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What Is The Effect Of High Thyroid Levels On Pregnancy?

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Posted on Tue, 13 Jan 2015
Question: Hi Doctor,

I was diagnosed with thyroid since 10 years. Currently I have conceived through IVF treatment. As of today, I'm 7 weeks 4 days pregnant. I have taking the below thyroid dosages - Thyronorm 100mcg for 5 days and Thyronorm 125mcg for 2 days. Please find below my thyroid test results.

Date Free T3 Free T4 TSH
----------------------------------------------------------------------------------
30-Aug-14 2. 20 1. 46 4. 88
30-Nov-14 2. 45 1. 45 5. 88
-----------------------------------------------------------------------------------
My gynecologist has advised me to take the same dosages. But I'm worried since the thyroid levels are bit higher and will it affect my pregnancy?
What is the idle thyroid values during pregnancy.?
doctor
Answered by Dr. Ajish TP (1 hour later)
Brief Answer:
You have to increase the dosage, ideal TSH is less than 2.5

Detailed Answer:
Hi XXXX,

Welcome to HCM. I have gone through your question and understand your concerns.

The thyroid hormone requirement is around 30% higher in pregnancy. In normal woman: hormone production increases by 30% naturally due to the effect of pregnancy hormones. In those with hypothyroidism, this won’t happen as their thyroid is damaged. So we have to increase the pre-pregnancy dose by 30% once you are pregnant.

The tests that we do in pregnancy are total T4 and TSH every month throughout pregnancy. T4 will be high in pregnancy - the normal value (usually 7.5 to 18) will be 1.5 times the normal given in lab (usually 5 to 12). The target TSH in pregnancy is less than 2.5 miu/ml in first 3 months and less than 3 miu/ml in remaining 6 months of pregnancy.

Your TSH is above normal target in pregnancy. Are you taking medictions regularly? If I were your treating endocrinologist, I would have increased the dose to 125-150mcg by now and followed up monthly with total T4 and TSH values. Please consult a physician or preferably an Endocrinologist and adjust your medication.

Hope I have answered your query. If you have any further questions I will be happy to help
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Ajish TP (42 minutes later)
Many Thanks Doctor for your detailed answer. I will get back to you if I have any doubts.
doctor
Answered by Dr. Ajish TP (17 minutes later)
Brief Answer:
Please let me know the follow up

Detailed Answer:
Hi XXXX,

Great to know that that the information was useful. I will be happy to help you with your treatment.

If you are satisfied with my answer, you can write a positive review and give a 5 star rating to my answer. By this way we would be encouraged to guide everyone in a better way.

Advanced wishes for a healthy mother and baby.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Ajish TP (21 hours later)
Hi Dr Ajish,
Thanks for your valuable information. It's very useful for us to monitor the thyroid levels frequently. We will going to discuss with our gynecologist for the increases of dosages based on the latest T4 & TSH results.

Please let us know the answers for the following queries.
1. Foods to be taken and avoided for Thyroid during pregnancy
2. Do's and Don'ts for Thyroid during pregnancy.

Once again thanks for your detailed useful information.

Thanks and Regards
XXXX
doctor
Answered by Dr. Ajish TP (2 hours later)
Brief Answer:
Diet issues + Do's and Don'ts

Detailed Answer:
Hi XXXX,

Welcome back
I will explain these two questions

1. Diet in hypothyroidism

Diet depends on cause of hypothyroidism. 2 major cause are Hashimoto's hypothyroidism ( auto immune) and iodine deficiency hypothyroidism. In iodine sufficient areas like XXXXXXX majority are Hashimoto's hypothyroidism

Hashimoto's: No diet restrictions. Can take whatever you wish.

Iodine deficiency hypothyroidism: Iodine rich diet in excess like iodised salt, sea foods etc. Avoid diet that decrease iodine content like partially cooked cabbage, cauliflower and tapioca

You can do anti thyroid antibodies to differentiate these two.

2. Do's and don't 's

Buy tablet only in manufacturers bottle (not as loose tablets).
Keep the tablet in a sun protected area.
Take the tablet in morning empty stomach (at least 4 hrs after meal)
No tea, coffee, food with in 60 min (at least 30 min)
Take tablet regularly
If you miss a tablet, take twice the dose next day.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist


Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Ajish TP

Endocrinologist

Practicing since :2002

Answered : 819 Questions

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What Is The Effect Of High Thyroid Levels On Pregnancy?

Brief Answer: You have to increase the dosage, ideal TSH is less than 2.5 Detailed Answer: Hi XXXX, Welcome to HCM. I have gone through your question and understand your concerns. The thyroid hormone requirement is around 30% higher in pregnancy. In normal woman: hormone production increases by 30% naturally due to the effect of pregnancy hormones. In those with hypothyroidism, this won’t happen as their thyroid is damaged. So we have to increase the pre-pregnancy dose by 30% once you are pregnant. The tests that we do in pregnancy are total T4 and TSH every month throughout pregnancy. T4 will be high in pregnancy - the normal value (usually 7.5 to 18) will be 1.5 times the normal given in lab (usually 5 to 12). The target TSH in pregnancy is less than 2.5 miu/ml in first 3 months and less than 3 miu/ml in remaining 6 months of pregnancy. Your TSH is above normal target in pregnancy. Are you taking medictions regularly? If I were your treating endocrinologist, I would have increased the dose to 125-150mcg by now and followed up monthly with total T4 and TSH values. Please consult a physician or preferably an Endocrinologist and adjust your medication. Hope I have answered your query. If you have any further questions I will be happy to help With warm regards, Dr Ajish TP (MD,DM) Consultant Endocrinologist