Pregnancy and supressed TSH

[alfonsina]

I am wondering if anyone in this forum has become pregnant and delivered a healthy baby while having her THS suppressed (below what is established as normal range i.e.: TSH: 0.01) Some doctors argue that the baby needs hormone to develop and that having the TSH suppressed will not do that job and can lead to miscarriage and other problems. Thanks for sharing.

A.

[alfonsina]

Great! so you had two successful pregnancies with your TSH being suppressed? well, that is great news then. It has been difficult to find more info online about it.

Thanks for posting that gives me some hope.

[alfonsina]

Gimel, Thanks for the amount of info you posted. As many members here I felt very frustrated when talking to doctors who cannot believe that another doctor has prescribed the dose I am in and that he is fine with the suppressed TSH. The latest endocrinologist was worried my TSH was too low and suppressed and pointed out my gland could be damaged for life because of that. She said my FT4 was okay, and wanted to lower my dose, what she does not understand is that if she continued to lower my dose my FT4 will continue to drop which is what concerns her in the end! She finally said that I was an "educated lady and in charge of my treatment" and I should also seek another opinion from a colleague, I accepted however her colleague does not take my insurance. I will print out the info you posted, thanks.

Ahmee, Good idea about telling other doctors about seeking explanations from the one who is prescribing, but in the end I had to switch to other doctors participating in my insurance and they all agreed my dose was way too high, I felt alone. I am now going back to the previews doctor because my I don't have insurance anymore. I have been thinking in investing in another doctor who charges $350 per first visit and much less for follow ups. I received good comments from a patient who is taking desiccated. I have to see my budget. Thanks.

[Super_sally888]

Hello,

I have been hypothyroid since 2000.  I have also had 2 successful pregnancies.

The key thing is to ignore TSH.  You should be medicated based on FT3 and FT4.

During pregnancy my endo wants my FT4 at the top of the reference range (as the baby will get and use the FT4).  FT3 should also be in the upper 1/2 of the reference range.  My TSH has been very low for many years and we typically just ignore it.

[ahmee]

Who is your prescribing doctor for the thyroid meds? Assuming your prescribing doc is understanding of your low TSH situation, I would refer all others doctors to the prescribing doc for their questions. Tell them you understand their confusion, but your prescribing doc agrees that this is best path for treating the disease and that you feel very healthy at the current dose. If you want to get more specific with them, you can repeat some of the good info gimel gave above.

[gimel]

For those that freak at your TSH level, just ask them what is it about low TSH levels that cause their concern.  If they say that it is because it indicates that your body thinks that your thyroid hormone levels are too high, then ask why should a hypothalamus/pituitary response to thyroid levels be given more consideration that the actual thyroid hormone levels themselves.  TSH itself causes no symptoms.  It has a poor correlation with Free T4 and worse correlation with Free T3.  The correlation is even worse when already taking thyroid meds.  Scientific studies have shown that TSH is frequently suppressed when thyroid hormone levels are raised enough to achieve euthyroidism.  So why ignore the actual thyroid hormone levels and how you are actually feeling, and get unnecessarily concerned about low TSH results?


Note this quote in the following link.  "Just as is it completely inappropriate to use a "normal" TSH to exclude hypothyroidism, it is even more inappropriate
to use a "normal" TSH as the goal of thyroid hormone replacement! Obviously, if the TSH production was inadequate to
start with, the TSH will be quickly suppressed with sufficient thyroid replacement. In addition, it is quite clear that the TSH-
production system is over-suppressed by once-daily oral thyroid supplementation of any kind. Our hypothalamic-pituitary-
thyroidal system obviously did not evolve to deal with once-daily oral T4 replacement! The TSH is not God's gift to
physicians! Taking all one's T4 thyroid hormone by mouth once daily  produces an unnatural T4 spike in the blood that over-
suppresses the TSH for 24 hours. Many studies have shown that TSH-normalizing T4 (levothyroxine) treatment leaves many
persons with low free T3 levels and residual signs and symptoms of thyroid insufficiency (Saravan 2002, Samuels 2007, Baisier
2001). In a landmark study, four experienced thyroidologists adjusted levothyroxine doses according to clinical criteria only  
(symptoms and physical exam). When these patients were tested it was found that their TSH levels ranged from <0.01
(suppressed) to 20mIU/L! Only the free T3 level correlated well with clinical euthyroidism. (Fraser, 1986)

http://hormonerestoration.com/Thyroid.html

[alfonsina]

Thanks for your response.

The doctors seem to be very divided about what is optimum when treating a case like mine, because in order to bring my frees up my TSH will become suppressed. Some of them, most of them, PO and specialists have freaked out when they see my TSH and then another doctor I was seeing and  one GYN I saw were just okay and mostly asked how I was feeling, instead of looking just at the numbers. It is very disturbing because it is not only about you anymore, that is my main concern.

I was in a combo of dessicated and Synthroid before and feeling good, but I had to change doctors due to insurance changes and here I am.
I wanted really badly to hear real stories to have a peace of mind, unfortunately I did not. I searched online and I could not find real stories either. Thanks for your comments which are always welcome and helpful.

A

[gimel]

Yes, a baby needs thyroid hormone, but TSH is only a pituitary hormone that supposedly reflects accurately levels of the biologically active thyroid hormones, Free T3 and Free T4.  In actuality TSH cannot be shown to correlate well with either Free T3 or Free T4, much less with symptoms, which are the most important consideration for the patient.  

Hypo patients taking significant doses of thyroid hormone frequently find that their TSH becomes suppressed.  That does not mean that you are hyper, unless you do have hyper symptoms due to excessive levels of Free T3 and Free T4, which you do not have.  There are scientific studies that concluded that suppressed TSH occurred In the majority of cases with patients taking thyroid hormone.  

In actuality your Free T3 level is far too low.  You should talk with your doctor about adding some T3 to your meds to bring your level up to at least the midpoint of the  range, or as necessary to relieve any hypo symptoms you have.  

Sorry that the only responses you have had were from men, not ladies that have experienced pregnancy.  LOL

[alfonsina]

These are my latest results:

Triiodothyronine,Free,Serum 1.8 L 2.0-4.4    pg/mL
TSH 0.080 0.450-4.500    uIU/mL
T4,Free(Direct) 1.30 0.82-1.77    ng/dL

It does not seem usual to see a pregnant woman with a a suppressed TSH :(

[gimel]

What are your latest Free T3 and Free T4 test results, along with reference ranges?

[alfonsina]

Thanks for your comment. I am not having any hyper symptoms, but the doctor insist in that having suppressed TSH is bad for pregnancy and in general. She freaks me out.

I am hoping someone in this forum who has gotten through pregnancy with a suppressed TSH  shared her story.

Thanks.

A.

[flyingfool]

TSH is NOT a thyroid hormone.  It is a pituitary hormone that is supposed to regulate the Thyroid gland.

What you really need is to determine the true thyroid levels. This is done by a blood test which tests for the two different hormones. The are Free T4 and Free T3.

TSH is unreliable and nothing more than a screening tool at best.  TSH can vary by as much as 70% within a 24 hour period.  So any particular snapshot is not necessarily even correlated well to symptoms or true thyroid levels.

I am male, but have read that proper thyroid levels are important to the development of the baby. So ensuring that your thyroid levels are proper is important.

Other than pregnancy side effects, What if any thyroid symptoms might you be having?

Low TSH would be consistent or viewed as high thyroid level or Hyper.  Are you having Hyper symptoms?