High TSH and High T4

[Praju17]

I am 10w5d pregnant with hypothyroidism from last 7 yrs and on tyronorm 100. When I got +ve pregnancy, nearly at 5 the week My test for TSH was normal.But now when I tested my TSH is 6.57 and T4 is 14.1. I don't know when it got increased? And all these weeks was important for baby's development, so I am worried,does it cause any problems to brain development of baby, pls any idea

[shaws Administrator]

Your doctor has to give you a rise in levothyroxine immediately. Your TSH has to be around 2. When you were first diagnosed your TSH was 5 and your doctor should have taken action immediately by raising your dose of levothyroxine to lower your TSH.

Other members who know more than me about pregnancy will respond as soon as they read your letter.

Your doctor is negligent. When you say your test when you became pregnant your TSH was normal. Normal would refer to someone who isn't hypothyroid, Our TSH should be 1 or lower if hypothyroid and when pregnant up to 2. Your TSH was too high and the doctor should have treated you properly. I shall look for some posts for you which may be helpful and other members will respond when they read your post.

[Praju17 in reply to shaws]

Thank you so much Shaws for your support. When I got + pregnancy test , I was near to 5 weeks prego. And at that time my TSH was 0.471 and FT4 was 1.78. that's why dr said I m not changing your dose.but now at week 10 ,TSH is 6.57 and total T4 is 14.1. But still he could have to increase my dose, bcoz of pregnancy. But he didn't. Today I tested my FT4 and result will come on day after tomorrow. After that my endocrinologist will change my dose. I don't know,in this 5 weeks of span my baby got affected or not?

[shaws Administrator in reply to Praju17]

There is set rules that if a patient has hypo and become pregnant they have to increase your dose so he was negligent particularly as you've had miscarriages before. (the fact that your results are awful. Your TSH should be between 1 to 2.

Is it not ridiculous that we, hypo patients, have to read, learn and ask questions. The fact of the matter is your doctor is negligent. These are the rules and I would run off a copy and give to your GP but why should patients have to do this?????

You need an instant blood test with an increase of 25mcg every six weeks till your TSH is lowered.

endocrineweb.com/conditions...

If something goes wrong with this pregnancy (I do hope not) I think a complaint is due to the NHS and I would see your local MP.

[shaws Administrator]

This is an excerpt from a past post and hope it is informative.

Clutter Administrator

Cherryabs, Congratulations on your pregnancy.

I'm afraid your GP is wrong and out of his depth. TSH in pregnant women should be in the low normal range 0.4-2.0 to avoid the risk of miscarriage and ensure good foetal development. Your medication needs increasing by 50mcg immediately and you should have follow up thyroid blood tests and dose increases until you are in the low normal range to avoid post-partum thyroiditis.

Print off the NICE recommendation below for your GP and ask for a referral to an endocrinologist or maternity specialist as soon as possible.

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

[greygoose]

Do you have a range for that FT4? It doesn't look high. Your TSH is high, but it doesn't have any direct affect on the baby. It needs to be lower because a high TSH indicates that your FT4 and/or FT3 need to be higher. I believe that the FT4 is the important one for the baby.

[Praju17 in reply to greygoose]

Thank you so much for reply. Today I had visited my endocrinologist,and he said exactly like you. Again given blood for FT4, n test results will come on day after tomorrow. Dr said I will change dose according to your FT4 results, but still my 2 day will get waste, I thought my dose should have to be changed as early as possible.can I take 125 mg by myself instead of 100 mg?will it create any problems?

[greygoose in reply to Praju17]

I cannot advise you to increase your levo without seeing a range for the FT4 you posted. Because I've no idea how high it is.

[Praju17 in reply to greygoose]

Hii

I got my FT4 report. And it is in range ie 1.36, and dr suggested 125 mg dose.

[greygoose in reply to Praju17]

Yes, but what is the range. Just being 'in-range' is not good enough.

[Praju17 in reply to greygoose]

Mine is 1.36 and it's ranges for 1st trimester pregnancy is 0.7 to 2.0

[Praju17 in reply to Praju17]

What do you think? Still it may create problems?

[ilenuca]

When get pregnant with hypo have to increase the dose by 30-50%. Your doctor have to know this things... A tsh over 10 may lower the intelligence of the baby. The good thing is your ft4 " in range". Now your baby has his own thyroid and it doesnt matter anymore for him. Now its about You.

[Praju17 in reply to ilenuca]

Yes,that was not suggested by my doctor. I don't know my ft4. I know is a total T4. My ft4 results will come on day after tomorrow. As you was saying my TSH was not above 10, thank God. Hope my baby has not been affected. Thanks for your suggestion.

[ilenuca in reply to Praju17]

And the range for t4 is? 7-14ug/dl?

[Praju17 in reply to ilenuca]

Thank you so much. Now I am waiting for my ft4 result.