Pregnancy and tsh confusion

[BumblingBee89]

Hi all,

I am currently 13w4d pregnant. I have been quite anxious about something going wrong but have relaxed a bit now I've had my 12 week scan and all is good!

One thing is worrying me and causing me so much confusion.

The important part of this is is that I've never ever been diagnosed with any sort of thyroid problem. It did once look subclinical but subsequent blood tests were 'in range'.

When I was ttc I had a blood test that showed my tsh was 4.6. The cut off point in the reference range was 6. So it was within range. I spoke to 3 different doctors, 1 of which spoke to a consultant, and I've spoken to the midwife now I am pregnant.

All of the seem completely confused as to why I'm worried.

But I keep reading that a tsh in the higher end of the reference range causes increased risk of miscarriage. When I say this, I just get back 'but you've never been diagnosed with an underactive thyroid?' And I'm told there is absolutely no concern whatsoever and nothing to worry about.

I just really really don't understand it. If I had been diagnosed would a tsh of 4.6 be a problem in pregnancy? Is it just not a problem because I've never had a diagnosis?

I don't feel like I can ask my doctors again because I think they see me as a bit if a worrier, and to be fair I am.

But I just really don't understand it all. Does anyone have any experience of this at all?

Tsh for conception and pregnancy should be less than 2.5
I've been on levothyroxine over 2 years now we went private as gp said I was subclinical and wouldn't prescribe I also have antithyroid antibodies. I wasn't ovulating when my tsh was 4.8 but after starting treatment once it got below 2.0 I did

If I were you I'd request to see a specialist midwife. Good luck x

Thank you Excitement. This is what I've read and heard online, but each doctor and midwife I have spoken to has been completely reassuring, to the point were I've felt a bit silly bringing it up in the first place.

I did ask one of the doctors about a referral to specialist but he just looked at me as though I'd grown an extra head and said that a referral would never be accepted with a tsh that's within range.

I just don't know what to believe. I want to trust the doctors and the midwife but the advice online is so conflicting.

Hi bumbling. I have hypothyroidism and did a lot of research when planning to ttc. The NICE guidelines say your tsh should be under 2.0 to be optimal, but as you say, the "normal" reference range is higher than this (my surgery uses 4.0 actually) and there must be hundreds and hundreds of women who conceive with tsh over 2 with no problems.

(Everyone is different so like a pp some people don't ovulate/can't conceive if the levels aren't right for them, but that obviously doesn't apply to you).

From what I've read the increased mc risk is in the first trimester as the baby gets its tsh from you. After this its own thyroid steps in so at 13 weeks you shouldn't now be at any increased risk.

You should ask to be tested again for yourself though. Ask for your t4 and t3 levels as well as tsh on its own isn't enough to diagnose properly.

Good luck!