Thyroid TSH levels in early pregnancy

[ChinChilly]

Hi,

I’ve found out I’m pregnant this week, I had an blood test MOT on 24/2 and my TSH levels came back as 4.1, my GP marked them as normal but obviously I didn’t know I was pregnant at this point.

I’ve seen lots of stuff on Dr. Google which says anything over 2.5 increases your risk of miscarriage, which has sent me into a blind panic. I’m going to call my GP tomorrow but has anyone had an experience of this?

Hi 👋🏼 when I was worried about TSH I looked at my local endocrinology guidelines - on my blood test under my results there was a link and statement saying ‘if this patient is pregnant or planning pregnancy please refer to...’ and the link. The guidelines stated that in the first trimester TSH needs to be 3.7 or under. Not sure if the guidelines are different between locations, but they are most likely created from the NICE guidelines. You will probably be put on medication to bring TSH down if follow up bloods show it’s still raised. Mine actually went down in the first trimester. Before I fell pregnant it was 3.5, then 2.5 after cutting our gluten and dairy, then 2.18 at around 8 weeks x

@MintGreenLife thank you, I’ve tried to have a look for the guidelines for my local endocrinology but I couldn’t find anything, guess I’ll just try call my GP tomorrow

Hi, I’m currently pregnant and in my first trimester my tsh was just under 5 and my midwife referred me to a consultant in endocrinology after my booking in appointment. They advised that the guidelines state tsh should be under 2.5 throughout pregnancy and started me on 50mcg of levothyroxine. I’ve had to have blood tests every 8-12 weeks and I’m now 35 weeks and taking 100mcg a day.

My under active thyroid was only picked up after my 3rd miscarriage yes as you read the numbers should be as shown below. I would definitely contact your GP and ask to be given levothyroxine if they won’t ask to see an endocrinologist they will monitor you throughout your pregnancy. I was started on 25mg which went up to 50mg as soon as I had a positive pregnancy test around the beginning of my third trimester my dose was then put up to 75mg.
First trimester
TSH

Hi op, with my first baby I was unmedicated but had a borderline underactive thyroid which I mentioned to my midwife at my booking in appointment. I was referred to a consultant for testing which came back my TSH was just under 4 so started on 50mg levothyroxine to keep me under TSH of 2.5. I will warn you though, it was an extremely slow process and took until week 18 of pregnancy to start medication. It may be quicker in your trust. I really struggled with exhaustion until this point and felt much better within a week of starting medication.
I'm pregnant with baby number two now and they are testing me every eight weeks. I stayed on medication from my first baby and found the first trimester so much easier being correctly medicated. I would see if your GP is able to help meantime, mine needed a letter from the hospital so I had no choice but to wait.

@ChinChilly definitely give your GP a call. Was it NHS tests that flagged up your TSH? Hopefully GP will take seriously and get some tests sorted for you. Mine did - my TSH was 3.5 before my BFP and they added thyroid tests into my bloods at my booking appointment x

@Cellwen @InTheCovidGarden @Charl1009 thank you all, I’m going to check in my GP.

@MintGreenLife I had a blood test in November past year and my TSH came back as 4.4, I asked for another blood test in Feb and they came back 4.1 both times my GP hasn’t been interessted, I did tell them I was TTC but they weren’t concerned

@ChinChilly I think they go by the usual guidelines for TSH in terms of medicating regardless of whether you are TTC or not, but now you are pregnant I expect they will want to make sure it’s under the upper limit. Let me know how you get on x

@MintGreenLife will do, I’m going to call them in the morning! Thank you 😊

I think it’s normal but on the higher side of normal. Mine are 1.4 after double my dose in early pregnancy.

@Thefaceofboe thank you for replying.

I may not need to call them, I’ve been quite crampy and I’ve had a small amount of brown spotting this afternoon, my tests also look lighter today.

Hi Chinchilly don’t get to disheartened yet sweetheart it could be implantation spotting. I keep a check on my thyroid levels myself as my GP wasn’t interested so I make sure I have bloods every 4 months it should be every 6 month but I’ve had so many miscarriages the last year they’ve been up and down like a yo-yo but 2.4 or below is always my target. My initial readings before medication was 4.8. I was having IVF at the time and even they didn’t pick it up. Keeping my fingers crossed for you hun I’m sure it will be fine xx

0.5-5 is normal

in my first pregnancy they didn't recheck my thyroid or up does at all, in my second i had one test and no higher doses. even treated my TSH is around 3.7 and is considered fine. The T4 level is more important

@Cellwen thank you, it’s so hard when GPs don’t take it seriously. So sorry for your losses 😞

@Pastanred my GP marked mine as normal and said it was fine, i think my T4 was 11.6 if I remember correctly

Your T4 is quite low - mine is 19.8 generally - it needs to be close to the top of the range ideally which is 9-24 so you are on the low side but in theory normal

both wouldn't get you treated with my gp but they're all different i think

@Pastanred my GP already said they wouldn’t treat it when the TSH was higher and the T4 was lower in November last year

i wouldn't worry as many people will have high levels of tsh (but normal in theory) and wouldn't notice

i think the pregnancy tsh levels are the levels for treated hypothyroid patients - given you are not technically hypo you probably don't need to be that low. Given the reference ranges are up to 5, thousands of normal healthy people will be having babies with tsh of 4.5 etc as its not a routine test

@Pastanred thank you for your reassuring words, I don’t have any symptoms of hypo and I would of been non the wiser if I didn’t push for a routine blood test in November last year and repeats in February this year. This is my first hint of a pregnancy which is why I am slightly irrational!

Would personally definitely push to get someone to look at this and consider giving you levothyroxine or if not then clearly explain to you why they don't think it's needed.

I am on levothyroxine 50mg for quite mild hypothyroidism and was told they wanted to keep it below 2.5. I feel better being on it especially as I have had a previous miscarriage. I did have one child before with no problems though while having TSH of around 3.5 to 4.5 as at that time I was told it didn't need medicating. Your levels would likely be ok so don't panic but obviously better to be on the safe side!

Good luck

@ellenpartridge I’m going to give them a call, I’ve got a repeat blood test on 23rd for a vitamin D deficiency (currently being treated) so I’ll ask them to lump in the thyroid test and go from there.

How far along in pregnancy are you op? And did they recommend you double your dose?

@Thefaceofboe very early, around 5 weeks! My thyroid isn’t treated, I noticed on my last blood test and raised it but my GP said it didn’t need treating.

Had more spotting this afternoon, more than yesterday so I’m not feeling confident about this pregnancy. Will just have to wait it out for the next few days

Ah yeah sorry I didn’t read that properly. Fingers crossed for you x

Just a quick update, I had some more bleeding this morning and my tests have turned barely visable now. I’m guessing it could be down to my thyroid but I’m at abit of a loss of what to do because my GP really isn’t interested 😕

Hi hun I’m so sorry to hear this sending big hugs. I had this in my first miscarriage. If I was you I’d go back to your GP explain you think your possible miscarriage could be down to your thyroid level. If they are like my GP they wouldn’t listen either I asked about this continuously during my first three miscarriages it was my NHS IVF doctor who finally took notice and prescribed me the medication. If they don’t listen ask if you can be transferred to an Endocrynologist. My last resort was a private gynaecologist, wish I’d known about him first before we started IVF it turned out we didn’t need IVF at all he could have saved me a lot of heartache. Thinking of you xx