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Pregnant. Thyroid test done. What does the values signify? Should I be worried?

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Cardiologist
Practicing since : 1981
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I am 13 weeks pregnant and my tsh is 5.05 how will this affect my pregnancy. All other reports of tiffa, double marker, gct, rbs are within normal parameters. This is my first pregnancy, i have had an mtp twice before. I a 35 year old indian and a psychiatrist by profession. No history of thyroid dysfunctions in mother or grand mother.
Posted Thu, 23 Aug 2012 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Anil Grover 3 hours later
Hi XXXXXX,
Thanks for writing in.
I am a medical specialist with an additional degree in the sub specialty of Cardiology. I read your question with diligence
You have neither written the units of measurement nor the reference value of the laboratory. However, TSH measured in uIU/ml normal value is < 0.019 uIU/ml, however reference range is 0.34-5.6 so 5.05 falls within normal limits. If units are different and it is above the reference range for the laboratory than it is high. In that case you will have to get Free T4 (FT4) measured if along with high TSH free T4 is high one should consider TSH mediated hypothyroidism, if FT4 is normal then sub clinical hypothyroidism and if FT4 is low then primary hypothyroidism. Since you have written all values are normal and even TSH of 5.05 by conventional methods is normal I do not think there is any cause for worry. There is no way it will affect your pregnancy The situation will be slightly different if you are on some kind of thyroid hormonal preparation. Please do write a supplementary query, it will be answered at the earliest. Good Luck.
With Best Wishes.

Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
 
Follow-up: Pregnant. Thyroid test done. What does the values signify? Should I be worried? 58 minutes later
Dear Dr. XXXXXXX

The TSH value is 5.05 uIU/mL and the normal reference range quoted is 0.2-3.0 uIU/mL (this reference is as per the American thyroid association on thyroid disease during pregnancy and postpartum). Free T4 has not been assessed.

As per studies published thyroid disorder, clinical hypothyroidism in first trimester increases the risk for higher rate of pre-eclampsia, spontaneous abortion, premature delivery, intra-uterine fetal death and disturbed fetal psychomotor development.

Since i am 35yrs old i am deeply concerned. Kindly advise.

Best regards,
XXXXXXX
 
 
Answered by Dr. Anil Grover 1 hour later
Hello XXXXXX,

I am glad that such an informed person is associated with the care of Ms. Milli. Everything will turn out to be right.

For most of the labs 5.05 falls within normal limits. However, you are right on the point of American Thyroid Association and when it is first child is concerned one has to very cautious as you are. The values are for iodine sufficient population which probably is the difference in the range.
According to research, during a normal pregnancy, the following are the TSH normal ranges for an iodine-sufficient population without autoimmune antibodies...
First Trimester: 0.24 - 2.99
Second Trimester: .46-2.95
Third Trimester: .43 - 2.78

So, according to this, TSH is raised. We have to get Free T4 measured and reach a conclusion as I had mentioned in my first mail. After we have that value, we can proceed. It is cause for concern not for panic. For American Thyroid Association recommends routine screening of TSH in pregnancy, whereas American Physician Association does not recommend screening healthy pregnant females. You have not mentioned about symptoms. Well, if there are any symptoms and once you have values of FT4 (it should not take that long to get the test done). Please write, I will reply at the soonest. Till that time worrying about something which is not there is not advisable. Regards. Good Luck.
With Best Wishes.

Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
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