TSH level 4.5 at week 5 of pregnancy

[Anonymous]

I'm hypothyroid and just got blood results yesterday that my TSH went from 1.3 to 4.5 in three weeks, and I'm at 8dp5dt today. Has anyone else experienced an elevated TSH level during the early weeks of pregnancy? How did you manage it? Worried about miscarriage with my levels... (I got a bfp on my FRER test starting 5dpt and it hasn't gotten any darker yet--first beta test is tomorrow)

[Anonymous]

Please see an endocrinologist immediately, this level of TSH can be risky in pregnancy. I also had my thyroid tank as soon as I got pregnant and had to see an endo who worked with me to lower my TSH. I saw Dr Michael West, who's a bit socially awkward, but good.

[Anonymous]

Agree with a PP. Get in to an endocrinologist immediately. make sure that you tell them you are newly pregnant via IVF and that this needs to be handled ASAP.

[Anonymous]

You are supposed to IMMEDIATELY increase your T4 dose by 25% when you find out you are pregnant. That is what my endo has had me do, through several pregnancies. You don't wait until your TSH is high to start increasing your dose.

Google it, please, and take that information to your doctor.

Or, frankly, increase your dose on your own right now and then go to your doctor with the info and explain why you did it.

[Anonymous]

I also have hypothyroid and recently got pregnant. I don't recall what my level was before, but my doctor had me call as soon as I got a bfp and she increased my dosage and had me retest every 4 weeks in the first tri to adjust as necessary.

[Anonymous]

I had a 5 TSH at my first pregnancy check up (probably about week 5). Upped my meds. Next test a few weeks later it was a 3.5. They upped my meds again.

No miscarriage or other issues so far. I’m not saying don’t get checked and up your meds, but I wouldn’t worry excessively about miscarriage. Relatively speaking, under 5 TSH isn’t so awful for thyroid function.

[Anonymous]

Thank you everyone! (original poster here)

I had no idea I was supposed to increase my synthroid dosage automatically. I talked to my endocrinologist today and he upped my dosage from 25 mcg to 75 mcg starting tomorrow- hope it's not too late! Told me to come back for more bloodwork in 3 weeks. He said it's common and normal for the TSH level to jump up in the first couple weeks of pregnancy due to estrace meds from IVF and general hormone fluctuations... I really hope so! Fingers crossed...!

[Anonymous]

It’s not too late. My TSH spiked to 10 when I got pregnant. My doctor increased my dosage and I had a healthy pregnancy.

[Anonymous]

Thank you!!

[Anonymous]

Not too late but definitely need to adjust your dose asap. Glad to see you've done that! Fwiw, there's some evidence that an elevated tsh while taking any synthroid is better than an elevated tsh without any, as the fetus will at least take all of the supplemental amount (leaving you with none). But yes, my endo told me she wants to be the 2nd person after DH to learn I'm pregnant so I could up my dose immediately.

[Anonymous]

Anonymous wrote:Not too late but definitely need to adjust your dose asap. Glad to see you've done that! Fwiw, there's some evidence that an elevated tsh while taking any synthroid is better than an elevated tsh without any, as the fetus will at least take all of the supplemental amount (leaving you with none). But yes, my endo told me she wants to be the 2nd person after DH to learn I'm pregnant so I could up my dose immediately.

Also, my successful pregnancy tsh was 6.8 at 5 weeks even after adjusting my dose at week 4. Congrats and good luck!

[Anonymous]

Yes. It's common. Mine was not as well managed as it should have been and was very high (almost 10) when I delivered (a bit early) but you are still fine with plenty of time for correction. And 4.5 is high but not disastrous.

[Anonymous]

Anonymous wrote:You are supposed to IMMEDIATELY increase your T4 dose by 25% when you find out you are pregnant.

We didn't increase my dose.
TSH was 1.2 at 6 weeks, .42 at 12 weeks and .5 at 16 weeks. Hoping it's still in that range at my appointment next week.

But yes, generally it's recommended to increase the dose early out and check levels regularly (ever 4 to 6 weeks).

[Anonymous]

I also have subclinical hypothyroid with levels around 4.5 and when I'm not pregnant I have no symptoms and don't take synthroid but each time we've decided to TTC, my doctkr always has me see an endocrinologist to get on synthroid 50 at least one month period to TTC so that my levels are in check prior to pregnancy. I'd get on It right away since you are already pregnant