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Pregnant, TSH high. Lab reports, ultrasounds normal. Previous thyroidectomy, partial neck dissection. On synthroid. Recommendations?

I am s/p thyroidectomy and partial neck dissection secondary to a small (
Currently, I am 21 weeks pregnant. Since finding that I am pregnant, I have been religious about checking my TSH, doing so every 4 weeks (twice as often as is recommended by my doctors - primary medical and endocrinologist).

My endocrinologist has given my primary doctor parameters to go by for synthroid dose adjustments as needed, however my dose has never been changed, even though it has been "creeping" up. To which I have never been given lab values, until today.

Currently my TSH is 5.95, Free T4 is 0.8. At hearing the values, I was appalled. I am a RN and I know this is well too high given my medical history and that I am pregnant. I insisted my primary contact my endocrinologist about my values. To which he replied: "TSH is much too high---current records indicate she is on Synthroid 0.125 mg daily--if this is the case I would increase it to 0.137 mg daily and recheck a tsh in 6 wks or so with goal tsh of around 0.5-1.0 at the most. Should also check a thyroglobulin tumor marker to make sure the cancer is in check."

My question is how serious is this - for me and my baby?
Asked On : Sat, 27 Apr 2013
Answers:  1 Views:  30
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General & Family Physician 's  Response
Hi and thank you for this query.
I am sorry too hear about your battle with thyroid problems.

Hypothyroidism is never good news during pregnancy. Your doctor should have gotten the appropriate doses for you before letting you get pregnant. From the results, you clearly need to step up the dose of synthroid and titrate to reach desired values through symptoms checks and TSH as suggested by your endocrinologist. If you are status post thyroid cancer, then checking the thyroglobulin is a great idea.

If not corrected your baby run the risk of having cretinism as a result of hypothyroidism. The baby relies on you to get the needed thyroid hormones which are very important in the brain development of the child. As for you, it is liited to the symptoms and possible complications if any should come on.

Hope you find this helpful
Wish you all the best and hope things get figured out soon for the best outcome to you and your baby.

Dr. Ditah, MD
Answered: Sun, 23 Jun 2013
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