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-   -   No added T3 during pregnancy?? (http://www.healthboards.com/boards/thyroid-disorders/915144-no-added-t3-during-pregnancy.html)

FinnMaid 08-22-2012 07:22 AM

No added T3 during pregnancy??
 
:wave:
A quick question. Has anyone heard of a recent study (?) showing that T4/T3 treatment can cause problems during pregnancy :confused: A "thyroid friend" of mine just got pregnant after being on T4/T3 treatment for a couple of weeks and now her endo (that's supposed to be "one of the best" in this country) says she has to quit T3 (when she clearly didn't do very well on T4 only). To me this sounds crazy (as T3 doesn't even cross the placenta) but if someone could give me a hint of where to look I'd be grateful :)

midwest1 08-24-2012 10:32 AM

Re: No added T3 during pregnancy??
 
I've been searching a bit for such a study at PubMed and MedScape. Can't find anything about that.
One thing's sure... I would [u]not[/u] buy this without seeing it in writing for myself. Can she ask the MD for evidence that this "study" actually exists? Seems bogus to me.

FinnMaid 08-24-2012 10:40 AM

Re: No added T3 during pregnancy??
 
We (me and a few of my other "thyroid friends") think he's referring to some fairly new guidelines by The Endocrine Society and somewhere there's a line stating that T4 treatment is the preferred choice - but no references proving T3 hazardous (obviously, T3 only is not an option as the fetus needs mom's T4).

She's afraid to fight this endo as he is supposed to be "the guy to see" but as we've seen in the past he certainly isn't perfect. After only a couple of weeks on T3 she was already starting to feel better, before added T3 her FT3 was in the pits (I'm afraid what'll happen to it now :dizzy: ).

lisa789 08-24-2012 12:15 PM

Re: No added T3 during pregnancy??
 
hugs to your friend and congrats with the pregnancy of course.

so far haven't encountered anything like that either (sure am interested in it).
Even when it's written in a guideline i kinda wonder:
1) is the guideline pro T3 in general or T4 only (quite a lot guidelines are 'T4 is all one needs")
2) is it based on T3 as such or other motivations? Not many doctors know how to medicate properly, even less when it concerns T4and T3, since most doctors will lowed the T4 dosage I can see the baby/fetus not getting sufficient T4 and consequently that might be a motivation to keep T3 out of it (although it's not due to T3 as such)
Can she ask the doctor about the guideline or is it to be tracked somehow?

FinnMaid 08-24-2012 12:41 PM

Re: No added T3 during pregnancy??
 
I haven't gone through the whole thing (a lot on my mind - the funeral today and stuff :( ) but we're talking about the The Endocrine Society (in the US) so you too should be able to find it - I don't think T3 was even properly mentioned, not in the pregnancy section of it at least. We've been searching for the "ultimate source" (= possible study) but since none of us have been able to find it I don't think there is any.

She's going to see the endo after a month or so so that she can ask questions - but as the doc is a bit "old school" I'm not sure if he'll go into details, it's very possible he'll just assume the patient will believe everything he says without questions.

FinnMaid 08-26-2012 10:13 PM

Re: No added T3 during pregnancy??
 
A friend of mine has actually contacted The Endocrine Society about these guidelines. Obviously she hasn't got a proper answer to the actual question: where's the proof? ;)

lisa789 08-27-2012 12:55 AM

Re: No added T3 during pregnancy??
 
maybe an idea to ask Elaine too, if there has been a recent study (which I doubt). probably since he is old school, he assumes it's better not to take T3 or so.

FinnMaid 08-27-2012 06:57 AM

Re: No added T3 during pregnancy??
 
[QUOTE=lisa789;5046138]probably since he is old school, he assumes it's better not to take T3 or so.[/QUOTE]This is the same endo that prescribed T3 in the first place and now he wants his patient off it :dizzy: We're still waiting for an explanation ;)

lisa789 08-27-2012 08:32 AM

Re: No added T3 during pregnancy??
 
he"s not the first who's willing to prescribe T3 but not during pregnancy (don't ask me why, but heard it before).

FinnMaid 09-03-2012 08:53 AM

Re: No added T3 during pregnancy??
 
So we're referring to this publication "Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline" and this was the statement that obviously has caused this whole thing "8.4c. If TSH concentration is 2.510 mIU/liter, a starting levothyroxine dose of 50 μg/d or more is recommended. Other thyroid preparations (such as T3) are not recommended. USPSTF recommendation level: C; evidence, fair." The Endocrine Society has responded to a letter by a thyroid friend of mine and indeed they were trying to refer to T3 only medication. Then why on earth doesn't it say so :dizzy: - there's just too much room for misinterpretation here.


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