Pregnancy with TSH level 2.71

[Anna_Ko]

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!

[Heloise]

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?

stopthethyroidmadness.com/u... stopthethyroidmadness.com/p...

[Clutter]

Anna_Ko,

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 thyroiduk.org.uk/tuk/about_... Email [e-mail] 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. 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 to the ATA First Trimester TSH levels between 2.5 and 5.0 are associated with in-creased pregnancy loss

thyroid.org/patient-thyroid...