Pregnant and diagnosed with hypothyroidism

[aljog19]

Hi, I'm currently 5 weeks pregnant and was diagnosed with mild hypothyroidism on August 12th (TSH 4.53). Started taking levothyroxine 25mcg on August 20th and found out that I conceived a week after I started taking medication.  However the most recent blood work done on September 1st showed a rise in TSH.
My current readings are: TSH      7.83     normal range 0.34 - 5.60 U/ml
                                     FreeT3  3.0      normal range 2.0 - 4.4 pg/ml
                                     FreeT4  1.10     normal range 0.6 -1.77 ng/dL
I'm taking an increased dosage (50mcg of levothyroxine) today onwards till my fourth week test. Is there anyone who can give their insight on this?

[des900]

Doctors want TSH to be brought down 3. but most don't give much attention to Free T3. My opinion is you need to bring both to normal levels. An increasing TSH usually means antibody present to destroy thyroid gland and that require levothyroxine replacement while constant supply of adequate Free T3 is needed for all metabolic and cellular activities.

Its OK to continue with doctors advice to remain on 50 mcg or suitable to bring down TSH. But get tested for these in meantime Vitamin D, B12, Ferritin and supplement fast if its not in optimal range. Also try to include Zinc, Selenium rich foods in diet.

[gimel]

I just wanted to mention that TSH is affected by so many things that 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.  When already taking thyroid med, TSH is even worse as an indicator, to the point that med dosage should not be based on TSH levels.  A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results.

There is tons of scientific evidence of what I am saying, but I think you will find this to be very interesting.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1341585/

In this study 148 hypothyroid patients were classified as clinically hypothyroid, euthyroid, or hyperthyroid.  They were tested for TSH, Free T4 and Free T3.  Of the 148 patients 108 were classified clinically as hypothyroid.  their TSH ranged from .1 - 19.7.  Of the 22 patients classified clinically as euthyroid, the TSH ranged from .1 - 14.4.  The remaining 18 patients were classified clinically as hyperthyroid.  Their TSH ranged from .1 - 123.5.  So clearly TSH is useless as a determinant of thyroid dosage.  In fact the researchers concluded that adjustments to the dose should be made according to the patient's clinical response.  

[Queenie101]

Hi there it is sometimes common for our TSH levels to fluctuate during times of change in the body like pregnancy however from the date you started your levothyroxine on Aug 20th to the date of your last blood work on Sept 1st there was not enough time for your body to adjust to the dosage. It usually takes 4 to 6 weeks for a dosage change of thyroid medication to show change in the body. I would not worry about it right now unless you're next test result shows that you are still hypothyroid. Normal range for everyone is different. What my TSH level needs to be for me to feel really good is around 0.9. Some people feel best at a 1.0. It may take a while for you to find your ideal level. Good luck!