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Dr. Andrew Rynne

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Pregnant. Test showed high TSh with normal T3 and T4. What medication is to be done?

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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Posted on Mon, 28 Jan 2013 in Thyroid Problem and Hormonal Problems
Question: Hi, I am 18 weeks pregnant and I found out my TSH is 6.86 today. My GP said my T3 and T4 were normal but I dont know what they are. I am currently taking 0.137 syndroid. What should I increase it to? My GP was not sure, should I go to 0.162 syndroid or 0.175? Please let me know ASAP, I am very worried. Thanks!!!
doctor
Answered by Dr. Rahul Tawde 2 hours later
Dear XXXXXXX,
Thanks for writing in. Its not abnormal to have normal T3,T4 in the face of high TSH. Infact majority of patients with TSH in this range have normal T3 T4.This is because TSH is a more sensitive index of thyroid function and changes before T3 T4 start to change. Increase it to 0.175 and check after 1 month. Target TSH is less than 2.5 or atleast less than 3. Take the tablets early morning empty stomach and give a gap of 1 hr before eating anything else.
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Tawde 15 minutes later
Thank you very much Dr. XXXXXXX I have 0.025 and 0.150 at home so I can combine the two to make it to 0.175.

Could something have happened to the baby in the last month with such a high TSH? When I was tested on December 1 my TSH was 3.1 and now on Dec. 30 it is showing 6.86. So potentially it has been too high for up to 4 weeks. My GP told me high TSH could lead to low IQ in the baby and developmental problems. Is 6.86 too high where this could have happened and my baby now has low IQ?

Also, how long does it take for the new dose of medication to start working - is it a few days or longer?

Finally, is there any chance if I take 0.175mg that that my TSH could get too low or 6.86 is way to high and this cannot happen?

Thanks so much!!! Your answer was really helpful.
XXXXXXX
doctor
Answered by Dr. Rahul Tawde 6 hours later
Even if TSH gets a bit low its not an issue to worry. 0.175 is appropriate for your TSH and it may take few days like 10 to 14 days to build up levels and attain steady state. High TSH can be associated with low IQ but it has to be quite high and for atleast few weeks if not more. Most patients with transient TSH elevation like yours' deliver normal babies. So dont worry- I think low IQ is a very remote possibility. You can combine 0.025 and 0.15.
Hope this helps
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Tawde 4 hours later
Thank you very much doctor XXXXXXX

I have one more question. Could I just ask you how high the TSH has to be in order to give low IQ problems? I know you would not know exactly but maybe a range. Also, for how many weeks?

Finally, how much is too low i.e. if it gets to 0.1 for example, that would still be ok?

Thanks!
XXXXXXX
doctor
Answered by Dr. Rahul Tawde 12 hours later
Based on evidence available TSH above 10 is occasionally assoc with low IQ. Most such patients were untreated for atleast 2 - 3 months. Very rarely has been TSH <10 associated with low IQ. TSH of 0.1 is ok.
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Tawde 1 hour later
Thanks doctor, that is very helpful!
doctor
Answered by Dr. Rahul Tawde 12 hours later
Thank you
Best wishes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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