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What Should My Thyroid Levels Be To Get Pregnant

Thyroid Medications During Pregnancy

Can women with abnormal TSH levels plan pregnancy? – Dr. Pradeep Kumar T J

If you have a high TSH then there are special changes that you must make once you know you are pregnant.

These changes include increasing your dose of thyroid medication immediately upon finding out or suspecting you are pregnant.


Because your child, especially during the early stages of development, is reliant upon your thyroid hormone until it can produce its own thyroid hormone.

During the first trimester, your child will be relying upon your thyroid gland for its thyroid hormone.

And, if you are taking thyroid medication your ability to produce thyroid hormone is limited.

This is why most doctors recommend that you increase your dose of thyroid medication anywhere from 20 to 50% .

In fact, this recommendation applies even if you miss or skip a period and suspect you might be pregnant.

The most critical time in development often occurs before you even know that you are pregnant.

Because of this, it’s very important that you pay attention to your body and try to find out if you are pregnant as early as possible.

Most physicians recommend the use of T4 only thyroid medications such as Synthroid and levothyroxine during pregnancy.

But does that mean you can’t use other thyroid medications?

Not at all.

In fact, many women use other thyroid medications such as NDT and cytomel/liothyronine safely during pregnancy.

Instead of focusing on which medication you use, you should focus on your thyroid lab tests and how you are feeling.

What Are The Common Signs Of A Thyroid Problem

Hypothyroidism, , is the most common thyroid disorder. Some of the common symptoms of hypothyroidism include:

  • Hair Loss

  • Puffiness, especially around the eyes

  • Constipation

  • severe PMS

  • Menstrual Irregularities

On the other hand, hyperthyroidism, although less common, can still affect a variety of patients. Some of the common symptoms associated with hyperthyroidism include:

  • Heart palpitations

  • Menstrual irregularities

What Causes Hypothyroidism

The most common cause of hypothyroidism is an autoimmune disorder called Hashimotos thyroiditis. The bodys immune system mistakenly sends out antibodies to destroy the cells in the thyroid gland. This may cause the thyroid gland to enlarge, known as goiter.

Hypothyroidism and goiter can also result from not getting enough iodine in your diet. Hypothyroidism also can occur after thyroid surgery or radioactive iodine therapy given to treat hyperthyroidism. In many cases, the specific cause of hypothyroidism is not known.

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What Is A Tsh Test

Thyroid testsBlood tests to measure thyroid hormones are readily available and widely used. Not all thyroid tests are useful in all situations.

TSH TestThe best way to initially test thyroid function is to measure the TSH level in a blood sample. Changes in TSH can serve as an “early warning system” often occurring before the actual level of thyroid hormones in the body becomes too high or too low.

A high TSH level indicates that the thyroid gland is not making enough thyroid hormone . On the other hand, a low TSH level usually indicates that the thyroid is producing too much thyroid hormone . Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid . In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.

Symptoms Of Hyperthyroidism & Hypothyroidism While Pregnant

How to get Pregnant Naturally with PCOS and Thyroid

Thyroid hormones

HyperthyroidismSymptoms of hyperthyroidism may mimic those of normal pregnancy, such as an increased heart rate, sensitivity to hot temperatures, and fatigue. Other symptoms of hyperthyroidism include the following:

  • Irregular heartbeat
  • Weight loss or low weight gain beyond that expected of a typical pregnancy

HypothyroidismSymptoms of hypothyroidism, such as extreme tiredness and weight gain, may be easily confused with normal symptoms of pregnancy. Other symptoms may include:

  • Constipation
  • Difficulty concentrating or memory problems
  • Sensitivity to cold temperatures
  • Muscle cramps

Causes of Thyroid Disease in PregnancyHyperthyroid diseaseThe most common cause of maternal hyperthyroidism during pregnancy is the autoimmune disorder Graves disease. In this disorder, the body makes an antibody called thyroid-stimulating immunoglobulin that causes the thyroid to overreact and make too much thyroid hormone.

Even if you’ve had radioactive iodine treatment or surgery to remove your thyroid, your body can still make the TSI antibody. If these levels rise too high, TSI will travel through your blood to the developing fetus, which may cause its thyroid to begin to produce more hormone than it needs. So long as your doctor is checking your thyroid levels, both you and your baby will get the care needed to keep any problems in check.

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How Do Doctors Treat Postpartum Thyroiditis

The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Graves disease, it may worsen after your baby is born and you may need antithyroid medicines.

Youre more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesnt go away, you will need to take thyroid hormone medicine for the rest of your life.

Even Mild Thyroid Dysfunction May Contribute To Unexplained Infertility

The Endocrine Society
New research suggests that a slightly underactive thyroid may affect a women’s ability to become pregnant — even when the gland is functioning at the low end of the normal range.

New research suggests that a slightly underactive thyroid may affect a women’s ability to become pregnant — even when the gland is functioning at the low end of the normal range, according to a study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

The study found women who have unexplained infertility were nearly twice as likely to have higher levels of a hormone that stimulates the thyroid gland than women who did not conceive due to known issues with their male partner’s sperm count. Thyroid-stimulating hormone is produced by the pituitary gland at the base of the brain and tells the thyroid gland to produce more hormones when needed. Elevated TSH levels can be a sign that the thyroid gland is underactive.

Unexplained infertility occurs when couples are unable to get pregnant despite months of trying and a medical evaluation shows no reason for their infertility. About 10 percent of American women between the ages of 15 and 44 have difficulty becoming or staying pregnant, according to the Office of Women’s Health in the U.S. Department of Health and Human Services. Between 10 percent and 30 percent of affected couples have unexplained infertility, according to the JCEM study.

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Normal Thyroid Levels For Tsh

Thyroid function is measure base of the TSH range of TSH blood test. The normal thyroid levels for TSH used to be from 0.5 to 5.0. After clinical studies, in 2003, the TSH range has been revised to 0.3 – 3.0 as normal TSH levels.

If you are trying to conceive, a normal level of TSH for conception should be lower than 2, that is what many reproductive endocrinologists prefer to see. Hypothyroidism is present when elevated TSH levels are present.

Normal Thyroid Levels for T4

Total T4 levels should be approximately 4.5 to 12.5. A low T4 level with High TSH indicates hypothyroidism. Free T4 normal range is approximately 0.7 to 2.0. If the value is low, it indicates f hypothyroidism.

Normal Thyroid Levels for T3

Total T3 levels should be approximately 80 to 220. Hypothyroidism is suspected when values are less than 80, while hyperthyroidism if over 220. Free T3 levels should be approximately 2.3 to 4.2. When values are less than 2.3, hypothyroidism is most likely.

Is An Underactive Thyroid Preventing You Getting Pregnant

How Your Thyroid affects Fertility & IUI 2 Week Wait Pregnancy Symptoms | Infertility Journey

    This series of articles is looking at fertility and how naturopathic medicine can help improve it if you are having difficulty conceiving. This time, I want to look at the role the thyroid gland can play in infertility. If you have missed any of the previous articles in this series and would like to catch up you can find them here:

    • Sowing a Seed: Improving Fertility with Seeds and Oil
    • Fertility & Folic Acid: Why Taking Folic Acid May Not Be Enough
    • Wanting To Get Pregnant? Dont Forget About Sperm Health
    • What Is PCOS And How Does It Affect My Fertility?

    The primary function of the thyroid gland is to produce hormones to regulate your metabolism, however it also plays an important role in female and male fertility and pregnancy by:

    • Thickening the uterine lining for the fertilized egg to attach to
    • Increasing body temperature to aid ovulation
    • Helping with cell differentiation which is needed for a rapidly developing fetus
    • Facilitating brain development in the fetus
    • Helping to maintain healthy testosterone levels in males
    • Helping with the production of the right quantity of high quality sperm

    When thyroid hormone levels are too high or too low the following pregnancy risks can occur:

    • Increased risk of miscarriage
    • Poor fetal development
    • Increased risk of premature birth

    The Thyroid and Fertility

    How Can I Tell if I have a Thyroid Imbalance?

    Signs of an Underactive or Overactive Thyroid

    • Female Infertility
    • Vision changes or bulging eyes

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    Relationship Between Birth Defects And Antithyroid Drugs In Early Pregnancy

    Antithyroid drugs are the treatment mainstay of hyperthyroidism during pregnancy, but potential teratogenic effects have been reported. All ATDs, including propylthiouracil , methimazole and carbimazole , are equally effective in controlling hyperthyroidism during pregnancy. However, they cross the placenta and may cause problems, particularly during first-trimester organogenesis. In 2009, the concern of a rare but fatal PTU-induced hepatotoxicity was raised.45,46) The U.S. Food and Drug Administration and the ATA recommended PTU use only in the 1st trimester, to be switched to MMI by the 2nd trimester.5,47) However, this recommendation has potential side effects from both drugs.

    A Danish nationwide study was conducted to determine the degree to which the use of ATD in early pregnancy is associated with an increased prevalence of birth defects.48) Andersen et al.48) reported that all ATDs were significantly associated with birth defects . Both were associated with urinary system malformation and PTU with malformations in the face and neck region. Omphalocele, omphalomesenteric duct anomalies, and MMI embryopathy were common in MMI/CMZ-exposed children.

    Conflicts of Interest

    Identify And Treat The Root Causes

    There are several possible underlying causes for Hashimotos that need to be tested and treated including nutrient deficiencies, adrenal dysfunction, abnormal sex hormone levels, poor iron levels, food intolerances and sensitivities especially to gluten, heavy metal toxicity, bacteria and viral infections, Candida, blood sugar imbalance, and leaky gut. Thanks to Dr. Izabella Wentzs new book Hashimotos Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, Hashimotos sufferers have the information they need to take control of their health.

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    Special Considerations For Women With A History Of Graves’ Disease

    In addition to the dosing and testing considerations explained in this brochure, women with a history of Graves disease who were treated with radioiodine or surgical thyroidectomy should also have Graves antibodies tested early in pregnancy to assess the risk of passing antibodies on to the fetus. If antibodies are elevated, follow-up testing is recommended at weeks 18- 22, and if antibodies are still elevated, additional follow-up is recommended at weeks 30-34 to evaluate the need for fetal and neonatal monitoring.

    What Are The Symptoms Of Hypothyroidism

    9 Weeks Twin Pregnancy. Now TSH 0.24, T4 16.2, on Thyroxin ...

    When the thyroid gland produces less thyroid hormone than it should , metabolism slows down and causes a variety of symptoms. At first, the symptoms of hypothyroidism may not be noticed, but over time these symptoms may become more obvious and severe and can include the following:

    • Fatigue
    • Repeated miscarriage

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    Is It Necessary To Perform Thyroid Hormone Tests In All Pregnant Women

    Guidelines on this matter vary among expert groups. In Korea, obstetricians do not perform routine thyroid hormone tests in pregnant women. The KTA recommends the following ambiguous suggestions: 1) There is insufficient evidence to recommend for or against routine TSH screening in early pregnancy 2) TSH measurement in early pregnancy is performed in high-risk pregnant women, although there is insufficient evidence to recommend for or against the pre-pregnancy TSH test 3) Routine free T4 measurement during pregnancy is not recommended and 4) There is insufficient evidence to recommend for or against routine TPOAb screening in early pregnancy.11) In conclusion, the KTA recommends only serum TSH measurement in early pregnancy and only in high-risk pregnant women. High-risk refers to a history of hyperthyroidism or hypothyroidism current symptoms/signs of thyroid dysfunction TPOAb positivity presence of a goiter history of head or neck radiation or prior thyroid surgery age > 30 years type 1 diabetes or other autoimmune disorder history of pregnancy loss, preterm delivery, or infertility family history of autoimmune thyroid disease or thyroid dysfunction morbid obesity use of amiodarone or lithium or recent administration of iodinated radiologic contrast and residing in an area of known moderate to severe iodine insufficiency.

    Can Hypothyroidism Impact Your Fertility

    An underactive thyroid can affect your ability to conceive. Heres what to do if you have hypothyroidism and are trying to become pregnant.


    When your thyroid gland isnt making enough thyroid hormone, it can have a serious effect on every organ in your body including your reproductive system.

    This means hypothyroidism may make it difficult to conceive if youre planning on having children. A study published in August 2015 in the Journal of Pregnancy found that women with hypothyroidism were less likely to become pregnant and more likely to take longer to become pregnant than women without the condition.

    Thats because women with hypothyroidism may not ovulate or ovulate with any regularity, and you have to ovulate to get pregnant, says Ingrid Rodi, MD, a gynecologist and reproductive endocrinologist at UCLA Medical Center in Santa Monica, California.

    Hypothyroidism can affect fertility in men as well, according to the Thyroid Foundation of Canada. Although hypothyroidism is less common in men, those who do have an underactive thyroid may have low libido and low sperm count, according to a review of research published in November 2013 in Frontiers in Endocrinology in November 2013.

    Additionally, hypothyroidism can lead to fatigue in both men and women. When youre fatigued, you may not have much sex, Dr. Rodi says. Its harder to get pregnant when youre not having much sex.

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    Levels Of Tsh To Get Pregnant

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    The Importance Of Treatment

    Hyperthyroidism: During Pregnancy

    You should begin treatment right away when you’re pregnant and you become hyperthyroid due to Graves disease or thyroid nodules. Leaving hyperthyroidism untreated can result in high blood pressure, thyroid storm, congestive heart failure, miscarriage, premature birth, low birth weight, or even stillbirth. For pregnant and non-pregnant patients, treatment typically begins with taking antithyroid medications.

    In cases where you’re already being treated with a low dose of antithyroid medication and your thyroid function is normal, your doctor may take you off your medication, at least during your first trimester when your baby is most susceptible. You’ll need to be monitored closely, having your TSH and FT4 or TT4 checked every one to two weeks during the first trimester and every two to four weeks during the second and third trimesters, as long as your thyroid function remains normal.

    Otherwise, if you’ve been newly diagnosed, you haven’t been taking antithyroid medication for very long, or you’re at a high risk of developing thyrotoxicosis , your dosage will likely be adjusted so that you’re on the lowest possible dose of antithyroid medication while still keeping your free T4 at the top end of the normal range or just above it. This protects your baby from overexposure since these medications are more potent for him or her than they are for you.

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    How Is Hypothyroidism Tested

    The main test used to detect hypothyroidism is measuring blood levels of TSH. An elevated TSH level usually means the thyroid gland is not making enough thyroid hormone, and the pituitary gland has responded by making more TSH to try to get the thyroid hormone levels where they should be.

    Other blood tests include measuring T4 and thyroid autoantibodies. Antibodies are substances made by your immune system, usually to protect you against bacterial and viral infections. Sometimes, however, the immune system can make antibodies against your own bodysuch as against your thyroid. T4 is a hormone produced directly by the thyroid gland. It is typically low in patients with hypothyroidism. An autoantibody is an antibody that attacks the cells and tissues of the organism that made it. Thyroid autoantibodies are seen in patients with Hashimotos thyroiditis.

    What Should I Eat During Pregnancy To Help Keep My Thyroid And My Babys Thyroid Working Well

    Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while youre pregnant. During pregnancy, your baby gets iodine from your diet. Youll need more iodine when youre pregnantabout 250 micrograms a day.1 Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized saltsalt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure youre getting enough, especially if you dont use iodized salt.1 You also need more iodine while youre breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan thats right for you and what supplements you should take. Learn more about a healthy diet and nutrition during pregnancy.

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