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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant.Prescribed Thyrofit Due To Abnormal TSH Level. Should Dosage Be Increased?

Sir my wife had premature abortion in the 1st month of pregnancy in last JUNE. after that we couldn t make it conceive. we undergone various tests and in it only one thing was abnormal. that was TSH level which is 4.77 mlU/l (on 10 -Jan 13.her period started on 8th of Jan13 when the test conducted on third day of the period) she undergone HSG on 18th of Jan 13and we started trying for baby on 20th onwards and on8th of Feb 13 we checked and found positive pregnancy result. she was started THYROFIT 12.5 DAILY(from 18 Jan onwards.till date its been 20 days on this medicine). now when we shown to a new doctor she said the dose should be increased to 25 mg.and we started 25 mg(she said 12.5 mg is too less dosage for a pregnant lady and it will affect the brain formation of the baby). but the old doctor said wait for the next TSH test in the end of this month. plz suggest me what to do. i am confused now whthr to increase the dose or to continue the old dose.
Sat, 16 Feb 2013
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Endocrinologist 's  Response
Hi

I would suggest that the dose of thyroxine is adjusted based on the levels of TSH. Please do not keep on changing doctors. Be in consultation with an endocrinologist only. During pregnancy our target is to have TSH levels between 2 and 3. Please check TSH after 6 weeks of starting the thyroxine. Do not check inbetween and also do not adjust dose in between.
Also check Serum Thyroperoxidase (TPO antibody levels)
So if you are taking 25 micrograms, take another TSH level estimation after 6 weeks of starting the dose and contact me again
Meanwhile continue your routine gynaecological check ups

Regards
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Pregnant.Prescribed Thyrofit Due To Abnormal TSH Level. Should Dosage Be Increased?

Hi I would suggest that the dose of thyroxine is adjusted based on the levels of TSH. Please do not keep on changing doctors. Be in consultation with an endocrinologist only. During pregnancy our target is to have TSH levels between 2 and 3. Please check TSH after 6 weeks of starting the thyroxine. Do not check inbetween and also do not adjust dose in between. Also check Serum Thyroperoxidase (TPO antibody levels) So if you are taking 25 micrograms, take another TSH level estimation after 6 weeks of starting the dose and contact me again Meanwhile continue your routine gynaecological check ups Regards