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 Thyroid question  

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A pregnant women in her second trimester complains of heat intolerance and palpitatons. Physical examination reveals a slightly enlarged non-tender thyroid gland and a normal cardiac exam. The serum thyroxine (T4) is increased, however the serum Thyriod stimulating hormone (TSH) is normal. Which of the following explains the normal laboratory findings in this patient

A. Decreased estrogen

B. Increased free thyroxine

C. Increased progesterone

D. Increased tri-iodthyronine

E. Increased thyroid binding globulin.

PLease give explainations as to why the choice you picked is right and other choices are wrong. Thank you.


serum TSH normal means thryoid fucntioining is normal matter wht the total T4 level might in this case the free T4 must be normal!
in pregnancy hig estrogens inc. blood levels of binding globulins which inc. the total count.

answer is E. Increased thyroid binding globulin


The answer is right. E .Would anyboby like to elaborate further details? What about palpitations and heat intolerance?


In pregnancy, level of HCG, struturally similar to TSH, is high. It can cause a little increase in Thyroxin & cause palpitation & little heat intolerance.This is physiologically normal.


oh tht's kool!

i never realized tht being structurally similar they may mimic eachother's efects at high level!

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