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.

I wanted to seek a second endo opinion but time is too limited, we are moving in a few weeks. I will of course be finding a new endo upon moving but I need to make a decision about the medication now. Thank you.

[Mark Lupo, M.D.]

Slightly low Free T4 in pregnancy with normal TSH is not uncommon (hypothyroxinemia in pregnancy).  We do not have standardized normal ranges for Free T4 in pregnancy. It does not mandate treatment as there is not compelling evidence that it is beneficial.  The 25mcg dose of synthroid would not cause harm, but is not likely necessary.  I recommend making certain that your pre-natal vitamin contains iodine (important for all pregnant women).  Continue to monitor thyroid levels closely given history of Graves - and remember there may be a higher risk for thyroid problems after delivery.

[VieKumoro]

sir. I have a question. I have this big lump like a tennis ball in my right nevk. The doctor said it's Thyroid. And several blog I read that if iwant to having a baby.. then the baby  might be midget...?  Is that true.. sir?  Please help me

[SunnySky06]

Thank you for the reply! I went ahead and started the synthroid a few days ago just in case, but will be monitoring levels every 2-4 weeks as a close precaution. I will definitely stay on top of it postpartum, as the problems that could arise really scare me. Thank you again for your time.