How often to test for TSH when hypothyroid during pregnancy

[jaguar75]

Hi, I'm having hypothyroidism and am 6 weeks pregnant now and am on 88 mcg Levoxyl. My latest test results show TSH=50 and FT4=0.57 and my doctor recommended to increase the dosage to 112mcg. And he recommended testing every 4 weeks.

But since the recommended range for TSH during pregnancy is < 2.0 i'm a bit concerned that testing every 4 weeks is too wide apart. Would you recommend testing every week or so to ensure that the TSH level can be corrected sooner ?

[Mark Lupo, M.D.]

I cannot give exact advice on this forum but w/ these types of numbers, 137mcg may be reasonable -- you must talk with your doctor about your concerns and dosing.  However, it is better to be a little overtreated than under-treated in pregnancy.  

[Mark Lupo, M.D.]

Every 4-6 weeks is fine (in general).

With the TSH of 50, the dose may need more of an increase than 88 to 112.....and I would initially recheck in 2-3 weeks to make sure things are getting back to target, although it does take 5-6 weeks for the TSH to fully reflect the dose efficacy.

[jaguar75]

Thanks a bunch for your reply! Btw, what dosage would you recommend ? Would like to move to the right dosage asap instead of waiting for a few weeks and then learning that i needed a higher dosage!

Thanks once again.

[Mark Lupo, M.D.]

that is the concern and the reason for quicker re-testing and possibly higher dose....

[jaguar75]

Thanks for your reply. Also i've heard that it's critical that this be fixed asap in the 1st trimester as the fetus doesn't have the capability to produce thyroid. Waiting for further 5-6 weeks means almost the end of the 1st trimester.  Should i be worried about this affecting the baby ?