Pre Conception Consultation For My Friend

Needtobestrong · Feb 14, 2018

I'm writing this query for sake of my friend who is married couple of years and just started TTC some months ago. she was staying with husband and working in a different city, when they decided to TTC..she has undergone few basic tests like pelvic ultrasound, vitamin b, vitamin d, blood counts, thyroid test, etc. other tests were ok but vitamin b and d and haemoglobin levels were on the lower end, so the gynaec whom she was consulting put her on multivitamin tablet and folic acid tablets..her thyroid test with T3, T4, TSH were done..T3 and T4 levels were normal but TSH levels were slightly elevated, I.e 3.5. The gynaec said nothing to worry about, no medicine needed ..
but soon after starting TTC , her husband got transfer to a different city, then they halted their TTC plans for couple of months..till the time they settled in the new place and she gets a job..she started working and continued her TTC, and waiting for good news..., but noticed high levels of fatigue and hair loss and unexplained weight gain and low sex drive..she got thyroid test done again. T3T4 both normal but TSH was close to 4..
She consulted a gynaec near her new home, the gynaec saw her reports but dint show interest in thyroid level..also told her that folic acid tablet is enough, no need for for any multivitamins..
Now by enquiring people and reading online stuff she found out that TSH level to be maintained between 1 and 2 during TTC else it affects fertility and later affects pregnancy..she is understandably angry that none of gynaec suggested Thyroid meds for her in spite of her TSH level, and her complaints of severe tiredness hair fall and weight gain? Is it that doctors are so super busy that they don't pay attention to basic aspect also?
She visited an experienced general practitioner when she had cough and cold and just showed those reports to her once..that general physician suggested her to take multivitamins , and Thyronorm 25 mcg everyday in empty stomach and then recheck thyroid level every 3-6 months.
i m just inviting everyone's suggestions based on their experience..should she follow the advice of the general physician and take the thyroid medicine?(I support it, as I'm Having thyroid issue too )..should she really continue consulting that gynaec who ignored a hormone issue so easily?

MonikaSG · Feb 15, 2018

I don't know about this specific issues but I too experienced unprofessional behaviour of even high profile doctor. They just make a guess and convince patients. We suffered a lot with that guess work but whom can we report to about this? They have the high moral responsibility towards their patients which they sometimes forget easily.

kalcandu · Feb 15, 2018

Hi.
I was lucky that my thyroid problem was diagnosed because i went to doc with Complaint of suspected anemia. This doc took one look at me and prescribed a battery of blood tests. I was full of disbelief as to why do i need all these tests. I was even more shocked when the report came back with almost everything abnormal, including tsh, which doc said was the root for all other imbalances as well. It took me several days to accept that i have thyroid issue because the symptoms are subtle. Your friend is lucky she could sense something is wrong and got tested. Regarding doctor, the normal range values for tsh are not standard worldwide. Even among doctors, some are aggressive in approach and some are conservative. One doc told me i can ttc at tsh of 3 but online it says much lower value (American standard).

While reading a lot of stuff online, i came across this statement: treating the patient and not the report. If your friend is not feeling well, taking medicine may help her feel better. Simply saying oh value is within range, is not effective approach. If the human being is suffering, medicine should be given.

My doc, after tsh elevated report came, made me test for thyroid anti bodies. It may help your friend to test for that, if she hasn't already.

Lastly, getting a good.doctor also is something which is crucial for us to manage our health conditions.. all docs will not be perfect.. We as patient should also be aware and alert. This is my opinion..sorry. i hope i addressed your question

Needtobestrong · Feb 15, 2018

@MonikaSG and @kalcandu thanks for the replies.
I too had many symptoms of thyroid issue but everyone brushed it aside saying that I'm over anxious ..after checking the levels and consulting a specialist I'm on the right track.
Seeing this happen with many of my friends as well.

Starkgirl · Feb 15, 2018

Every doctor follow different reference range and I do believe TSH level 4 is not too high some doctors still consider it normal
Since her TSH increasing it’s better if she sees an good endocrinologist and do whole thyroid panel test.
same time ask her to maintain her carbs intake , also exercise is very good for thyroid health.
I read in one forum that vitamin D is directly linked to thyroid health may be that is why her doctors asked her to take multivitamin (not sure)

Hope your friend feels better , good luck

DDream · Feb 15, 2018

Needtobestrong said: ↑

She visited an experienced general practitioner when she had cough and cold and just showed those reports to her once..that general physician suggested her to take multivitamins , and Thyronorm 25 mcg everyday in empty stomach and then recheck thyroid level every 3-6 months.
i m just inviting everyone's suggestions based on their experience..should she follow the advice of the general physician and take the thyroid medicine?(I support it, as I'm Having thyroid issue too )..should she really continue consulting that gynaec who ignored a hormone issue so easily?
Click to expand...

OP, the concern you have is very genuine. Let her gynac deal with gynac issues not TSH.
Ask you friend to consult an endocrinologist if she has doubt about it. They will give thyroid medicine (*thyroxine) may be in low quantities (25mcg).It is important to have TSH close to 1 according to my doctors during pregnancy as it can affect brain development of the baby during pregnancy. Baby absorb everything from mother. Right?

She should follow her general physician for dealing with TSH and take the medicine. Thyroid medicine is one of the safest medicine one can take during pregnancy. She can continue with folic acid and other prenatal vitamins during this time as suggested by gynac. Please dont neglect it.

-----------------------------------------------------------------------------------------
Here is my story :- My TSH level was 4.3 ( normal is 0-5) when I confirmed by first pregnancy. My family doctor was very concerned at it was close to upper limit, especially during pregnancy. So she suggested an appointment with endocrinologist. I have started taking 25 mcg of thyroxine every morning in empty stomach. (atleast 30 minuted before breakfast).
My endocrimonogist confirmed inflammation of nodules and suspected some infection of thyroid ( viral fever and sinus issue I had before. ) . I followed the instructions and continued taking the medicines during pregnancy, till my kid was around 1yrs. By that time the inflammation of nodules were gone & my TSH became less than 1. So I waited another six months without medicine and checked again. TSH became normal so stopped it.

I dint took any thyroid medication during second pregnancy as TSH was normal and close to 1.

But after two years since the birth of my second child, my blood work revealed elevated TSH and I was very tired and weak during that time. Now I am again taking the medicine for thyroid. My vitamine D levels were very low and I am now taking both.