I am currently 4 weeks pregnant. My latest blood test has come back as;
TSH: 2.25miU/L
T4: 13.6pmol/L
My blood test results from 2 months ago prior to being pregnant were;
TSH: 1.69miU/L
T4: 20.8pmol/L
I have found guidelines online that recommend that TSH levels should be below 2.5miU/L and some older ones stating that TSH should be below 2.0miU/L during the 1st trimester of pregnancy.
These same guidelines also state that T4 levels should be on the higher side of the normal range which is currently 12-22 pmol/L
And that it is recommended that patients should have an increase of 25-30% dosage of levothyroxine as soon as 4 weeks pregnant.
So here are my thoughts.. with my TSH being on the higher end of the normal range in pregnancy (or slightly over depending on what guidelines you read) AND my T4 being on the low end of the range.. surely a slight increase in levothyroxine is needed? Especially when comparing my results from pre pregnancy, there's definitely been an increase in demand since pregnancy.
My Dr is very much of the mindset you're below 2.5miU/L so you're fine without having an actual conversation about my concerns. It is giving me anxiety having to wait a month to retest my thyroid levels (which they said was the next step) which will probably have worsened I imagine and gone outside the normal range for pregnancy which increases my chance of miscarriage. (Research has found a correlation between TSH over 2.5miU/L and miscarriage)
I have booked a phone consultation with the Dr to discuss their thoughts but I'm also worried am I over reacting? I feel like I have a reasonable argument for a dosage increase. I think the receptionist thought I was slightly nuts on the phone!
Thank you for any thoughts!!
Written by
NaomiMay
To view profiles and participate in discussions please or .
No, you're not over-reacting, and your GP is very ignorant.
Pregnant or not, no-one should have a TSH over 2. A euthyroid TSH is around 1. And, of course your T4 will have dropped because the baby is taking it, and will continue to take it until its own thyroid is developed and functional.
You don't give a range for the FT4 but it looks low. You need that increase in dose as soon as possible.
Slightly different scenario, but as the grandmother of four babies who miscarried because of undiagnosed hypothyroidism of mother (later diagnosed privately), this is something close to my heart.
This breaks my heart to read this. I feel so angry at how many undiagnosed or poorly treated hypos out there are having unnecessary miscarriages. I have been up a lot in the night worrying about if I'm over or under reacting and have been feeling very alone with these thoughts (poor husband looks confused as anything when I try to explain) I feel so relieved today to read these responses and very empowered for my doctors appt on Tuesday. Thank you so much for your response.
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
You are not nuts - please tell yourself you are being normally concerned. Don't be apologetic - state the research you have told us. All the best for your pregnancy!
Thank you everyone. The Dr still didn't want to increase my dosage by 25mcg. I got very annoyed at this point and demanded they speak and get advice from an endocrinologist as this happened in my last pregnancy. They did this and the endocrinologist agreed I should have an increase. I just can't believe the ignorance of some GPs.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Good luck!
Pregnancy and under active thyroid
Pregnancy, thyroid levels and antibodies
Thyroid Disorder May Mean Tough Pregnancy
Thyroid Levels and Pregnancy
Hypothyroidism and Pregnancy
