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lyly14 - April 10th, 2008 2:31 PM

Hi Dr. Jacob,
Thank you so much for all your time and effort you put into this board.

I have a question about TSH levels. I know that typically a level of .3 to 5.0 is considered normal but I have heard that levels over 3.0 may indicate thyroid dysfunction (hypothyroidism).

I was reviewing my bloodwork from about a year ago and saw I had a tsh level of 4.95. My RE never mentioned any concern, but many of my immediate family members have hashimotos thyroiditis and hypothryroidism. For your patients who have had miscarriages or struggle with infertility, would you be concerned with a level of 4.95 and positve anti-thyroid antibodies?

Thanks,
lyly


B. Jacobs, M. D. - April 10th, 2008 6:32 PM

You are probably hypothyroid. Hypothyroidism may impair fertility and increase the risk of miscarriage. With a family history of Hasimoto's disease, you should see a medicine endocrinologist. Also, there are a few who feel the auto immune nature of Hashimoto's disease may create the same problems with reproduction, even if your thyroid hormone level is normal.
Good luck.

lyly14 - April 10th, 2008 8:55 PM

Thank you for the information. I am going to call and schedule an appointment with the endocrinologist.

My family has a long history of auto immune disease (lupus, Rheumatoid arthritis, hashimoto's). I have been seeing a rheumatologist since my early 20's for various symptoms. She feels I have an auto immune problem, but can't identify it. My current RE has not really investigated immune issues. I wont go into details about my history but should I talk to him about immune factors and possible treatments? Or is there another specialist you would refer your patients with suspected auto immune problems that may be impacting fertility?

B. Jacobs, M. D. - April 11th, 2008 6:34 AM

Please discuss your auto immune problems with your RE. He/she will need to determine what protocols to use to help you achieve a successful pregnancy.
Good luck.

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