Graves' Disease Support Group
Graves-Basedow disease is a medical disorder that may manifest several different conditions including hyperthyroidism (over activity of thyroid hormone production), infiltrative exophthalmos (protruberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). This disorder is the most common cause of...
I have had Graves' disease for over five years and finally the past year has been normal for TSH and free T4's. I got pregnant with twins in September. I am 15 weeks in December and my TsH levels are low. Dr. has upped my meds from 50 mg PTU two times a day to 50 mg three times a day I go back this week and I'm afraid he's going to up it some more. Even though my free T4 is normal. I will request this time that he does a free T3. Here are my lab results for the past couple times:
Tsh range 0.4-4.5 mlu/l
Free t4 range 0.8-1.8 ng/dl
8/11 tsh 1.22
10/27 tsh .02, free t4 2.4
12/8 tsh 0.3, free t4 1
Thanks so much for your advice I know the doctor goes against TSH but I kind of monitor my own levels and medicate her how I feel.
Tsh range 0.4-4.5 mlu/l
Free t4 range 0.8-1.8 ng/dl
8/11 tsh 1.22
10/27 tsh .02, free t4 2.4
12/8 tsh 0.3, free t4 1
Thanks so much for your advice I know the doctor goes against TSH but I kind of monitor my own levels and medicate her how I feel.
Yes, definitely need the FT3 and cannot use the TSH to dose meds by. Sorry that this doctor doesn't seem to understand this/
{{{hugs}}}
You're already hypO. The FT4 is below mid range. Need to work on taking less PTU to keep the Free Ts (incl. FT3) at mid range to the upper third ranges. At this point hypO is not good for you and the twins.
{{{hugs}}}
I posted some medical articles concerning thyroid/Graves and pregnancy in our general Grave info group. Just a heads up- it's tricky to read them due to medical terminology, but give it a try. For example- In the first article I posted:
Some studies report a decrease in free T4 during pregnancy, others report no change or even an increase [1,15,16]. Direct free T4 measurements may be unreliable during pregnancy. Measurement of free T4 in the dialysate or ultrafiltrate of serum samples using liquid chromatography/tandem mass spectrometry appears to be the most reliable, and when this method is used, free T4 concentrations were shown to decrease gradually with advancing gestational age, particularly between the first and second trimester [17,18]. This assay is relatively expensive and not universally available. Other free T4 assays (and probably free T3 assays) frequently fail to meet performance standards in pregnant patients, owing to increases in TBG and decreases in albumin concentrations that cause the immunoassay to be unreliable [15]. To compensate, some kits have provided different free T4 normal ranges for pregnant patients, usually lower than those of nonpregnant patients. Method-specific and trimester-specific reference ranges of serum free T4 should be used, if available [9]. (See "Laboratory assessment of thyroid function", section on 'Serum free T4 and free T3'.)
As an alternative, serum total T4 measurements, which are more reliable during pregnancy, can be measured to assess thyroid function [15]. When free T4 measurements appear discordant with TSH measurements, serum total T4 should be measured. Total T4 and T3 levels during pregnancy are 1.5-fold higher than in nonpregnant women due to TBG excess. Thus a normal reference range for pregnancy should be used.
http://www.dailystrength.org/groups/graves-disease-general-info
Eventhough he didnt want to. He is keeping me @3 a day. I dont have the shakes but will monitor myself for hypo.
{{{hugs}}}