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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Hashimoto's and 7 weeks pregnant
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Hashimoto's and 7 weeks pregnant
by melcurr, Feb 21, 2009 12:43PM
I am seven weeks pregnant. I have Hashimoto's and also PCOS. I was pregnant last year but only made it to 22 weeks and lost the baby. They are not sure as to the cause of my loss.
Well, this pregnancy I had a TSH of 0.35 before I knew I was pregnant. I was on 75mcg of Synthroid. My doc took me to 62.5 mcg. I found out I was pregnant two weeks later and had a TSH test. I was 4 1/2 weeks pregnant and my TSH had gone to 3.50. Well, last year during my pregnancy I was on 62.5 mcg of Synthroid with a TSH of 4.5 at 4 weeks pregnancy. My old doc (same practice) took my meds up to 88 mcg and I stayed at a TSH level between 1.6 and 2.0 the whole rest of my pregnancy until the loss. This doc insisted on only taking me back up to 75 mcg after she saw my level go from 0.35 to 3.50 in two weeks. So I relented even though I really felt I needed 88 mcg. Two weeks later, now 6 1/2 weeks pregnant I had a TSH pulled and it was 4.5. So I asked to be bumped to 88 mcg now. And she now insists it needs to be 100 mcg. So I have been on that for the last two days but I am so fearful this level will be too high. One time when I wasn't pregnant they took me from 75 mcg to 50 mcg and I went from a TSH of 0.008 to 8.0 in four weeks. So I am very sensitive to changes.
I wanted to try 88 mcg before going to 100 mcg but she said no. What will be the ill effects if I should really be on 88 but I am taking 100? Could this make me hyperthyroid enough to damage my pregnancy? I am very concerned after the loss last year and I am really upset that it is taking so long to get right this time. Could I miscarry if I am pushed into the hyperthyroid ( such as a TSH of 0.008?) range?
Thank you for your second opinion.
Melinda
Well, this pregnancy I had a TSH of 0.35 before I knew I was pregnant. I was on 75mcg of Synthroid. My doc took me to 62.5 mcg. I found out I was pregnant two weeks later and had a TSH test. I was 4 1/2 weeks pregnant and my TSH had gone to 3.50. Well, last year during my pregnancy I was on 62.5 mcg of Synthroid with a TSH of 4.5 at 4 weeks pregnancy. My old doc (same practice) took my meds up to 88 mcg and I stayed at a TSH level between 1.6 and 2.0 the whole rest of my pregnancy until the loss. This doc insisted on only taking me back up to 75 mcg after she saw my level go from 0.35 to 3.50 in two weeks. So I relented even though I really felt I needed 88 mcg. Two weeks later, now 6 1/2 weeks pregnant I had a TSH pulled and it was 4.5. So I asked to be bumped to 88 mcg now. And she now insists it needs to be 100 mcg. So I have been on that for the last two days but I am so fearful this level will be too high. One time when I wasn't pregnant they took me from 75 mcg to 50 mcg and I went from a TSH of 0.008 to 8.0 in four weeks. So I am very sensitive to changes.
I wanted to try 88 mcg before going to 100 mcg but she said no. What will be the ill effects if I should really be on 88 but I am taking 100? Could this make me hyperthyroid enough to damage my pregnancy? I am very concerned after the loss last year and I am really upset that it is taking so long to get right this time. Could I miscarry if I am pushed into the hyperthyroid ( such as a TSH of 0.008?) range?
Thank you for your second opinion.
Melinda
Doctor's Answer
by Mark Lupo, M.D., Feb 22, 2009 10:20PM
, Feb 22, 2009 10:20PM
From what we understand about thyroid and pregnancy, it is better to run a little high (ie lower TSH) than a little low. So it is not likely that 100mcg will do harm and we do know that most women require dose increases during pregnancy. Miscarriage is associated with Hashi, but keeping levels normal may help -- more research is needed on this. There is research that suggests a low TSH (with normal T3 and T4) is not associated with complications during pregnancy.
