Hi Elaine,

Thanks so much as always for your help.

I have suffered with Graves' disease for the past ten years and have been in remission a couple of times as well as having a few lapses. I was first diagnosed after the birth of my eldest child in 2006. I then had two more children in 2010 and 2012 while the disease was stable. Unfortunately, my antibodies started rising from September last year and I'm currently on medication. I have just found out though that I'm five weeks pregnant and would be very grateful if you could address my concerns.

My lab work is currently as follows
FT3 - 2.83 ( 2.29-4.17)
FT4 - 0.64 ( 0.72-1.52)
TSH 0.66 ( 0.54-4.26)

Two weeks ago it was
FT 3 - 2.91
FT4 - 0.58
TSH - 0.87

Until two weeks ago I was talking 50mg of PTU a day. For the last two weeks I have been taking 50mg every other day.
The only problem is that I just switched to PTU six weeks ago as I was hoping to become pregnant and my liver function ALT rose to 173 two weeks ago and down to 94 today. It seems that my body prefers mercazole so I would like to switch back at some point but don't want the medication to effect the baby.

My first question therefore is whether my dose is appropriate and how long I should stick with PTU.

My second huge concern is the level of antibodies in my system. When I asked my doctor if it was ok to try for a baby I was told that my thyroid function was ok so It should be ok to try. When I saw her today though she expressed concern about my antibody levels.

My antibody levels are TRAb - 47.3 ( -10.0-10.0%)
TSAb:EIA - 411 (0-120)

They seem really high which I know is not a good thing. Could you please let me know how these high levels may effect my pregnancy.

Thank you so much for your help. It really is much appreciated.

Hi,
You're on way too much PTU. You should be on the lowest dose needed to keep FT4 at the high end of the reference range. Levels too low for you can be a big problem for your baby as your hormone must supply the baby's needs for at least the first 11 weeks. ask if you can stop the PTU. Inappropriately high doses also cause a rise in liver enzymes.
Low levels also encourage thyroid antibody production and that's why your TSAb is high. with the right or no medication, your TSI will fall. I have to wonder about your endo as with a dose as high as 50 mg it shouldn't be given ever other day. I can't imagine your needing more than 12.5 mg daily after first stopping PTU for 3-4 days. best, elaine