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What Does My Thyroid Test Report Indicate?
Question: I am 21 weeks pregnant..On 21st week thyroid test my TSH value came 4.58 while the normal value is upto 4.5 but T4 is not tested.
Before on my 8th week TSH was 5.4 and doc did another test for T4 and it was normal.So she said i didnt need medication.
I asked her if i need medication...she said as long as your T4 is normal you dont need anything and we will repeat the test on 21st week again. And 21st week came out to be 4.58 which is lower than before(5.4)
Lower TSH is Hypothyroidism which connected with babys brain development.I am passed 5months with elevated value so i am very worried about the same.Did i make any mistake trusting my OB's word,or slightly elevated values are fine.
Also my BP is 150/80 she said its fine unless there is no protein in urine.
I am really confused as she is reputed OB,Is she doing right or i am over reacting.
Please help me out in this
Before on my 8th week TSH was 5.4 and doc did another test for T4 and it was normal.So she said i didnt need medication.
I asked her if i need medication...she said as long as your T4 is normal you dont need anything and we will repeat the test on 21st week again. And 21st week came out to be 4.58 which is lower than before(5.4)
Lower TSH is Hypothyroidism which connected with babys brain development.I am passed 5months with elevated value so i am very worried about the same.Did i make any mistake trusting my OB's word,or slightly elevated values are fine.
Also my BP is 150/80 she said its fine unless there is no protein in urine.
I am really confused as she is reputed OB,Is she doing right or i am over reacting.
Please help me out in this
Brief Answer:
Thyroid
Detailed Answer:
Endocrinologists tend to follow these values as desirable during pregnancy:
First trimester: less than 2.5
Second trimester: less than 3
Third trimester: less than 3.5
Unless the specific lab that you go to has mentioned their own cut-offs for pregnant status on the report, then those can be respected, provided they too follow the latest guidelines.
Normal ranges on the lab report for non-pregnant adults should not be applied to pregnant women.
Further, T4 is not the best way to monitor thyroid hormone status during pregnancy. It rises by 50% owing to increases in TBG (Thyroid Binding Globulin) during pregnancy. So free T4 is a better test to perform.
It is important to know your thyroid autoantibody levels. If they are positive, it makes a strong case to start you on thyroid medication.
When I see someone like you in my practice, I start thyroid medication even when antibodies are negative.
The point of running the antibody test then is, that if they are positive it suggests the possibility of this condition (hypothyroidism) being permanent. If they are negative then I attempt gradual withdrawal after delivery only.
These are anti TPO (thyroid peroxidase) and anti Thyroglobulin antibodies.
Do you have a family history of thyroid problems?
Do you have a neck swelling in the thyroid area?
Seeing an endocrinologist will provide the opportunity for an in-person thorough examination and facilitate better decision making.
I am not an expert in high blood pressure during pregnancy. However, if it is persistently elevated in the range you are referring to then I would like to believe it is not normal. But I defer to the OB in this matter.
Thyroid
Detailed Answer:
Endocrinologists tend to follow these values as desirable during pregnancy:
First trimester: less than 2.5
Second trimester: less than 3
Third trimester: less than 3.5
Unless the specific lab that you go to has mentioned their own cut-offs for pregnant status on the report, then those can be respected, provided they too follow the latest guidelines.
Normal ranges on the lab report for non-pregnant adults should not be applied to pregnant women.
Further, T4 is not the best way to monitor thyroid hormone status during pregnancy. It rises by 50% owing to increases in TBG (Thyroid Binding Globulin) during pregnancy. So free T4 is a better test to perform.
It is important to know your thyroid autoantibody levels. If they are positive, it makes a strong case to start you on thyroid medication.
When I see someone like you in my practice, I start thyroid medication even when antibodies are negative.
The point of running the antibody test then is, that if they are positive it suggests the possibility of this condition (hypothyroidism) being permanent. If they are negative then I attempt gradual withdrawal after delivery only.
These are anti TPO (thyroid peroxidase) and anti Thyroglobulin antibodies.
Do you have a family history of thyroid problems?
Do you have a neck swelling in the thyroid area?
Seeing an endocrinologist will provide the opportunity for an in-person thorough examination and facilitate better decision making.
I am not an expert in high blood pressure during pregnancy. However, if it is persistently elevated in the range you are referring to then I would like to believe it is not normal. But I defer to the OB in this matter.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor
Thanks for your Reply.
I even wanted to meet an Endocrinologist in person but i am not getting any appointment without my OBs referral.
I am not sure if she has tested my Thyroid auto antibody but sure will esquire on monday n will request to perform this test on me.
I repeatedly asked for medicine if i required but she denied saying that the level is stable.
I am really confused what to do as Hypothyroid mostly can effect IQ level of the child.
My question to you is what are the chances of TSH 4.58-5.4 to effect the brain development within 22nd week of gestation.
I dnt have any family history of thyroid and no neck swelling for me.
Please suggest.
Thanks
XXXX
Thanks for your Reply.
I even wanted to meet an Endocrinologist in person but i am not getting any appointment without my OBs referral.
I am not sure if she has tested my Thyroid auto antibody but sure will esquire on monday n will request to perform this test on me.
I repeatedly asked for medicine if i required but she denied saying that the level is stable.
I am really confused what to do as Hypothyroid mostly can effect IQ level of the child.
My question to you is what are the chances of TSH 4.58-5.4 to effect the brain development within 22nd week of gestation.
I dnt have any family history of thyroid and no neck swelling for me.
Please suggest.
Thanks
XXXX
Brief Answer:
Follow up
Detailed Answer:
Studies have had mixed results with IQ outcomes of the offspring of mothers whose TSH levels were slightly above the upper limit of the ideal range, with some reports of adverse impact while others showed no effect.
So there is no definitive statistically or medically accurate response for this.
Moreover, such treatment decisions are best made in person after an endocrinologist has had the opportunity to examine the individual, followed by a joint discussion on the next best course of action at this stage.
Follow up
Detailed Answer:
Studies have had mixed results with IQ outcomes of the offspring of mothers whose TSH levels were slightly above the upper limit of the ideal range, with some reports of adverse impact while others showed no effect.
So there is no definitive statistically or medically accurate response for this.
Moreover, such treatment decisions are best made in person after an endocrinologist has had the opportunity to examine the individual, followed by a joint discussion on the next best course of action at this stage.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor today i spoke to my OBs nurse as per her My development should be ohk.
But still i wanted to meet an endocrinologist so she refereed one.
She also gave me my values when my TSH came 5.4.
My FT4 was 1.2 and my T4 was 9.6.
Could you tell me are those values can effect the IQ level of the Baby.
Also if i go to the endocrinologist would that help me now because as per my knowledge baby mostly depends on mothers Thyroid upto 12 weeks and later they have their own thyroid.
But still i wanted to meet an endocrinologist so she refereed one.
She also gave me my values when my TSH came 5.4.
My FT4 was 1.2 and my T4 was 9.6.
Could you tell me are those values can effect the IQ level of the Baby.
Also if i go to the endocrinologist would that help me now because as per my knowledge baby mostly depends on mothers Thyroid upto 12 weeks and later they have their own thyroid.
Brief Answer:
Second follow up
Detailed Answer:
1 There are no high quality studies, to the best of my knowledge in published medical literature, that provide precise answers to your question ie whether the baby's IQ will be affected given a certain threshold of values on the FT4 and TSH result in the mildly abnormal range.
If the TSH is grossly elevated then it is known to adversely affect IQ of the child.
But with TSH mildly high with normal thyroid hormone levels, there are no systematic properly conducted studies that provide definitive answers regarding affect on baby's IQ.
2 Even beyond 12 weeks it is prudent to continue treating 'hypothyroidism' as the benefits outweigh the risks of treatment in general.
3 I am glad you are scheduled to see an Endocrinologist. It is best to discuss this in-person
Second follow up
Detailed Answer:
1 There are no high quality studies, to the best of my knowledge in published medical literature, that provide precise answers to your question ie whether the baby's IQ will be affected given a certain threshold of values on the FT4 and TSH result in the mildly abnormal range.
If the TSH is grossly elevated then it is known to adversely affect IQ of the child.
But with TSH mildly high with normal thyroid hormone levels, there are no systematic properly conducted studies that provide definitive answers regarding affect on baby's IQ.
2 Even beyond 12 weeks it is prudent to continue treating 'hypothyroidism' as the benefits outweigh the risks of treatment in general.
3 I am glad you are scheduled to see an Endocrinologist. It is best to discuss this in-person
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
I have an upcoming appointment tomorrow to discuss my lab report with an endocrinologist in person.
I would request you to let me know whats are the questions i should ask her interns of My current status and health so that i could be reassured on the facts that my values have not effected my baby.
Also should i ask her to repeat my Lab works???
Please suggest some questions i can write and go for consultation though i know everyone has their own line of treatment.
still any suggestions would be great help.
Thanks
XXXX
I have an upcoming appointment tomorrow to discuss my lab report with an endocrinologist in person.
I would request you to let me know whats are the questions i should ask her interns of My current status and health so that i could be reassured on the facts that my values have not effected my baby.
Also should i ask her to repeat my Lab works???
Please suggest some questions i can write and go for consultation though i know everyone has their own line of treatment.
still any suggestions would be great help.
Thanks
XXXX
Brief Answer:
Third follow up
Detailed Answer:
Simply ask your endocrinologist the same questions you asked me here on this forum.
Furthermore, it would help if you prepared a table showing the TSH and T3/T4 values over time, date wise.
Third follow up
Detailed Answer:
Simply ask your endocrinologist the same questions you asked me here on this forum.
Furthermore, it would help if you prepared a table showing the TSH and T3/T4 values over time, date wise.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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