Blood Test Results--- TSH/Thy. Stim. horm ---UPDATE

mander82 · April 2014

I am able to view results of my bloodwork online, of course its all Greek to me.....I googled the results and learned alot, and everything looked normal, except for this one. I am not really sure if my results are ok or not.

Does anyone understand this, or have a similar result ?

These are my results, which seem high for normal circumstances, but am I reading this right that my results should be even lower in the 1st Tri ?

It says the .40-4.50 mlU/L is the normal range, mine is 4.27, but then it has the numbers listed below for the different trimesters. /scratches head.....

Thanks !!!

TSH/Thy.Stim.Horm	0.40-4.50 mIU/L	4.27
REFERENCE RANGES BELOW ARE APPLICABLE TO PREGNANT FEMALES FIRST TRIMESTER - 0.26 - 2.66 mIU/L SECOND TRIMESTER - 0.55 - 2.73 mIU/L THIRD TRIMESTER - 0.43 - 2.91 mIU/L

UPDATE :

So I got my results back for getting tested again

My TSH number came back @ 3.34, which is a good bit lower than the 4.27 I had before. My Free T4 number came back @ 1.0, which is in the normal range. Whew !!! I am so glad I pushed to get tested again and have the additional test done. I feel so relieved that my numbers came back better

Thank you all again for helping me understand these numbers, and the possible side effects of these numbers being out of whack !

jess123456 · April 2014

Tsh can be super confusing. My TSH was at a 4 point something a bit ago and with some levothyroxine it went down. Are you currently on thyroid medication? My RE likes to see my TSh at about 1 or 2 and I actually got blood taken yesterday and it was .48. They have me doubling up my dose twice a week since pregnancy but I suspect they will want me to down it a bit. Definitely ask your doctor about your dosage because perhaps they will want to up it a bit. Pregnancy hormones can change up the activity of the thyroid a lot.

mander82 · April 2014

I am not on any medication for it. I have never had any known issues with my thyroid. Google is killing me right now. I may be on the verge of freaking out here, but I am starting to think I may be calling my doctor today.

@jess123456 Thank you so much for your reply, I keep refreshing the bump page in between reading online about these crazy numbers.

jess123456 · April 2014

I hope I didnt worry you. It's really not a high number at all and based on the chart you found it's within a standard range so know that if you doctor thinks it could go down a bit a very small dosage of medication could probably easily due the trick. I know it's hard but def stay off Google. I can convince myself I'm dying every day if I Google every single thing.

If it helps, my tsh went from a 4 to a 1.5 in a very short time. Please don't worry. I have a very good friend who had a TSH in the 200's after she delivered her son and that would really be a red flag but with medication it's now under control.

BlackBooks · April 2014

I have hypothyroidism and from my personal experience physicians will vary widely in how they interpret those numbers and how they act on them. A regular family practitioner or ob would probably be much more conservative in treating mild or subclinical hypothyroidism versus an endocrinologist or an RE, especially if your actual thyroid hormones, T4 is usually the one they look at, are well within normal range.

Why not put a call in to your doc and ask if there is a concern?

mander82 · April 2014

@jess123456 Thanks again, I am going to call my Dr. today to see what they think. It says on the test result website that if I have any questions or concerns to call the dr. for an explanation, so I will see what they say

As long as its not hurting my precious little fetus, I am not too worried

No more Google for me, I read enough to make the call to the dr. , so I am done trying to scare the shit out of myself.....lol.

lisaren · April 2014

I just saw my Endo and he lowered my synthroid because my tsh was 3.1. It was 68 when I was diagnosed 4 yrs ago, 2 months ago it was 4.5.
Your number does not look terrible, are you on medicine?

mander82 · April 2014

@Lisaren No, I am not currently taking any meds for thyroid, I wasn't aware that I had any issues likek this. I just called my dr. office, at first the girl started saying that my number was in the normal range, but then I explained to her the lower range it had for first tri, then she put me on hold.....got back on the phone and said I was right, it is higher than it should be since I am pregnant. She said she will talk to the dr. and call me back.

Thank all you ladies for your input, I really appreciate it

jess123456 · April 2014

So glad you were able to speak with them. Like I said, it should be a really easy fix if they want it a tad lower. I'm only on 50mcg of levothyroxine and I double up the dose twice a week and that seems like too much for me.

The one negative about thyroid meds (at least my med that I know of) is that you have to wait ideally an hour to eat after taking it which can be tricky with morning sickness. I put it next to my bed with some water so I don't have to get up. My doctor also told me to wait at least four hours after taking it before I take my other medicine like vitamins.

mander82 · April 2014

Dr. called back and said they don't go by the pregnancy numbers.....they go by the normal range, which means I am in the normal range.

This is a relief, at the same time, I am still worried......I guess since this is my Dr. and thats what my Dr. said, then thats what I have to go by. I will still be bringing it up to discuss further at my next appt. in May.

Wanted to say thank all you ladies again for your help!

marajay6 · April 2014

The reference range of .4 to 4.5 is pretty commonly used. For someone with a well functioning thyroid, their TSH will be on the low end of that reference range. Someone who falls on the high end, such as you, doctors will use their discretion as to whether or prescribe thyroid medication. However, as your research indicates, most endocrinologists and doctors like to use a narrower reference range for pregnant women.

Before I was pregnant, my endocrinologist was happy keeping my TSH below 2.0. Now that I am pregnant, he has increased my medication to keep my levels as close to 1.0 as possible.

What doctor has ordered your TSH test? Do they want to put you on medication? If they aren't concerned but you are, ask for a reference to an endocrinologist. Don't wait another month.

mander82 · April 2014

@sj+cm131 Thanks!

It was my OBGYN that ordered the blood tests, they ordered a whole slew of tests to be done, 6 tubes of blood worth.

I have never had any pre existing issues that I have known of. Not sure how I would have known that I had issues before though.

The dr. that is in the office today was not the dr. I seen for my first check up, but one of the members of their team. He does not seem concerned. He said they go by the regular range, not the pregnancy range.

I am still not 100% clear on what affect this could have on me or my baby during pregnancy, so I am back on Google......damn you Google!

marajay6 · April 2014

BlackBooks said:
I have hypothyroidism and from my personal experience physicians will vary widely in how they interpret those numbers and how they act on them. A regular family practitioner or ob would probably be much more conservative in treating mild or subclinical hypothyroidism versus an endocrinologist or an RE, especially if your actual thyroid hormones, T4 is usually the one they look at, are well within normal range.

Why not put a call in to your doc and ask if there is a concern?

I agree with this. I find the GPs just look at the reference range and decide if it is ok or not whereas endocrinologists know that for some people it is better trai the the lower to middle end of the reference range instead of just hitting it. Like you said, endocrinologists are also way more likely to look at both t4 and TSH.

marajay6 · April 2014

mander82 said:
@sj+cm131   Thanks!

It was my OBGYN that ordered the blood tests, they ordered a whole slew of tests to be done, 6 tubes of blood worth.

I have never had any pre existing issues that I have known of.   Not sure how I would have known that I had issues before though.

The dr. that is in the office today was not the dr. I seen for my first check up, but one of the members of their team.    He does not seem concerned.   He said they go by the regular range, not the pregnancy range.

I am still not 100% clear on what affect this could have on me or my baby during pregnancy, so I am back on Google......damn you Google!

I don't want to freak you out and I don't know how far off thyroid levels have to be for the risks to get real. But untreated hypothyroidism has been linked to higher rates of miscarriage and also slowed development (mostly mental) for the baby. I don't know how far from normal your thyroid has to be for the risks to start to be worrisome. Thyroid levels are monitored more frequently in pregnant women since they can be a bit more erratic and doctors aim for a narrow range. Your levels aren't too elevated, so I don't know how concerned you should be. If you can't get past your concerns talking to your OBGYN that did the tests, do t be afraid to talk to an endocrinologist.

lisaren · April 2014

Honestly I've never heard of a pregnancy range. Not that it's not a real thing, but nobody has ever referenced that terminology to me

moroccojade · April 2014

I have had thyroid problems for years.

I like my level to be in the 2 range while pregnant....

I would be sure to get retested again in a month (at the latest). You would hate for that number to get any higher. I would also ask to have my FT4 tested, too.

mander82 · April 2014

I sent an email to my dr, the one I seen at my first appt, I let her know that I am very concerned and these results worry me. I asked if I could be tested again, or have other supporting tests done to make sure this is not going to cause issues for me or baby. The T4 test is not listed with any of my test results, so I am guessing they did not do that test. If she doesn't help me confirm this is nothing, then I may call an endocronologist and see if they will help me eliminate my concerns. If I do nothing and something happens, I will be soooo upset with myself.

Thanks again everyone, you guys rock!

KatzKiss · April 2014

If your doctor doesn't offer to test your levels when you go in, remind him. Mine tests my TSH once a trimester because I have hypothyroidism. Normally they test every six months, but pregnancy can mess with your levels.

marajay6 · April 2014

KatzKiss said:
If your doctor doesn't offer to test your levels when you go in, remind him. Mine tests my TSH once a trimester because I have hypothyroidism. Normally they test every six months, but pregnancy can mess with your levels.

Based on the literature I have read, including the brochures my endocrinologist has sent me, it seems that it is widely recommended that pregnant women with a history of thyroid issues get tested at least every 4-6 weeks.

mander82 · April 2014

I learned all sorts of things today about this stuff.....the biggest one being that there is a difference between hypOthyroidism and hypERthyroidism.....ha ha!

This is me to a T though.....which make me think that um. yeah. maybe I have a problem. I have all the red ones, so not every symptom, but probably more than enough. Now I feel like I am being a hypocondriac

Hypothyroidism signs and symptom may include:

Fatigue
Increased sensitivity to cold
Constipation
Dry skin
Unexplained weight gain
Puffy face
Hoarseness
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Thinning hair
Slowed heart rate
Depression
Impaired memory

justjinny · April 2014

You might be interested in reading the Guidelines of the American Thyriod Association for the Management of Thyroid During Pregnancy, rather than searching Google. It's pretty dry reading, but has the facts not a bunch of scary stories

If you don't get anywhere with your doctor, you should print out the guidelines, highlight the sections and bring it in to discuss. In the past I've had to do this to get my thyroid meds adjusted so I'd be at better levels while TTC. If your doctor's not an endocrinologist, they may not know all the common guidelines for unique situations like pregnancy.

It's not unusual for people to be slightly hypothyriod and not notice symptoms. I was WAY out of the normal reference range when I was first diagnosed and didn't really notice the symptoms until they went away a few weeks after starting meds. It does take about 6 weeks from starting meds until you will notice a change in your levels.

Since I'm hypothyriod I'd knew have to watch my levels during pregnancy. When I was 5wks I got a blood test that showed I was 4.87 on the same reference range as you. My doctor increased my thyroid meds by 30% and said it's not uncommon to go up to even 50% beyond what you'd normally be on.

My sister had no history of thyroid issues prior to pregnancy, but ended up taking a very small dose of meds during her 2nd-3rd trimesters because pregnancy threw her out of the normal range. She had a beautiful healthy baby and after pregnancy her thyroid levels came back into the normal range.

KatzKiss · April 2014

sj+cm131 said:

If your doctor doesn't offer to test your levels when you go in, remind him. Mine tests my TSH once a trimester because I have hypothyroidism. Normally they test every six months, but pregnancy can mess with your levels.
Based on the literature I have read, including the brochures my endocrinologist has sent me, it seems that it is widely recommended that pregnant women with a history of thyroid issues get tested at least every 4-6 weeks.

Yes. I have read that as well. My doctor only tests once a trimester. I trust his judgement. Plus, I know what symptoms to look for if I suspect something is wrong. I am currently 1.9 and not worried at all.

mander82 · April 2014

So I got a reply from the email I sent to my doctor yesterday. They are having me redo the TSH test and they are doing a T4 test.

I didn't really read a whole lot about the T4 test yesterday, but I am really hoping the results of these tests will more clearly indicate if I need treatment or not.

I just can't fathom the fact that I could easily eliminate all the possible side effects of a high TSH number, and doing nothing about it.

Sounds like from what you guys said, one little pill a day could bring that number down, and if thats best for baby, then why would I not do it ? DH thinks I am being a hypocondriac, but I don't care, I don't want to brush off something that perhaps I should be taking seriously.

moroccojade · April 2014

My endo said that he wants all women to have their meds increased by 50% as soon as they get pregnant. I've been flamed for sharing this info. But it's something to ask your doctors about. Why?

Sure, your levels might be fine at 4w. But next time you'll be tested will be 8 weeks at the earliest. One doesn't want their TSH to skyrocket and their T4/T3to plummet in that month. Babies need proper thyroid hormones!!

OP, if you are offered thyroid replacements- grab them. They will only be of benefit to you and your
baby.

amberhoothoot · April 2014

Well I have absolutely no thyroid at all. It was removed in 2007 after they suspected cancer and graves disease.

I believe they treat patients differently based on whether you have a whole, partial, or no thyroid. They also check whether you were previously on thyroid meds before being pregnant. I don't know the exact numbers but if you were not on meds before then you number is not terrible. A better questions is "Do you feel terrible?"

I feel terrible when my TSH is anything above a 3. But that could be because of my having no thyroid at all. My recent test showed 3.87 and my RE said that was way too high for first trimester and no thyroid, so my pills were increased. I am normally hovering around a 1 and while pregnant they would like me to be between 1-2 at most.

My OB told me 3.87 was just fine (but it's not for me).
Much like OB's are NOT reproductive specialists, they are also NOT endocrinologists. If you feel terrible, maybe check in with an endocrinologist.

mander82 · April 2014

@amberhoothoot Its hard for me to say whether or not I feel terrible. I am always tired and cold, and I have dry skin even in summer....this is all normal for me. Of course I am more tired since getting pregnant. I am not one to complain about symptoms or one that runs to the dr. for every little thing, so who knows if what I have felt all my life is normal or not. Growing up on a dairy farm and milking cows since I was 10 made me a tired person....ha ha! I think I have enough of the "symptoms" to get this checked into further, but I can probably blame all these symptoms on other things as well. I feel like I am reading into possible pregnancy symptoms all over again!! ha ha ha ha!! Fuck symptoms !!!!

I am going tomorrow morning to get blood drawn for the TSH and Free T4 test, so I should have a better understanding next week of whether or not I have a real issue, or if I am just being a hypocondriac

moroccojade · April 2014

The 4.7 is clear. You are not being a hypochondriac.

If your next results are similar, I hope you have a very proactive doctor.

lizzielu82 · April 2014

Also get the non-generic, synthroid, for your prescription. The generic version did not work for me.

The good news is that 4 is not all that high so I'm sure you'll equal out quickly. Glad to hear your doc is taking this seriously and good luck!

amberhoothoot · April 2014

lizzielu82 said:

Also get the non-generic, synthroid, for your prescription. The generic version did not work for me.

The good news is that 4 is not all that high so I'm sure you'll equal out quickly. Glad to hear your doc is taking this seriously and good luck!

Agreeing on getting the real synthroid. My endocrinologist made me swear not to get generic. Just doesn't work right or something.

lisaren · April 2014

Yep yep about synthroid. The generic messed me up!

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Blood Test Results--- TSH/Thy. Stim. horm ---UPDATE

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