Doc from new clinic called last Friday regarding my thyroid testing with surprising results. The TSH came back at 2.98. Even though the normal range is up to 4.5 for regular people, both clinics like to see the number under 2.5 for women trying to get pregnant and during pregnancy. It's the first time my thyroid has been flagged at all abnormal.
Bright and early Monday morning I started stirring up some dust and placed calls to my RE, PCP, and OB/GYN to get values from previous TSH testings. It would have been mentioned in the past if something was elevated or abnormal, right? RE nurse was first to call back and my number was 2.09 in January earlier this year. I asked her to send me a lap slip to get it retested so that current clinic has accurate numbers before we start up again and I went for bloodwork Monday afternoon.
PCP called back and said my level was 3.81 in March - yikes!!! It was 2.01 the year prior. PCP mentioned that anything under 4.5 is considered normal and that she wouldn't put me on medication for 2.98. She said it can fluctuate greatly between labs so she recommended getting retested to make sure.
IVF 6 baseline was supposed to be on Monday. I'm not ready. I don't want to start yet. We don't have finances straightened out, I didn't place my medication order yet, and I'm not ready for the pain and discomfort, and I'm still working on losing weight. I could use another month or two off. But we want to get a cycle in before the holidays so that we can rest and recover during that time, not to mention trying to enjoy the holidays. I don't want to postpone a whole cycle to October but I also can't start a cycle next week. My nurse was out on vacation this week so I figured out the timeline with someone else. I needed an extra week. I wanted just a breather before we jump into it again. My RE said I could either do a 5th week of bc pills or have a mini menstrual cycle before starting which is what we chose. Even though it's a logistical niddah nightmare, I don't want to suppress too much before starting a stim cycle.
The summer is already starting to come to a close and I kind of feel cheated out of a break. We spent most of June and July grieving and recovering. I have a mental block in my mind about planning a vacation even though we could definitely use it and summer will be over before we know it. While I'm sad we didn't get to do any kind of trip or fun stuff, I'm kind of glad it's almost over. I need the pressure and questions of "are you going away this summer?" to end. There's no reason we can't plan getaways for the fall or winter or spring. Another post for another day.
My thyroid results came back from testing earlier this week: 1.91. So I guess it's not elevated? I'll bring it up to my RE before a transfer but it's interesting that there's so much fluctuation between labs. The tests were done 4 days apart.
IVF 6 baseline was moved to end of August, so we're gearing up to get started again.
TSH fluctuates more than I expected -- I once had a increase of 2 within a few days. I still don't quite get why.
ReplyDeleteGood luck with all the logistics/planning!
Also don't beat yourself up about planning a vacation - there's always time in the fall/winter to do a quiet/low stress getaway.
I was told there's a difference in labs that do the testing. So much? And people go on medication based on results from one lab vs the other?? I don't get it at all.
DeleteI guess it depends on the lab. But TSH shouldn't differ that much from lab to lab. It sounds like your thyroid is not stable. Thyroid medication will help with that.
DeleteI've heard that recent research has said that thyroid should be between 1 and 2 for pregnancy. Closer to 1 is optimal. Ideally get it down before your transfer. Under 4.5 is what they used to say but not anymore but it seems like some doctors haven't been updated to the new recommendations. Anyway, best of luck for your new cycle!!
ReplyDeleteYeah, with those values it sounds like you have hypothyroidism. Do you have any symptoms? Recurrent miscarriage is certainly a symptom. 4.5 is way too high! Your PCP definitely doesn't know what she is talking about. I would be feeling like crap if my TSH were in the 2s, 3s, and 4s. I feel good when my TSH is closer to 0.10, becAuse I know my free T3 is high. It's been taking me three years to make my thyroid optimal for me. A non-optimal, sluggish thyroid is an effective form of birth control. TSH is a pituitary hormone and doesn't take into account thyroid function. Have you gotten free T4 and free T3 tested? You definitely want to get your thyroid normalized before undergoing treatment again. dr. sher says at egg retrieval TSH doesn't matter, but for transfer you definitely want thyroid to be optimal.
ReplyDeleteYou definitely want to start taking levothyroxine (or the brand name, Synthroid) before your next transfer based on these numbers. The generic is quite cheap and it's just not a big deal. I take one every night at the same time I brush my teeth. Barely even notice it anymore.
ReplyDeleteAnother thing to consider is that estrogen interferes with thyroid uptake, which means whether it's a natural pregnancy or FET, the surges in estrogen can wreak havoc and make TSH go up even more.
You don't have to get your TSH level to any precise number, but closer to 1 is good. It may take a few tries and testing it once per month for a while to get it down to that level, but thyroid hormones are incredibly important for developing embryos / fetuses, which can't make their own thyroid until somewhere in the second trimester, I think.
I'd maybe start with 50 mcg/day for a month and see how it goes. Docs these days (even a lot of RE's) aren't nearly as careful about this stuff as they should be, in my opinion. Again, you don't have to get it to some exact magic number, but you certainly don't want to let it keep creeping upwards.
Good luck! Sorry for another stress on top of everything.