TSH levels and pregnancy

posted 2 years ago in Pregnancy
Post # 2
Member
449 posts
Helper bee
  • Wedding: July 2015

drdeebee :  disclaimer: I’m not a doctor, I can only answer from personal experience dealing with TSH during pregnancy. I have Graves disease which is an autoimmune thyroid condition, treated with radioiodine so I’m now underactive and taking thyroxine. I’ve been dealing with it for ten years (diagnosed at 22) and I’m now 19 weeks pregnant. When I found out I was pregnant at 4 weeks my TSH was 3.1 so my endocrinologist increased my dose and by 8 weeks it had fallen to 0.7. It’s since fluctuated but as I have blood tests every four weeks we’ve managed to alter my dose before it goes beyond the limits (0.3-2.5). He likes TSH to be below 2. It was 2.4 at 16 weeks so he increased my dose again and now it’s around 1.4.

Your doctor will absolutely want to do something about this – put you on thyroxine immediately and refer you to an endocrinologist. Don’t worry about it but don’t take no for an answer. It is important you’re on thyroxine and have monthly blood tests. However, the research that I’ve done suggests that ft4 is actually more important than TSH as it measures your actual level of thyroid hormones, and your doctor will want that in the top third of the range. Be sure to ask your doctor what that number was.

I was worried about low thyroid hormones affecting the baby as well and my endo assured me that it’s *uncontrolled* hypothyroisim that causes issues. 3.5 is barely out of range so I very much doubt it will have had an effect. For reference, many places regard 5 as the cutoff for hypothyroidism (when someone is not pregnant), and some places don’t even treat until it’s at above 10. Obviously this isn’t the case during pregnancy but I hope it reassures you that 3.5 isn’t extremely high. It’s an incredibly common condition and consider all the women who are pregnant and don’t have thyroid test, their babies are perfectly fine. 

Unfortunately I can’t answer your question about post-pregnancy but it may well be a transient condition related specifically to pregnancy. If it’s not, it’s very easy to treat with thyroxine so don’t worry about that x

ETA Thyroid function often drops quite quickly in the first trimester so if your TSH is 3.5 at 10 weeks it’s entirely possible that it was well within range for at least some of those weeks. I don’t know that for sure but hopefully it might reassure you.

Post # 3
Member
43 posts
Newbee
  • Wedding: April 2017

Are you going to see an endocrinologist? I’m 4 weeks pregnant and my TSH levels were 6.75, so she told me to go see an endocrinologist. I have an appointment on Wednesday, but after googling things I’m feeling pretty scared about everything. Dr. Google is overwhelming 

Post # 5
Member
449 posts
Helper bee
  • Wedding: July 2015

drdeebee :  I’ve heard cases of TSH getting into the hundreds. That’s the point where a doctor would advise termination, as with any uncontrolled condition, not when TSH is at 3 or 6. If your TSH was at say, 20, your doctor would be more concerned. If you want to boost your thyroid naturally before your bloods come back, check that out on Google. I think you need to increase iodine consumption?

The antibodies will just check whether your thyroid disorder has an autoimmune basis or more likely to be transient. If your antibodies come back positive it’s likely you have an autoimmune condition, like hashimotos or Graves disease. My endocrinologist told me that in rare cases antibodies can cross the placenta and affect baby’s growth but he says he’s never seen it before. I have extra scans later in the pregnancy to check baby’s growth for this. I was concerned but he assures me it’s highly likely that everything will be normal. Your antibodies may come back fine! He says that he thinks TSHR is more likely to cross than anti-TPO antibodies, if that info helps you at a later date x

Post # 6
Member
449 posts
Helper bee
  • Wedding: July 2015

alawyerbee :  6.75 at 4 weeks is ok, it’s higher than they like but with thyroxine that number will fall rapidly and by 8 weeks you should be in the normal range. At 4 weeks the “baby” is just a bundle of cells, I’ve heard it’s only important at 5-6 weeks onwards.Mine was 3.1 at 4 weeks and then 0.7 at 8 weeks (to illustrate how quickly it falls. This was with a 25% increase in dose) The waiting around for appointments SUCKS doesn’t it!!

Post # 8
Member
379 posts
Helper bee
  • Wedding: June 2015

I have Grave’s Disease-it had been in remission for about 10 years and then popped back after I had a miscarriage in the fall (maybe a coincidence, maybe not).  Numbers adjusted on their own, but when I had my blood drawn 6 weeks after just to be sure my TSH was a bit off (2.670).  They called me to let me know the same day that I got a positive pregnancy test!  Haha.  I started Levothyroxine immediately (this is all two days ago, by the way).  Saw my Dr yesterday and she wasn’t worried, nor was the Endocrinologist.  I agree that it is only a big deal if the numbers are waaaay off, otherwise they can manage it.  The nurse at the endocrinologist’s office said it just means that I will need to get my blood drawn way more frequently (“welcome to motherhood!” she said with a cackle!)

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