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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Deranged Thyroid Profile During Pregnancy?

Hi, Doctor: I am now in the 16th week of pregnancy. I did the thyroid surgery to totally remove the thyroid in 2007. Before pregnancy, my status was very stable with TSH:0.56, FT3: 4., FT4: 20 ( I was on 0.125 synthroid every day). At about the 9th week of pregnancy, I did the blood test and got the result as TSH: 2.35, FT3: 3.6, FT4: 18 and the doctore increased my dose to 0.137 every day. I was on this dose for about 2 months, then on May 24, my 15th week pregnancy, I did the blood test and got the result: TSH: 3.91, FT3: 3.4 (lower than normal), FT4: 17. I m wondering why my result was not improved although I have increased my does for almost 2 months? Now the doctor increase my dose to 0.137 for 4 days and 0.15 for 3 days and want me to come back 2 month later. Will this dose be good for me? I really worry about the baby as it looks during the first trimester my thyroid level is low. Is my case serious? Will this affect the baby s development or IQ? If the new dose is still not good for me, then I will increase my dose again but I have to wait for another 2 months to do the blood test as my doctore said the blood level will be reflected about 6 weeks later after I change the dose. But I m just worring that I ll be in the low level again in another 2 months. Could you please give me any advise for my case? Thanks a lot. I am in Canada and the reference for test is TSH: 0.35~5, FT3: 3.5~6.5, FT4: 9~23. Thank you!
Wed, 5 Aug 2015
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OBGYN,  's  Response
Thyroid disease is quite commonly managed during pregnancy because it is frequently found in women of reproductive age. Your thyroid hormone requirement steadily will increase during pregnancy as the fetal thyroid does not start making it's own hormone until the second half of pregnancy. Your TSH may be higher than before, but your free T4 (which is the part that crosses the placenta to supply the baby) is still within the normal range that should give the baby enough hormone for normal development. Thyroid hormone is most critical to the fetus in late pregnancy, and gradual dose adjustment is normal in managing thyroid disease in pregnancy. I hope this was reassuring and good luck with your pregnancy.
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What Causes Deranged Thyroid Profile During Pregnancy?

Thyroid disease is quite commonly managed during pregnancy because it is frequently found in women of reproductive age. Your thyroid hormone requirement steadily will increase during pregnancy as the fetal thyroid does not start making it s own hormone until the second half of pregnancy. Your TSH may be higher than before, but your free T4 (which is the part that crosses the placenta to supply the baby) is still within the normal range that should give the baby enough hormone for normal development. Thyroid hormone is most critical to the fetus in late pregnancy, and gradual dose adjustment is normal in managing thyroid disease in pregnancy. I hope this was reassuring and good luck with your pregnancy.