Pregnancy Labs Updated -Should I be concerned?

[caetlin_h]

August 5, 2011 (before conception)
TSH     0.01    range 0.40-4.0
totalT3  223    range 60-181
FreeT4  1.45    range  0.5-1.50

October 15th 2011 (9 weeks pregnant)
TSH <0.01    range 0.40-4.0
FreeT3  3.7   range 2.3-4.2
FreeT4  0.99    range 0.5-1.50

November 19th 2011 (13 weeks pregnant)   same ranges
TSH  0.01    
FreeT3  2.8
FreeT4  1.35
TSI       2.0    (anything under 1.3 is considered abnormal)

So at this point, the endo says that I'm "subclinical" and although my labs aren't great, their ok for not being medicated.  However, she wants to recheck every four weeks and wants to do a 20 week ultra sound to check the babies thyroid.  She also said that the Antibodies can cross the placenta wall so we should check them again in the second trimester.  This woman is EXTREMELY difficult to get on the phone, and has a thick German accent and very hard to understand, so whatever help you can all give me would be SO appreciated!  here are my questions:

1.  If my labs aren't bad enough to medicate, then why are we worried about the size of the babies thyroid gland?  What are the chances of me having a baby who's hyperthyroid?

2. Can I take Selenium during pregnancy to lower antibody levels? (nobody can seem to answer this) And is it true that only the TSI antibody is the one that is of concern, not the others (which are SO much higher)

3. Why would my TSH stay the same, but my T3 and T4 move all over the place?  They seem to go up, down, all around -is this typical?

4.  Do you agree with her assessment, is it better for the baby to stay unmedicated at this point?
Thank you everyone, I really appreciate it!  Nobody else can seem to help me and I feel like time is being wasted!

[Barb135]

In my opinion, you have both Graves and Hashimoto's.  

It's my understanding that all of the thyroid antibodies can cross the placental wall, but I'm not a doctor and don't work in the medical field; I know only what my research shows.  Here's one site that explains it relatively well.

http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Pregnancy can make your levels bounce around and I notice that your FT3 went down, while your FT4 went up; that makes me wonder if you might not be converting FT4 to FT4, well right now.  Studies have shown that selenium helps with the conversion process, so if your doctor approves it, you could try adding a selenium supplement.

[caetlin_h]

TSI tested positive with a result of 2 and anything over 1.3 is considered abnormal.  Not nearly as high as the others, but abnormal none the less. So I'm confused.  If high antibodies for all 3, then what does this mean?  A previous poster mentioned that ONLY TSI antibodies can cross placental wall, is this true? Why wouldn't the others?

[Barb135]

Yay -- it worked.........

Yes, this is a large jump, and warrants very close observation.

[Barb135]

Per verification via PM, I'm going to try to get your antibody results in here, but can't guarantee they will post any better for me than they did for you.......

2009   TPOab = 120 (range < 61)
           TGab  = 185 (range < 22)

Current  TPOab = 1300 (range < 61)
             TGab   = 844   (range < 22)

[Barb135]

I just sent you a PM, with my interpretation of your results.  If I'm right, let me know and I'll try to help get it in here.

Bottom line is: it looks like you've had Hashimoto's for at least a couple of years.  

You mentioned that you tested positive for ALL the thyroid antibodies, but I don't see a TSI result - that would be Thyroid Stimulating Immunoglobulin, which is the definitive test for Graves Disease.... please post that, with reference range, if you have it.  

[caetlin_h]

nope, not working. TGab range is <22. jumped from 185-844  TPOab range is <61 and jumped from 120 to greater than 1300