Thyroid level pregnancy

[Natalie2900]

Hi everyone!

So I've had a real nightmare with my TSH level during my pregnancy. Trying to make it low as it should be first trimester was 1.7 shot up to 15 then went back down.

My level is now at 0.1/0.7 ( can't remember oops )
Just wondered can anybody tell me what there level was in the second trimester? Is my level ok? I've checked online and says it is, my doctor said to take 200mg one day and 175mg the next to reduce it a little.

Anyway what was your TSH level in the second trimester ? Xxx

[JCleRoux]

No answers but watching with interest as I have the same problems. My TSH was high and am on thyroxine. Curious about what it should be in the second trimester too.

[Natalie2900]

www.thyroiduk.org.uk/tuk/guidelines/Lothian%20Guidance%20for%20Diagnosis%20and%20Management%20of%20thyroid%20function%20in%20pregnancy.pdf

This website is the guidelines my midwife uses. My doctor is so uneducated in thyroid which makes me so nervous! I'm just below what this guideline says so I'm just wondering how bad is it being just below 😩

[Natalie2900]

What was your tsh level?

[JCleRoux]

Mine was 4.0 in October last year and 3.9 in April. I'm on 25mg thyroxine and getting retested on Tuesday.

[GenerationEx]

I kept mine around 1 for 1st trimester and varied between 1 and 2 for the rest of pregnancy. It felt a little high for my usual, but I wanted to err on the side of hyper as it is safer. Post pregnancy I am keeping around 2 as around 1 feels a bit hyper for me. Just get tested very regularly and adjust as you go along. If you keep between 0.4 and 2 you can't go wrong.

[GenerationEx]

Also, you should be able to see the endocrine maternity consultant if you have any issues or just get referred to an endocrinologist by your GP. Be pushy as it is important.

[TinyTickler]

If you have a thyroid problem your pregnancy must be consultant led. Get a referral asap.

My thyroxine was increased by 25mg each trimester.

[user1474526419]

Hi, I'm 27 weeks now, I've been put on 150mg which is what I was on before I was pregnant, I was on 150mg, raised to 175mg then down to 125mg now back on 150mg, they said that they didn't want the baby having to much thyroxine so changed to 150mg, I'm not too good at this level but it's what's best for the baby.
I'm on Levothyroxine as I have no Thyroid due to having Thyroid cancer two years ago.

[TinyTickler]

They 100% do not know what they're talking about and you need to get a referral asap. I Also had my thyroid removed many years ago too and was referred to an endocrine consultant from my first scan who advised it should be increased by 25mg each trimester as creating a baby obviously uses thyroxine.

Please get a referral as soon as you can, and if you get the same advice get a complaint in to your gp.

[user1474526419]

Hi, I'm under a endocrine, my gp put my on 175mg when I fist told them I was pregnant, my ent consultant put me on 125mg one day then 150mg the next, my endocrine consultant has now put me on 150mg as they don't want the baby having too much thyroxine, I haven't a clue so heavily rely on them

[User3112]

Hi all just thiught I would comment on this post as I had my thyroid removed at 13 and my thyroid levels has played a massive part on my pregnancy conception and pregnancies in general. I took over a year to fall pregnant due to fluctuating thyroid levels they do need to be between 0.5 and 2 and as soon as mine were I fell pregnant. I have had two pregnancies so far. GPs generally don't know much about your theyoid levels so when you get pregnant ask for a blood test around 8 weeks as your levels can fluxtuate. First pregnancy just needed to stay on same amount. 2nd pregnancy my tsh at 9 weeks was 5.7 which is too high so did 4 weeks at an increased dose of 125mg to 150mg and retested 4 weeks later and down to 1.7 much better and all still OK currently 15 weeks. In my experience it's best to ring you GP at 8 weeks and say midwife asked for thyroid blood test. Then Probs again at 16 weeks xx

[MariaDingbat]

Another vote for getting a referral to an endo asap! Even if you can get one just to review your bloods every 6 weeks or so. I have Hashimotos and was on 125mg prior to pregnancy, upped to 150mg when I got a BFP. My TSH was 0.5 before conceiving and is currently 0.14, which my endo is happy with. My T4 had dropped from 21 to 15 but again they're happy enough with this for now and aren't changing my meds.

[MariaDingbat]

Oh and I'm 23 weeks now and all is well so far.

[TenThousandSpoons0]

Whether you definitely need endo review in pregnancy would depend a little bit on what the cause of hypothyroidism is to start with, (eg treated Graves = needs endo or obs consultant) and also on whether there’s any difficulty in managing it. It’s strange to me that it creates such confusion for the doctors/midwives because it’s usually pretty straightforward!
As a rule of thumb you want to be below about 2.5. If very low then you may be in too much thyroxine - it sounds like you’re just right at the moment.
There’s no harm to baby from “too much thyroxine” - the correct dose is the one that keeps your levels stable. Typically that is about 25% more than your usual dose during pregnancy. There are all sorts of ways to dose To achieve that - alternating days is pretty common.
Usually the thyroxine requirement increases straight away in first trimester and up to about 20ish weeks or so and then plateaus - so most commonly further dose adjustments aren’t needed in the second half of pregnancy. Generally TSH levels should be checked about every 4 weeks but if stable after 24-28 weeks or so then just once later in third trimester. Usually you can go straight back to usual dose once the baby is out and just check levels 6 weeks later.
If you google “American thyroid association pregnancy” you should be able to bring up a very detailed guideline which would answer any specific questions as well (warning -it’s very long!!).