High TSH in pregnancy

[Lavenderrose92]

i’m 4.5 weeks pregnant and my TSH is 7.5, i am on levo and have a appt with GP this afternoon to discuss increasing my dose due to pregnancy.
I am aware the aim is below 2.5 and increase ranges can cause miscarriage.
my tsh was 1.75 6 weeks ago so it hasn’t been raised for long.

has anyone had successful pregnancy with high TSH?

High TSH would suggest an underactive thyroid that may require an increased levo dose whilst baby’s thyroid develops.

yeah i’m aware of that. I was asking if anyone had any success stories.

I understand your post, my point was that it would be treated - and therefore your TSH would come down and would not be high.

I was always told on getting a positive test to immediately increase dose by 25 micrograms a day and have a TSH blood test

I had the same advice. GP was momumentally useless on this front. I always had to somewhat manage myself and push for blood tests ect. My TSH was briefly around 6 during first tri and all was well however

Same as the above, I immediately doubled my levo as I'm pretty sure my first miscarriage was due to unmanaged TSH. I am pregnant now and haven't been on levo for a while but have dug and old pack out and taken 25mg today just in case! If you've got enough medication, I'd just double it, it can be managed really quickly I've found in the past. I also found GPs useless tbh.

You've actually made me wonder what mine is, I was around 2 a few weeks ago but it could have shot up. You can get TSH tested at booking in appt but I wouldn't wait to increase dose until then.

OP, good to get it sorted out but try not to worry too much, I’ve looked after loads of ladies in your situation and everything has been fine. In general you want to increase your total weekly dose by about 30% and then recheck levels in about 4 weeks, once stable <2.5 then check each trimester.
(so add up your total dosing for the week, multiply by 0.3 and that’s the amount you need to increase - you can spread it over the week eg 100mcg weekdays, 150 weekends, or whatever works to get to the total dose).
congratulations on your pregnancy

Did the gp increase? If not, I’d start taking the additional 25mcg yourself as that’s the recommendation and see someone else armed with the guidelines. You probably need a bigger increase than 25 if your TSH is that high.

I didn’t have mine checked pre-pregnancy. The last time I had it checked it was 2.48 in 2022 after I had a miscarriage. I had it tested but it was an ok level then.

Mine was picked up by accident at 18 weeks by the gp when I was feeling very tired. I only wanted an iron level check. It was 4.6, it then took the gp 11 weeks and two more tests to start me on levothyroxine. The gp still didn’t think it was needed because it was borderline, it was me querying it due to online saying it should be below 2.5/3 and then the endocrinologist at the hospital said to start a low dose of levo. So I took it from 29-39 weeks of pregnancy and stayed below 2 for that period luckily.

Im now holding my 8 week old baby. I don’t know about the early weeks though or when my tsh had increased. I do think the early weeks are important so contact your gp now for advice? The endocrinologist told me it should be below 2 in pregnancy for reference.

Wow you were lucky and well done you for managing yourself. Doctors seem to be very relaxed about this.

and how is your baby? I presume high THS didn’t have any negative impacts

best wishes

Quite shocking some GPs don't know this and I'm a (retired) GP.
It's pretty bread and butter stuff. Even our trainee GPs know about it. I could never remember the figures to treat but I knew hypothyroidism and pregnant= do something and I had the relevant guidance saved on my computer to look up!

She’s really good Thankyou. She’s now 5 months old, 75th percentile and a pretty happy baby.

I had read up a bit about it and came across posts from people on here so when the gp was saying she thought I would be ok without the medication because it was borderline high (for a not-pregnant adult) I just wasn’t sure because some literature was saying 2 vs the 4.6 I was on and it was saying about risks. Luckily she was happy querying it with the hospitals endocrinologist, who then insisted on the medication. Only a lose dose though.

I had my blood tested again 12 weeks after the birth and luckily my TSH has remained at the 2 mark for now. I stopped taking the low dose levothyroxine after the birth. The endocrinologist said I had a choice, either keep taking it for life or stop and see what happens (although she did say if I wanted another baby then to remain on the medication).

The gp helped me when my midwife didn’t, so I’m very thankful for her helping with my iron levels, and stumbling across the thyroid issue.