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Thyroid UK
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Tsh 159 and pregnant


Im new here, and encouraged by the thoughtful responses in other posts. I hope to get some advise as well.

I was disagnosed with hypothyroid as a baby. Im now 35. I typically try to do as much stuff naturally as I can. After my last baby two years ago, I decided to get off my medication and just use supplements which were know to assist thyroid function...selenium, iodine, zinc...just naming a few....there are lots more, I know (trust me, I was taking supplements by the handfuls...I thought it would help since at one point I was able to bring my levels from a 50 to a 28 doing this same thing -- but I realise, that is just going from worse to bad and my levels still need much improvement).

Anyway, I recently found out I am pregnant with our 4th child. Immediately I wanted to know my thyroid levels because it had been a few years. To my shock, my tsh revealed levels at 159 (yes, one hundred fifty nine).

I immediately got back on my medication. I have used levothyroxin and synthroid ...but what my body responded best to was armour thyroid. I spent years on the synthetic crap and once I went to armour thyroid my numbers dialed within range in a matter of months. I am well aware of the reasons why docs dont like armour (being natural its harder to determine exact levels of thyroid with each dose, whereas synthetics are easier to monitor). Either way, doc was okay with me getting on 60 mcgs a day of armour.

This is frustrating though because I was once on 120 mcgs but that was when my tsh levels were in the 50s. But now (since I havent been medicated for 2 years) my levels are at 159 and they are only giving me half the dose .....30mcgs. OB says she is fine with increasing it before next lab...but family doc says she wants to ease into it since it has been a while...she doesnt want my heart to race. So I understand.

Anyway, I got to talking to my OB some more about it all and she says she is not too worried because my free T4 levels were within range at .6. Im not sure if she was just trying to ease my mind or if there is truth to it. She explained it by saying the tsh is showing me that my pituitary gland is working overtime for production.....but the free T4 is showing that hormone/thyroid levels are being achieved for baby and myself.

I have since started a gluten free diet and I am avoiding foods that are known to slow down the thyroid (sweet potatoes, brussel sproats, brocolli, etc)....all of which I was previously eatting lots of, thinking my diet was excellent. I am feeling slightly better....but still very tired and extremely hungry and thristy. I have an appt scheduled with an endocronologist but they cant get me in until 4 months from now.

My questions are....

1. Is the ob right to think the free t4 is the test to look at more when pregnant?

2. Should I insist my dosage gets increased instead of waiting another 2 weeks to get a lab test done? Baby is growing daily!

3.Is there anything else more I can do...in another post I saw something about taking t3 or getting t3 tested but I am not knowledgable in that area.

4. Should I try to find a diff endocronologist who can get me in sooner?

Please be sensitive/kind in your responses....being pregnant, I never would have wanted my health in this state for baby.....it happened without planning. I am doing everything I can to ensure my body is now being taken care of and praying over that child daily. Thank you!

5 Replies

Your tsh is alarmingly high but I would urge you with congenital thyroid dysfunction never to give up your meds as its dangerous. You obviously have kids to think about also. I know at the time you were probably trying to help yourself with more natural alternatives which are good but only in conjunction with the actual meds. I did the same for a few years and was fine for a good year, then it made things worse. This was before diagnosis for me though. I would say your dose does def need an increase. You need to get your tsh down but yep t4 is also important especially within the first 12 weeks of pregnancy.

It's important to get ft3, ft4, tsh and your antibodies tested in one go to get an overall clear picture of what is going on. I would insist on all these being tested.

T3 is also important during pregnancy and this really needs to be towards the top end of the range and you don't have a clear picture of where it is at present. Its more important in later pregnancy though. The baby requires both all the way through though. At times they rely on your supply and then their own takes over but then they also have periods of growth where they continue to use a bit of your free thyroid hormones.


Re you preferring NDT. Scare stories have been spread by those who wanted to persuade the Associations to only use levothyroxine and gave monies to the medical professions to do so, plus the rumours and monetary rewards and it worked.

However, you can read this which was sent to the BTA and RCoP which denies all of the rumours. Dr Lowe, before his death, did this scientific article and sent it to the BTA and RCoP with proof about the use of NDT. Despite three yearly reminders, none of them had the courtesy to respond or disagree.


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Do you have a range for that FT4? It looks awfully low. Just being 'in-range' is not good enough. It's where in the range it falls that counts.

Your family doctor is right to start low, and increase slowly. But wrong about NDT being difficult to monitor. The production is just as well controlled as any other type of thyroid hormone production.

How long is she leaving between you resuming NDT and the next test? It should be six weeks, not necessary to leave it any longer than that. But, if you increase before the test, you will skew the results. Perhaps that doesn't really matter, given how high your TSH was, but it might confuse your doctor. However, as long as you've left at least two weeks since starting the NDT and the increase, and you only increase by 1/4 pill, I can't see it can do any harm.


being natural its harder to determine exact levels of thyroid with each dose, whereas synthetics are easier to monitor

There are rules for how much active ingredient there has to be in porcine thyroid meds, just like there are rules for drugs like levothyroxine.

I've never looked at it but there is something called the US pharmacopeia which (I think) lists what different active ingredients any meds should have in them :


I don't know if it is freely available or if people have to pay to read it.

But if you ever want some entertainment, do a google search for "history of synthroid" and read a few of the articles that come up. Did you know that the FDA forced the makers of synthroid to apply for a new license around the turn of the century because they had so many problems with synthroid not being the strength it should be?

I have a feeling that Armor Thyroid has only been recalled once in many years (in 2005 I think). Synthroid and other levothyroxine products have been recalled over and over again.

The idea that levo is easier to monitor doesn't cut any ice with me. Doctors could learn. But no, they just expect patients to live with a poor quality of life and wasted lives for the convenience of doctors who think thyroid monitoring should be made easy for them.


Do a search on pregnancy on the site, i have bern reading a lot of threads lately and am sure i remember seeing some that are relevant to your situation and believe it was specifically the T4 levels that were cited as crucial during pregnancy


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