Thyroid and pregnancy

[Srabani_babli]

My wife is 29 years old and she is taking thyronorm 25 from last November 2015, because that time her TSH level was 5.84. now she is 17th week pregnant and last medical report shows that her TSH level is 2.62 on 24th April 2016. But doctor prescribed to take thyronorm 50. because the told us in pregnancy the thyroid level should be less than 2.5.
Now my questions why the dosage increase ? is it safe to take thyronorm50 instead of thyronorm 25. please suggest.

[Super_sally888]

Hello,

yes thyronorm 50 is safe in pregnancy.  It is normal to increase thyroid hormone dosing during pregnancy.  So I believe you should follow your Drs advice.

it is also recommended as per Gimel above to test Ft3 and Ft4.  In pregnancy drs like to keep these at the upper half of the range.

[gimel]

First thing to understand is that even though doctors use TSH like it was the perfect test for thyroid status, at best it is only an indicator to be considered along with more important indicators such as symptoms and also levels of the biologically active thyroid hormones, Free T4 and Free T3 (not the same as Total T4 or Total T3).  So it is totally inadequate to medicate a hypothyroid patient based on TSH alone.  Doubling the dosage of Thyronorm without first testing for Free T4 and Free T3 doesn't seem a good idea..  

So I suggest that you get the doctor to test for Free T4 and Free T3 now and also every time she goes in for tests in the future.  Most important is that med dosage should be adequate to relieve hypo symptoms and should be monitored by testing Free T4 and Free T3.  Adequate levels of Free T4 and Free T3 would usually be at the middle of the range, at minimum.  

Also, since hypothyroid patients are so frequently low in the ranges for Vitamin D, B12 and ferritin, I highly recommend testing for those as well and supplementing as needed to optimize.  D should be targeted for 55, B12 in the upper end of its range, and ferritin should be about 70.  If not tested I would request and also discuss with the doctor.