TSH during pregnancy

[logris]

I am 14 weeks pregnant.  I'm trying to keep my TSH level between 1.0 and 2.0 since I've read that in order to maintain a healthy pregnancy, TSH should be between 1.0 and 2.0  I'm within that range now because on my own I increased my Synthroid to 75 mcg.  I was on 50 mcg and my TSH got up to 2.05  I informed both doctors (endo and OB) about this, but they did not want to make any changes in my 50 mcg medication.  They said they won't make any changes until my TSH gets to 4.0  Wouldn't that be dangerous to let it get that high during pregnancy?  How common is 2nd trimester miscarriage for a woman with hypothyroism? Also, do I need to take an antibodies test? I want to do everything to ensure a healthy pregnancy and baby.

Thanks so much for your help,
Logris

[Mark Lupo, M.D.]

I would be interested in antibodies as if positive, there is an increased risk of miscarriage.  The guidelines suggest a TSH no higher than 2.5 and there is not any documented increased risk with a slightly low TSH, so typically the dose is increased pro-actively....most patients need a 25-40% dose increase.   Close monitoring of thyroid function is important.

[cosmicsoul]

Hi there -
Please ensure that your TSH is not creeping higher than 2. Doctors are ignorant in general and as you can see they have no ideas about treating you. If they had any clue - they would know that the TSH should be below 2 especially when pregnant (you are supplying your and your baby's thyroid hormone until she/he is born). I give you credit for self medicating you. I did that too - but I am on Armour thyroid. I do not know much about pregnancy but I would continue to self medicate if I were you. Let them believe that you are on 50. OK? And ensure that you check your TSH often.... to monitor that you are not too low (less than 0 on the hyper side). Checking for antibodies is a good idea, then you will know if you have an autoimmune disease or just hypothyroid. When high antibodies are present - difficulties in pregnancy, healthy baby delivery and miscarrage (miscarriage) are likely. This is why it is important that you take enough medicine to compensate too. When you are pregnant you might even need more - maybe 100 - you should see this on the labwork. It also would be a good idea to switch doctors who understand about these issues and you are not all alone switching the dose of your medicine. I wish you and your baby good luck and hoping for low level of antibodies if you have any!!!!

[logris]

Thank you for your response.  I would bet (just by the way I am feeling) that my TSH is close to or right above 2.0  The last couple of days I have been so tired that all I want to do is sleep all day and night.  I am forcing myself to stay awake now, but I have a bad headache because I want to sleep. I slept 10 hours last night and took 2 naps today and STILL feel very tired.  The 75 mcg may not be enough.  I'm going to try to get a TSH tomorrow, but I probably won't get reults for several days due to the 4th of July holiday.  Other women I know who are pregnant do not sleep this much, but they also don't have a thyroid disorder.  I am switching OB doctors.  I hope the new one is understanding.  I tried to switch endo, but the only other endo in my town wants a referral from the one I am seeing now.  I can't just make an appointment on my own.  If I can't get the quality of care that I need from these doctors, I may have to get my husband to accompany me to these doctor appointments.  It seems that his requests are often not ignored.

[cosmicsoul]

it is hard to deal with insurance and the typo of coverage you have when you do not get what you want. I even paid out of pocket when I found the doctor I thought is helpful. Sometimes you can pay out of pocket for a little bit but I know this is not a solution for a long term as it is very costly. being so tired - could be your TSH is 5 or 6 or higher. Remember YOU supply yours and your baby with thyroid hormone while you are pregnant. Being tyried is the first sing of a thyroid problem.

[logris]

I had a TSH done on Tues. 7/3/07.  I got the results today.  It is 1.29.  If you remember, I had increased my medicine to 75mcg (up from the 50mcg that the endo and OB wanted me on).  Do you think I should continue on 75mcg for the next 2 weeks and retest the TSH then?  That is my plan.  Also, you suggested that I let the endo believe I was still on 50 mcg even though I made the increase myself.  Why do you think I shouldn't tell him about the increase?
I changed OB doctors also and this new one seems to really care.  I'm going to ask about the antibodies test for my next endo appointment.

Thanks,
Logris

[cosmicsoul]

Retsting is a very good idea. Why not telling them? Because they dont want you to increase them but in order to keep your levels under 2 you shold - around 1 is ideal or 1.5. See, my TSH was creeping up to 5.9 and my doctor thoght it was normal and also thought that I need not more meds - but I was always tired. Then I took more meds and I gained energy and TSH went down. Sometimes doctors tell you to do things that will not help you. As I said - as long as you monitor yourself and your blood work so you dont take too much or too little you are good. I hope this is helpful to you!

[happyandhypo]

Why bother to see a doctor if you are not going to be honest with your medical history or current medication dose?  

[racabear]

A related discussion, Pregnant with Hypothyroid was started.