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  1. #1
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    Default Borderline TSH during first trimester - advice please!

    This is my 3rd pregnancy. My 1st I had no problems during pregnancy, but developed post partum thyroiditis. Resolved after 1 year. 2nd pregnancy I had a hypothyroid not discovered until 6 weeks, miscarried. Resolved immediately. Now I am pregnant again. Last week I got my TSH checked and it was 2.7. Fabulous the doctor said, not a problem, get it checked again in 2 weeks. However after doing some research I have found studies that during the first trimester the TSH should be 2.5 or less?? This particular doctor I have problems with in the past, he does not seem very educated on Thyroid problems. However due to Xmas holiday leave there were not many doctors to choose from. Does anybody have any advice on whether I need to go on Thyroxine based on a Borderline TSH? I have had another blood test this morning, obviously if it is a lot higher I will but if it is still borderline I'm not sure if I should demand treatment or not??
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  2. #2
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    Hi @SpicyTurtle. I have Hypothyroidism (discovered before I got pregnant) and my endocrinologist likes TSH levels to be at 2 or below for pregnancy. I had to get mine down to 2 before he'd 'let" me start trying to get pregnant. Now that I am pregnant, he's increased my thyroxine dose to keep me under 2.

    2.5 isn't that far outside those levels, so I wouldn't freak about it, however best to be proactive about it. My old GP was really poorly informed about my hypothyroidism so best to see a specialist in my opinion - if you are in Melbourne I'm happy to give you the details of mine so you can ask for a referral.

    Otherwise - maybe try a new doctor until you find one who will give you some Thyroxine? The risk of taking thyroxine when you may not need it is lower than the risk of not taking it when you do need it, in my opinion.

    Good luck!

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    Thanks mrsa2b. I went to see a different doctor today who didn't seem to concerned either. Although I printed some info on TSH needing to be 2.5 or lower during 1st trimester and he took me a bit more seriously then. He fast tracked my bloods and said we will decide tomorrow when. They comeback if I need to go on Thyroxine. My T4 was normal which he said was the most important one.

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    I really don't know much about this at all, but I was just over the border from my 10w bloods and I got told the same, to leave it until next bloods. It was slightly in the lower range at the next bloods !!

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    How did you go SpicyTurtle?
    My doctor was quite concerned about it, but my levels around were 4-5. We've been testing every month or so whilst I was ttc so as soon as I was pregnant she re-tested to see if they are still higher and I need Thyroxine.
    She basically told me that if me levels were over 2.5 I'd go on it, but she would give me a smaller dose. She said that apparently research on Thyroid levels in pregnancy was quite mixed and there is no clear guideline but that she felt it was better safe then sorry!
    Hopefully if you were over 2.5 they've got you started on thyroxine by now!

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    Default Borderline TSH during first trimester - advice please!

    In the end I had a repeat blood test done 1 week later and my level had come down to 1.9, so I don't need treating! However I will get it checked every 2-4 weeks throughout my pregnancy.

    What are your T4 levels? From what I understand, although TSH is important, having a low T4 is what would possibly cause the most risk to the baby (eg. Miscarriage, developmental problems) however, that is untreated and quite severe hypothyroidism. My doctor said he wouldn't have treated me unless my TSH went about 3. I would get a referral to an Endocronologist to continue your treatment throughout your pregnancy, but personally with levels 4-5 I would feel happier if it was treated with thyroxine. There are studies done that show risk of miscarriage increases if levels are between 2.5 - 5. At least you have caught it early

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    That's good that it has come back down. Mine has gone up to around 6, so I've just started on Thyroxine and looks like I will be having tests regularly as well. I do have a referral to a Endocrinologist so will be going to see one soon.
    I didn't realise that being too low isn't good either, but all the tests I have done in the past few months have always been high so I don't think that is a problem for me, but I guess the regular testing will tell if it does!


 

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