hypothyroid diagnosis & TTC

[peaches' mom]

I am putting this out to the MDC community as there is so much wisdom & experience here, I really hope you can help me!

I had bloodwork done this week to look at my hormone levels, assuming everything would come back "normal" (at least according to conventional medical ranges). Anyway, I got a call yesterday pm from the Dr's office asking me to get more bloodwork asap. Based on the first test, they said that I am most likely hypothyroid. This next test will confirm.

DH & I are TTC, and this month's FW will be this coming week (likely not before I get the results). So, the million dollar question is, should we TTA this month? I realize that to some one month off isn't a big deal, but we have been wanting another baby for so long now - the thought of "wasting" a month breaks my heart. It doesn't help that DH is a teacher so a June baby (i.e. conceived this month) would be ideal with him being off.

Can anyone clarify for me the risks of being hypothyroid while pregnant? I've been reading online (lots of very scary things), and wanted to get some more reliable information.

This may be moot because it seems likely that hypothyroidism is the reason we haven't been successful. Will going on the synthetic hormone correct this? Or do they prescribe Clomid or something else?

Also, I have read that hypothyroidism can occur postpartum (although every source I have seen says within a year). I am nursing my 25 month old DD, many days quite often but generally not overnight. Can that impact on when it occurs? Maybe I'm grasping at straws here

Thank you so much for any insight you can give me. I'm finding it very hard not to stress about it.

[GoBecGo]

nak

i'm a hypothyroid mama, dx after weaning (because i lost my milk 7monthPP) DD1.

if i were you i would tta this month because i've had 4 early losses and at least 3 of them were during hypo periods (once not enough meds, twice unmedicated), the 4th was probably due to H1N1. hypothyroidism CAN cause terrible problems for baby and mother, cretinism, microcephaly, high BP, PPH etc. BUT i conceived, carried and delivered DD1 with undx hypothyroidism and my labour was fine, she is perfectly healthy - most times if the body CAN compensate, but still, knowing it was a factor i was very careful to be properly medicated and monitored with dd2.

going on thyroxine supplementation will usually mean you can conceive normally, it can take a few months for normal levels to establish and for the body's systems to come online properly again.

when i was dx i was 7months PP and the doc told me that hypothyroidism relating to being PP ended by 9-12months PP at the latest. so this far out, i would think yours is permanent. sorry. nursing doesn't make much difference - some women have supply problems due to it, some don't, when i weaned from the one feed i could still provide my hypothyroidism, as yet still unmedicated, improved massively, though not enough for me to avoid medication.

[peaches' mom]

Thanks a lot, GoBecGo.

Am I understanding your last couple lines properly - that when you weaned your hypothyroidism improved? Assume this was with DD1? How is it going since DD2?

[MaerynPearl]

the 12 months is how long it can take to come on... it can take up to 5 years to clear up in extreme cases... so it could still be postpartum thyroiditis.

mine after DS took 2 1/2 years to clear up (just in time to get pregnant with DD) and after DD took 3 years. but that was from their birth... with DD I did not develop the postpartum thyroiditis until my 6 month check... we do not know how long I had it before diagnosis with DS.

Needless to say, here soon I am going to deliver again and need to be checked VERY closely because having it twice... I do have a slight chance of not getting it but that chance is so very slight as to be unlikely. More than likely I will have it.


ETA - in neither case did my clearing up coincide with weaning... I was still hypo at least a year after weaning DD.


Also, both my doctor AND my midwife have expressed to me that even though it cleared up in the past and I am tested yearly at my physical and get regular levels... I still need to be monitored through pregnancy (had three tests, all have come back fine so far)

[lisab82]

Hi Peaches mom, I have hypothryoid and I have been TTC for about a year now. I have been seeing a fertility doctor since May and he immediately put me on a medication called Synthroid. The doctor said that hypo throyid can cause early miscarriage. I would say see what your doctor says about TTC this month. So I know how you feel right now. But if your on meds and can fix your problem then its for the best

I wish you only the best!

[peaches' mom]

Very interesting, Maeryn. Thank you for this.

And all the best in the days ahead. I'll be looking for your announcement that little Mae has arrived! Very exciting

[GoBecGo]

Originally Posted by peaches' mom

Thanks a lot, GoBecGo.

Am I understanding your last couple lines properly - that when you weaned your hypothyroidism improved? Assume this was with DD1? How is it going since DD2?

i only weaned because my very hypo body was struggling to make any milk. i began to lose it at 4monthpp, it was never my intention to wean so early, but weaning DID improve my blood numbers. this time i am properly medicated and being careful with my supply. dd2 is 3months old, i am having post-partum thyroiditis (currently hyPERthyroid, just had meds adjusted) right now but my milk, touchwood, is fine.

i have hashimotos - it runs in my family. hypothyroidism is a bit like diabetes - if you have it, it effects your pregnancies, if you only have it pregnant/post-partum you're more likely to end up getting it all the time.

Maerynpearl - did you come off meds after 3 years post DD? or did you not medicate for those 3 years?

[blackbird2]

Hi - I was dx hypothyroid early to mid-pregnancy with my first. I think as long as you're working on getting it under control you're fine ... it's just a little more complicated to do so while pregnant because your dose increases. Some labs include a thyroid test as part of the standard early pregancy blood draw, so i'm sure for a fair number of people, that's when they find out.

I was totally scared by the news too. But everything turned out fine. I just have to take a pill every morning now. Not great, but not aweful.

[MountainMamaGC]

I was dxd before I got pregnant with DD. I conceived after 6 months of trying. My cycles were longish but still normal. (33-35 days) Since my period came back post partum my cycles have been gradually getting smaller and smaller (30-31 days). I get my thyroid tested twice a year to make sure my levels are good. I stopped taking my pills once and encountered the worse depression ever. Unless you are willing to follow the advice of a good ND, synthroid may be the way to go.

[2xand2y]

I was dxd when I was 18. I've had 2 confirmed and one possible miscarriage (all around or before 8 weeks) and 4 uncomplicated, normal healthy pregnancies ending in 4 uncomplicated, normal, healthy vaginal unmedicated births resulting in 4 beautiful healthy average (or better ) children. I despise taking my little pill and although I usually have good intentions I am almost always noncompliant and therefore symptomatic. My endocrinologist told me that most of the "science" linking hypothyroidism to less than healthy babies was weak at best.

I conceived both of my girls the ovulation following my 2 confirmed miscarriages, and I believe the miscarriages were needed to prep my body to carry a pregnancy to term.

I think you should go ahead and TTC. You'll figure out the rest with your Dr. when the results come in.

[Dov'sMom]

I think as long as you have the synthetic hormone you should be okay.

I've been hypo since my first pregnancy. I thought it had resolved itslef, but when I realized my periods were anovulatory I had ti checked again -- ovulated three weeks after starting Synthroid and the baby is 6 months old!

[Katia]

I haven't read all of the replies, but I am hypothyroid and have successfully conceived and carried two babes to term. I think there are natural supplements as well, but I am on a synthetic hormone. Not only is it crucial that you treat the hypothyroidism during pregnancy, but you should be blood tested for it regularly during pregnancy and semi regularly after pregnancy. (Currently, my levels are fluctuating and I am being tested monthly and my supplements are being adjusted accordingly.) You may be on supplements for life.

This very well could be the reason you haven't been able to conceive! Get yourself treated and yes, do try this month! When I conceived my first, I had a history of it but had been off meds, told my OB, she tested me and I was still hypo, so got put on meds after becoming pregnant.

Good luck!

[GoBecGo]

OP just a random thought, but do you chart? When i was hypo and charting i WAS ovulating, but my BBT was so low i had to make my own charts as none of the shop-bought ones had my temps on them, i was way off the bottom...

[peaches' mom]

Thanks everyone. It means a lot to get feedback & I am very hopeful given there are so many others who have managed to conceive through hypothyroidism. GoBecGo, your most recent post was very timely (BTW, yes I do chart and my temps have been lower than normal for me but not off the charts the past few months) - I got the call this afternoon from my MD to confirm the diagnosis. The past week has been a rollercoaster.

For anyone who has BTDT, here's where I'm at. I'd love your perspective if you can share.

My most recent bloodwork -
TSH = 7.06
Free T4 = 11

thyroid antibodies both came back positive (suggesting this is going to be a longterm condition)

MD wants me to start on 50 micrograms of Synthroid asap (she said today), blood rechecked in 6 wks. I have an appt with my naturopath for thurs.

For those in the know, how soon can I expect for TSH to be within a normal (if not optimal) range? Should I be TTA with these (current) numbers? My MD thought that I likely won't be able to conceive with these #s (which makes sense given we've been trying for awhile). But the question I have is will the Synthroid enable me to conceive prior to having good (i.e. safe) levels for pregnancy? I am very scared by the potential for neurological impairment.

Thank you once again for your input. It is incredibly helpful & a huge relief emotionally.

[GoBecGo]

My meds affect my bloods within 3-4 weeks. It depends on the individual of course, what your eventual supplementation need will be. But i was diagnosed with a TSH of 12, but refused medication (i had a hard time integrating it all). I began on 25mcgm/day of levothyroxine (same as synthroid) with a TSH of 6.8 (after weaning) and i had "normal" TSH 4 weeks later (TSH was then 4.78, lab range in those days was 0.5-5.0, now in my lab it's 0.3-3.0, i was still symptomatic at TSH 4.78). I was raised to 50 and then 75mcgm/day based on symptoms, and went on to 100mcgm/day when i was pregnant with DD2.

When it comes to TTA vs TTC with these levels - i wouldn't ttc this cycle, i would wait just those few weeks to see the next blood result. I would take the synthroid, see the naturopath, and hang out until the first result is in. Just be close with your husband and try not to worry too much. I don't really think you can have levels good enough to fall pregnant but not safe for pregnancy, kwim? Especially if you're being monitored the whole time. But if you wait you might save yourself a lot of worry, and a lot of worry in early pregnancy (or indeed any time) isn't good news, you're likely to enjoy your pregnancy a lot more if you wait a cycle or two until your levels are improved. I know it's hard - i found it super hard, i had 2 losses before each of my healthy babes, which might have been related to my levels (i was normal at conception but took a dive afterwards - doctor doesn't know if the loss caused the dive or the dive caused the loss, it's chicken and egg and there's a lot they don't know about these things yet). My DD2, my first kid with DH, was born ON HIS BIRTHDAY, if that wasn't meant to be i don't know what was!

I would expect your numbers to be improving within 3-6 weeks, and if you're ttc you can ask them to go on checking you every 4-6 weeks until you conceive and throughout the pregnancy.

[peaches' mom]

Thank you, thank you, THANK YOU GoBecGo! I can't tell you how helpful this is, I could feel my stress level going down as I read your post You are so right, there is no benefit at all to going ahead TTC before my levels are checked again. It is a huge switch to make in my brain (I've been so eager to be pregnant asap), but definitely not worth the stress.

Am I understanding correctly, your TSH levels went down from 12 to 6.8 due to weaning alone? I don't think I mentioned in my earlier posts, but I am currently nursing DD2. Would I expect my levels to change for the better when she weans?

I am so sorry for your losses. It is amazing how much is still unknown/misunderstood about TSH & hormones as a whole. That's amazing & really cool that DD2 & DH share a birthday, definitely meant to be.

[Rainy229]

FWIW, my RE (nurse practitioner) told me that with my *borderline* hypothyroid (just under 4), it was "extremely doubtful" that I would be able to conceive, and that she wanted my TSH under 2 - where "most babies are conceived." I don't know where she gets her info to say extremely doubtful and that one about most babies... but it makes sense.
My DTCM also told me (who lowered my TSH from over 6 to under 4 without meds!!) that there's a threshold BBT for ovulation to take place... I don't recall any more info about it, nor did I ask any questions - but I'm kinda thinking the threshold BBT is related to TSH... if the BBT is too low, the TSH is prob. too high....

HTH!

--Rainy

[GoBecGo]

Originally Posted by peaches' mom

Am I understanding correctly, your TSH levels went down from 12 to 6.8 due to weaning alone? I don't think I mentioned in my earlier posts, but I am currently nursing DD2. Would I expect my levels to change for the better when she weans?

Yes, at the time of the 12 i was only feeding her once a day, and at the 6.8, just 4 weeks later, i had quit that one feed. BUT i want you to understand that i was very ill then. Realistically i was only making about half an ounce of milk (i gave her one feed at 5am and after i weaned her from the breast she simply stopped waking for milk then, so i don't think i was meeting hunger, more the comfort and closeness). It broke my heart to wean her. I was very symptomatic then. I had stress fractures in my feet from running (which i was doing to stave off the depression i was getting) as i couldn't heal fast enough to "recover", my hair and especially eyebrows fell out, my resting pulse was so low at one point the GP wanted to call an ambulance to the surgery to take me in and was convinced i must be doing or taking something else to cause it (it was 38bpm), i had no appetite, i moved my bowels (ok, TMI, but a symptom) only twice a WEEK (i'm usually once or twice a day). I was pretty ill.

I wouldn't want you to do anything hasty as regards weaning because of my experience, it is SO unclear as to why my levels improved then - weaning may have been a factor, but it could have been unrelated. I think for my body BFing when so severely hypo was hard, but i know other women who BFed with no issues and far worse numbers than I.

[jenger]

Thanks, all, for this thread!

I have had mild symptoms of hypothyroid for well over a year, maybe two, and have been ttc for 14 cycles now...

My TSH has been around 4 the 2 times I've had it checked. My GP called it normal, but my naturapath is treating me with 50mcg of levothyrine - it feels great! (Although I a starting to lag again, in this 4th week of treatment...)

Regardless, thanks all for the questions, answers and information! It is helpful to know that it is likely thyroid issues that is keeping me from conceiving.

On that note - Since I ovulate regularly, what about hypothyroid is effecting my fertility?

Thanks again.

[GoBecGo]

Originally Posted by jenger

Thanks, all, for this thread!

I have had mild symptoms of hypothyroid for well over a year, maybe two, and have been ttc for 14 cycles now...

My TSH has been around 4 the 2 times I've had it checked. My GP called it normal, but my naturapath is treating me with 50mcg of levothyrine - it feels great! (Although I a starting to lag again, in this 4th week of treatment...)

Regardless, thanks all for the questions, answers and information! It is helpful to know that it is likely thyroid issues that is keeping me from conceiving.

On that note - Since I ovulate regularly, what about hypothyroid is effecting my fertility?

Thanks again.

As i understand it...they don't really know. My doctor told me they think it can result in or at least contribute to miscarriage because your body is unable to meet the demands of the newly-implanting pregnancy fast enough - major things happen in a matter of days early after conception, and it's possible that the body lagging a little in meeting chemical "requests" from the zygote/embryo would result in it failing to attach properly or in it's demise soon after. This could become visible as a late period or an early loss. It's also possible that though you can mature an egg enough that the body WILL ovulate, the egg isn't perhaps mature enough to fertilise successfully. It's a delicate dance, in those early days of a pregnancy, and they don't really know yet half of the things which are critical to it all working.