Hypothyroidism question

[Midwesterner04]

Hi All,

I was wondering whether any of you have experience with hypothyroidism during the second trimester.

I am around 21 weeks pregnant and just found out that my TSH is elevated to around 4.3, after normal bloodwork (TSH 1.4) about 8 weeks ago. My T4 is currently on the high end of normal, which isn't quite what I expected due to the high TSH, but pregnancy causes all sorts of interesting things to happen and thyroids can be pretty unpredictable.

Anyway, I am waiting for advice from my endocrinologist but in the meantime have been wondering what up to 2 months of high TSH could mean for my baby. I have read all sorts of doom and gloom about how the second trimester is the most dangerous time to have an underactive thyroid, etc, etc... I don't think worrying provides much help to my baby and am choosing to be sure that everything is fine. To that end, I was wondering if any of you have encountered somewhat prolonged thyroid problems, particularly during midpregnancy, and gone on to have great pregnancies and healthy babies?

I would be grateful for any advice! :-)

Best wishes to all of you!

[Adamsmama]

I don't have any advice, really. I'm just wondering do you have hypothyroid -- and are you on meds for it? I would just assume they would up your meds if you are on them. I'm on L-thyroxine for hypo right now and TTC...my endo just told me if I get pg to automatically up my meds by a certain amount because of the increased strain pregnancy causes on the thyroid.

[MaerynPearl]

I am prone to postpartum thyroiditis (hypo after having a baby) and because this increases your risk of developing hypo at some point in your life and always being hypo (postpartum tends to go away) I am tested monthly ... and would have to say that while a level in the 4s is worth medicating... I would not worry over its effects on your baby... if it was over 5 I might start to worry... 4 is really more borderline-bad-worth-treating rather than just outright bad.

[Midwesterner04]

Thanks, MaerynPearl and AdamsMama!

To answer your questions, I have had generally well-controlled hypothyroidism for about 4 years and have been on Synthroid for most of that time. I was stable and maintained a consistent dose until about 5 weeks into my pregnancy, at which point my TSH became too low and my T4/free T4 too high. I moved to a slightly lower dose of thyroid hormone, which brought my thyroid levels much closer to normal, but still too high. At about two months my dose was lowered yet again, and my thyroid levels quickly became "textbook." They remained so through at least the beginning of my fourth month, IIRC. I'm not quite sure when in the last several weeks the TSH became a problem, but my guess is that the unrelenting headaches I have had for the past 6 days or so reflect that hormonal shift.

I guess what bothers me about reaching a TSH of 4.3, which is barely above my lab's normal range (up to about 4.2 is ok), is how far it is from the upper limit acceptable for pregnancy. My endocrinologist called a higher dose of Synthroid into a local pharmacy, so hopefully that will help and all will be well. I am also hoping that the fact that my T4 never got low will be helpful.

Thanks again!