6 weeks pregnant - TSH 8.4?

Good Morning,

Not asking for strict medical opinion, but more a question of whether anyone with similarr experience to our situation would suggest we seek alternate medical advice?

My wife has had hypothyroidism since birth, and prior to falling pregnant had a TSH of 2.9 as of May. A little over a week ago we found out she was pregnant, so under her mother's advice she went to see her GP to get her thyroid levels re-checked. Her GP was very reluctant to retest as she had so recently been tested but my wife insisted it be checked. Her results came back yesterday with a TSH of 8.4, and her GP has now upped her dose to 150 micrograms of levothyroxin from a previous dose of 125 micrograms, and for her to be next checked in 4 to 6 weeks.

Can anybody tell us please :

Whether doctors can gauge a dosage requirement accurately from the change in someone's TSH tests?

Whether this would need confirmation the new dosage is working prior to 4-6 weeks' time?

Whether we should possibly be seeking medical advice from a different GP?

She's already miscarried once in the past 12 months, and we're very worried about this happening again. Please, tell us if we sound like we're flapping without reasonable cause, or whether (were you in this situation) you'd seek alternate medical advice?

Thank you for reading this

A flapping father-to-be.

3 Replies

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  • Hi Vince,

    Congratulations on the pregnancy! I'm so sorry to hear of your wife's miscarriage and can really understand your concern this time. I don't blame you for flapping, I think I would be too.

    There is a lot of new information out now about thyroid levels in pregnancy and it is clear that it is really important to get thyroid levels closely monitored and optimised during pregnancy. Your wife will need her free T4 (FT4) tested as well as TSH during pregnancy and there are specific reference ranges for each trimester of pregnancy. It takes 6 weeks for TSH to fully change following a dose change so retesting is not usually done before then.

    Your wife's TSH is well above normal range (usually around 0.5 to 4.5ish but this varies around the country). I think if it was me I would ask her doctor to consider upping her thyroxine again in view of the latest guideines or get a second opinion.

    I recently replied to another member, Bellini, on here about this and I think the links I gave her would be very useful to you too. If you look at my profile you will see links to all my answers and a direct link to the main answer is thyroiduk.healthunlocked.co...

    Also see

    acb.org.uk/docs/TFTguidelin... UK Guidelines for the Use of Thyroid Function Tests pages 39 and 40

    tinyurl.com/yyodja a study into the TSH of 65000 people.

    Many of us with hypothyroidism find it useful to keep a record of our thyroid levels together with the reference ranges in order to get optimal treatment. It can be a useful record.

    If you need any more information please just ask & do let us know how you get on.

    Good luck!

  • You most definitely are not flapping without reasonable cause!

    In your situation, I would be printing all the relevant info I could find, to take to the GP. Often, it's not that GPs don't want to do what's best, simply that they actually don't know what it is they should be doing!

    Here's a link to a very recent article that's worth reading and adding to your stack of info.

    THYROID HORMONE REPLACEMENT IN PREGNANCY

    Adding two additional tablets of levothyroxine per week, when instituted immediately upon confirmation of pregnancy to women with known hypothyroidism significantly reduces the risk of maternal hypothyroidism throughout pregnancy.

    thyroid.org/professionals/p...

  • Barbara/RedApple

    Sorry for the time taken in writing this, but thank you both so so much. We've arranged an appointment with another GP at the same practice, have printed out a rather intimidating amount of information (much of which was referenced by your good selves), and after a bit of fun with a highlighting pen, we'll be off to see whether we can get this sorted.

    We will keep this thread up to date.

    Thank you once again, I can't overstate how helpful you have been.

    Vince

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