What to do with a TSH of 7.5 in early pregnancy when you are already on 200mcg Levothyroxine

[gagaA]

Hi, im 7 weeks gone and my TSH is 7.5 and my doctor says i should increase my dosage to 300mcg. Who has/had an experience like this please,

[shaws Administrator]

Those who have knowledge will respond. I would like your GP to test your Free T3 and Free T4 as these have to be optimum. It will also indicate whether or not you are converting T4 (levothyroxine) into sufficient T3.

Levothyroxine (T4) is an inactive hormone and it has to convert into T3 the Active hormone needed in all of our receptor cells. Some of us cannot convert effectively and may need T3 added to T4.

I'm not medically qualfied and I think you should have been referred to an Endocrinologist.

I would phone GP and request these two tests and others more knowledgeable than me will also respond. Blood tests always have to be at the very earliest, fasting and allow a gap of 24hours between last dose and test and take afterwards.

[gagaA in reply to shaws]

Okay. Thank you

[shaws Administrator]

This is from TUK which might be helpful too.

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

[shaws Administrator]

This is an excerpt from link below:-

1.1.4. If overt hypothyroidism is diagnosed during pregnancy, thyroid function tests should be normalized as rapidly as possible. The T4 dosage should be titrated to rapidly to reach and thereafter maintain serum TSH concentrations of less than 2.5 U/ml in the first trimester (or 3U/ml in thesecond and third trimesters) or to trimester-specific normal TSH ranges.

tinyurl.com/y8s34gea

[humanbean]

How do you take your Levo? Do you take it first thing in the morning, with water, an hour before eating and drinking (apart from the water)?

It is possible that you are under-medicated. It could be that you aren't absorbing what you take very well. Or it could be both.

I know that it is essential to get your thyroid hormone levels up quickly in pregnancy. But a raise in dose of 100mcg per day might be a hell of a shock to the system all at once. Could you add 25mcg per day for a few days then add another 25mcg? then add another 25mcg etc? It still isn't ideal, but possibly better than sending your heart bonkers and you having to take something to slow your heart down.

What was your TSH before conception? And have you had your thyroid hormone levels measured, before or since conception? In other words, do you know your Free T4 and Free T3? They will give a better idea of how under-dosed you are than the TSH.

[SlowDragon Administrator]

Essential to test vitamin B12, folate, ferritin and vitamin D too. Often we are low in these.

Obviously when pregnant you need good levels of all these, especially folate and B12 for baby's neurological development

Do you have Hashimoto's? Also called autoimmune thyroid disease diagnosed by high thyroid antibodies?