Did anyone experience high tsh early in pregnancy??

[coyle]

We are right at 8 weeks and I'm very concerned: our tsh was 5 when conceived (being raised after rai surgery back in 2003) then the synthroid was raised from 112 to the current 125 but tsh read 6.13 t3-4 low end of range. Went to an endo that wants to wait 1 more month before raising levels to make sure they've stablized. I think the baby is developing it's brain right now 8-10weeks. Took another blood work up at the obgyn the other day and this week am going to do the blood work for the endo. If the levels keep falling We've got some of the old 88mcgs, maybe should take 1/2 with the 125 to get things going. Regardless, has anyone went thru this, and if so what was your experience and how did you pregnancy come out? I'm not looking for reassurance just the information. If it's bad I'd like to know that too. The endo is saying He's going to be going for levels between 1-2 so that's good but he's more interested in monitoring the t4 and doesn't seem interested in the ft3 at all.
Thank you all so much, this is such a helpful resource; God Bless you all!!!

[coyle]

latest lab has t3 low at 18 (22-35 in range) t4 high at 15.6 (8-12.5 in range) and ft4 midrange at 2.8 (1.8-3.8 in range.) So it looks exactly like the t4s not converting effectively to me but my GP wants us to go back to the endo and I think he's just going to be concerned with the tsh which was 1 but now is 1.65 (.46-3.0 in range.) He just says the baby gets it first and it's no big deal. Looking at this lab is this true?

[magpieannie]

I don't know about switching directions completely now that you are already pregnant.But maybe adding t3(Cytomel) to the Synthroid that your on would be the answer to getting that t3 up. However, you know that the Synthroid would have to be reduced anytime Cytomel is added.  Can you post your new labs again with reference ranges next to your actual lab result. It makes it easier for us to see just where you are at. Yes, it is good to stay on top of things! Thank God for the internet as we really do have to be our own advecate. "They" (some doctors) can't just pass off that they know it all when we are educated and informed about our condition. They insult our intelligence in that they infer that we can't tell the difference between junk and good info. when we read it online. Maybe you can set up a phone consult with Dr. Lowe through Tammy for $4.65 per minute to get his opinion of where your levels are at at this point of your pregnancy and you can get his advice on if you need to persue this or not. God Bless and try not to worry!

[coyle]

Yes, I am going to read it right now. We switched to taking the synthroid at night because a study found it raised ft3 and lowered tsh. Makes sense. The only problem might be sleeping on it but whatever. What about taking armour for raising ft3? I know this dr won't be ok with it, he said we were only going to monitor the tsh. They all say don't read stuff off the internet but it's a good thing we do right. Thanks!

[magpieannie]

Go to www.ThyroidScience.com and read the article written by Dr. Lowe on Pregnant Women and Their Newborns:Among the Victims of T4 Replacement. You can also schedule a phone conference with him by contacting his wife Tammy at askdrlowe.com

[coyle]

the new lab tests have the tsh at 2.56 and 2.61 (2 different labs taken a day apart and the higher one later in the day so...) the ft4 is 1.4 of a range between 0.8-1.8 and the ft3 is 279 between 230-420 (they didn't test ft3 at the 2nd lab) I don't have the gyno lab in front of my but the ft3 there was good also. The total t3 is 169 of a range between 97-219 so it looks like waiting brought it down hurray. They increased to dose from 125mcg to 137mcg and we are going back in 2 months but have a gyno test in 3 weeks so we'll be able to make sure it's doing ok without waiting so long.
Here's how it went down:

We got pregnant 9-10 after raising synthroid from 88 to 112 on 9-1 the levels were 5tsh then and when they tested on 10-7 they were 6.13tsh and they raised it to 125mcg. The next lab was 11-1 and the levels were down to 2.6 so I'm optimistic that the levels were probably already low pretty soon after raising to 125. Hopefully damage was minimal but it would've been better if we had gotten the levels down to 1-2tsh before getting pregnant. Oh well, should be ok. The ft3 is a LOT lower than I'd like and I don't know why they keep placing all the emphasis on the t4 and tsh but not so much the ft3. If anyone can answer that and explain just what the baby is using I'd sure appreciate it and it would be a valuable bit of information to people reading this in the future. Is the DR right, did the baby get the thyroid hormone before the mother, sounds bogus to me. Nature makes the Mother put out a lot more thyroxine or whatever in the first trimester for some reason right. Well, I'll update in 3 weeks when we get the next labs. I would suggest to get a pediatric endocrinoligist or even 2. The nearest one to us was too far but the one we are using specializes in diabetes.
Thanks and God Bless!

[gimel]

Wow, I feel totally inadequate to talk about anything related to being pregnant.  LOL  I do think that doctors would like for their patients to be Euthyroid, which means neither hyper nor hypo.  Unfortunately it seems that they judge this by a TSH test, which may or may not be adequate.  

TSH is a pituitary hormone that is affected by many variables, including the time of day when blood is drawn.  It is inadequate as a diagnostic, by which to determine medication.  It does not correlate very well at all with hypothyroidism symptoms.  At best TSH is only an indicator to be considered along with the more important indicators, which are symptoms, and also the levels of the actual, biologically active thyroid hormones, FT3 and FT4.  FT3 is actually the most important because it is four times as potent as FT4 and FT3 correlates best with hypo symptoms.  

Normally I would say that the very best way to treat a thyroid patient is to test and adjust levels of FT3 and FT4 with whatever meds are required to alleviate symptoms, without being constrained by TSH levels.   Frequently we have heard from members that this requires FT3 in the upper part of its range and FT4 near the midpoint of its range.   With you being pregnant, perhaps a cautious approach would be best, so maybe a good target would be to get FT3 and FT4  both to the midpoint of their ranges, rather than just rely on TSH alone.  Probably good to discuss all this with your doctor, who has to make decision on meds.

These are just my thoughts, hopefully other members will also respond.

These

[coyle]

t4 was 10.2  in a range of 4.5-12.5
ft3 was 248 in a range of 230-420

Will have the results of a couple more labs next week.

[gimel]

Was that total T3 and total T4, or free T3 and free T4?  Would you please post the actual numbers and reference ranges used by the lab?

[coyle]

That's great. If you've got a good Doctor they can get it just right, especially if your t3 & 4 are right. I'm waiting to get blood results back, praying they are better and not worse since we are pregnant and the endo wants to wait.

[Trishlk]

I go every 6 weeks for blood tests. My T3 and T4 are fine and my TSH was too low but we are working on that now

[coyle]

I would suggest doing more than praying your doctor will take care of things. If you read around here you're going to need to get them to keep your levels between tsh 1-2 and your ft3 and ft4 in the high range of acceptable and not let them make you wait 3 months in between.

[Trishlk]

I am wondering this too- I am only 5 weeks pregnant and I have hyperthyroid too- my numbers were too low- and so we decreased my dose- then when I got pregnant she increased my dose. I am so confused about all this, all I can do is pray she and my OB know what they are doing!