Very High TSH and Pregnant

[rts]

I am 12 weeks pregnant with my second child. Last week I had the standard prenatal blood panel and my TSH level was 10.23. My OB sent me back for a thyroid panel late last week and my TSH was 9.30, T3 was 3.3 and T4 was 0.9.
I am extremely sluggish and exhausted, I am having trouble keeping the right temperature. I have trouble taking a shower because I get horrible chills. Sometimes I can sleep like a rock and other times I have insomnia. I am a mess. I feel like garbage.
My mother had Grave's disease when she was 12 as a result of losing her father. She has taken hormone replacement ever since. I have never had any previous problems with my thyroid and my last pregnancy was low risk and very normal. I have never miscarried or had problems getting pregnant.
I am waiting on a call back from my OB Doctor's office this morning. I don't know if I should just find an endocrinologist on my own, or let my OB treat this. I am tempted to just take myself to the hospital.  
What should I do?

[rts]

Thanks for your speedy answer. My OB perscribed 137mcg levothyroxine with another test in 6 weeks. I have a formal appt with her later this week. In themean time, a family friend suggested a chiropractor. I have never seen a chiropractor, so I was a little sceptical. He found some weird tender places in my neck and did a few adjustments that took all of 30 seconds. I walked out of there feeling better than I have in MONTHS! For the first time in a long time I had enough energy to give my 1.5 year old son a bath and put him to bed. I don't think I will run any marithons soon, but I am most certainly among the living! I am so excited to possibly get a good night's rest for a change! Obviously, I will still take the levothyroxine (in the morning before food). I think I will request a blood panel in 3 weeks instead of 6 weeks. Thank you for your help. This message board is a huge help. I feel better just knowing that I am not alone. My big worry now is that the baby is ok. Thanks again. rts

[Mark Lupo, M.D.]

You need to start levothyroxine ASAP - you have two high TSH levels confirming hypothyroidism.  Would test thyroid antibodies to confirm this is hashimoto's (increased risk due to mom's history of Graves).  

In terms of start dose -- this is where there may be a difference of opinion from doc to doc -- with pregnancy it is better to be a little on the high side than a little on the low side -- I would usually start with 75-100mcg of levothyroxine in this case and recheck every 4-5 weeks during pregnancy and adjust the dose as necessary.