Hypothyroidism and planning pregnancy

[ennogh]

Hi everyone,

I have reading up on the need to increase levothyroxine during the first three months of pregnancy. We are going to try to get pregnant soon and I am currently on 100 mcg levothyroxine. My question is, what do you think is the best approach to making sure my medication is right: talk to the GP before or after getting pregnant to see what their approach is? Are there standard approaches for this?

Have you found your GP knew to increase medication or have some decided to raise the medication on their own? Do you get offered regular tests for thyroid? Do they test just TSH or also T3/T4? Do they use the usual reference range for TSH or is it supposed to be lower for pregnancy (mine at my last test was 2.67, so not very low, but within their normal range).

Thanks for the help everyone.

[Jackie]

Hi Well if it was me, I would make sure what my TSH, T4 and Free T3 tests show, important with ranges. Then if FT3 lowish in range and TSH on the high side, in range. Then, I would ask for some T3 in addition to the T4.That is just because you want to be really well. Not ,essential to the pregnancy. Also ,if not sure you are having the correct treatment for you do all the research and pick an endo you would like to see and ask for a referral. All this and loads other things are of course, endo. They would also then do the other thyroid related tests which you do need with thyroid disease( or ask GP to).. I hope that helps.

Best wishes, an exciting time for you.

Jackie

[helvella Administrator Thyroid UK]

Some (many? all?) UK labs do now seem to have specific reference ranges for pregnancy by trimester.

This article is a reasonable start point:

thyroid.about.com/od/hormon...

As it is from the USA, be careful as you read. The ATA guidelines that are linked there are comprehensive.

Talk *** before *** getting pregnant. In my book, most women should have a significantly lower TSH before getting pregnant than you have. That needs to be looked at together with at least FT4 level.

Pregnancy is also one of the few times when there does seem to be broad agreement that appropriate iodine supplementation might be the right thing. Iodine requirements do rise in pregnancy. But be very, very careful and get advice.

Also get the other usual things checked before pregnancy - vitamin B12, folates, iron/ferritin and vitamin D.

If you talk and your GP is helpful, then all is well. If you talk and GP is not so helpful, then you know you need to consider how to handle that (e.g. change GP or make appointments with different GP within practice).

Rod