Question:
In pregnancy, which of the following levels is altered the most?
In pregnancy, which of the following levels is altered the most?
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Rising TBG in pregnancy lifts the bound (total) hormone pool the most.
Updated On: Jun 24, 2026
- Total T3
- Free T3
- Free T4
- TSH
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The Correct Option is A
Solution and Explanation
Step 1: Pregnancy increases thyroxine-binding globulin (TBG) because of high oestrogen, and hCG mildly stimulates the thyroid. The total (bound + free) thyroid hormone levels therefore rise substantially.
Step 2: Because TBG roughly doubles, total T3 and total T4 climb markedly and stay elevated throughout gestation. This makes total T3 the parameter that is altered the most among the options.
Step 3: Free T3 (option b) and free T4 (option c) remain essentially unchanged or within normal limits, since the extra binding protein soaks up the additional hormone but the free fraction is buffered. TSH (option d) only shows a transient early dip from hCG cross-stimulation and returns to normal by the second and third trimesters, so it is not the most altered.
Step 4: Therefore total T3 is the correct answer.
Step 2: Because TBG roughly doubles, total T3 and total T4 climb markedly and stay elevated throughout gestation. This makes total T3 the parameter that is altered the most among the options.
Step 3: Free T3 (option b) and free T4 (option c) remain essentially unchanged or within normal limits, since the extra binding protein soaks up the additional hormone but the free fraction is buffered. TSH (option d) only shows a transient early dip from hCG cross-stimulation and returns to normal by the second and third trimesters, so it is not the most altered.
Step 4: Therefore total T3 is the correct answer.
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