A quick question. Has anyone heard of a recent study (?) showing that T4/T3 treatment can cause problems during pregnancy 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
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 not 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.
__________________ "We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln
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 ).
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?
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.
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 2.5–10 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 - there's just too much room for misinterpretation here.