Subclinical Hypothyroidism

[S0220]

Hi all

Does anybody have any experience of Subclinical Hypothyroidism in pregnancy? Currently 8 weeks pregnant and my bloods have come back to show my thyroid level is very slightly raised. My T4 levels have come back within normal range which I have been told is a good sign.

My GP is going to refer me to the obs and gynae team and they will make a decision about whether I need to be placed on a low dose of thyroid medication, particularly given I am now pregnant.
All other bloods have come back absolutely fine.

Anybody else have any experience of this? Is this something to be worried about? I made the mistake of doing a Google search and have seen things about complications and risks in pregnancy that could be related to hypothyroidism but then other pages say that the evidence is conflicting.

Any reassurance or information would be much appreciated ☺️

Bump ☺️

Hello - I have hypothyroidism and found some doctors really don’t understand what the required levels are for pregnancy. What were your TSH levels? From memory, they should be below 2.5 in the first trimester, and below 3 in the second and third trimester, so if above that then I would push to go on levothyroxine.

What were your actual results?
What is your TSH? NHS guidelines state that tsh should at least be below 2.5 in pregnancy.

If it were me, I'd be pushing hard to go on thyroxine. Inadequately managed Hypothyroidism is very closely linked to miscarriage. Do not let them fob you off.

Do push for a second opinion if they choose not to treat you. Hypothyroidism comes with risks in pregnancy and also will make you feel like utter crap if untreated.

Thank you all for your replies. I just called the doctors back to ask for my exact TSH level. It's 8.53 which really worries me based on what's been said about it being around the 2.5 mark.

Gosh I think finding out the exact level has sent my anxieties soaring even more!

That is way too high for pregnancy. They must start you on thyroxine and refer you to an endocrinologist.

You can tell them to refer to the guidelines from NICE and British Thyroid Foundation.

However, don’t panic! Your level is ok for a non-pregnant person and will likely not cause a problem. But there is an increased risk of loss if they don’t get you medicated. So you must insist.

Let us know how you get on.

@Merryclaire thank you for your advice. The doctor did say she would refer me today and I should hear back within 24-48 hours and more than likely I will be put on a low dosage of the medication.

Do you know if given medication, will this likely be life long or just precautionary given that I am pregnant?

Goodness your TSH is sky high.

Demand treatment for that OP. I cannot believe a doctor let you walk out of their clinic with a TSH like that. Never mind whilst pregnant.

@S0220 Hi, my TSH was 9 at 8 weeks pregnant and I was being managed by the recurrent miscarriage clinic at the time, they specifically told me not to panic as it was no where near the worst they had seen and started me on 75mg of levothyroxin which I’ve had to take throughout pregnancy I suspect they will do the same for you! Please don’t panic, I’m now almost 39 weeks pregnant and everything with baby is normal so far!

Are you symptomatic? 8.53 is too high for anyone.

Hypothyroidism can be temporary but you will only know after your baby is born.

Head over to the thyroid forum on healthunlocked.com they're so knowledgeable and SO helpful.

My TSH shot up a bit in 1st trimester, so this may be the case for you. I think it’s because the baby is using your thyroid, then when they develop their own it should settle down a bit.

It’s not unheard of to develop a long term thyroid condition during pregnancy, but chances are you won’t need thyroxine long term unless you struggle with symptoms or are trying to conceive again.

Is it just the referral coming through in the next 2 days or a decision on whether to medicate? If the former then I would press them as you could be waiting weeks.

The good news is that if your TSH is below 10, then it is unlikely to cause long term problems for the baby. However, as pointed out it is still linked to miscarriage and stillbirth so while I’m sure you’ll be fine, you need to mitigate that risk and get started on thyroxine ASAP.

With some doctors you do need to push (or speak to a different GP) as they are often following regular guidelines and not pregnancy specific ones.

Hi OP,

I wouldnt worry too much. O&G are quick at responding and if they are not your midwife can grt you into medical disorders clinic.

Try not to panic even if you were on levothyroxine from today it takes around 6 weeks to become therapeutic and make a difference to your TSH. Its not such an acute issue to worry about.

I had subclinical in oregnancy 1 and by the time of 2 on levothyroxine and it didnt really make much difference to my pregnancy journey... more growth scans is all.

Best of luck

Anything over 4 isn't subclinical I don't think? So your GP sounds a bit clueless. Like others said, you need to be started on levothyroxine asap and be referred to an endocrinologist.

Thank you all so much for your replies and advice. As far as I'm aware, I should hear back in the next two days and I will most definitely push to be put on medication. The GP did advise that this will most likely be the case. I want the medication!!! Anything that will reduce the chances of any complications or risks.

Really hoping it'll be okay but I will be sure to keep you all updated ☺️

Thank you all again x

Hi OP, I know this is an old thread but I was wondering if you could please let us know how you got on? I'm in a similar situation x

Hi @bookworm100!

So I was put on Levothyroxine during pregnancy, started off on 50mg but now upped to 75mg.
Had quite a few additional appointments and blood tests to monitor throughout pregnancy! I'm now 5 months post partum and still on 75mg although may possibly be reducing after my next blood test.

To be honest, it made no real difference pregnancy wise. I also was none the wiser as I had no signs or symptoms of any thyroid issues, it's only because my booking bloods picked it up!

Wish you all the best x

Thank you!