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Sub clinical hypothyroidism, thyroid replacement therapy, disturbances post child birth. Future problems in pregnancy ?

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29 year old female; delivered my first baby in feb this year via a c-section. further please refer the data and questions below
Test dated : 17 sept 2011 ( approx 7 months post delivery)
TSH           5.72            ref. range: 0.45-4.7
Free T3          2.06          ref. range: 1.45-3.48
Free T4          0.59          ref. range: 0.71-1.85

Test dated: 07th XXXXXXX 2011 (approx 3.5 months post delivery)
TSH          <0.005          ref. range: 0.27-4.20 (different laboratory for this test only)
Free T3          3.12          ref. range: 1.45-3.48
Free T4          1.01          ref. range: 0.71-1.85


-Does it mean im hypo or hyper; do I need medication? or is it a temporary post partum thyroid that may resolve on its own?
-If medication then what? Should it be safe while breastfeeding?
-I got periods 4 months after my delivery; got them twice and now again no sign since past 60 days. I ve been excusively breastfeeding my baby upto 6 months until I introduced solids
- low milk supply over past 2 weeks, is it because of thyroid dysfunction; still want to breastfeed… how to keep up and boost my supply?
-what symptoms should I look for, what medication? Safe while bfeeding….. how to keep my milk supply up as I still want to breastfeed and not formula feed?
-would it be a problem if i plan second baby in some time for either me or my baby?
Posted Tue, 8 May 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Rakhi Tayal 1 hour later

Thanks for writing to us.

1. The variations in TSH (thyroid stimulating Hormone) could be due to subclinical Hypothyroidism, which is a mild form of hypothyroidism that has no apparent symptoms. Investigations show high levels of TSH and normal free T4 levels and hence it is important to get TPO antibodies (Thyroid Peroxidase Antibody test) done.

If the TSH levels are >10, then we usually start the thyroid replacement therapy. If the levels are between 5-10, this is a grey zone. In such a scenario, we ask for the TPO antibodies or anti TG (Thyroglobulin) antibodies and if they are raised, we start the thyroid replacement therapy. So until and unless these tests are done, we cannot call the thyroid as Normal.

2. If medications are needed, they are safe in breast feeding rather it will be best if you get your baby's thyroid profile also checked.

3. Lack of regular periods is a feature of Hypothyroidism. Since you have had regular periods twice, get a pregnancy test done to rule out pregnancy.

4. Low milk supply is probably not due to thyroid status. Increase in protein intake might help.

5. Planning a baby so soon after delivery is not recommended. You better wait for at least two years for you to recover fully and then complete your family.

I hope my answer and recommendations are adequate and helpful.

I will be available for your further follow up queries if any.


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Follow-up: Sub clinical hypothyroidism, thyroid replacement therapy, disturbances post child birth. Future problems in pregnancy ? 1 hour later
Thank your reply Dr. Rakhi! i shall get the test you mentioned done with further personal consultation with a doctor.
- However can you please suggest if i should see a endocrinologist or G.P.
- i do not want another baby immediately and will definitely keep them atleast 2 n a half years apart; what i wanted to ask was will that pose a future risk for conception ; whenever we plan another baby or will it be a problem for the baby if i conceive? Although i ve checked and im not pregant :)
- Ive heard thyroid disorders happen in the first postpartum year? is that true? however i understand that only further investigations can reveal if it is true in my case.
- Would high protien diet suffice the breastmilk spply? pls advice really concerned on this as i ve taken an years break from work coz i really wanted to bfeed my baby for one full year :(

Answered by Dr. Rakhi Tayal 49 minutes later

Thanks for writing again.

It will good if you consult an Endocrinologist for further guidance.

Hypothyroidism is easily treatable with thyroid hormone replacement. There is usually no problem in further conceptions or child bearing.

Slight thyroid hormone disturbances are common in pregnancy and postpartum.

Reduction of breast milk after six months of delivery is difficult to increase with the help of medicines.

Dietary changes might help a bit.

I hope, this answers your query.

Wishing you an early recovery.


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