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Hypothyroidism and Pregnancy

Last Updated: · Patients
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Question

My husband and I are trying to conceive and I have Hypothyroidism-I was diagnosed shortly after birth (at 29 weeks) and have been on a regimine of eltroxin ever since (ranging from 0.1 to 0.137 at present-Synthroid didn’t agree with me and made me retain more water). There have been several changes with my dose in the past 5 years because I’ve been complaining of increased fatigue, unexplained weight gain, shortness of breath after walking short distances, etc. Despite several requests for a referral to an endocrine clinic, I’ve resolved to regular blood tests. I’ve wanted to make sure everything was “in order” before we started trying…I was told by my new GP that my condition shouldn’t be a problem so we went ahead. Recently, I’ve been reading up (which can be both a good and bad thing) and the information has been more disturbing than promising regarding my ability to conceive and have a healthy pregnancy… FYI, my most recent results during the past six months have floated around 1 and 0.887 for my TSH and free T4… Do you have any suggestions?

Response

Your current thyroid test results seem reasonable. There is certainly no contraindication to getting pregnant while on thyroxine therapy. Most (but not necessarily all) women need an increase in thyroxine dose during pregnancy. The best thing to do is to increase by 50 micrograms once you know you are pregnant, then wait for a month and then have a thyroid test. (NB If you test before a mont the results are misleading). The dose of thyroxine can then be adjusted as necessary to keep the TSH value around 1. Thyroid function needs to be tested at least once in every trimester. After delivery you should immediately go back to your usual dose. There is no probem in breast feeding when on thyroxine. I think this is probably all you need to know at present. If there is anything else please mail.