Tests not improving?

Hello,

I was diagnosed hypothyroid back in Nov 14 when I was 22 weeks pregnant, GP useless but fortunately I was referred to the antenatal consultant who has been good. My Levothyroxine has been increased a couple of times now but if anything my tests are getting marginally worse. I am now 38 weeks pregnant and wondering if it is normal for levels to not get better despite med increases as the pregnancy progresses? and if i can expect to see an improvement once i've had the baby? I have no idea how pregnancy effects an underactive thyroid.

Results have been:

Dec 13, no meds, not pregnant.

TSH 5.17 (0.27-4.2)

FT4 18.0 (12.0-22.0)

Nov 14, no meds, 22 weeks pregnant.

TSH 6.40 (0.27-4.2)

FT4 13.3 (12.0-22.0)

Jan 15, 25mcg levo, 28 weeks.

TSH 3.69 (0.35-5.50)

FT4 13.2 (10.3-22.7)

Feb 15, 25mcg levo, 32 weeks

TSH 7.87 (0.35-5.50)

FT4 13.8 (10.3-22.7)

B12 477 (180-900)

March 15, 50mcg levo, 38 weeks

TSH 7.75 (0.35-5.50)

FT4 11.6 (10.3-22.7)

Meds now increased to 75mcg, bloods to be repeated 6 weeks post delivery. Does this seem normal? Thank you for any help!

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2 Replies

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  • Carrotcake, Not long to go now :)

    I would ask for a thyroid blood test six weeks after your dose was increased to 75mcg and not wait until the post delivery test.

    NICE recommend the TSH of pregnant women should be in the low-normal range 0.4-2.0 with FT4 in the top 75% of range. You have been undermedicated throughout your pregnancy but happily it hasn't resulted in miscarriage which it might have.

    cks.nice.org.uk/hypothyroid...

    Hormonal changes like puberty, pregnancy and menopause can all trigger hypothyroidism. In pregnancy it is often transitory and may go back to normal levels within 6 months of delivery. Ask your GP or specialist to test thyroid peroxidase (TPOab) and thyroglobulin (TgAb) antibodies to rule out autoimmune thyroid disease (Hashimoto's) as the cause of your hypothyroidism. Hashimoto's leads to the eventual failure of the thyroid gland.

    thyroiduk.org.uk/tuk/about_...

    Most people are comfortable with TSH just above or below 1.0 with FT4 in or towards the top 75% of range. Read Dr. Toft's comments on dosing and levels in the link below.

    thyroiduk.org.uk/tuk/about_...

  • Hi there, sorry to hear that you not feeling good. It is very very important that they check your Ft3 levels and check thyroid antibodies along with ferritin, b12 folate and all the usual suspects. Just checking Tsh and ft4 is not enough to get the measure of this.It looks as if you have been quite under medicated and this needs to be addressed. The obstetrician should sanction all this testing. No wonder you have been feeling rotten. Hopefully the titration will help but it might not be quite enough. So I would give them a call and tell them how you are feeling. Good luck

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