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Old 09-06-2012
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Default thyroid hormone changes in pregnancy

Hi all:

Kaplan Lecture notes says that during pregnancy, free T3 and T4 remains unchanged. But UW says during pregnancy, thyroid hormone requirement is increased, can someone please explain why ? is it similar to the reason in cases of HRT for menopaused women that thyroid metabolism increases?

Thank you!
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Old 09-06-2012
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Total T3 and T4 go up because of the increase in TBG but the free T3 and T4 remain unchanged because the excess is bound to the TBG.

All binding proteins go up during pregnancy except albumin which goes down.

Hope this helps!
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Old 09-06-2012
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Quote:
Originally Posted by Dr_Laura View Post
Total T3 and T4 go up because of the increase in TBG but the free T3 and T4 remain unchanged because the excess is bound to the TBG.

All binding proteins go up during pregnancy except albumin which goes down.

Hope this helps!
Thank you for reply, Laura

what you said is like KLN, but UW says we should monitor thyroid hormone and adjust the dose every 4~6 weeks during pregnancy.
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Old 09-06-2012
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Quote:
Originally Posted by chienpolska View Post
Hi all:

Kaplan Lecture notes says that during pregnancy, free T3 and T4 remains unchanged. But UW says during pregnancy, thyroid hormone requirement is increased, can someone please explain why ? is it similar to the reason in cases of HRT for menopaused women that thyroid metabolism increases?

Thank you!
Pregnancy is a hypermetabolic state and a period of growth. Therefore, more thyroid hormone is required (and produced) hence the increased total thyroid hormone but the free T3 and T4 remains unchanged due to the increase in TBG.

The hypermetabolic state of pregnancy can mimic the symptoms seen in hyperthyroidism.
Therefore, you need to monitor them for hyperthyroidism.
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