Your Thyroid Levels While Pregnant

 

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TSH Levels During Pregnancy: Healthy Ranges by Trimester

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Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen—cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a health care professional to feel during a physical exam. Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid.

Thyroid function tests change during normal pregnancy due to the influence of two main hormones: human chorionic gonadotropin (hCG) and estrogen. Because hCG can weakly stimulate the thyroid, the high circulating hCG levels in the first trimester may result in a low TSH that returns to normal throughout the duration of pregnancy. Estrogen increases the amount of thyroid hormone.

You find out you’re pregnant and find out your TSH is 5.0. Your doctor starts you on 50mcg of levothyroxine thyroid medication and your TSH lowers to 2.6. 2.6 is outside of the recommended range of 0.1 to 2.5 which means your thyroid is not optimized.

Your doctor then increases your dose to 75mcg of levothyroxine and rechecks your TSH. Low thyroid levels during pregnancy, for example, can be caused by high levels of hCG. When this hormone is present, the result will be lower TSH levels, which can lead to hyperthyroidism. And the opposite can happen due to estrogen, resulting in the thyroid underperforming and causing you to gain weight (outside of normal pregnancy weight). When you’re pregnant, your body is constantly evolving—your belly is growing, your hormones are changing, and sometimes your thyroid goes haywire.

Because of these changes, pregnancy can trigger a thyroid problem. You may be more susceptible to a thyroid condition during pregnancy for genetic reasons, from pre-existing hypothyroidism that hasn’t been treated properly, or from previous damage. Hypothyroidism is one of several thyroid diseases in which the thyroid gland doesn’t make enough thyroid hormone so levels of the hormone levels become low.

When thyroid hormone levels are too low, it causes symptoms like tremors, weight loss and frequent bowel movements. Severe, untreated hypothyroidism during pregnancy may cause complications that affect the baby and lead to delayed development. In the first trimester, hCG — which is similar to TSH — stimulates production of thyroid hormones. And throughout pregnancy, increased estrogen levels produce a hormone that helps transports thyroid hormones in the blood.

By the third trimester, the thyroid’s volume may be 10-15 percent greater. All of this is normal. Thyroid function tests change during pregnancy due to the influence of two main hormones: human chorionic gonadotropin (hCG), the hormone that is measured in the pregnancy test and estrogen, the main female hormone. HCG can weakly turn on the thyroid and the high circulating hCG levels in the first trimester may result in a slightly low TSH. The thyroid makes hormones that help your body work.

If it makes too little or too much of these hormones, you may have problems during pregnancy. Untreated thyroid conditions during pregnancy are linked to serious problems, including premature birth, miscarriage and stillbirth. If you’re pregnant and already taking this medication for abnormal thyroid hormone levels, your doctor may recommend increasing your dose by about 30 to.

List of related literature:

During normal pregnancy, daily thyroid hormone requirements increase by approximately 30% to 40% above baseline beginning very early in gestation.

“The Brigham Intensive Review of Internal Medicine E-Book” by Ajay K. Singh, Joseph Loscalzo
from The Brigham Intensive Review of Internal Medicine E-Book
by Ajay K. Singh, Joseph Loscalzo
Elsevier Health Sciences, 2017

Figure 61.2 Relative changes in maternal and fetal thyroid function during pregnancy.

“Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice E-Book” by Robert Resnik, Charles J. Lockwood, Thomas Moore, Michael F Greene, Joshua Copel, Robert M Silver
from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice E-Book
by Robert Resnik, Charles J. Lockwood, et. al.
Elsevier Health Sciences, 2018

During pregnancy, a 30–40% increased need for thyroid hormones is the result of increased placental uptake, higher thyroid-binding globulin levels, and greater blood volume.

“Treatment of Infertility with Chinese Medicine E-Book” by Jane Lyttleton
from Treatment of Infertility with Chinese Medicine E-Book
by Jane Lyttleton
Elsevier Health Sciences, 2013

Hypothyroidism during pregnancy is less frequent because many women with hypothyroidism are anovulatory or have high rates of first-trimester miscarriages.

“Primary Care E-Book: A Collaborative Practice” by Terry Mahan Buttaro, Patricia Polgar-Bailey, Joanne Sandberg-Cook, JoAnn Trybulski
from Primary Care E-Book: A Collaborative Practice
by Terry Mahan Buttaro, Patricia Polgar-Bailey, et. al.
Elsevier Health Sciences, 2019

Figure 60-2 Relative changes in maternal and fetal thyroid function during pregnancy.

“Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice” by Robert Resnik, MD, Robert K. Creasy, MD, Jay D. Iams, MD, Charles J. Lockwood, MD, MHCM, Thomas Moore, MD, Michael F Greene, MD
from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice
by Robert Resnik, MD, Robert K. Creasy, MD, et. al.
Elsevier Health Sciences, 2013

Although the thyroid gland increases in size by approximately 15% during pregnancy, this is not usually detectable on clinical exam.

“Swanson's Family Medicine Review” by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
from Swanson’s Family Medicine Review
by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
Elsevier Health Sciences, 2008

and T Increased 4 levels while iodine largely demand unchanging during pregnancy free lev­can cause both a 15% increase in sonographic thy­roid size in normal women, and a 25% increase in the pre­pregnancy levothyroxine requirement once a hypo­thyroid woman becomes pregnant.

“Swanson's Family Medicine Review E-Book” by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
from Swanson’s Family Medicine Review E-Book
by Alfred F. Tallia, Joseph E. Scherger, Nancy Dickey
Elsevier Health Sciences, 2012

During pregnancy, the thyroid gland tends to become slower.

“Brighton Baby: a Revolutionary Organic Approach to Having an Extraordinary Child: The Complete Guide to Preconception & Conception” by Roy Dittmann
from Brighton Baby: a Revolutionary Organic Approach to Having an Extraordinary Child: The Complete Guide to Preconception & Conception
by Roy Dittmann
Balboa Press, 2012

Week of pregnancy Fig. 3.10 Relative Changes in Maternal Thyroid Function During Pregnancy.

“Obstetrics: Normal and Problem Pregnancies E-Book” by Mark B Landon, Henry L Galan, Eric R. M. Jauniaux, Deborah A Driscoll, Vincenzo Berghella, William A Grobman, Sarah J Kilpatrick, Alison G Cahill
from Obstetrics: Normal and Problem Pregnancies E-Book
by Mark B Landon, Henry L Galan, et. al.
Elsevier Health Sciences, 2020

During pregnancy, the thyroid hormone requirements in the majority of patients may increase up to 50% compared to the patient’s prepregnancy L-thyroxine dose.

“Surgery of the Thyroid and Parathyroid Glands E-Book: Expert Consult Premium Edition Enhanced Online Features” by Gregory W. Randolph
from Surgery of the Thyroid and Parathyroid Glands E-Book: Expert Consult Premium Edition Enhanced Online Features
by Gregory W. Randolph
Elsevier Health Sciences, 2012

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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19 comments

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  • Hello! My tsh is 3.08, t3 is 0.87 and t4 is 6.62. I have been trying to conceive for the last 3-4 months. Should I take any medicine for improving my fertility?

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  • Anybody tested out the Rotogenflux Methods (do a search on google)? We have heard many amazing things about this intelligence boost system.

  • Hi, very interesting video. I’m trying to get pregnant and my husband and I are waiting for help since we’ve been trying for a while. I’ve recently done some bloodtest on tsh and they showed I have 3,1. But because it’s considered within the normal range the doctors don’t want to help me with that issue, despite me noticing several symptoms of low thyroid function (already before I started trying to get pregnant I noticed this). What should I do? The doctors won’t help me and I just know that so many of my problems stem from me having such a high tsh…

  • Mam..my wife is having thyroid problems & she’s taking 50mg thyroxine sodium tablets from last 6months…now she’s 11weeks pregnant.Her TSH level is 4.7 at present. Is it normal? Doctor told us to continue with 50 mg tabs…Should we continue with 50 mg or higher dose??

  • Dr does taking low thyroid medication can treat PCOS, I assume that my PCOS caused by low thyroid which appears in my childhood?

  • Hi, my tsh, t3, t4 have been in normal range during my pregnancy until this last week. I’m 22 weeks pregnant, my Dr. Wants me to start taking levothyroxine for low tsh which read to be.26, does that sound reasonable? And she got my results back the next day which seemed weird to me.

  • I’m glad I’ve found this. Currently fighting to get some medication. My level is 7.25. 10 years trying to get pregnant and had miscarriages but my dr’s think it’s not high enough to treat ��

  • I have been married since 9years without any child. My Fallopian tubes was blocked I tried everything possible to get pregnant nothing was working. I visited so many hospital’s my problem never seems to end i lost hope and feel depress. One faithful day I start checking online on how to get pregnant in the comment section people were testify about how they get result with Dr Marcus.. I was suprise about the testimony and decided to talk with him about my own issue… After explaining to him he said I have to purchase some medication from him after getting this medication i became pregnant and give birth. If you want to talk to Dr Marcus  contact him on whatsapp +2349035530865Email address:[email protected] gmail.com

  • This is a good explanation but a little difficult to follow on the interface and with the audio: just to recap a few key points: When patient is pregnant they will have high beta hcg, this is structurally similar to TSH and so in pregnancy the bHCG will decrease TSH levels causing a slight increase in thyroid hormones. For this reason if a patient is being treated for hypothyrodism they will need to increase their dose of Levothyroxine (T4) due to this decreased amount of T4 caused by the bHCG mimicking TSH. In states of high estrogen such as pregnancy or OCP use (estrogen pills for post menopausal for example), the TBG is increased. This causes more T4 (which is the main hormone in the plasma) to bind more to TBG. This increased bound T4 (part of total T4) is in an inactive form thus there is a decrease in free T4 but an overall increase in total T4. T4 is converted into T3 in peripheral tissues so if theres less free T4 there will be concurrently less free T3. Think of T3 as the form in tissues. TSH will remain normal despite this and patient is considered euthyroid.

  • Sir muze thyroid ki problem nai h.
    I am 4 month pregnant. In Ist trimester my thyroid report is normal. But now when Dr. recheck my thyroid then it’s level is 6.03. Now what I do?
    My double marker test report is normal.

  • My TSH was 3.63 in my 6th week…But my doctor doesn’t start medicine….and in my 6th month my TSH was 3.4 and my doctor started levothyroxin 25 mcg… Now i am in tension, is there any problem to my fetus…

  • Hi doctor I’m suffering with thyriod since three years recently I face miscarriage and its third time my t3 and t4 is normal but tsh was 0.5 can this tsh level couse my miscarriage plz help me want to contact with you from muscat

  • TSH for the first & second trimester of my wife is 2.95 & 3.40 but she has no complication and not taking any medicines. It is perfectly going fine.

  • i had 5 TSH during first month of pregnancy then i had started thyroid pills. My TSH level decreased to 3 in second trimester and at the end of second trimester it becomes 1.55 and it remains same.

  • I am 7 month pregnant.. I am having thyroid and gestational diabetics.. I am taking insulin every day.. can I drink some coffee..

  • I’m 6months pregnant and my TSH level is more than 100. And until now I am so worried about my baby’s condition. I’m afraid. Can someone tell me what to do. I have my endocrinologist and he gave me medicine every morning. ������

  • thyroid report mein agr pregnancy likha ho to kya eska matlb lady pregnant hai plz answer jrur dijiye mene thyroid test krwaya tha us report mein physiological rise in total t3 t4 levels seen in pregnancy likha hai to kya matlb hua eska jab k urine test me result negative aya tha

  • Wow. The fear mongering in this video was almost comical. Everything is life threatening! >_< I don't think it was meant to be so, but it did come off that way to me.