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What Causes Elevation Of TSH Levels During Early Pregnancy?

Posted on Thu, 30 Apr 2015

Question: Hi XXXXXXX

Hope you remember our last conversation. This is about my wife.

Can you tell me TSH levels raise during initial period of pregnancy?

Regards,
XXXXXX

Answered by Dr. Deepika Patil (1 hour later)

Brief Answer:
There will be raise

Detailed Answer:
Hi XXXXX,

Yes I do remember our last conversation. Hope you are doing good. Thanks for writing to me.

In early pregnancy there will be increased demand for the thyroid hormone as the embryo is dependent on mothers hormones. There will be also increased iodine loss and excess oestrogen in the body. So there will be low T3 and T4 levels and raised TSH level. So the thyroid hormone supplement needs to be adjusted and monitored every monthly .

The level of raise in TSH depends on pre pregnancy level , weight and the iodine supplement taken orally.

Hope I Have answered your query. If any further queries are there I would love to help.

Regards
Dr Deepika Patil

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepika Patil (16 hours later)

Thanks XXXXXXX I am doing good and hope you are also doing good.

As I told you earlier my wife had miscarriage after 10 weeks and when we tested for TSH, it was 5.25 that time. So after that we have taken 4 months gap and she started medication for thyroid. 40 days ago the TSH level is 1.7 and we felt happy.

Now I am suspecting my wife might be pregnant but may visit doctor this weekend. Last Saturday as a routine checkup we had TSH test and the result was 3.48.

So I am worried though my wife is taking medication, how come the level raised?? I thought the level will even more drop from 1.7 which is not the case.

Please suggest me is this normal behavior? My wife's last menstrual date was 26th Feb.

Regards,
XXXXX

Answered by Dr. Deepika Patil (20 hours later)

Brief Answer:
It's not normal

Detailed Answer:
Hi,

Sorry for the late reply. I am doing good.

Yes the TSH level should either drop or remain same. As it raised that means the thyroid demand is increased due to either stress or some disease or pregnancy or drug resistance.

I suggest you to get the pregnancy test done and then consult your treating doctor to rule out the cause for raise in TSH . The treatment will be treating any other underlying disease or just increase in the dose of medication.

If pregnancy comes positive then monthly or even early , you need to check hormone levels and get the dose adjusted . If TSH is well maintained then no problem in pregnancy.

Hope I have answered your query. if any further queries are there I would love to help.

Regards
Dr Deepika Patil

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Deepika Patil (3 hours later)

Thank you.

My wife's last menstrual date was 26th, Feb. So is it correct time to get the pregnancy test done so that the results will be accurate?

Also could you tell me after how many days/weeks usually baby will get heartbeat?? Why I am asking is last time due to lack of heart beat only my wife had miscarriage.

Regards,
XXXXXX

Answered by Dr. Deepika Patil (8 hours later)

Brief Answer:
You may get pregnancy test done

Detailed Answer:
Hi XXXXX,

Yes you can get urine pregnancy test done . It's accuracy is around 95% . I suggest you to get it done and if it comes negative then you may go for blood B- HCG level estimation. Urine test never give 100% accurate result .

Blood test has 100% accuracy.

Around 5 -6 weeks from last menstrual cycle , fetus heartbeat can be picked up in ultrasound scan.

Hope I have answered your query. If any further queries are there I would love to help.

Regards
Dr Deepika Patil

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepika Patil (41 hours later)

Thanks XXXXXXX

Today we had the pregnancy test done and it was positive.

One thing to share is yesterday we had one more round of TSH test and the level is 5.43. It raised drastically from 3.47 to 5.43 in 6 days. Doctor suggested to use present 25 mg and add additional 12.5 mg thyroxine. Is it fine or the dose can be raised even more to 50 mg?

Also the doctor prescribed Folic acid tabs and progesterone tabs. Is it fine to use them as I was wondering we can't use artificial hormone intakes??

Regards,
XXXXX

Answered by Dr. Deepika Patil (19 hours later)

Brief Answer:
Hormones are adviced

Detailed Answer:
Hi XXXXX,

Congratulations to you.

Usually suddenly thyroxine is not increased. So your doctor increased to 12.5 and will assess again and adjust the dose.

Folic acid needs to be taken as it will help in development of baby. It is a vitamin type. Progesterone is given because previously your wife had miscarriage. Progesterone helps in maintaining pregnancy and prevents miscarriage. So I advice to take the supplement. Folic acid is not hormone . Progesterone is hormone. And given in natural high risk pregnancy.

Hope I have answered your query . If any further queries are there I would love to help.

Regards
Dr Deepika Patil

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepika Patil (2 days later)

Thank you XXXXXXX for all your valuable suggestions.

Regards,
XXXXXX

Answered by Dr. Deepika Patil (3 hours later)

Brief Answer:
My pleasure

Detailed Answer:
Hi XXXXXX,

I am glad that I have been of some help to you. If no further queries are there you may close the discussion and rate the response.

Regards
Dr Deepika Patil

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj