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TSH level dropped to low after delivery. Should Thyronorm be stopped altogether?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions

My wife was diagnosed with excessive TSH serum of 7.85 in Feb 2012 (Free T3 and T4 were within acceptable range) when she was six month pregnant. Subsequently, her gynae asked me to take Thyronorm 25 mg. She subsequently, checked it again in Mar 2012 thyroid level came out normal at 3.79. Post her delivery in May 2012, her gynae asked me to continue medicine for another three months and then check again after leaving for 10 days. We checked in Aug 2012 and it came out at below 0.01 (T3 and T4 were normal). Want to check if she should leave the medicine altogether or she requires another one to bring TSH at normal levels. She has't take Thyronorm for past three weeks now.
Posted Fri, 21 Sep 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Mayank Bhargava 48 minutes later
Thanks for posting your query.
During pregnancy, there are two hormones, estrogen and human chorionic gonadotropin (hCG), which are released into the blood, and these hormones may increase or decrease the production of Thyroid Stimulating Hormone levels.
Thyroid hormone concentrations in blood are increased in pregnancy, partly due to the high levels of oestrogen and due to the weak thyroid stimulating effects of human chorionic gonadotropin (hCG) that acts like TSH.
During third trimester, Normal TSH level is 0.43-2.78
Women with higher TSH levels have a greater than three-fold increase in the risk of very preterm delivery.
But in your wife case, TSH was just 7.85 and treatment of hypothyroidism is started when TSH > 10.
High TSH with low free T4 suggest hypothyroidism.
What was your wife's symptoms when TSH was advised?
So now there is possibility that your wife was suffering from subclinical hypothyroidism during pregnancy and now there is no need of Thyronorm, as TSH is below normal and indicating hyperthyroidism, most likely due to Thyronorm.
You should keep watch on TSH during coming years as TSH may again go above.
She should avoid cauliflower, cabbage, capsicum, broccoli and lettuce (if taking regularly).
Put your query if you have.
Best regards,
Dr. Mayank Bhargava
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