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Taking Levothyroxine Due To Thyroidectomy. Found Out Pregnancy. Any Problem In Fetal Development?

Posted on Mon, 18 Feb 2013

Question: Hi! I am 28 years old and have been taking 112 mcg of levothyroxine for a few years, due to a thyroidectomy. I recently found out I'm pregnant, so I scheduled an appointment with my TSH was at 5.70. My doctor told me that is slightly above the normal range of .40 - 4.50. He retested my TSH levels and said he would get back to me, but that he hates to readjust thyroid medication as he doesn't want my TSH to get too high. I have just found out that during your first trimester, your TSH should be between .26 and 2.66, which my doctor failed to tell me. I am worried that my TSH is way too high for pregnancy, and am even thinking about taking an extra levothyroxine pill tonight. I have read that hypothyroidism while pregnant can lead to problems in fetal development, as well as miscarriage. Please let me know what you think I should do. I hate to wait until Monday to call my doctor.

Thanks so much!!
~ XXXXXXX

Answered by Dr. Madhuri Patil (8 hours later)

Hi XXXXXXX

Thank you for the query.

You correctly read about the TSH levels during pregnancy. In fact, we, in India, tell the women who plan for pregnancy to take tab levothyroxine (LT4) for their hypothyroidism to increase the dose of L-T4 by at least 25% as soon as they know about conception.

Hence You must go ahead and make your dose to 150 mcg per day taken strictly empty stomach and keep at least 1 hour gap between your tablet and any drink or food intake.

The information you read further about the effects on the baby is true, but immediate action by you will certainly avoid this. Many a time (we need to establish the percentage by correct statistics) women with TSH values as high as 100 in their first trimester have delivered normal babies because they started taking Tab LT4 after coming to know about their hypothyroidism. So, no worries.

Please call your doctor at once or fix an appointment at the earliest. The dose needs to be increased quickly to set things right.

Now a bit unrelated matter: Was your thyroidectomy done due to any thyroid cancer? If yes, then please make sure your TSH is less than 0.1 always until you complete 10 years safely after the thyroidectomy.

Take care and let me know if you have any related query.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Madhuri Patil (43 hours later)

Thank you so much for your thorough response. That's exactly what I needed to know! It makes me feel much better to know that some people have had such high TSH values compared to mine in the first trimester and had no problems.

I had a thyroidectomy due to a benign nodule.

Thanks again,

~ XXXXXXX

Answered by Dr. Madhuri Patil (1 hour later)

You are welcome. Take care and all the best.

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

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