# Hypothyroid and Infertility



## BrynneTM (Mar 12, 2014)

I'm a 30 year-old female, diagnosed with ADHD, eczema, and environmental allergies year-round - all since elementary school. Current medications are Adderall, Flonase, and Ortho Tricyclen Lo (meds haven't changed in the last 8+ years). When I was 25 years-old, routine blood work ordered by my general practitioner (GP) showed my AST liver enzyme was elevated, so the GP ordered labs for TSH and Free T4. Over the next few years, the GP has requested the same labs to monitor my thyroid. My TSH level has been fluctuating, with the lowest level at 2.28 (range 0.50 - 4.50 uIU/mL) in August 2012 and the highest was 8.38 in December 2011. My free T4 level has been normal each time between 1.02-1.4 (range 0.50 - 4.50 uIU/mL). One time only in 2010 - Thyroperoxidase Ab = 0 (0 - 100 WHO Units = Negative).

GP said it was up to me if I wanted treatment for hypothyroid since my BMI was healthy and unchanged and I wasn't complaining of other symptoms. I really didn't have any understanding of the symptoms or what the purpose of treatment at that point would be, so I decided to go with the "wait and see" method.

Fast forward to today, I've started to think about my thyroid again and my primary concern is potential difficulty conceiving in the future. I haven't had any children yet and I'm single, so this would be a couple of years away. I discussed this with my gyn today and she said if the thyroid issue was going to affect future pregnancies, I would have irregular menstrual cycles. I questioned if the irregular cycles could have been masked by the birth control pill (BCP) and Gyn said that might be possible, but also didn't seem concerned.

So GP says I can wait to treat until I have symptoms and Gyn says I don't need to worry about infertility unless my cycles are irregular, but all of those things are difficult to determine because of my medications and previous diagnoses (ADHD, eczema) that have similar symptoms to hypothyroidism. My mood and motivation might be lower than in the past, but that could also be because depressing things keep happening.

I suppose I should see an endocrinologist at this point and I'm hoping the GP will put in an order for labs in the mean time. What additional labs should I ask for? Thoughts on the urgency of pursuing this?

Thank you in advance!


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## joplin1975 (Jul 21, 2011)

I think the "urgency" of it all should not be directly related to fertility, but rather to overall endocrine/hormonal health. That is...it sounds like something is going on with those fluctuating numbers and low free t4 and thyroid issues don't generally get better...things tend to get worse, particularly without treatment. And, because it impacts so many different systems, I would be more concerned about whole body impacts and less concerned about babies that are a few years off.

I would inquire about re-running your thyroid labs: TSH, free t4, and free t3 and you antibodies, to include TPO again and perhaps TSI. I would also request an ultrasound.


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## BrynneTM (Mar 12, 2014)

Thanks for the response. I'll ask my GP to put in the orders for the lab work you mentioned. Is the ultrasound typically something they do same-day at the endocrinologist's office or something I could request in advance? I'm trying to limit the trips I make back and forth to the doctor just because more tests are needed.


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## joplin1975 (Jul 21, 2011)

I think it depends.

Mine was done at an imaging center, not affiliated with my endo...so it was a separate trip. But certainly some endos and GPs have the equipment in house.


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