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Risk of RADIOACTIVE IODINE for GRAVE'S DISEASE In pregnancy.

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Hello, I am 4 weeks and 2 days pregnant. I had Grave's Disease as a teenager and took radioactive iodine to treat the problem. I've been on Synthroid for almost 20 years. My first OB/GYN visit is scheduled in 18 days, so I'll be 6 weeks and 6 days pregnant then. My GP does thyroid lab work for me annually, but plans to let the OB/GYN take care of it during the pregnancy. I'll insist that my TSH is checked during the first visit. Can I wait until I'm almost 7 weeks pregnant to get my TSH tested (my OB/GYN says I can, but I want a second opinion from an endocrinologist)? My TSH and FT3 and FT4 levels were tested about 3 weeks ago and were 0.28 uIU/mL (TSH), 2.82 pg/mL (FT3), and 1.31 ng/mL (FT4), so my doctor lowered my Synthroid dose from 137 mcg to 125 mcg. I've had a miscarriage in the past and have a fear that by waiting until 7 weeks pregnant to check my thyroid levels that I'll have another miscarriage. Thank you.

Category: Endocrinologist

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Dr. J Muthukrishnan
Category: Diabetologist
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 20 Doctors Online

Expert:  Dr. J Muthukrishnan
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Hello,
Thank you for your query at DoctorSpring.com
As you have recently checked TSh, I suggest you can wait but don't reduce the dose. Instead take 150mcg and check after 4wks. Target your TSH to less thn 2.5. Also, if possible check your TSH RAb done. This will give the risk of relapse or hyperthyroidism in the baby.
Feel free to discuss further,
Regards.

Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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