Thyroid Levels and Pregnancy

Is anyone else pregnant?

My TSH went front 2.49 in month 1 to 1.9 in month 2 and now in month 3 it's up to 3.28 (miu/l)

Went to my GP last night on the recommendation of my midwife to ask for a higher dose of thyroxine (currently 75mg) and he said that unless it goes over 4.2 then he won't change me.

Is this right? I asked him if my baby will be ok with fluctuating levels and he said yes.

My baby is the result of 3 years of infertility and 2 goes at IVF so extremely precious and I am being extra careful.

What do you think?

5 Replies

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  • I do hope that someone can help you because the info that your GP has given you doesn't sound good.

    I have just read that in pregnancy an increase in thyroid medication is required. I do remember reading recently that the reason why we are so tired in those first few months of pregnancy is because the baby is taking our thyroxine so this would make sense that we would need an increase whilst pregnant. Could you try to see another GP?

    Please don't worry, hopefully we can help you with this.

    When is your baby due? It is very exciting!

  • Thanks.

    Baby is due the first week of December. I'm seeing my midwife in 2 weeks so will ask her. I'm also seeing a consultant at the end of July so will bring it up with him. My dosage was increased the month before I got pregnant but that time I saw a different doctor. My GP showed me the NHS guidelines - but we all know that's not necessarily up to date information.

    <b>Updated on Jun 10 2010 10:21AM:</b> Thanks for the update Barbara - I have just left a message with my midwife and have emailed the BTF for clarification on my case.

    I'll let you know how I get on.

  • Bellini I have received this today:-

    thyroid.about.com/b/2010/06...

    Please keep us posted.

  • Hi Bellini,

    Congratulations on your pregnancy! :-)

    I think that your GP is not fully up to date. If it was me I would phone your midwife straight away and tell her that your GP has refused to increase your thyroxine. Otherwise, or maybe as well, go back to your GP as soon as possible and show him the following from a GP magazine called Pulse. I've included the weblink to this but you need to register if you want to read it - free and easy to do. This is the latest up to date information about the treatment of pregnancy and has been made for doctors to study as part of their CPD.

    I've also pasted an exerpt from the BTF website below that, some very up to date informationabout pregnancy.

    I hope these help, do let us know how you get on.

    "http://www.pulsetoday.co.uk/story.asp?sectioncode=50&storycode=4126143

    Key questions on thyroid disease (1.5 CPD hours)

    26 May 10

    10 And what about hypothyroidism in pregnant women?

    Untreated maternal hypothyroidism results in neuropsychological damage to the offspring. Patients with hypothyroidism who become pregnant need to have the dose of levothyroxine increased on average by 50µg daily in order to maintain normal serum TSH concentrations.

    The advice to patients with established hypothyroidism is that they should increase their dose of levothyroxine by 25µg daily as soon as pregnancy is confirmed and make an appointment for thyroid function tests to be measured some two weeks later. The aim is to achieve a free T4 concentration of 16-20pmol/l.

    Further measurement of serum free T4 and TSH should be made six weeks later and again in the middle of the second and third trimesters.

    The pre-pregnancy dose of levothyroxine can be restored four weeks after delivery by which time the increased concentrations of thyroxine binding globulin will have returned to normal. It’s not clear whether this meticulous care is necessary and it may well be that any thyroxine therapy in the hypothyroid mother will allow normal foetal development.

    Dr Tony Toft is consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, and a former president of the Royal College of Physicians of Edinburgh and of the British Thyroid Association"

    btf-thyroid.org/

    Pregnancy

    The aim of this project is to get out some important messages that all women with a history of thyroid disease need to know about: 1) increasing the dosage of thyroxine by approximately 25-50 mcg in women with existing hypothyroidism; 2) diagnosis and treatment of postpartum thyroiditis; and 3) the risks to mother and baby if a thyroid disorder is left untreated during pregnancy (miscarriage, pre-eclampsia, and placenta abruptio). The Pregnancy Project group met in February to outline strategies to publicise the message of thyroid disorder and pregnancy.

    We have produced a TiP (Thyroid in Pregnancy) card that we will be giving out at conferences, meetings and mailers.

    This little information card, the size of a credit card, contains brief but clear information about these points. If you would us to send you some TiP cards, so you can pass them on to friends and family, please contact us at pregnancy@btf-thyroid.org. You will be helping us to get our message out. And you can give us your feedback too - send an email to the address above.

    Articles about pregnancy and thyroid have been accepted for publication in two midwifery journals and an article on thyroid, pregnancy and the risks has been accepted for publication in the DoH Children, Families and Maternity e-bulletin. We also highlighted pregnancy and thyroid disorders at the British Endocrine Society conference in March and will be doing so at the Royal College of General Practitioners' conference in October."

  • thanks Suze (sorry my PC doesn't seem to let me respond in the correct place - think it's my work's firewall).

    Anyway, is that the Mary Shomon article? Yes, I got that too.

    Luckily in my 1st trimester my thyroid was low. It's only now it's gone up so I think I'm ok for now. Spoke to a lovely lady at the BTF yesterday and she gave me some more back up to take into my midwife.

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