TSH during pregnancy and right level of T4 and T3

[Ania22]

TSH during pregnancy

I am just wondering if TSH is important during pregnancy. I have done a few private tests, my gp is testing only for TSH.

2 months ago my TSH was 3.57 but my free T3 and free T4 were at right levels but because my TSH was a little bit high I thought I increased intake of Nature Thyroid...

Then the next month my T4 was a little bit low but T3 was out of the chart, too high, TSH was 1.2....so I lowered my dose again.....

I asked the gp many times to test all the hormones, but only TSH was tested and was 2.9 and I am being told to increase my medication intake.

I will have another advanced thyroid profile check and if my T3 and T4 are good I am not going to increase my medication.

Is there any way to encourage gp to test for T3 (and T4)?

[SeasideSusie Remembering]

Ania22

See

btf-thyroid.org/pregnancy-a...

If you have an underactive thyroid (hypothyroidism)

If you are planning a pregnancy you should speak to your GP to arrange thyroid blood tests and ideally aim for a Thyroid Stimulating Hormone (TSH) level of less than 2.5mU/l at the time of conception

It is recommended that your TSH should be less than 2.5mU/l in the first trimester of pregnancy and less than 3.0mU/l after that

As soon as you know you are pregnant it is usually recommended that your levothyroxine is increased immediately by 25-50mcg daily. You should then contact your GP and arrange to have a thyroid blood test

and

thyroiduk.org/tuk/about_the...

[Ania22 in reply to SeasideSusie]

I am already pregnant.

I am not a doctor but T4 and T3 is what matters as far as I know, rather than TSH on its own as it is very often misleading in fact.

4 weeks ago my TSH was 1.2 but my T3 was very high above the range.

My TSH was 2.9 b(just tested by the gp) at 19 weeks but nothing else has been tested.

I will test for T4, T3, TSH in about a week time. If T3 and T4 will come back fine I definitely won't increase my medication.

[SeasideSusie Remembering in reply to Ania22]

I may be missing the point here but your question was

"I am just wondering if TSH is important during pregnancy"

and I gave you some reliable information from reputable sources which answered your question 🤔

I have not seen information about FT4 and FT3 levels during pregnancy, if others have they may respond.

[Ania22 in reply to SeasideSusie]

SeasideSusie thank you for your reply. I did not put any numbers as I just wanted to find out what other think about THS itself.

I said that my FT3 was tested 4 weeks ago and it was very high, while FT4 was low.....and TSH 1.2.....

[radd]

Ania22,

Congratulations on your pregnancy.

Yes, TSH is hugely important during pregnancy as increases to encourage further thyroid hormone required for your baby. When we are hypothyroid it is usual to increase thyroid hormone meds because your baby will be dependant on you until growing his own thyroid gland at about 12 weeks.

There are other hormones such as human chorionic gonadotropin (hCG) that also increase thyroid hormone levels and some that may inhibit such as oestrogen that may raise thyroxine binding globulin (TBG) that transport thyroid hormone but risks binding too much. Therefore, TSH is used as an indicator for your GP that there is essentially enough thyroid hormone that is critical for your baby’s normal development of the brain and nervous system.

If increasing NDT puts your FT3 over range it may be that your doctor needs to add some T4 until you see a specialist. NICE states TSH should be kept low-normal range (0.4–2.0 mU/L) and an FT4 concentration in the upper reference range.

NICE guidelines.

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

BTF guidelines.

btf-thyroid.org/Handlers/Do...

[Ania22 in reply to radd]

There are so many posts saying that TSH is not so important....but the other hormones...so I am confused...so is it only TSH which is important while pregnant...and FT3 and FT4 is not important?

[radd in reply to Ania22]

Ania22,

Maybe the other posts you read are not referring to pregnancy but people who are being inadequately dosed by doctors using TSH levels as a guide?

All hormones levels are important and more so during pregnancy to ensure good baby development.

[Ania22 in reply to radd]

I know that they are not referring to pregnancy but from my understanding FT3 and FT4 comes before TSH. TSH is more as a guideline......

Unfortunately there are not many posts here about TSH, FT3 and FT4 during pregnancy...

[radd in reply to Ania22]

Ania22,

An excellent read is “Your Healthy Pregnancy with Thyroid Disease” by Dana Trentini & Mary Shomon.

Lots of best wishes with your pregnancy 😃

[Ania22 in reply to radd]

Thank you

[Katiethedubs in reply to Ania22]

Hiya, I have Hashimotos which was only diagnosed because I was struggling to conceive my second baby. After some battle to get my TSH below one I finally fell pregnant. I was very nervous about miscarrying but my GP, also a Hashimotos sufferer as it happens, was fantastic. She upped my dose and did mostly use TSH and T4 to monitor be during the pregnancy. At points my TSH was really low at 0.25 but my t4 mid range. Another doctor wanted to lower my dose and actually I ended up ignoring him and waited for my GP to come back from leave. She was happy for me to stay on a high dose worrying that as my baby grew and put stress on my body that my thyroid would need to work harder. I think she felt that had my T4 been at the top end and TSH v low then a decrease in levo might have been justified but as it was middle of the lower end of range she wouldn’t risk it. I stayed on that dose most of the pregnancy, had lots of tests every month and was monitored closely.

If you are worried push through your midwife for an endo referal, at the very least for your GP to consult an endo with your results.

I never had my T3 measured throughout. But I trusted my GP, she was fantastic. I now have a healthy 1 year old boy.

Good luck with your pregnancy x