TSH of 5.5 in pregnancy

[Tamarah00]

I am 6.5 weeks pregnant and the tests that my Dr did show TSH of 5.4. This is within the range on the test (up to 5.5). She did not test FT4 or any other thyroid enzymes.

I am taking Eltroxin (Thyroxine Sodium) 100mcg 5 times a week since 2003 and have been taking thyroid medication (hypothyroidism) of differing dosages since 1998. However, this is the first time I see the TSH creeping up again in the last 4 years.

My Dr told me not to return before week 14. Is this something I should return for anyway? Does it indicate that I have to increase my medication?

Thanks
Tamarah

[Super_sally888]

Hi,

According to the latest guidelines, a TSH of 5.5 is too high anyway (your lab is outdated) - normal levels are now revised to about 3.0 or 3.5.

Dr. Lupo's comment is correct.  Thyroid meds need to be increased immediately that you get pregnant and it is very important not to be hypo during pregnancy.  Note his comment about TSH not being above 2.0 in pregancy.

Is your doctor an endocrinologist?  If not, or even if she is, apparently she doesn't recognise the importance of thyroid hormone to a healthy pregnancy and you should seek a second opinion / find another Dr..

No harm to take Dr. Lupo's recommendation and increase your thryoid meds to 7 days a week, with retest in 5 weeks.

Do try to find a more knowledgable dr.

I just saw my endo to discuss getting pregnant.  In anticipation, we are currently adjusting my thryoid meds to get everything high normal (FT3 and FT4).  Then he wants to see me 1 month before I start trying to get pregnant to discuss meds and how they would be managed during pregnancy.

Hope this helps.

Sally

[Mark Lupo, M.D.]

The TSH of 5.4 is high for pregnancy.  The average dose increase needed during pregnancy is 25-40% - would consider talking to your doctor about an increase.  With the information you give, we would usually increase to 100mcg at least 6x/week with a follow up lab in 5 weeks -- that would be a 20% increase -- would even consider an increase to 7 days/ week as it is better to be slightly over-treated than slightly under-treated during pregnancy.

Guidelines suggest TSH should be no higher than 2.0 for pregnancy.

[Tamarah00]

Just wanted to clarify -- I get the results directly off the web, not via the Dr. I doubt she even looks at anything which is not flagged as "out of range", and this is stated as in range.