Okay so last month I finally decided to dig into my thyroid stuff ’cause we’ve been trying for a baby without luck. People kept mentioning thyroid hormones and fertility, but nobody really spelled out exactly what to check. Free T4 kept coming up, but like… how do you even know if yours is actually good?
Where I Started
First thing I did was head to my doc and straight up asked for thyroid tests. Got the basic TSH test done, which came back “normal” at 3.8. But I’d heard that for baby-making, you gotta look deeper than just TSH. Felt stuck.
The Deep Dive
After Googling like crazy, I found five tests that actually tell the full story for fertility:
- Total T4 Test: Did this first. Docs use it to see overall thyroid hormone floating around. Mine was mid-range, didn’t really tell me much about fertility.
- Free T4 Test: This is the GOLD everyone talks about. Shows the unbound hormone actually available for your body to use. Mine was 1.0 ng/dL – technically “normal” but right at the bottom edge.
- Reverse T3 Test: Never heard of this before! Turns out it blocks your real T3. Got it checked and bam – mine was elevated. Explains why I felt tired 24/7 despite “okay” T4.
- Thyroid Antibodies Test: Super crucial. My anti-TPO antibodies were high, meaning my immune system was attacking my thyroid. Didn’t even know I had this issue.
- Free T3 Test: Last piece – shows if your body’s actually converting T4 properly. Mine came back low, so that “free” T4 wasn’t even being used well.
Putting It Together
My “normal” free T4 was actually garbage for fertility because:
- It was borderline low
- My body couldn’t convert it properly
- Antibodies were wrecking my thyroid
- Reverse T3 was putting brakes on everything
Showed the results to a new doc who got it immediately. Started on thyroid meds and supplements to lower antibodies. Now we’re tracking everything monthly – that free T4 needs to sit solidly in the upper half of the range for baby chances.
Biggest lesson? TSH alone is useless for fertility. You gotta check these five things together like puzzle pieces. No more guessing.
