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Serum and Urinary Levels of Thyroid Hormones in Normal Pregnancy

From the Departments of Endocrinology and Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Abstract

Total serum T₁ concentration rises in parallel with a rise in serum thyroxine-binding globulin (TBG) early in pregnancy and continues to rise until late pregnany when a peak level, about twofold higher than the levels in the non-pregnant state, is reached. It remains elevated in the early postpartum period. A significant elevation in total serum T₃ is seen in the third trimester only, when levels of TBG are highest. Serum T₃, returns to normal range early in the postpartum period. No significant alteration in the urinary excretion of T₃ and T_a is observed in late pregnancy, suggesting thereby that circulating free T₃ and T_a levels remain within the normal limits. Elevated thyroid stimulating hormone levels are seen in early pregnancy and are maintained until the early postpartum period. This may occur in order to maintain higher circulating T₃ and T_a levels. However, in the present knowledge of normal T_a turnover rates throughout pregnancy, a certain degree of insensitivity of the thyroid to TSH cannot be excluded.

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