregnancy, she wanted me between 1 and 2. I think part of the reason they want it on the lower end if you are trying to get pregnant is that the moment you DO get pregnant, it messes with the thyroid (and if you're on a supplement, you usually need more before you even know your pregnant and can have it tested). However, WHEN you do get pregnant, don't let your TSH number freak you out. Mine was up at 17 and everything turned out just fine. I stressed about it and I'd like you to not stress like I did!

Thank you Rae, will try not to stress. I just thought I am glad I paid attention to my lab results otherwise if it does affect my fertility and I would struggle to get pregnant I would wonder and stress more why it doesn't happen.