What Do These Following Blood Reports Indicate?

Brief Answer:
Thyroid

Detailed Answer:
Sorry to learn about your wife's thyroid status.

Clearly, she needs a higher dose of thyronorm. The exact dose will be best determined by the treating doctor. Frequent TSH and Total T3 and Total T4 checks will be helpful to rapidly adjust the dose upwards in order to target a TSH of 0.4 to 2.5

Whether or not this will certainly affect the baby is difficult to answer because there is no way to predict how one baby is affected versus another. So in general, a high TSH can lead to some challenges in the child. You can discuss this with your endocrinologist in further detail.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person. So it is good you are already seeing one.

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Brief Answer:
Follow up

Detailed Answer:
1 The TSH may take several weeks to normalize and come down. However, the thyroid hormone levels like T3 and T4 are also helpful during this time to indicate whether thyronorm dose is adequate

2 With normal T3 and T4 , it is likely that baby has started to receive good amounts of thyroid hormone. The goal is to achieve target TSH quickly

3 Thyronorm starts working immediately but takes few weeks to reach steady state in the bloodstream

4 Thyronorm must be taken 60 minutes before breakfast , on empty stomach, with water.

If your wife has been prescribed Iron and calcium supplements, these must be taken at least 4 hours after thyronorm.

There are no other diet or food related restrictions.

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Brief Answer:
Second follow up

Detailed Answer:
1 Testing again in two weeks is a reasonable next step

2 Getting the dose right is a scientific process handled well by the endocrinologist who I am sure will do his best. So stay in regular touch with your Endocrinologist.

3 Treatment was begun as soon as the high TSH was detected. That is the standard of care and best practice to start Thyronorm was followed.

4 After delivery the dose of Thyronorm will likely go down by 33 % to 50%. A repeat TSH and Free T4 after reducing the dose will be needed 6 weeks after delivery

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Brief Answer:
Third follow up

Detailed Answer:
1 Headache and tiredness are not normal for anyone.

2 Thyroxine over-replacement can lead to:

anxiety, emotional lability, weakness, tremor, palpitations, heat intolerance, increased perspiration, and weight loss despite a normal or increased appetite, unexplained weight loss, irregular heart rhythm, muscle weakness, menstrual disorders, osteoporosis, high blood calcium, heart failure, shortness of breath, and a deterioration in sugar control in patients with previously diagnosed diabetes.

3 It can have harmful effects on pregnancy.

Mild over-treatment does not usually cause any problems for a woman or her baby. But severe over-replacement with thyroxine can lead to problems if it isn’t treated. These can include:

●Problems in the mother, such as heart problems or a condition called preeclampsia
●Problems with the pregnancy, such as preterm labor (when labor starts too early) or miscarriage (when a pregnancy ends on its own)

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