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Under active thyroid, miscarriage, thyroid now stabilized. Safe to conceive ?

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Practicing since : 1991
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I am 37 and have had an underactive thyroid for 10 years. I had a miscarriage at 18 weeks in February 2011. My thyroid was not checked until week 12 of my pregnancy and at 15 weeks my dose was upped from 125mcg daily to 175mcg. I was later told that my baby had died between 12-13 weeks and my thyroid should have been tested far sooner. I want to try for another baby as soon as possible. My thyroid has taken a while to stabalise after the miscarriage. My question is how often should my thyroid be tested during a future pregnancy?
Posted Fri, 13 Apr 2012 in Pregnancy
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query. It is unfortunate that you had a miscarriage.

1. Your thyroid levels should be tested every six to eight weeks during your next pregnancy.
2. You must monitor your pre-pregnancy thyroid levels and increase your dose under strict supervision of an endocrinologist and your gynecologist. Your TSH should be low and T3 T4 levels should be on the higher side of normal before you conceive. Get a complete hormonal profile done.
3. Thyroid hormones are bound by thyroglobulin and stored in the thyroid gland and released slowly on demand. This means that your thyroid hormones are unlikely to drop suddenly, or within four to six weeks of a normal test.
4. After any dose adjustment, get your levels checked within four weeks.
5. Other common medication during pregnancy such as antacids, iron formulations and others can interfere in the absorption of your thyroid hormone supplement (which are safe and adequate for your baby).
6. At least once in a trimester, get a complete set of thyroid tests done, which include TSH, T3, T4, Free T3, Free T4, ultra TSH, Thyroid antibodies.
7. Clinically, signs of hypo or hyperthyroidism should also help your physicians decide the timing of your tests.

Wish you a successful pregnancy in the near future.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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