Hyper to Hypo 20 weeks pregnant

[SunnySky06]

Little background, after ttc for a year my husband and I went to the infertility dr and my blood test came back hyper thyroid with Grave's disease. I felt fine, never had symptoms and my thyroid was fine just a year before. Anyway, I was put on PTU by my endo and was on it for 15 months with my levels continuing to be FT4 low, FT3 usually slightly high and TSH within a "normal range" with my very low dose of 50mg of PTU. I got pregnant in Sept through fertility treatments(IUI) and my endo decided we should see how I do off of the meds.

I've been off of my PTU since Sept and my labs have been pretty good, now I'm 20 weeks pregnant and my OB wanted new labs since my last ones were 4 weeks ago. He tested my TSH and my FT4. TSH was fine at .84(.34-4.82) and FT4- .69(.89-1.76). I freaked out when I saw it and have been in tears for 2 days. I called my endo and he is fine with that level, no need for any medication. My OB calls today and said he wants me on .25(whatever measurement) of synthroid to get my t4 up, I told him what my endo said and OB says it's ultimately up to me if I want to take it. I called endo back, he says he disagrees and my level is fine but knows I'm upset and tells me it won't harm me to take it, it's such a low dose. He says that my level was actually normal because pregnancy range starts at .60 even though the range on my lab doesn't reflect that

So basically I have to decide if I think I need synthroid, my OB said he thinks I should. I'm just worried about my baby and we are moving in 5 weeks so I feel I should take it now to see how it affects me at my next draw in 3-4 weeks before we take off on our 4 day move across the country. Does this seem accurate to take the synthroid. Sorry for the novel.

[goolarra]

I just sent you a PM with the name of a doctor from gimel's list.  Go to the top of the page and look in your Inbox under the My MedHelp drop down menu.  Neither doctors nor MH like us to post their names and phone numbers on the open forum, thus the PM.  I hope he's great!

[SunnySky06]

Thank you so much! I feel better about taking them, I was really panicked over what to do but every thyroid board I've posted on said it would be best to take them. I think it is too early for side effects but last night and this morning I have had a light headache, hopefully that's normal.

I hope to find a great endo when we move, do you know of any in the Seattle area or know where I could look to find some recommendations?

[goolarra]

Your FT3 was on the low side then, so it looks like you could use the meds your doctor prescribed.  I think it's good that you started taking them.  Best of luck.    

[SunnySky06]

I went ahead and took the synthroid this morning, even though I know it won't be long enough I asked my OB to run my labs in 2 weeks with the FT3. My FT4 and FT3 ran opposite while I was on hyper meds(ptu) but I came off of the meds mid Spet. My labs have been pretty normal then until now. My lab before this low FT4 was Dec 2 and these were the results

FT3 2.66(2.00-4.40)
FT4 1.01(.76-1.46)
TSH .49(.358-3.74)

[goolarra]

Could you ask your endo to rerun FT4 and TSH and add FT3 in?  In your initial post, you said that your FT4 tended to be low, even when your FT3 was high.  So, it would be really nice to know what your FT3 is doing and would help you make the decision on whether to take the meds or not.  It would just make it a more informed decision.  

[SunnySky06]

Thanks for the responses. Yes, my OB prescribed me 0.025MG of levothyrox. I know the medication is safe to take, I'm just worried about taking it after so recently being hyper. I'm afraid it will bring my back to being too hyper. Or that something wonky happened with my labs. But, I think being a little hyper is better than a little hype.

With these labs, would you take the synthroid?

[goolarra]

I thought this was a rather interesting article on the ATA website:

http://www.thyroid.org/thyroid-disease-and-pregnancy/

It seems to answer a lot of questions.  

As the article points out, once past the first trimester, your baby is producing her own thyroid hormones.  So, she is no longer totally dependent on you for them.

TPOab is the marker for Hashi's, correct.

I tend to agree with your endo that it's a low dose and won't hurt you.  I assume your OB wants you to take 25 mcg of levo, which is 0.025 mg, not 0.25 mg, correct???  

[SunnySky06]

My OB did not test my FT3, I had it last tested on Dec. 2 and it was at 2.66(2.00-4.40). My endo usually test all 3 and I requested my OB test all 3 in 2 weeks. I think I'm going to take the meds since it's a low dose and I'm afraid if I don't take it, it will have a negative effect on my baby.

The endo said my FT4 was fine because in pregnancy the range is different, starting at .60 but even at that range I believe my FT4 is still too low for pregnancy. Since the baby relies on FT4 for neurological development.

I had my antibodies tested in Sept at my request, but my endo ran the TBII instead of TSI. When we move I'm going to request my TSI be ran since it's usually ran around 27 weeks of pregnancy in thyroid patients anyway. I will also see a perinatologist to check the babies thyroid, hopefully later next month. Endo did run my TPO which is Hashi's correct? It came back at <6 (0-34) and my TBII was I think 30 but it didn't give me a range.

[alfonsina]

Under my experience endos never agree with OBs in terms of thyroid medicine and optimal numbers to get or during pregnancy. In the end I have the sense that none of them wants to take responsibility since there is a new life in the way.
I agree with all what Goolarra says and I have to say that I have had two endos telling me that FT4 should be at least mid range for optimal conception and pregnancy. One of them did not even care about FT3, she insisted FT4 was more important. But I don't agree with that.

Antibodies are important and when I was told about mid range FT4 I always tested negative.

[goolarra]

Did your OB test your FT3?  It was your FT3 that you said was usually on the high side.  FT3 is the biologically active form of the thyroid hormones.  Perhaps you could ask your endo to test again, adding in FT3?

Which level is it that your endo says is "fine" because the range starts at 0.6 if you are pregnant?  Is that TSH or FT4?

Has anyone tested your antibodies to see if pregnancy has sent your antibodies into remission?