Thyroid UK

Hypothyroid during early pregnancy

Hi everyone. I unexpectedly found out I was pregnant recently. My tsh was about 7 at time of conception. I have had a total thyroidectomy a few years ago.

My tsh is now 4 and I am at 6 weeks. I have read that the optimum is below 3.

Is there anyone out there who have had a high tsh during early pregnancy? I have gone on google and researched but nothing is clear. It does mention it can cause low IQ and mental retardation etc which terrifies me. My gp cant advise and basically said I cant give u a solid answer as the baby may be fine.

I have become that anxious about this that I've thought about terminating as I do not think I could cope with a disabled child.

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I think you should ask your GP to refer you to an endocrinologist ASAP or at least discuss your case with one. I think I have read that TSH should be below 2.5

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Thank you. I already asked the GP to do this and she basically fobbed me off by saying oh you will see the endocrinologist during the time you see the midwife. I asked how many weeks and she said about 12 weeks. I thought. I can't wait this long.

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I am on my tablet and can't post links to PDFs but I suggest you Google 'hypothyroidism and pregnancy guidelines' and find some evidence of what needs to be done and present this to your GP. If necessary see a different one because it's important that you are looked after properly. Here is ThyroidUK's page with links regarding this thyroiduk.org.uk/tuk/about_...

I think maybe it's Clutter who knows about this and may have some links and further information.

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healthunlocked.com/search/t...

The above link will take you to earlier posts on this Forum discussing the TSH levels in pregnancy - hopefully you will find something helpful :-)

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Coco-Glitter,

Your TSH is high because the foetus is dependent on your maternal thyroid hormone until 12 weeks and is taking what it needs from you. I would increase dose by 50mcg because having TSH >3 increases the risk of miscarriage. Show your GP the NICE, BTA and ATA statements below.

The TSH of women planning conception and newly pregnant should be in the low-normal range 0.4 - 2.5. When pregnancy is confirmed dose is usually increased by 25-50mcg to ensure good foetal development. NICE also recommends that hypothyroid women planning pregnancy should be referred to en-docrinology. cks.nice.org.uk/hypothyroid...

Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee

13. The serum TSH reference range in pregnancy is 0·4–2·5 mU/l in the first trimester and 0·4–3·0 mU/l in the second and third trimesters or should be based on the trimester-specific reference range for the population if available. These reference ranges should be achieved where possible with appropriate doses of L-T4 preconception and most importantly in the first trimester (1/++0). L-T4/L-T3 combination therapy is not recommended in pregnancy (1/+00).

onlinelibrary.wiley.com/doi...

According the ATA First Trimester TSH levels between 2.5 and 5.0 are associated with increased pregnancy loss

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Thanks everyone. I'm actually stunned at the NICE guidelines. It basically states that an endocrinologist should be contacted right away. I think in the case of abnormal tsh they def should be and a total thyroidectomy. The problem is this pregnancy was very much unplanned. If it had been planned I would have made sure I was at optimum levels.

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Also I've called the GP as per i was told no appointments and I basically demanded. So someone is phoning me tomorrow asap.

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Congratulations! TSH needs to be under 2.5 in first trimster. Also note as others mentioned you need to increase your increase your dosage by 30 - 50 % as soon as you find out you are pregnant. Take a blood test every 2 weeks till TSH is stable and below 2.5.

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It is essential you get seen and on some medication ASAP! See hypothyroidmom.com/ and also look for the book "Your Healthy Pregnancy with Thyroid Disease: A Guide to Fertility, Pregnancy, and Postpartum Wellness" by Dana Trentini

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Thanks everyone for your advice. I don't know if it just where i live (scotland) but even trying to get a gp appointment can take weeks. I don't know how I'd even get bloods every two weeks. They have already been so relaxed about my problems.

So spoke to the gp today. She said no your thyroid is good at 4.1. I pointed her in direction of nice guidelines and she then said oh I'll refer u to endocrine. Which can take two weeks! I'm now 6 weeks 6 days pregnant. For me it's getting a bit late in the day now for me to make a decision. But I do need to think of the risks. Never felt such a heavy heart in my whole life.

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I gave birth 7 days ago to a baby boy that appears to be perfect. Clearly IQ, etc. cannot be measured at 7 days of age. My TSH was 30 (thirty) at 5 weeks gestation. I tortured myself with worry, and was very close to terminating the pregnancy. After much consult with endocrinologists and fetal-maternal specialists here in the US, I decided to keep this baby. Of course there is risk and I will feel responsible if he has a disability, but so far all is well, he is not fussy, and he is beautiful. If I could go back, I would try to remain calm during those weeks, or at the least try to sleep better and eat more. I suspect the worry was more harmful than the thyroid levels. I was told the tiny fetus would likely still have gotten adequate thyroid hormone with a TSH of 30 since it was so early. The remainder of my pregnancy was absolutely ideal. Everything was normal and I felt great. This is my second child and both the pregnancy and these first days have been easier this time. I fully attribute the ease to my improved diet (AIP).

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KimberlyR Congratulations! I am so pleased that things have been positive for you. I am so glad it has all worked out and your baby is healthy. I know how that anguish when your TSH is abnormal actually feels.

To be honest, I think because I have other autoimmune disease and outstanding health issues (osteoporosis, bladder problems and unstable tsh) I think adding that into the mix is entirely what has caused my worries. I am now writing a complaint to the healthboard about how endocrine literally discharged me and dropped me like a bomb the first time my tsh went normal post thyroidectomy. Then wanted nothing to do with me again when the thyroid levels started becoming abnormal and the absorption issues came to light.

I am also starting to feel quite ill with this pregnancy aswell and I think my body is telling me it is struggling.

Sadly I think it has shown how much the health service is strapped and running on such low resources that poor care is seeping into all aspects of the healthcare system.

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Hi coco-glitter, congratulations on becoming pregnant. I can see that you've received some excellent advice here and signposting to the nice guidelines but just to let you know that I saw my fertility specialist today (I'm trying to conceive) and asked whether I needed to see an endo specifically and the Dr told me that providing my TSH was in range it's nothing to worry about.

I also wanted to say that from the research I've done, morning sickness etc. can actually be a really positive sign in pregnancy (the correlation is more sickness, less incidence of miscarriage) as it's related to your hormone levels fluctuating so don't necessarily look at feeling poorly as something to be worried about. I hope that this eases your worry a little before you have your app. and good luck with it all x

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