Elevated TSH

ColleenS629 · March 2011

My nurse just called me and apparently my TSH level is elevated so they are putting me on Synthroid for the remainder of my pregnancy. I'm assuming this isn't a big deal... anyone have any experience with this?

StaceyM06 · March 2011

I'm far from an expert on this so I hope someone else with thyroid issues responds, but I know that may indicate hypothyroidism. My SIL had this during her last PG and just had to be monitored closely. She has a healthy 2-year-old now. I believe every 6-8 weeks she had her TSH tested again to make sure the medication was working and keeping it in normal range. Did your dr. mention anything about testing your T4? I had this tested along with my TSH in Feb since hypothyroidism runs in my family. My OB said the T4 is a more sensitive test, but that's all she told me since I ended up being in the normal range.

ColleenS629 · March 2011

They didn't mention testing my T4 but I don't know if they already tested that too... I didn't even know they were testing my TSH again but I guess it's part of the blood tests that they do once you're pregnant. They did say that they would test my levels again before I'm released to my OB to make sure the medication doesn't need to be adjusted.

FmrAFBrat · March 2011

I've had hashimotos (hypothyroid) since I was 8 so I've been on synthroid, a combo of synthroid & cytomel, thyroid compound, & armour thyroid in my lifetime.

As long as you are being monitored by a doctor you should be okay & it shouldn't be a problem. Your TSH should be ideally around 2.5, but even in the 3ish range it should be okay. I am being monitored by my endocronoligist and they have been keeping a tight watch. Thyroid numbers are actually backwards...a high TSH means your thyroid is underactive, whereas a low TSH number means your thyroid is overactive.

I'm not sure what type of thyroiditis you were diagnosed with, but I have hashimotos which is an autoimmune disorder (my body makes antibodies against itself) so I have to be monitored to make sure my body doesn't make any antibodies against the baby, since that could increase my risk of miscarriage. I actually talked to my endo before TTC just to be educated on what can happen....so maybe you should talk with your doctor about your exact situation.

Karen1998 · March 2011

If your OB tested it, s/he probably only tested TSH. That's about all you can get a non-endocrinologist to test. I asked my peri about my thyroid since my T3 was low on the last testing and he said that TSH and free T4 (there are several T4 tests, so "free" was the key one) were the ones they worry about during pregnancy. I plan to ask my endo to test the free T4 next time as he has not been testing it, despite doing a full panel.

I've been hypothyroid for about 12 years now. It's simply controlled with medicine. I'm a bit more of a complicated case as my body does not fully convert T4 (Synthroid) into T3 (what you feel as energy), so I also take supplemental T3 twice a day.

In the first tri, they tested me about every 4-6 weeks. It actually takes 4-6 weeks for your body to fully adjust to the hormone, so they have to wait at least 4 weeks inbetween tests. Now that I'm stable (it bounced up and down during first tri, which is common), I go about every 8 weeks. Non-pregnant, I go about every 3 months as I'm one of those special patients that needs my meds modified seasonally (some tend to use more thyroid in cold weather than in warm). I don't see it as a big deal, but I've also had it so long that it's just a way of life for me.

One of the keys with the medicine though is that you must take it alone, with a full glass of water. I take mine immediately upon waking. You can't eat for an hour or two after taking it (or several hours before) and you shouldn't take any vitamins or fiber within several hours of taking it. I take my prenatals and other vitamins (including calcium) at night. If I take extra fiber, I take it at lunchtime so it has at least 3 hours inbetween thyroid doses. Fiber can block the absorption of thyroid. I also mostly avoid soy and iodine, as both can inhibit thyroid production. It helps that I don't like soy. I'm not a doctor, but I've scoured the net and books for years trying to get to feeling better as I really struggled finding a doctor that would properly manage my dosage.

Karen1998 · March 2011

bethanyreese:
I've had hashimotos (hypothyroid) since I was 8 so I've been on synthroid, a combo of synthroid & cytomel, thyroid compound, & armour thyroid in my lifetime.

As long as you are being monitored by a doctor you should be okay & it shouldn't be a problem. Your TSH should be ideally around 2.5, but even in the 3ish range it should be okay. I am being monitored by my endocronoligist and they have been keeping a tight watch. Thyroid numbers are actually backwards...a high TSH means your thyroid is underactive, whereas a low TSH number means your thyroid is overactive.

I'm not sure what type of thyroiditis you were diagnosed with, but I have hashimotos which is an autoimmune disorder (my body makes antibodies against itself) so I have to be monitored to make sure my body doesn't make any antibodies against the baby, since that could increase my risk of miscarriage. I actually talked to my endo before TTC just to be educated on what can happen....so maybe you should talk with your doctor about your exact situation.

My endo likes to keep it between 1 and 2 for pregnancy and TTC. However, I was .7 while TTC and in early pregnancy and they just kept my meds the same. Then, at 10 weeks I popped up to about 2.3 and I freaked. They just upped my meds. I asked my OB about it as I was worried and she said the key range during pregnancy is 1 to 4. So, apparently the range is fairly large for a normal TSH during pregnancy.

And Bethany, you make me feel like less of weirdo as you're also on a mixed dose! It's pretty uncommon to be on both meds. I took Armour for years, until the mixture was too off for me. I haven't gone to compounded meds, but I'm glad I have that option if I need them.

Clerk9 · March 2011

The other ladies had great information for you! I just wanted to offer a quickie physiology lesson, if you're interested (because I'm a total geek & also feel very strongly about patient education).

TSH = thyroid stimulating hormone. This is the hormone that tells your thyroid gland to produce thyroid hormones (T4, which then gets converted to T3). Having a low T4 can be an indication of hypothyroidism, but lots of other things can cause T4 to decrease, too. So if you want to make sure that the low T4 is due to hypothyroidism, you check the TSH level, too. If T4 is being falsely lowered (which can happen if you're sick or have other problems), the TSH will be low, too. If you're truly hypothyroid, the TSH will be HIGH. This is because your body is basically screaming at your thyroid gland: "Hey! We need some more thyroid hormones around here! Do your freakin' job!!!"

The other hormones the ladies were talking about are T3 & free T4. T3 is the actual active thyroid hormone (the one that really counts), but it's more difficult & expensive to monitor, so most places will look at T4 instead. Free T4 is the T4 that's actually available to convert to T3; sometimes it looks like overall T4 levels are normal, but when you see what's actually available (the free T4), it's low.

Now, I'm not a human physician, so I'm not sure what their protocol is for making a definitive hypothyroid diagnosis. With hypothyroid dogs (FYI dogs tend to be HYPO & cats HYPER!), we usually do a T4 first as a screen. If that comes back low, or if it's normal but there are really prominent clinical hypothyroid signs, we'll go on to test TSH. I usually only start patients on thyroid supplements (synthroid) if both come back abnormal or the TSH is abnormal + strong hypothyroid symptoms.

This is probably waaaaay more information than you ever wanted. But it's a HUGE pet peeve of mine when any kind of medical professional gives a patient/client test results & a treatment plan without taking the time to help them understand what's going on & why you're doing what you're doing. (I'm not saying that your doctor specifically didn't explain things. But it happens so, so frequently.) HTH & GL!!!

VeilSdeGTO · March 2011

I don't have as much great info as some of the ladies on here. I just wanted to say that this happened to me during my first pg. They prescribed Synthroid, which I took once a day. They will check your levels periodically throughout your pg.

I started to feel so much better within a couple of weeks. I had more energy, my hair wasn't falling out as much, and my weight gain (I gained close to 30 pounds within the first 6wks of pg) leveled out.

With this pg, they tested me and said my levels were within range, but will continue to check them, jic. From my understanding, it isn't a big deal if it is controlled through medication.

ColleenS629 · March 2011

Thanks for all the info everyone! It was my RE that tested it. My TSH was 3.64. The nurse said that like to have it below 2.5 during pregnancy because it's better for the baby's neurological development. She told me that they would put me on Synthroid now and test me again before they released me to my OB to see if the levels needed to be adjusted (I guess after that my OB will be monitoring it). She said that I most likely wouldn't have to continue it after pregnancy. She did ask me if I had any questions but I couldn't think of anything because I was kind of caught off guard. I thought I had already gotten all my results back. I wasn't expecting a call at all, let alone a call that something was wrong.

sunshinenva · March 2011

Wow your question resulted in some awesome responses. Ladies you educated me big time. My RE started me on synthroid and I never questioned why because my mother started synthroid when she was pregnant. The RE just doubled my dose this week. Perhaps I should ask them more questions about the synthroid.

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