“16 weeks pregnant TSH 23...next steps?”
My TSH is .23, I am 16 weeks pregnant. I am of course concerned about how this may affect my baby. I was told to follow up with an endocrinologist but would love to hear your opinion on what you would recommend, and if this is of serious concern to my babies health. Please tell me what your recommendations would be for similar diagnosis.
Female
6 Answers
Repeat the test and include a free T4. Also, I would request thyroid antibodies, family history, Total T4, and Total T3. During pregnancy, the binding hormone increases and a T3 resin uptake is inversely related to your thyroid activity. Don't just rely on one TSH. If your thyroid is malfunctioning, you should ask your obstetrician about your symptoms also. After the repeat test, if there is still an abnormality, then request an endocrinologist.
Your question is one that invites an opinion that is a landline for physicians. So, the best answer is for you to see an endocrinologist. However, to stop your fears which I consider more worrisome than your thyroid levels, don’t worry, you and your baby will be fine.
Dr. Norwood
Dr. Norwood
I think you do need to follow-up with an Endocrinologist. Do you have any prior thyroid issues? If not, it may be a normal finding in pregnancy. Additionally, if your prenatal vitamin had biotin in it, it can cause a TSH of 0.23 if a biotin linked assay was used to measure your TSH. I wouldn’t worry about it but follow-up with your Endocrinologist
It is a very good idea to see an endocrinologist who will recheck all thyroid hormone levels and based on your history and labs will be able to give you an answer. It is difficult to give an answer based on one TSH value.
Dr Strizhevsky
Dr Strizhevsky
The TSH range for the second trimester is 0.55-2.73. Your TSH of 0.23 is slightly lower (but normal for the first trimester), meaning that your thyroid hormone levels (T3 and/or T4) could be a little too high. Alternatively, your hCG might be a little higher than normal, which could also produce this result. So, you don't necessarily have a problem. However, you could also have some form of autoimmune thyroiditis. In any case, I recommend seeing an endocrinologist and having blood drawn for TSH, free T4, free T3, TSI, TRAb, anti-TPO and anti-thyroglobulin, plus, of course, a physical exam for signs of thyroid disease.
Hope this helps.
Hope this helps.
Dear Patient,
Absolutely see an endocrinologist as a tsh of 0.23 is consistent in the second trimester with hyperthyroidism. In the first trimester, the hormone Human Chorionic Gonadotropin can affect thyroid lowering tsh, but this should resolve by second trimester of pregnancy. Yes, hyperthyroidism can have adverse effects on both mother and baby such as causing high blood pressure, pre eclampsia, early delivery, as well as low birthweight babies. It is treated with antithyroid meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
Absolutely see an endocrinologist as a tsh of 0.23 is consistent in the second trimester with hyperthyroidism. In the first trimester, the hormone Human Chorionic Gonadotropin can affect thyroid lowering tsh, but this should resolve by second trimester of pregnancy. Yes, hyperthyroidism can have adverse effects on both mother and baby such as causing high blood pressure, pre eclampsia, early delivery, as well as low birthweight babies. It is treated with antithyroid meds.
Respectfully,
Marvin A. Leder, MD FACP FACE
