[MHLee]

#1060393

Underwent a total thyroidectomy 1.5 years ago for Graves’ disease.

Had my 12 week appt yesterday and just heard back from the nurse about my TSH check. With no dose change (I’ve been on 175mcg/day the entire pregnancy) my TSH dropped this month from 1.27 to 0.23.

The nurse asked me lots of questions to try to figure out if I’ve been taking my medication correctly (of course I am…I have no thyroid and don’t mess around with my health…or baby’s!). She said that the OB would is dropping my dose to 150mcg/day and we’ll recheck next month.

T4 was fine, but they didn’t check the T3? She said they didn’t need to know my T3, which I found odd…

Anyway, I’m completely confused. I thought your TSH is supposed to rise during pregnancy. What could this mean? Thyroids can’t grow back, right?

I’m also wondering if I need to be followed by an endocrinologist. I don’t have one right now (mine moved away), and most around here take 6 months to get in, but I can try to find one if I need to.

Thanks for your help!

[Kimberly]

#1182381

Hello – It’s actually common for TSH to drop during pregnancy. In fact, the latest guidance from the American Thyroid Association recommends trimester-specific TSH ranges for women who are pregnant. You can find more info at the link below; this would be a great resource to print out and discuss with your provider. (The section on testing starts on page 6 of the PDF or page 1086 of the original journal article).

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://thyroidguidelines.net/sites/thyroidguidelines.net/files/file/thy.2011.0087.pdf

Hopefully, others will chime in as to whether they chose to go back to an endocrinologist to monitor levels during pregnancy.

Wishing you all the best!

[LaurelM]

#1182382

Hi,

We got pregnant with our 2nd after about a year of treatment with ATDs. I went into remission during my 1st trimester. I was referred to a high risk OB by my primary. My primary had handled my uncomplicated 1st pregnancy. All 3 of my Drs- my OB, endo, and primary kept each other informed throughout my pregnancy which turned out to be very uneventful. You may want to ask your OB what kind of experience they have with GD mother. They should be following you a little more closely than a standard pregnancy just to be sure. I had more frequent monitoring and labwork. As Kimberly stated, the normal range for the thyroud hormones changes in pregnancy. You will also need a TSI run in your 3rd trimester. Even though you no longer have a thyroid, those pesky antibodies can still cause some hijinks. Congratulations on your little one to be!

Laurel.

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