Fertility and Thyroid Conditions

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Fertility Issues with Hypothyroidism

March 2009

Hi, I have been trying to get pregnant for 4 years. I am seeing an acupunturist and she has told me that my TSH of 3.91 is high and that alot of fertility doctors want to see it at 2 to get pregnant. I have symptoms like cold all the time, sleeping too much, brittle nails and thyroid problems really run in my family. My kaiser doctor dismissed me 100% when I brought this up with her, saying you are fine.. and that the range of 1-5 is normal not the range of 1-3 which is newer that my acupunturist told me about.

Anyway my doctor won't treat me and I am convinced my thyroid is playing a role in this. I also had a free T4 test done and it was on the low end .9 and the scale starts at .7

Help! Does anyone know a doctor I can see at Kaiser or anywhere that will believe me and knows about this. Or a fertility clinic that will treat this. Or has anyone used natural supplements to bring their TSH level down and concieve.

Let me know!

I can highly recommend Dr. Eric Buxton at UCSF. I had a TSH very similar to yours and it is NOT normal. The thyroid is a very person-to-person thing, so what's normal for one person is not necessarily normal for another. Since I started seeing Dr. Buxton about a year ago my TSH has come to about 1.0, which is great for TTC. I think I have some other issues as well, however, which prevents my conceiving without further intervention. I happen to have two adopted children, one of them new to our family, so we are not TTC at this point. However, I continue to take my thyroid hormones as they help with other issues I was having before (low sex drive, hot flashes, etc.).

I really suggest you call Dr. Buxton. You'll have to pay for it yourself, but if a pregnancy is the outcome then won't it be worth it? His office number is (415) 681- 7707. Jen

It's hard to find a Dr. at Kaiser (in my experience) who connects one part of the body to the other. It sounds to me like you ahve hypothyroidism...cold, brittle nails, tired. How about weight gain? Hair falling out? Hoarse voice? COnstipated?..many more symptoms. Even if a Dr. won't connect hypothyroid to infertility, you should be on thyroid meds. There are synthetic hormones and more natural hormones such as ''Armour Thyroid''. I've been on that for years (rx'd by Kaiser). Do you go to Oakland, or Richmond? (You can get Armour thyroid at Kaiser pharmacies) At Richmond Kaiser I can recommend Marianna Philippek. She's nurse practitioner and more wholistic minded than any other Dr. I've met at Kaiser. Good luck. June
You need to see an endocrinologist. I went through the whole ''your levels are fine'' with an internist at Kaiser. I insisted on seeing an endocrinologist, they said fine, so now Dr. Kanter, and endocrinologist at SF Kaiser, is my doctor. They usually do more through bloodwork and are more knowledgeable about hypothyroid issues. They should test for antibodies as well as tsh levels etc. Good luck! Ilene
Your acupuncturist is right. Your doctor is informed about what is considered normal for the general population. But there is good research indicating that a SMALLER range is more optimal for fertility. (I was treated for my thyroid by Dr. Marcelle Cedars at UCSF... and she is highly, highly informed.) Thyroid is one of the easiest, most straightforward fertility issues to treat, using standard Western medicine. (Synthroid is the drug name.) You should get yourself to a doctor who will treat it. Chris
If you can't find a new doctor, or even if you can, bring this article with you. http://www.aace.com/newsroom/press/2003/index.php?r=20030118 Paragraph 3 addresses the new (2003!) recommended range for normal thyroid functioning, 0.3-3.04.

Your doctor is simply outdated. What's more, s/he should be more concerned that you feel bad than that your number is within range....There's reason #1 to find a new doctor. Good Luck

In college I was on thryoid. When I left college I was off them for years.

I married, joined Kaiser & wanted to be pregnant. I had several miscarriages and for 2 years begged Kaiser for thryoid. My TSH was a bit worse than yours- 4.9 (top of the range, meaning lower on thyroid) and my T4 was very low- (1 )- still the docs brushed me off, told me I was normal & they wouldn't treat out of range. ###Note: my mother and sister had trouble conceiving-trying for 7+ years each with multiple miscarriages- and both got pregnant the month after they began taking thyroid). Kaiser's infertility docs wouldn't give me thyroid either. Even after the fertility drugs failed.

Then, by chance, I had a drug reaction that was rare and I was able to convince my GP that this reaction was caused by low thyroid (it is indicated in the drug notes) - A blood test confirmed the reaction. Only then, and quite reluctantly, my GP gave me thyroid. [[[This drug reaction was a lucky break, so to speak]]]

I got pregnant my next cycle, did not miscarry and now I have a son! Once I was pregnant the Kaiser docs were very diligent about keeping my TSH normalized and even increased my levothroid dose. Today, I see a doctor outside of Kaiser who wants to keep my TSH closer to 2! Many private fertility clinics want your TSH closer to 2. ^^^^^^^So, if you want to be pregnant, just pay out of pocket to see another doctor for a ''2nd opinion''. I'd suggest a ''women focused'' practice (not just a gyno, but the whole body of the woman). & preferably one that is more progressive (biodentical hormones, acupuncture, etc.) and more likely to look at the newer data on thryoid levels.

Keep trying all the other fertility treatments available too- once your thryoid is fixed. It could be a combination of problems you have.

###Note 2: I was miscarrying nearly every other month (very early miscarriages!- late miscarriages too) I would take the ''first response'' pg tests before my period- and have a ''+'' result till my period was 3-4 days late, then I'd get my period. I had a blood test at Kaiser on at least 2 of these early miscarriages, that proved I had been pregnant To me, this showed I was ovulating pretty well, & that something was making me miscarry. Kaiser, however, felt it was just ''bad eggs''. Which makes sense- but the fact I got pregnant and stayed pregnant the first month after thyroid makes that assumption not so assured. done that

I had the same problem with Kaiser -- not that I wanted to get pregnant, but I was suffering many problems that I thought were due to my low thyroid, but my doctor kept saying, you are close to normal, so just ''stick with the dosage you are on.'' That was unacceptable, so here is what I did:

1) I got the book _Living Well with Hypothyroidism_ by Mary Shomon. Her website is: http://www.thyroid-info.com/. The book is incredibly helpful on many levels. I cannot recommend it highly enough. In the book is a list of every possible symptom of hypothyroidism. I checked off mine (18 of them), despite being on horomones and having a ''normal'' TSH of 5-6.

2) Next, I emailed my doctor a detailed list of each symptom, and I included references to the latest studies which showed that a TSH at 2 or just under was better for patients. The email was very long, and since Kaiser emails are limited, it took several emails, just to get the complete message across. Do bombard your doctor. She needs to hear it.

3) I was referred to an endocrinologist at Kaiser, Dr. Bashkir. He says that your TSH should be close to 2 as well. If you need to, I would include in your email to the regular doctor that you would like to be referred to an endocrinologist. The Kaiser endocrinologists have information the regular doctors do not have. (You should put this info in your email as well.)

I suggest that if emails do not get you a referral to an endocrinologist at Kaiser, switch doctors until you get this taken care of.

You must constantly push your Kaiser doctor to get an help with thyroid problems -- at least this has been my unpleasant experience. kiwi

Check out the following links:

1) For inspiration, here is a story of a woman who finally got pregnant by battling her doctors to get her TSH level to below 2.0.


2) For information about the thyroid, here is a list of the top 10 thyroid websites, which are critiqued by patient advocate Mary Shomon:


Good luck! Know what you're going through