High tsh

[Kamnak]

Hi I m 6weeks pregnant and my tsh is high 11.8 I m taking 125mg of thyronorm now what should I do to get normal tsh should I increase my dose

[jimh111]

You should be under the care of a doctor and your TSH below 2.5. I would ask to increase your levothyroxine by 50 mcg now.

[EleanorM-G]

Congratulations on your pregnancy!

I have just had my 3rd baby. I self medicated for pregnancy 1 and 2 on NDT (a mix of T4 and T3.) and extra T3. During pregnancy 3, I was persuaded by my consultant to change to T4 only. (Levo.) I am now 8mths post pregnancy, and self medicating as before.

When you find out that you are pregnant, then increase your Levo/thyroxinne (T4) by 30%, straight away. The demand increases as soon as 4-6 wks into pregnancy and we are trying to avoid miss carriage/brain damage to the baby. Then go to your GP and make sure they know you need blood tests every 4weeks until 20weeks. (In the meantime, your GP should refer you to a consultant, but often you don't get an appointment with them till about 12wks....) The results of these tests, will likely show that you need further increases. (Don’t increase without the blood tests to tell you how much you need.) Your blood tests need to include T3 results. If your GP won’t do this, get private testing done through “Blue Horizon.” As always, get copies of all your blood tests, and post on here for advice. Do not accept your GP telling you that you are “normal” or “within range” as very few of them know what is healthy for pregnancy. (or otherwise!) At 20 wks, the demands usually plateau and you will need tests/increases less often. (The book tells you how often.)

If like me, you take NDT (T4 and T3) rather than Levo/thyroxine (T4) then the instructions for increasing are not as straight forward, but can and must be done. To get advice, I emailed Lyn Mynott who began Thyroiduk: [e-mail]. I put “Pregnancy Guidelines” in the subject line and she asked a doctor for me. He advised that I follow the instructions for increasing levo, but that I shouldn’t increase T3 at the same rate as increasing T4. (This was easy for me, because I take NDT plus extra T3.) You will read some articles saying that you shouldn’t take T3 in pregnancy as it crosses the placenta and some saying its fine-you will need to do your own research.)

Check out the website, hyperthyroidmom.com. It has lots of great articles, (I have included some thyroid/pregnancy articles at the bottom) and advice you can take to your GP. (You GP will know very little about the thyroid in pregnancy, so it is very important for you to get as knowledgeable as you can.) Buy the book “Your Healthy Pregnancy with Thyroid Disease”, by Dana Trentini & Mary Shoman.

The book I mentioned above, gives this advice about the TSH levels you need to have to have a healthy pregnancy. This is really helpful to take to your doctor.

First trimester: less than 2.5 with a range of 0.1-2.5

Second trimester: 0.2-3.0

Third trimester: 0.3-3.0.

TSH should be monitored every 4 weeks during the first 20 weeks of gestation, then once again between 26 and 32 weeks

If you are on NDT (Ie. Taking T3, your TSH should will be almost 0 with a low T4 in pregnancy (and non pregnancy)

Keep an eye on your B12 levels, as pregnancy places a high demand on these and people with an underactive thyroid are usually deficient to begin with. (You can’t overdose on B12, anything you don’t need you will pee out. A bit of a waste of money, but not dangerous!) Also your folate, ferritin and vit D.

Some articles, you may like to read:

thyroid.org/professionals/e...

cks.nice.org.uk/hypothyroid...

cks.nice.org.uk/hypothyroid...

hypothyroidmom.com/what-eve...

dl.dropboxusercontent.com/u...

thyroiduk.org.uk/tuk/about_...

thyroid-info.com/articles/p...

healthunlocked.com/thyroidu...

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum

online.liebertpub.com/doi/p...

Ps. I have 3 beautiful, healthy children!