Thyroid in pregnancy guidelines
Common Questions and Answers about Thyroid in pregnancy guidelines
armour-thyroid
Hi Dr. Lupo,
I have Hashimoto's, however my labs are normal. My TSH is 4.33 and my free t4 .9, free t3 230 TPO antibodies over 1000. I also am in premature menopause as of age 32, I'm 41 now. Doctors have gone back and forth trying me on thyroid meds. I can't tolerate even the smallest amount 12.5 levothyroid makes me feel hyper.
to put me on armour, and WOW it was like somebody turned on a light switch.. my thyroid panel levels all normal, feel like a million bucks.... So these new guidelines.. are they saying a Dr will not be allowed to prescribe anything but a syhthroid drug?.. some people cannot tolerate synthroid, in fact I know some who are allergic to some of the compounds in synthroid.. no way do I want to go back to a drug that made me miserable...
Continuing with the case of thyroid, TSH is a measure of thyroid function, and as the thyroid fails the TSH gets bigger, We know from studies in the heart as well as bench analysis that if the TSH is above 1, the thyroid function – its effects on different body tissues, is abnormal. Cardiac output, the ability of the heart to pump blood diminishes with a TSH above 1. Yet our lab range of “normal” continues to be 0.4 to 4.5 – a range so broad as to include a lot of sick people.
I am currently 20 weeks pregnant and my TSH is 0.08.
The doctor told me that usually the thyroid over active during pregnancy, but I am already 20 weeks and the level should've gone down a lot.
I am currently taking PTU but it doesn't seem to be helping my TSH. It is still very high. This is so frustrating. I don't know what do to?
The guidelines for TSH levels in pregnancy - first trimester 0.1 - 2.5 mU/L, second trimester 0.2 - 3.0 mU/L, third trimester 0.3 - 3.0 mU/L.
It is starting to seem, due to the power of the internet and the patient information we share on sites such as MedHelp and others you no doubt know, that there is building momentum for change in the treatment of our mutual thyroid dysfunction. It's a good time to add your voice to the demand for better care.
Thanks.
Many patients report anecdotally that they feel better on a natural desiccated thyroid, compared to levothyroxine, and there are a number of practitioners who have found natural desiccated thyroid effective with a subset of their patients.
(Per Endo he follows current American Thyroid Assoc. guidelines for thyroid panel. This February I requested transfer to a different primary provider and she agreed to order TSH, FT4, FT3 but I just accessed my lab results and they only tested TSH which was 4.67 (per their report the reference range being .45-4.68) with no FT4 warranted. She did retest my Vit D which was now 21.5 and I did see she ordered me an prescription for Vit D 50,000 iu (twice weekly) which I am waiting for in mail.
The American Association of Clinical Endocrinologists (AACE) and the American Thyroid Association (ATA) convened a task force on hypothyroidism in adults. The result was jointly published in 2012 in the journals Thyroid and Endocrine Practice as Clinical Practice Guidelines for Hypothyroidism in Adults (The "Guidelines.
With first pregnancy, had to increase dosage to keep TSH levels within range, as is expected in pregnancy. Same with this pregnancy, started at 137 mcg, up to 150 mcg, and then increased again to 175 mcg when recent TSH came back at 7.76. I'm with different OBGYN this time around who wants me to go for non stress tests TWICE a week for baby. When I asked the reasoning behind it, no real answer was given.
From what I have read, it is pretty safe to be on anti-thyroid meds (PTU being the preferred drug) during pregnancy. Of course, there are risks with the meds, but it seems to be better to try controlling the thyroid with the meds, as opposed to not taking any meds at all, b/c if left untreated, there can be many complications for both mother & baby.
MY TSH level in 2nd month of pregnancy was 6.11. Normal level is below 3. Doc recommended 25mcg of thyroxine soidum tablets. I am not convinced if it is appropriate amount. Doc. says that after 4 weeks he will again check TSH level and will see if the dose of medicine is to be increased or not. I am worried lest my baby develops some problems.
I understand exactly why it's a big deal for you when you're trying to conceive, however, it's not the levothyroxine that's causing your period to be late; it's being hypothyroid.
12.5 mcg of levothyroxine is a very small dose - basically a starter dose. Did your doctor indicate whether s/he might be planning to increase your dosage, after a certain amount of time?
Would at least ask for a thyroid test (TSH) and consider TPO antibodies as well -- but no harm in going ahead and requesting basic thyroid testing (TSH). It is important to optimize thyroid function before/during pregnancy. Current guidelines suggest TSH should be no more than 2.0 in most cases.
Hello,
Normal levels of TSH are 0.5-5mIU/L.Your TSH is still raised which means hypothyroidism.In order to get pregnant, make sure that your thyroid is really well regulated. For that,pls consult your endocrinologist for decreasing the dose of eltroxin.After this the normal levels of thyroid hormones are confirmed by doing several blood tests that show your hormones to be normal. Women with hypothyroidism usually ovulate once they are well controlled.
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