Anonymous
01/30/2020 00:56
Subject: Re:TSH and shady grove
Anonymous wrote:Anonymous wrote:Any recommendations for endocrinologists in MD/DC? Just went to Shady Grove and was told my TSH of 3.2 is totally normal and doesnt beed to be treated.
Shabina Ahmed in Bethesda but it takes a long time for an initial appointment. Or Linda Liu in Rockville but don't go to anyone else in that practice. 6 years ago SG told me their cutoff for IVF was TSH of 2.5 and they actually preferred it to be around 1.0 while cycling. If you have a good PCP I'd start with them.
Thanks!! I will follow up. Looks like Shabina Ahmed is not taking on any more new patients, sadly.
Anonymous
01/27/2020 22:46
Subject: Re:TSH and shady grove
Anonymous wrote:Anonymous wrote:This is fascinating. SG wouldn’t even let me cycle until my TSH was under 2. Maybe my doctor (Nair) is just more vigilant about it? Granted, I’ve known I’m hypothyroid since high school...
Very interesting. Fwiw my consult was woth Dr Doyle in Rockville. Maybe VA and Rockville practice independently? He clearly did bot think a TSH over 3 was a concern - made me feel like I was creating a problem where one doesn't exist.
We are at the DC office with Nair and often see Dr Moon there, too, who I think someone else said was on top of TSH as well? (Doyle actually did one of my D&Cs) I do think there are differences of opinion on topics between doctors. for instance, I was on baby aspirin (and bleeding heavily in pregnancy) due to MTHFR, prescribed by Nair, but another SG doctor in Rockville who did an early “urgent” ultrasound on me said she wouldn’t have suggested the baby aspirin at all, MTHFR or not.
Anonymous
01/27/2020 17:52
Subject: TSH and shady grove
I cycled at SG Rockville 6 years ago and they had a cutoff of TSH 2.5. Your doctor should be concerned since TSH can rise once you start stims.
Anonymous
01/27/2020 15:54
Subject: Re:TSH and shady grove
Anonymous wrote:This is fascinating. SG wouldn’t even let me cycle until my TSH was under 2. Maybe my doctor (Nair) is just more vigilant about it? Granted, I’ve known I’m hypothyroid since high school...
Very interesting. Fwiw my consult was woth Dr Doyle in Rockville. Maybe VA and Rockville practice independently? He clearly did bot think a TSH over 3 was a concern - made me feel like I was creating a problem where one doesn't exist.
Anonymous
01/27/2020 13:48
Subject: TSH and shady grove
When we cycled with SG, they would always test my TSH. They actually caught it and told me I needed to go to an endo.
Fast forward to 5 years later, I got pregnant on our own and my TSH was 5.5. I was working with an endo to bring it down when I got pregnant and had to be very aggressive after I learned I was pregnant, So, it is possible to get pregnant with a TSH higher than 1 or 2. May not happen but it is possible.
Fast forward to 5 years later, I got pregnant on our own and my TSH was 5.5. I was working with an endo to bring it down when I got pregnant and had to be very aggressive after I learned I was pregnant, So, it is possible to get pregnant with a TSH higher than 1 or 2. May not happen but it is possible.
Anonymous
01/25/2020 18:40
Subject: Re:TSH and shady grove
This is fascinating. SG wouldn’t even let me cycle until my TSH was under 2. Maybe my doctor (Nair) is just more vigilant about it? Granted, I’ve known I’m hypothyroid since high school...
Anonymous
01/24/2020 13:40
Subject: Re:TSH and shady grove
I had my thyroid unofficially diagnosed by my OB during initial OB infertility workup (turns out I have hashi's). She referred me to Dr. Nair at SGF and I also see Dr. Goyal at MedStar Georgetown (regular RE, I like her if you're looking for one). Both feel very strongly about keeping TSH below 2.5.
Dr. Nair at SGF was the one who first put me on levothyroxine and has always been adamant that my TSH should be below 2.5. Both doctors have also told me that they want my levels to be very closely monitored if I get pregnant (we tried 6 mos. with the thyroid regulated to see if that did the trick, then a couple IUI rounds, gearing up to start IVF next month).
Now, I'd say that I often ask for testing from both my endo & SGF to make sure all is good and to keep checking in on levels (my vitamin D is a little low, which SGF initially caught), so I think some self-advocacy helps, but I've found Dr. Nair at SGF to be good on my thyroid issues, FWIW.
Dr. Nair at SGF was the one who first put me on levothyroxine and has always been adamant that my TSH should be below 2.5. Both doctors have also told me that they want my levels to be very closely monitored if I get pregnant (we tried 6 mos. with the thyroid regulated to see if that did the trick, then a couple IUI rounds, gearing up to start IVF next month).
Now, I'd say that I often ask for testing from both my endo & SGF to make sure all is good and to keep checking in on levels (my vitamin D is a little low, which SGF initially caught), so I think some self-advocacy helps, but I've found Dr. Nair at SGF to be good on my thyroid issues, FWIW.
Anonymous
01/22/2020 14:20
Subject: Re:TSH and shady grove
Anonymous wrote:Any recommendations for endocrinologists in MD/DC? Just went to Shady Grove and was told my TSH of 3.2 is totally normal and doesnt beed to be treated.
Shabina Ahmed in Bethesda but it takes a long time for an initial appointment. Or Linda Liu in Rockville but don't go to anyone else in that practice. 6 years ago SG told me their cutoff for IVF was TSH of 2.5 and they actually preferred it to be around 1.0 while cycling. If you have a good PCP I'd start with them.
Anonymous
01/22/2020 09:27
Subject: TSH and shady grove
Also, also, something to consider....at Shady Grove, they had me on birth control a month before I started IVF and my TSH level skyrocketed to over 5. My GP was like, “whoa. What is going on?” Also, like others have said... SG will test your TSH level if you insist on them doing so when they do your bloodwork, but they will NOT adjust your medication levels. I had to wait another month, then another month after that because they then found fibroids, then another month for them to removed, start birth control again, then the next month start IVF. Just typing it all out makes me frustrated. But it ended up working out. Just stay on top of it (especially if it works out during the first trimester).
Anonymous
01/21/2020 21:49
Subject: Re:TSH and shady grove
Any recommendations for endocrinologists in MD/DC? Just went to Shady Grove and was told my TSH of 3.2 is totally normal and doesnt beed to be treated.
Anonymous
01/16/2019 19:07
Subject: Re:TSH and shady grove
From the NIH:
Of 394 infertile women, 23.9% were hypothyroid (TSH > 4.2 ?IU/ml). After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal.
Of 394 infertile women, 23.9% were hypothyroid (TSH > 4.2 ?IU/ml). After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal.
Anonymous
01/16/2019 19:06
Subject: TSH and shady grove
Anonymous wrote:Wow, I would be furious and so disappointed! I'm at Cornell in NYC and my RE was more on top of my thyroid than even my endo, who felt that testing once/month was aggressive enough. My RE was kind enough to test every.single.week. that I was in there for monitoring (so, basically, from BFP at 4 weeks until I "graduated" at 10 weeks). Granted it was mostly for peace of mind on my end, but my numbers really did fluctuate during that time.
There's also some thought that pregnancy can trigger an autoimmune response -- I never had a single symptom of elevated TSH prior to my first pregnancy, which my OB gratefully tested at my first appointment. I ended up losing the pregnancy and was in a "thyroid storm" for a year. When I finally ended up at my Cornell I was diagnosed with DOR, which my RE also said he sees a lot of among hashimotos patients.
This is rambling but I'm really full of rage for women whose doctors aren't supportive of aggressive TSH monitoring.
I am angry too. I read a NIH study that showed extremely high success rates for naturally conceiving for “unexplained fertility” cases where the woman started taking thyroid medication. I have “unexplained fertility”. It makes me wonder if some fertility clinics aren’t treating it because it isn’t lucrative.
Anonymous
01/16/2019 16:51
Subject: TSH and shady grove
Wow, I would be furious and so disappointed! I'm at Cornell in NYC and my RE was more on top of my thyroid than even my endo, who felt that testing once/month was aggressive enough. My RE was kind enough to test every.single.week. that I was in there for monitoring (so, basically, from BFP at 4 weeks until I "graduated" at 10 weeks). Granted it was mostly for peace of mind on my end, but my numbers really did fluctuate during that time.
There's also some thought that pregnancy can trigger an autoimmune response -- I never had a single symptom of elevated TSH prior to my first pregnancy, which my OB gratefully tested at my first appointment. I ended up losing the pregnancy and was in a "thyroid storm" for a year. When I finally ended up at my Cornell I was diagnosed with DOR, which my RE also said he sees a lot of among hashimotos patients.
This is rambling but I'm really full of rage for women whose doctors aren't supportive of aggressive TSH monitoring.
There's also some thought that pregnancy can trigger an autoimmune response -- I never had a single symptom of elevated TSH prior to my first pregnancy, which my OB gratefully tested at my first appointment. I ended up losing the pregnancy and was in a "thyroid storm" for a year. When I finally ended up at my Cornell I was diagnosed with DOR, which my RE also said he sees a lot of among hashimotos patients.
This is rambling but I'm really full of rage for women whose doctors aren't supportive of aggressive TSH monitoring.
Anonymous
01/15/2019 19:43
Subject: TSH and shady grove
Years ago SG disregarded a TSH of 0.033. My endo said it was madness to try since there is increased miscarriage. I had seen the study and so I was relieved I was not crazy. I went to Abassi and she did a work up. Pregnant on my first and only cycle with her. This was after various cancelled cycles and overstimming at SG. Their head of research could not answer me when I asked if a descriptive was significant. He sputtered.
Anonymous
01/15/2019 19:21
Subject: TSH and shady grove
Anonymous wrote:Anonymous wrote:Their attitude is that the research is at best mixed and TSH/thyroid has not been shown to make a difference. I got the impression that at least one doc there thinks it’s the endo doctors trying to get a piece of the lucrative fertility business.
Dr. Braverman, an RI, believes that issues with egg quality are often mitochondrial and that egg quality can be improved post-lap (with a qualified doctor doing the lap). A lot of women who don't suspect endo end up having it, and then go on to have success (this is more so anecdotal from a group of women I'm in who suffer from immunological issues). There really is something to excising endo and having success later, IMO.
In this particular thread, “endo” means endocrinologist, not endometriosis.