Re: T3 level in pregnancy

From: R. Daniel Braun (rd.braun@gmail.com)
Tue May 23 19:20:25 2006

The TSH only drops if the FREE T3 & FREE T4 rise. In normal pregnancy the total T3 & Total T4 go up but the FREE T3 & FREE T4 stay the same. As the T3 goes up the T3 Resin Uptake goes down. We don't measure the T3 Resin Uptake anymore. With the LOW TSH, she is chemically hyperthyroid. Even without symptoms in pregnancy, the fetus can be affected. If there is any question, I would repeat the TSH about 1 week after the first just to make sure the lab didn't make an error.

Dan

On 5/23/06, Atkinson, Samuel M <ATKINSONS@ecu.edu> wrote: >
> T3 is elevated in pregnancy and usually comes down after 20 weeks. It
> is inversely proportional to HCG. As her TSH is low she is appropriately
> dropping it as T3 goes up. As you said, clinically she isn't hyperthyroid..
> As with any test that doesn't compute, repeat it in one month.
>
> sAm
>
> ------------------------------
>
> ------------------------------
> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *Hen=
> ------------------------------

ry > Gregor
> *Sent:* Sunday, May 21, 2006 7:37 PM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* T3 level in pregnancy
>
> *The views of listers would be appreciated. A 35yo G1P1A2 (VIP 1, sab 1)
> presented at 8+wks EGA by dates, exam and sono. 1st preg'y was VIP. 2nd
> delivered at term, approx 5 yrs ago with PIH as well as antenatal Bell's
> Palsy. 3rd preg'y was SAB at 6wks, in '05.*
>
> *Patient's only meds in last three months were Imitrex and antibiotic of
> unknown type for bronchitis. She quick smoking upon recognition of
> pregnancy. She had complaints of fatigue which seemed beyond that usually
> attibutable to pregnancy or family/occupational activities, so a TSH was
> drawn with her prenatal lab panel.*
>
> *TSH was dec'd to .021. FT4 was nl at 1.64 ( .89 - 1.80 ). FT3 was
> increased at 4.9 ( 2.3- 4.2 ). She is without clinical or ROS findings
> suggestive of hyperthyroid-*
>
> *ism and has a negative PH of thyroid ds.*
>
> *At first I thought perhaps HCG was contributing ... even tho' I
> understand it to be rather weak as a thryotropin, the levels are possibly
> high enough...however the T4 was normal. Is this a T3 toxicosis that should
> be considered pathologic and treated? Should a range of thyroid antibody
> studies be checked....??*
>
> *Opinions appreciated.*
>
> *Hank*
>
> ------------------------------
>
> ------------------------------
> Ring'em or ping'em. Make PC-to-phone calls as low as 1=A2/min<http://us.r=
> ------------------------------

d.yahoo.com/mail_us/taglines/postman11/*http:/us.rd.yahoo.com/evt9666/*http:/voice.yahoo.com>with Yahoo! Messenger with Voice. >

--
R. Daniel Braun


       "The way to health is an aromatic bath and scented massage everyday"..
                                Hippocrates



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