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Dr. Andrew Rynne

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Pregnant. Test showed TSH level 3.1. Should I be concerned?

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Dr. Asra Ishtiaq Ahmed

OBGYN

Practicing since :2008

Answered : 689 Questions

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Posted on Fri, 21 Dec 2012 in Women's Health
Question: according to my blood test 2 days ago, my ths level is 3.1 and i m 4 weeks pregnant. so i need to be alarmed?
my doctor recommended further testing and the possibility of taking some medication to lower ths. is that recommended?
doctor
Answered by Dr. Asra Ishtiaq Ahmed 18 minutes later
Hello there.

Thanks for writing.

Yes your TSH level is slightly elevated considering that you are in your first trimester and 4 weeks pregnant.

TSH levels should be maintained below 2.5 mU/l in the first trimester of pregnancy (upto 12 weeks) and below 3 mU/l in later pregnancy.

Considering the above fact, you may require a thyroxine supplement at a low dose to start with to bring the TSH level within the recommended range.

However you may take a repeat test from other lab just to be sure that the result is true and then start your medication.

TSH levels high in pregnancy suggest hypothyroidism and need to be treated in pregnancy. This is because they may result in miscarriage, still birth, premature labor or intrauterine death of the baby if uncontrolled. Also mental defects in the baby can occur.

Thyroxine supplements used to correct the hypothyroidism and TSH levels have NO side effects to the baby.

I hope I have answered your query.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed 5 minutes later
thank you
so if i start my medication now, considering the fact that the fetus is already 4-5 weeks, could the baby have any risk of slow mental develpment by now
doctor
Answered by Dr. Asra Ishtiaq Ahmed 3 minutes later
Hello there.

Thanks for writing.

No the baby should not have any risks.

The earlier you get your TSH levels controlled the better it is.

It is only after long term and persistent hypothyroidism that mental development of the child is affected.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed 18 minutes later
thanks a lot Dr Asra XXXXXXX
doctor
Answered by Dr. Asra Ishtiaq Ahmed 33 minutes later
You are most welcome for queries.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Asra Ishtiaq Ahmed 29 hours later
Hello dr asra
I retook the ths test today and the reading was 2.6... Do I still need to consider thyroxine?


I also took toxoplasma test as my IGG was positive ( above 650) and so I took the IGm test today and it gave a reading of .53 ( which the lab interpret as equivocal). How risky is this?

Please advise on both tests
doctor
Answered by Dr. Asra Ishtiaq Ahmed 2 hours later
Hello there.

Thanks for writing.

Your repeat TSH is just boderline. The decision of starting thyroxine would depend on how your free T3 and T4 levels are and if your endocrinologist finds symptoms of thyroid deficiency in you.

Else a repeat test after a month is needed just to be sure that the levels are remaining within the expected normal range.


Positive Toxoplasma IgG test with equivocal or negative IgM test can be due to infection with Toxoplasma for probably 1 year or longer.
It does not indicate that the infection is definitely recent and acquired during pregnancy that it would affect the baby. In such cases repeat IgG testing is done after 3-4 weeks interval.

Four fold increase on repeat testing in IgG titre confirms suspicion of active infection and requires treatment.
If no change in titre then it is possibly a chronic infection (acquired in the past) and does not require treatment.

I hope I have answered your queries.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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