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What Does My Thyroid Test Report Indicate?

Posted on Fri, 3 Jul 2015

Question: Dr, I am on 10th Week Pregnancy ( Post IUI), currently on following Medicines-
A} Thyrox 75 Daily empty stomach
B} Dupashton 10 mg twice daily
C} Lutigen Gold 5000 IU Injections twice a week
D} Folvite Tablet once daily
E} ASA 50 mg once daily
F} Doxinate twice daily
On 15th May my USG TVS Showed Average Gestation Period of 8 Weeks 3 days With Foetal Heart Rate
168 b/m.
On 30th May I did a check up for TSH Profile and Gulcose Fasting results are as follows-
Plasma Gulcose Fasting- 100 mg/dL
T3 = 0.70
T4 = 6.8
TSH = 6.5

Is my this level of TSH a cause of concern & what precautions should i take to bring down my level of TSH? Since my Gulcose Level is almost near border line but i feel very thirsty during this summer days, what are the drinks that i can safely with regard to my gulcose level? My Gynao has told me to continue Duphaston 10 mg twice daily till 14th Week & Inj. Lutigen Gold 5000 IU till 12th Week? is that ok and would it help to support foetus?

Answered by Dr. Mahesh Koregol (2 hours later)

Brief Answer:
increase thyrox

Detailed Answer:
Hi,

Following is my reply

1. Please raise thyrox to 100 from 75.

2. You can drink water, butter milk, coconut water etc..

3. Lutigen gold and Duphaston won't harm fetus. Can be continued. They are not necessarily though

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (14 hours later)

Dr,
Can you please explain me the role of Duphaston Tablets & HCG Injections like the one Lutigen Gold 5000 IU, in the first trimester of Pregnancy? After 48 hours my taking these Injection i becomes very weak and severe headache that reduces after some time, is that normal after taking these injection?

Answered by Dr. Mahesh Koregol (6 minutes later)

Brief Answer:
It is common to feel weakness and giddiness

Detailed Answer:
Hi,

Duphaston contains progesterone hormones and Lutigen gold contains hCG. Both of these help in supporting pregnancy.

It is common to have headache due to flushing after taking these. Since you are already in 10th week of pregnancy, it is safe to stop these medicines now.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (31 hours later)

Dr, My gynao has advice me today for NT Scan and Double Test. I understand Double Test is a blood test. Can you please tell me normal reference range for NT Scan and also for Double Test. Are both of these test safe for my fetus?

Answered by Dr. Mahesh Koregol (9 hours later)

Brief Answer:
Risk ratio is calculated

Detailed Answer:
Hi,

These tests are safe and necessary. Please get them done.

Reference range is calculated after comparing with ultrasound scan and it states only the risk ratio and not a reference value.

Let me know the report so that I can interprit it for you.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (9 days later)

Respected Dr. ,
As per attached report of my NT Scan & Double Marker Test, kindly clarify me the following points-

1} Blood Test Report Shows Screen Positive Cut off With Trisomy 21 (Down) 1:250 and Trisomy 18/13 1:100. Does this indicate my baby has a risk of Down Syndrome?

2}My HCG, Free Beta is hight @ 82.10, whereas PAPP-A is only 1.42, Is my HCG high because of Lutigen Gold 5000 IU Injections which I am taking as adviced by my Dr, the last injection i would be taking is tomorrow on 11.06.2015. IS PAPP-A Levels normal as in 11th Week Pregnancy when the test was done?

3} Nasal Bone is unknown as per ultrasound result of 11th Week Pregnancy- is it normal at this time? If Nasal Bone is not visible even on 20th Week Scan do i have to take Calcium Supplements? Or should i start intake of Calcium Supplements from now onwards only?

4} I understand my Nuchal Thickness (NT) is 1.38mm which is very much in normal range, but why my scan giving Impression of Average Gestational Maturity of 11 Weeks & 5 days at P.O.A of 11 Weeks & 3 days. Why this 2 days difference in POA and Average Gestational Maturity?

5} Dr. XXXXXXX i trust you fully and hope to get a XXXXXXX and bold answer from your side whatever the truth may be, me very much concerned and worried about Nasal bone not seen in scan as of now and Low PAPP-A, kindly guide me for the same and tell me calcium supplements name which i can take for Nasal Bone.

3 Reports are attached herewith for your reference.

Answered by Dr. Mahesh Koregol (4 hours later)

Brief Answer:
Need second opinion ultrasound scan

Detailed Answer:
Hi,

I saw the reports attached. Following is my reply:

1) Blood report alone is not indicative of any disease as it needs to be combined with ultrasound scan report.

2)Your PAPP-A is normal. free beta hCG is marginally high ( one of the reasons could be due to Inj. hCG you are taking which is not required anymore) which is not significant alone without comparing with ultrasound scan.

3) If you see combined value with ultrasound scan report, this looks perfectly normal. The risk of any of the trisomies is not high and is normal.

4) Nasal bone should have been seen by now. I think doctor performing ultrasound scan has not concentrated on the nasal bone. Hence I suggest repeat ultrasound scan in one of the best centres in XXXXXXX and request them for locating nasal bone which should be normal. Present doctor has probably not tried finding it.

5) No need to start calcium so soon as it wont make difference in nasal bone formation.

6) One week of difference is acceptable in ultrasound scan at this gestational age. It is normal to have 2 days difference. NT is normal.

7) All you need is another ultrasound scan from another centre. Nothing else is required and there is o reason to worry about any abnormalities. Dont take anymore hCG injections.

Let me know if you need any more help.

Regards,
Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (13 minutes later)

Thanks a lot Dr. XXXXXXX for your reply. I would request my doctor to look for nasal bone when i go for a scan next week, my doctor does a normal scan in his clinic every time I visit for check up purpose, hope by my request he would be able to trace nasal bone, do u advice me to wait for 20th week anamoly scan in which i would be able to see nasal bone?

Dr. at times i feel very feverish and body pain so i take Calpol 650 on SOS, hope this is ok?

Sometimes I am unable to sleep at night, for that can I take Alzolam 0.5, or say restyl 0.5 pills?

Answered by Dr. Mahesh Koregol (51 minutes later)

Brief Answer:
Avoid alzolam

Detailed Answer:
Hi,

Get second opinion scan from a different doctor.

You dont have to wait till 20th week for seeing nasal bone.

Dont take dolo 650 unnecessarily. Avoid alzolam as it is harmful for baby.

You can directly contact me by pasting following link in your browser next time:

http://bit.ly/askdrmaheshkoregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (17 hours later)

Dr,

I really trust you a lot and your reviews are very much helpful for me. I would be consulting my doctor next week and would ask him for nasal bone unknown report, meanwhile since me very impatient can you please tell me is Nasal Bone Unknown on 12th Week NT Scan a cause of concern/worry? Some patients do see there baby's nasal bone in anamoly scan at 20th week? is this true? Even if my doctor is unable to see nasal bone this time what are treatment available for that? How would my baby be affected by unknown Nasal Bone as of now?

I have stopped taking Lutigen Gold 5000 IU Injections but me taking Duphaston 10 mg twice daily along with Folvite once a day and ASA 50 mg once a day.

Me really worried about not tracing nasal bone in the scan? Please tell me what can be the reasons for the same and what further treatment can be done so that it is seen.

Answered by Dr. Mahesh Koregol (1 hour later)

Brief Answer:
Nasal bone needs to be seen

Detailed Answer:
Hi,

Nasal bone should be seen by 12 weeks if not there is possibility of abnormality. That is the reason i requested for a second opinion.

Your doctor might have missed it or not trained enough to locate it. Please get tested by another doctor.

You can continue tablets you have mentioned.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mahesh Koregol (9 hours later)

Dr,
As advised by you i would go for another scan of mine within a couple of days. Meanwhile can you please tell me how different is normal pregnancy from IUI pregnancy which is of mine? what extra precautions should i take care of mine?
Some says till 12th week its very risky and have to be careful and some says miscarriage risk is till till 20th week? which one is correct? at times me worried about thinking all this? As said by you Nasal Bone should be seen by 12 weeks, suppose if it is not seen in my case what medicines are there for making it visible in 20th week scan? Have heard sometimes Nasal Bone is not seen during whole pregnancy but still patient delivers a healthy baby- is it true?

Answered by Dr. Mahesh Koregol (10 hours later)

Brief Answer:
No difference between IUI and natural pregnancy

Detailed Answer:
Hi,

There is no difference between IUI pregnancy and natural pregnancy. Hence no additional precautions are required.

Miscarriage can happen anytime but more possibilities till 12th week.

No medicines are capable of bringing up nasal bone. If nasal bone is not seen, amniocentesis might be needed to check for abnormalities.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar