Hypothyroid and pregnant

[Hblaize]

Hi all,

These are my latest labs from about 3 months ago. I am now 11 weeks pregnant and am on 1 grain of NDT after being on no meds for approx 3 months due to struggling to get hold of some more NDT. I've been taking again for last 3 weeks and am feeling ok but pretty weak on 1 grain. Not sure what I should be doing about dosing. I need to get some T3 as levels were low. Before running out last time was on 4 grains. Should I be steadily increasing?

Thanks for help and advice. Obviously worried about developing baby.

Here are my labs:

Ft3: 2.1 pmol/L 3.10-6.80

25-OH vit D level-(MBA). 89 nmol/l (>50 sufficient.)

Vit b12 (mba) 702 ng/L (180.00-900.00)

Magnesium (SA) 0.82. (0.70-1.00)

Serum electrolytes (SA)

Sodium 141. (133.00-146.00)

Potassium 4.5 (3.50-5.30)

Creatinine 66 (45.00-84.00)

eGFRcreat 1.73 m*2 >90 (> 90:normal)

Calcium 2.4 (2.20-2.60)

Serum ferritin (MBA) 49 ug/l (15.00-445.00)

Total white cell count 8.5 10*9L (4.00-11.0010)

Red blood cell count 4.76 10*12L (3.80-5.3010)

Haemoglobin estimation 130 g/L (120-150)

Serum free T4 16.2 pmol/L (12.00-22.00)

TSH <0.02 mIU/L (0.27-4.20)

Drs note: results suggest over replacement. A reduction in FT4 should be considered providing the patient has not had thyroid cancer and requires suppressive therapy.

I have not had thyroid cancer and have been on 4 grains thyroid-S.

Iron: 19.49 (6.60-26.00)

TIBC: 59.39 (41.00-77.00)

Transferrin saturation: 32.82 (20.00-55.00)

Ferritin: 63.9 (13.00-150.00).

Thank you.

[Clutter]

Hblaize,

TSH 0.02 is suppressed but doesn't mean you were overmedicated as long as FT3 remained within range.

Didn't you have a thyroid test to check levels when pregnancy was confirmed? Dose is usually increased when pregnancy is confirmed.

[Hblaize in reply to Clutter]

Dr said he'd refer me to endo but not heard anything yet-that was 3 weeks ago. I'll chase up on Monday.

[Saggyuk]

Do you mean that you haven't been on any meds for most of your pregnancy? This can be quite dangerous. Pregnant woman normally need a large increase when pregnant as baby requires it from you also so you need to get new blood tests asap and try to get an appointment with endo to resolve promptly - as in this weekend if poss. I had an increase of 50mcg Levo on top of my normal dose by the time I was 4-6 weeks pregnant. These results are completely irrelevant if were from three months ago before you were pregnant and before you stopped taking meds. Levo is better than taking nothing when pregnant if you can't source any I'm afraid.

Please see the following links that give some info on thyroid when pregnant:

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

btf-thyroid.org/information...

[Hblaize in reply to Saggyuk]

I've been on 1/2 building to 1 grain since 5 weeks pregnant-so am taking but worried is not enough. Am seeing midwife for first visit on weds-but will call Drs on mon and ask for urgent bloods and chase up endo referral. Thanks so much for your reply and all the info. X

[Saggyuk in reply to Hblaize]

Apologies if seemed a little blunt - it's just it's one of those situations where the quicker you realise the issues and your pushed to get it sorted, the better outcome for both you and the baby so it doesn't really pay to deal with it more sensitively - especially if you were on 4 grains and dropped to barely anything for that length of time.

Yes, I would call on Monday, speak about your massive drop in meds etc and refer to the NICE guidelines which state he should be contacting specialist endo as matter of urgency - especially with possibility of high tsh and being undermedicated.

While I was pregnant I had monthly blood tests and additional scans to check the baby's development.

Your previous results when on 4 grains don't seem overmedicated to me as although the tsh seems a little supressed- your t4 is hardly near the top of the range and your T3 is really low - any idea why that is?

There doesn't seem anything hugely wrong with the rest of your results either, look pretty good to me - maybe increase your iron from diet a little to be optimal and meet your increased needs while pregnant.

Did you get folate tested?

I should say congratulations and wish you the best of luck as well

[Hblaize in reply to Saggyuk]

Thank you, that's lovely of you. I appreciated the urgency in your message. I will deffo hassle GP on Monday and express my concerns etc. Definitely not something I want to get wrong and go wrong! Is all a bit scary but good to be fully aware so I can get forceful where needed! Thanks so much again, x

[Saggyuk in reply to Hblaize]

How did you get on? Just came back as realised when on another post that I linked the wrong page for the British thyroid foundation: This page is the one with more specific info:

btf-thyroid.org/projects/pr...

[ljk1]

Be prepared for them insisting you take Levo only! There is no proof that NDT or T3 is dangerous during pregnancy but they will tell you it is. Congrats and good luck!

[nugoori]

Congrats on your pregnancy and good luck!