t4 role in pregnancy

[dxbgal]

hi all ,

what role does t4 play in a pregnancy ? my t3 is constantly higher than t4 and i am a bit worried ..

i am on nature throid 1.5 grain

[Clutter]

dxbgal, NICE recommends that TSH of pregnant hypothyroid women should be in the low-normal range of 0.4-2.0 with FT4 in the top 75% of range. The assumption is that the high level of FT4 will ensure good T4 to T3 conversion. The recommendation is based on women taking Levothyroxine. Levothyroxine dose is usually increased by 25mcg-50mcg when pregnancy is confirmed to ensure good foetal development during the first trimester when the foetus is entirely dependent on maternal thyroid hormone.

If you haven't increased dose since your pregnancy was confirmed you should raise by half a grain.

TSH is often suppressed and FT4 may be below or low in range when taking NDT due to the T3 it contains. FT3 should be halfway through to the top third of range. I'm not aware of recommendations for levels of FT4 and FT3 for pregnant women on NDT, but TSH should be low-normal as above. You may find information on hypothyroidmom.com or other American sites like Mary Shoman's as NDT is widely used in the USA.

[dxbgal in reply to Clutter]

hi ,

could you please explain what does TSH being suppressed mean ? would it mean higher then 4 ?

also because my t4 is on the lower side , should i try increasing the dose to 2 or should i take 25 mg of levothyroxine and 1.5 grain of ndt ?

thanks

[Clutter in reply to dxbgal]

dxbgal, suppressed TSH is low,<0.03. I don't think it matters whether you raise NDT to 2 grains or add 25mcg T4 to 1.5 grains but do one of them.

[HIFL]

Healthy fetal development is dependent on adequate amounts of T4, not T3. If you're only taking 1.5 grain, then you should seriously consider adding T4 to your dose. There's a good explanation here: tiredthyroid.com/blog/2013/...

[dxbgal]

i am not pregnant yet but we are planning to be soon ..thus my concern to sort out my issues once and for all ...

i am sick of it being unstable ... i am on 1.5 now and will have a blood test in june to see what my results are .. will report back once i know ...

if my levels are still unstable ....as in my t3 is higher than my t4 .... i will have to add to levo to ndt ..is that advisable or should i increase my dose to 2 grain and take no levo ?

i have realised that too much ndt results in my tsh being all over the place and my docs start worrying !!

its all so stressful !!!!!