Thyroid UK
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Correct dose for pregnancy

Hello, I am new and seeking advice. I take 25mcg levo to my hypothyroidism found in 2011, I am also pregnant and worried about miscarrying my baby. My TSH in Nov 2017 was 0.03 (0.2 - 4.2) on 175mcg and it is now 4.60 on 25mcg, I feel very unwell with headaches, pelvic pain, bone pain, fatigue, losing hair. Any advice welcome, thankyou, as to how to proceed

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Jenn1986,

Why was your Levothyroxine reduced from 175mcg to 25mcg and why? Dose adjustments are supposed to be in 25mcg - 50mcg adjustments not swingeing reductions like that.

You are undermedicated and having TSH >3.0 increases the risk of miscarriage. I would increase Levothyroxine dose to 75mcg and retest thyroid levels in 4 weeks.

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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Thankyou it was reduced in October 2017 due to endo not understanding why I had such a low TSH and hypothyroid symptoms. So have I left it too late?

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Jenn1986,

Too late for what?

Endo should know better than to make such large dose reductions. Suppressed TSH doesn't mean you were overmedicated as long as FT3 was within range. I would complain to the head of endocrinology or via the hospital's PALS.

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Its never to late. Go and raise hell with your gp you need more medication asap.

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Jenn ~ try not to worry too much ~ your endo is a complete fool! Please stay on the forum because you will need advice on how to deal with what seems to be an epidemic of sheer madness that is rapidly spreading through the medical profession regarding thyroid disorders. It's not your fault and most of us on here have been subjected to it at some point ~ most of us still are, so you are not alone in this. You will find lots of members to help with vitamins, minerals and blood tests. I hope you will soon feel much better ~ please keep in touch. Warmest wishes Mamapea x

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I think you urgently need to see a different GP who knows about pregnancy and TSH levels.

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Hi Jenn - just wanted to reiterate that you need to see a different doctor who understands about pregnancy and hypothyroidism as it seems absolutely awful that he/she would drop your dose so much ESPECIALLY when you are pregnant! You are only supposed to drop in 25mcg increments and also you need MORE levothyroxine when you are pregnant not less. You need to sort this out quickly before your TSH levels get too high as this can affect the pregnancy. Your TSH level isn't super high yet but you need to sort this out asap. Wishing you the very best.

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