Pregnancy Normal TSH but Low Free T4

My wife is currently 21 week pregnant and using medication for hypothyroidism from last 2 years. Recent test results showing Normal TSH (1.11) but bottom border Free T4 (0.83). Doctor is saying everything fine. is there any thing to worry about the results?

Standard Range
TSH : 0.320-5.500 MIU/ML
Free T4 : 0.6-1.7 NG/DL

Date          TSH       Free T4   Pregnancy Week      Comments
7/6/09        3.070
8/28/09      3.170
10/14/09    2.040
12/5/09      0.904                       1
1/27/10      5.190     1.22         9                            Increased Medication
2/19/10     1.060       1.28           12
3/19/10     1.560       1.00           16
4/28/10     1.110        0.83           21

[TamraW]

Her FT4 looks too low, but the most important test, the FreeT3 is not even being tested. This tells me you need a new doctor. My TSH is a 0.01. My endo does not treat TSH because it is a pituitary hormone, NOT a thyroid hormone. We like my FreeT3 to be in the top 1/3 of the range and my FT4 around the middle.

Everyone is different, but the key is getting your wife feeling well with no hypo symptoms such as dry skin, dry eyes and hair loss, constipation, fatigue, pain in feet and legs, brain fog, depression. I know it can be hard to tell because pregnancy has its own set of health problems, but I suggest a new doctor pronto, to ensure the well being of the baby.

:) Tamra

[Super_sally888]

Hi,

This would not be good enough for my endo.

When I was pregnant he wanted to keep FT4 at the top of the reference range. He ignored TSH completely as he said it is not reliable in pregnancy for use in adjusting medications.  I would think an increase in meds is definitely now recommended.

It is normal to have to increase thyroid meds by up to 50% during preganncy.

Testing FT3 also could be helpful.

Please get a second opinion.  Please get the thyroid meds increased.

[sman139]

Thanks Sally,

      We are going to visit endo this week. By these current/pass test results do you think is there any effect on baby?

[sman139]

Thanks Tamra,

      We are going to visit endo this week. By these current/pass test results do you think is there any effect on baby?

[Super_sally888]

Hi,

I think the results are not terrible for the baby, but there does need to be adjustment in meds made asap.

[magpieannie]

go to www.ThyroidScience.com and read the research article by Dr. John Lowe -"Pregnant Woman and Their Newborns: Among the victims of t4 Replacement". This really talks about the importance of keeping the freet3 high enough  during pregnancy. My daughter was born without a thyroid gland. I've often wondered if my thyroid hormone levels were too low during pregnancy and I never new it??? Please find a doctor for your wife who will keep a better eye on ALL the thyroid hormone levels and who understands the importance to the baby that these be kept higher in normal range throughout your wifes pregnancy.