Pregnant, what is the right dose of Levo for my TSH level?

[HelenG1985]

Hello

I have an underactive thyriod to which I am taking 50 micrograms Levothyroxine. When I found out I was pregnant, my TSH was 2.5, my GP didn't change the dose, 4 weeks later (now; 8 weeks pregnant) TSH is 3.4, and FT4 is 18. My question is; should my GP adjust the dose of the levo to a higher dose, to stay in the range between 1-2 TSH, the ideal range for pregnancy? I really need an answer on this please, as I am so scared to loose the baby..

Thank you.

[SeasideSusie Remembering]

I believe TSH should be below 2 or 2.5. If Clutter is around I think she has information and links about this which you can discuss with your GP.

[HelenG1985 in reply to SeasideSusie]

Thank you Susie, I am just so scared that it is too late to change the dose..

[Clutter]

HelenG1985,

I would increase your dose to 75mcg as TSH >3.0 increases the risk of miscarriage.

The TSH of women planning conception should be in the low-normal range 0.4 - 2.5. When preg-nancy 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

[HelenG1985 in reply to Clutter]

so do you think it is too late to increase the dose? four weeks ago when I tested it was 2.5 and the GP said to stay on 50 micrograms Levo. Now 4 weeks later, I know I have to increase it, but is it too late? I am so scared

[Clutter in reply to HelenG1985]

HelenG1985,

You've not miscarried so it's not too late Show your GP the the documents I linked to above.

[HelenG1985 in reply to Clutter]

Thanks a lot Clutter! you are a star *

[Clutter in reply to HelenG1985]

HelenG1985,

You can either cut 50mcg tablet in half to take 75mcg daily or take 50mcg/100mcg alternate days which will average 75mcg. I'd start today and not wait until you get a GP appointment.

[HelenG1985 in reply to Clutter]

I was also saying so to myself, thank you again Clutter x

[SlowDragon Administrator]

Yes, make an appointment to see GP

Dose should be increased to keep TSH under 2.5 as per NiCE guidelines

See page 3

gp-update.co.uk/Latest-Upda...

[HelenG1985 in reply to SlowDragon]

thank you - will do..

[Greybeard]

As one of the reasons to increase dose is to prevent miscarrage, it is not too late as you are still pregnant. Good luck. cks.nice.org.uk/hypothyroid...

Print it off and insert it into doctor.

[HelenG1985 in reply to Greybeard]

Thank you a lot Greybeard63 - it is very reassuring x

[SeasideSusie Remembering in reply to Greybeard]

"Print it off and insert it into doctor."

There's a few things I'd like to insert into the doctors at my surgery

[Marz]

Have you also had B12 - VitD - Ferritin and Folate tested. VitD needs to be around 100 and can help to ensure the health of your baby as it grows up I have read. Protects the immune system.

B12 is also very important and if the Mother is too low it can impact the mental abilities of the newborn. Folate/Folic Acid you probably know about now and it works with B12 in the body so it should be mid range - Ferritin too ( stored iron )

Hope all goes well .... Mother Nature is great at taking care of things so try not to worry as this special time ....

[HelenG1985 in reply to Marz]

Hi Marz, thank you for your reply. This is the third time I try to reply, so I hope you can see it. I've been taking B complex and D3 for months before conception and then I switched to Pregnancare vitamins mix that has ferritin and iron in it. So hopefully that will be OK. Thank you for your kind reassurance. Hope all goes well for you too x

[HelenG1985]

Hello all, I just would like to thank you all for your support and reassurance yesterday. You have given me hope and information when I most needed them.

My GP has agreed to adjust the dose to 75 micro-grams. She said they didn't raise it previously -4 week ago- because my FT4 was 21, which couldn't take any raise. So now things are making sense.

Again, thanks a million for your support. I am so lucky to have found this website.

My best wishes to you all. Helen xx

[Muffy]

In one word 'yes' your doctor should adjust your TSH levels to below 2.