mkgbrook

Alma,

Are you seeing a MFM? Maternal Fetal Medicine specialist? You are classified as a high risk pregnancy as a result of your hypoT status. As a result your OB should have you seeing a HIGH RISK OB = MFM. The MFM if upto date on the latest thyroid care for pregnant women will tell you that you need an FT4 level ABOVE 1. TSH is IRRELEVENT! The stop testing it and ONLY go by your FT4 and FT3 levels. Pregnancy hormones and changes in estrogen/progestorone levels effect the reliability of TSH in PREGNANT women. Endos are not as well versed at dealing with pregnant hypoTs.. so yours saying your TSH is fine shows IGNORANCE in this matter.

So I recommend that you get in to see a MFM/High Risk OB ASAP. Let them CO-manage your thyroid status. It is true that the baby will skim what it needs off the top, BUT if your levels fall below 30-40% some of the MFMs/OBs believe there is not enough thyroid hormone for both mother and child.

1) Rule of thumb is OPTIMAL FT4 levels are 60-80% of normal range for a pregnant woman.
2) Next rule: 40-60% is safe, but the mother will suffer hypoT effects.
3) Below 40% and there is increased risk for the fetus.

4) Thyroid maintenance and management rule of thumb for a MFM:
A) As soon as pregnancy is detected thyroid homone dosage should be increased 25%.
B) Then the FT levels should be monitored every 4-6 weeks until optimal levels are reached.
C) If hypoT prior to pregnancy detection the monitoring and dose adjustments are done EVERY two weeks by FT4 and FT3 level monitoring.

Your Endo did not do this. But in the Endos defense they may not know how pregnancy effects the TSH versus FTs and thus are clinging to their TSH watcher status. However your OB should and an MFM should know this WITH OUT fail.

Now don't be scared. The main thing that low thyroid hormone in a developing fetus causes is delayed to slow development rate. At your last US were you at least at 50% on the growth scale? If your US matched the chronological age of the fetus, it is getting what it needs now. At 22 weeks the fetus's thyroid will come on line. This will allow for it to handle shifts in your actual T4 levels, BUT it still needs T4 from you. In the final trimester the brain is developing and this si where increased cognitive deficiency will have a greater chance of arising if your are STILL too low in your T4 levels. SO you still have time to get your house in order. Be forceful and aggressive about your thyroid management and care. You are caring for TWO. MAKE your ENDO look only at the FTs. Force them to be aggressive about increases. Get in to see an MFM. If you have Hashi's pregnancy can have two effects. It can cause increased hyperT/hypoT swings... OR it can kill your thyroid all together. My first pregnancy I was on the Graves/Hashimoto's roller coaster. This one... well I went from almost being optimal at 112 mcgs of T4 to needing 175 mcgs of T4 WITH 1.5 grains of Armour daily. This is most likely going to increase again. Pregnancy 2 has also kicked in a thyroid hormone resistance issue.

Good luck and congratulations on your developing bundle of joy.

MG

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If we learn by our mistakes, I am working on one hell of an education.