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Pregnant. Test showed high TSH level. Taking levothyroxine. How long should I continue this medicine?

Hi I am 4 weeks pregnant and my TSH WAS 17, 2 DAYS BEFORE AND TODAY IT WAS 9.5. I have started my levothyroxine 100microgram. i tested my TPO and its 1300 u/ml. what should i do? what could be the reason for this auto immunity, i am a doctor myself still I am not able to conclude on myself. Long before pregnancy my thyroid functions were normal. Did the pregnancy trigger the autoimmunity or it started earlier to my pregnancy? I am worried about PPTD too. should i have to take Ltroxine through out my life or is there any chance I can stop therapy once i get normal after delivery and so? how far would this affect my foetus? i also have pcos .
Asked On : Thu, 10 Jan 2013
Answers:  2 Views:  80
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Pathologist and Microbiologist 's  Response
Hello Dr Priya
Welcome to HCM

Thyroid disorders are known to flare up during pregnancy.
Whether prgnancy stimulates auto-immunity is not proven.
But what is impotant during pregnancy is to mainatain normal levels of T3 and T4 during pregnancy because these hormones play an impotant role in the brain development of the fetus especially during first trimester.
So, in face of hypothyroidism continue levothroxine and get the levels of T3 and T4 regularly.

Whether you will require treatment after delivery wil be guided by your TSH levels at that point of time.
PCOS will not have any effect on your current pregnancy.

I hope it helps.
Dr Shailja P Wahal
Answered: Thu, 10 Jan 2013
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OBGYN Dr. Aarti Abraham's  Response
Mar 2013
thanks for the query.
pregnancy does affect autoimmune functions.
But if you are TPO positive, that cannot happen suddenly.
Was your TPO also normal before pregnancy, or were only thyroid functions done.
As you might be aware, TSH of 17 is quite raised, and periconceptional TSH is recommended to be below 2.5.
So it might affect the fetus as it is the crucial time of development, and also lead to preterm labour and obstetric adverse effects for the mother, if untreated.
You should consult an endocrinologist, and start the appropriate dose of levothyroxine, and alongwith that monitor the TSH to maintain it to 2.5 or less.
Most patients need lifetime therapy, and autoimmunity further increases that chance.
Also, PCOS compounds the effects of hypothyroidism, you should also take adequate calcium and vitamin D supplementation in the second trimester.
Take care
Answered: Thu, 10 Jan 2013
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