Thyroid UK
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Pregnancy with TSH level 2.71

I had a chance to visit endocrinologist abroad and she said I should reduce my TSH level to at least 2.5 (from 2.71 currently) before trying to conceive, to avoid problems with the health of the baby. She said, I can achieve this by increasing my L Thyroxin dose to 125 micrograms (currently I'm taking 100 micrograms). My TSH level used to be much higher in the past. When it dropped to 3.71 around a year ago, my GP said my Thyroid function is normal and I can start trying. I am worried about so big differences in what the two doctors suggest. What is the correct reference level here? If I really need to switch to L Thyroxin 125mg, how do I convince my GP to prescribe it to me, since he is sure my Thyroid function is normal? Many thanks in advance!

2 Replies

Hi Anna, Actually most of us try to get our TSH reduced to about 1.0. I'm afraid it is a battle to get doctors to cooperate. This information may help. Are you in the UK or US?



The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

The TSH of women planning conception 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 endocrinology.

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).

According to the ATA First Trimester TSH levels between 2.5 and 5.0 are associated with in-creased pregnancy loss


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