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What does this thyroid report during pregnancy indicate?

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Posted on Fri, 20 May 2016
Question: Hello!

I am currently a delegate in the US and just found out that I am pregnant (week 6). It's still difficult for me to understand the health care system and knowing which doctors are really good and I received different opinions on my Lab results (my blood was drawn in week 4) - what should I do??

TSH 3.700 uIU/ML (0.450-4.500)
Triiodothyronine, Free, Serum 3.0 pg/mL (2.0-4.4)
T4, Free (Direct) 1.12 ng/dL (0.82-1.77)

In the internet I keep finding the information that my TSH needs to be < 2.5...
There is very controversial information if the TSH value itself is sufficient to decide if I need to take any tablets or not...

History: I took some thyroid tablets from 2010-2014 and stopped after a miscarriage. The doctors had very different opinions if I needed the tablets in the first place and I feel much better since I am not taking the tablets any more.
My results last autumn (approx. 1 year w/o tablets) were good. I got pregnant w/o tablets.

I would be glad to receive more information if I should take the tablets again...
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Answered by Dr. Shehzad Topiwala (3 hours later)
Brief Answer:
Thyroid

Detailed Answer:
I follow your question.

Typically most thyroid experts recommend aiming for a TSH of 0.1 to 2.5 in the first 12 weeks of pregnancy.
So when I see a pregnant woman at 6 weeks with a TSH of 3.7 I would start 25 mcg levo throxine and check
TSH
Total T4
Total T3
in 4 weeks to ensure TSH is at target.

I would also like to check
Anti Thyroid Peroxidase (TPO) antibodies
Anti Thyroglobulin antibodies

However what you ought to do depends on a thorough evaluation by an endocrinologist in-person.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What does this thyroid report during pregnancy indicate?

Brief Answer: Thyroid Detailed Answer: I follow your question. Typically most thyroid experts recommend aiming for a TSH of 0.1 to 2.5 in the first 12 weeks of pregnancy. So when I see a pregnant woman at 6 weeks with a TSH of 3.7 I would start 25 mcg levo throxine and check TSH Total T4 Total T3 in 4 weeks to ensure TSH is at target. I would also like to check Anti Thyroid Peroxidase (TPO) antibodies Anti Thyroglobulin antibodies However what you ought to do depends on a thorough evaluation by an endocrinologist in-person.