Question:
What are metabolic changes occurring during pregnancy leading to hypothyroidism?
Author: H KAnswer:
Increased iodine renal clearance, increased TBG serum, inner ring deiodination of T3 and T4 by placenta, Stimulation by hCG, this causes a downwards shift in the normal range of TSH. TSH assessment based on population trimesters (first: lower range decreased by 0.4 and upper by 0.5, then we have gradual return towards non-pregnant range in second and third trimesters)
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