Hello. My Wife Is 8 Month Pregnant. Her Mum Is

Posted on Mon, 18 Mar 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 18 Mar 2019 Answered on

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Question : Hello. My wife is 8 month pregnant. Her mum is a doctor. She has been taking blood tests since the start of the pregnancy. She has always had low thyroid hormone problems in her life and her mother never put her on medication as she felt the drugs were unsafe over the long term. She has been having no supplements during pregnancy either. The hormone levels are at 9 with the lower limit being 10.5 I think. I did not really know about this subject and trusted my wife and her mum (who know much more about medicine) than me. Now however I have read lots of risks about risks of the babies iq/cognitive and brain development due to this untreated low levels of hormone. I am angry that nothing was done but either my wife, her midwife (in France) or her mum (a medical professional) am I right to be concerned? What are the real risks to the baby? Is there anything that we can do to control this now that she is 8 months pregnant. Many thanks. Concerned father

Answered by Dr. Dr. Antoneta Zotaj (1 hour later)

Brief Answer:
TSH is the main index of thyroid function, if this is normal there is nothing to worry

Detailed Answer:
Hi,

Welcome to "Ask a Doctor" service.

I carefully reviewed your query and understand your concerns related to the effects of low thyroid function in pregnancy.

There are a couple of tests that are generally done to check the thyroid function. The most important one is TSH followed by FT4.
It is important for us to know which test are you referring to and which are the units (uploading a test result will be very helpful).

TSH normal range is 0.5-5 mIU/L while FT4 is 0.7-1.9 ng/dl (or 9-24 pmol/L). These values might vary a little in different labs.

By what you explain if the level is 9 while the lowest is 10.5 very likely you are not referring to TSH which is the main hormone that indicates the thyroid function. If TSH is normal, no matter how much FT4 is, it generally does not affect the baby.

So to conclude:
- It would be best if you could upload the blood test results to better understand which indexes are not normal and how important this is
- If TSH is normal (in pregnant women it should be less then 3.5 mIU/L) then there is nothing to worry even if the FT4 is slightly reduced.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Antoneta Zotaj (33 minutes later)

Many thanks for your quick and detailed response

To finalise the test results are: (reccomended ranges in brackets)
TSH 2.390 (reccomended range 0.2 to 4.2)
T4L: 10.2 (reccomended range 12.2 - 22.0)
T3L: 4.53 (reccomended range 3.1 - 6.8)

AC anti-thyroglobuline 25 (<115)
AC anti-thyroperoxydase 80 (<34)
Anti corps anti recepters de la TSH <0.3 (<1.75)

Regards,
Ian

Answered by Dr. Dr. Antoneta Zotaj (35 minutes later)

Brief Answer:
Thyroid function is normal, there is no risk for the baby from the thyroid

Detailed Answer:
Hi Ian,

Thank you for the lab results.
As can be seen TSH and FT4 are within the normal range so your wife does not have thyroid function problems and there is no chance that the baby will have problems due to thyroid hormones.

The only abnormal test is AC anti-thyroperoxidase, this is an antibody that is generally produced and may "attack" the thyroid in the future, so this means that your wife is at risk to develop low thyroid in the future (but has not developed it yet). She will need to check her TSH every year to make sure she diagnoses low function early if it happens.

So to conclude:
- the thyroid function of your wife is normal at the moment and the baby is not likely to have problems related to this
- your wife might in the future develop thyroid problems due to high antibodies, so she might need to check her TSH every year to diagnose it early and treat it( take oral thyroid hormones) in case it happens.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Antoneta Zotaj (27 minutes later)

Many thanks again,

Is the T4L: 10.2 (reccomended range 12.2 - 22.0), as it is below the 10.2 nothing to be concerned about. As she is in the third trimester I think this can sometimes be a bit below the normal range,

Many thanks,
Ian

Answered by Dr. Dr. Antoneta Zotaj (22 minutes later)

Brief Answer:
T4L is pretty close to normal range, still not a problem for the baby

Detailed Answer:
Hi,

T4L is the same test that I called FT4 previously. Some labs consider normal value 9-24 so her value is pretty close to lower limits but is not very low. On the other hand as I already mentioned above the main index of the thyroid function is the TSH hormone and when TSH is normal we do not worry much about FT4, especially if it is so close to the normal range.
FT4 shows the thyroid hormone level at one time, TSH shows the thyroid function in average for longer times so it is more reliable.

I would like to reassure you that there is nothing to worry and that the baby is not at risk from the thyroid function of the mother.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D