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4 months pregnant, thyroid, high TSH. Taking thyronorm, increased dosage. Precautions?

I am 4 months pregnant. And suffering from Thyroid from past 2 years. But 4 months back it was normal and i got conceived. Now I am 07 weeks and done the thyroid test 3 days back. My TSH is showing 32. Worring about my baby? Kindly advice, is it effecting my baby and If i am taking medical advice now. will it be helpful. before I was taking thyronorm 125 mcg. 2 days back doctor incresed the dosage. Ask to take 150 mg. Kindly advice on the same.
Asked On : Thu, 4 Oct 2012
Answers:  3 Views:  274
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OBGYN 's  Response
hello there..
You are a known case of hypothyroidism where in there are raised TSH levels.
During pregnancy you will typically find that your need for thyroxine (thyroid hormone)increases. Your baby needs it for brain development, and you need it to help your body adapt to the changes of pregnancy, especially in the first twelve weeks. By having regular blood tests every four to six weeks you can make sure that your thyroxine is at the correct level. As a rule of thumb, your need may increase by 50 to 100 per cent every month till they get normal.

In pregnancy It is recommended that TSH levels are maintained below 2.5 mU/l in the first trimester of pregnancy and below 3 mU/l in later pregnancy.
Since you checked it a bit late in pregnancy, the levels have gone too high.You should continue the the thyronorm tab as advised by your endocrinologist and get your thyroid tests done every 4-6weeks till normal range achieved.
Hypothyroidism in pregnancy can lead to following complications so take care.
Uncontrolled hypothyroidism during pregnancy can lead to
Preeclampsia (raised BP with chances of fits)
Anemia—too few red blood cells in the body, which prevents the body from getting enough oxygen
Low birth weight
Stillbirth (dead baby born )congestive heart failure, rarely
Excess bleeding during delivery in mother

Because thyroid hormones are crucial to fetal brain and nervous system development, uncontrolled hypothyroidism—especially during the first trimester—can affect the baby’s growth and brain development. Synthetic thyroxine(thyronorm tab) is safe and necessary for the well-being of the fetus if you have hypothyroidism.
You need to inform your baby's doctor after birth that you had hypothyroidism so that they check your baby's thyroid functions after birth.

take care
Answered: Fri, 5 Oct 2012
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Pathologist and Microbiologist Dr. Shailja Puri 's  Response
Hello and welcome to HCM

I understand from your query that you are suffering from hypothyroidism and you are taking thyronorm (synthetic thyroid hormones).

Now that you have conceived your TSH has increased. An increase in TSH indicates that the level of thyroid hormones has decreased in your body.

Thyroid hormones, shortly known as T3 and T4 are inversely related to TSH.

An increase in TSH indicates decrease in T3 and T4 levels and vice-verse.

T3 and T4 are required for normal development of your baby especially during the first trimester of your pregnancy (first 12 weeks).

Since your TSH level has increased, it implies that level of T3 and T4 has decreased.

The level of T3 and T4 has to be increased by increasing the dose of thyronorm.

So, don't worry. Continue the increase dosage of the medicine and get TSH levels done at regular intervals of your pregnancy and thereafter.

Thanks and take care
Dr Shailja P Wahal
Answered: Thu, 4 Oct 2012
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Pulmonologist Dr. Arnab Maji's  Response
Thanks for query
From the report it is clearly seen that you are suffering from hypothyroidism. Hypothyroidism in gestational period affects your fetus most in the first trimester i.e. 1st 12 weeks of your pregnancy. So it is very important to control your hypothyroidism with proper dosages of thyroxin. Your doctor has rightly increased the dose to 150 mcg. Kindly repeat your TSH level after 2 weeks. If possible kindly test your baby for TSH and thyroxin level fromcord blood after 48 hours of birth and 7 days after birth and should also take a consultation from a neonatologist.
Thank you.
Answered: Fri, 5 Oct 2012
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