High TSH values ​​in pregnancy: the endocrinologist replies

Hi doctor, I’m turning to you to find out if since it’s only now that I’m on the 21st week. of pregnancy, I discovered that I had the tsh at 4.31, and I started with Levothyroxine sodium 50 mcg, can my baby have significant repercussions? thanks..i’m very anxious

the TSH of 4.31 certainly did no harm to her or the baby. It’s just a sign that your thyroid gland is having a hard time producing all the hormone you need. The child already has a functioning thyroid and is therefore autonomous from this point of view.

 Cordial greetings, 

 Dr. Isabella Negro 

Hello Dr., I’m asking for your opinion.
I’m a 22 year old girl in the 6th month of pregnancy, I took the TSH exam and I have a value of 4.9. Could it be caused by pregnancy or could it be genetic?
As my mother has thyroid problems that no longer work.
How do I check if it’s a temporary problem or if I’ll always have to keep it checked even at the end of pregnancy.
A thousand thanks

Dear Mrs,

thyroid problems and in particular autoimmune thyroiditis which causes hypothyroidism in the vast majority are  familial, i.e. they can be present in several members of the same family with a predilection  for the female sex. However, since it is not genetic disease, such as hemophilia or Mediterranean anemia for example,  it is not certain that it should come because her mother has it, she just has a predisposition. So right now focus on your pregnancy and recheck your TSH every 2 months so it doesn’t  get too high. It could be just a temporary change.

After the birth, without haste, you will be able to do a dosage of the anti-thyroid antibodies  and an ultrasound which will be able to confirm or not the thyroid pathology. Based on this result,  the doctor will decide whether to have an annual check of thyroid hormones or not to do more checks. 

Good luck for everything,

Dr. Isabella Negro
Dear Dr. Negro, I am contacting you for greater clarity regarding my case history. I am 39 years old and I am in the 19th week
of gestation, I have only now realized that I have a tsh value which has increased from 8.60 to 9.60 over a month despite having
FT3 values ​​(2.67 and FT4 (just over 1 ) averagely normal . They advised me to take the specific drug immediately even if – they
explained to me – that by now the fetus has its thyroid functioning. My strongest doubt concerns the possible causes relating to the fact of
not having taken the drug during the first trimester: “may have caused some deficit to the fetus and/or problem”? … compatibly with
its time (and my anxiety) i would appreciate an answer quickly.
Thanks Infinite.,

as long as the thyroid hormones remain within the normal range, the baby also in the first  trimester of pregnancy does not suffer from any kind of deficiency. 

When the hormones drop below the normal level, the child is in any case covered  because the mother provides them by depriving herself of them (so it is the mother who feels bad). The real problem occurs when hormones are very low or almost undetectable (usually the TSH at that point  is above 100). So don’t worry and follow the treatment that has been prescribed  to have all the energy necessary to face the pregnancy.


Dr. Isabella Negro

Dear Dr,
I’m bothering you to ask you for a brief clarification regarding the TSH value, as prior to the pregnancy I’m carrying on
(I’m on my 21st week) the doctor had prescribed tests to check my thyroid values ​​and a ultrasound, which highlighted some small nodules to be monitored every 6 months.
From the thyroid values: high TSH and regular FT4/FT4 I had been diagnosed with subclinical hypothyroidism, but without any further investigation by the Endocrinologist I consulted.
After this I got pregnant and my gynecologist prescribed me TSH control as I don’t sleep much and I’m gaining weight despite being on a strict diet, also taking into account that I am one of the many “gluten sensitive”. The value found by the exam just done is a TSH of 4.08. I would be grateful if you could help me understand if more checks are needed and if this value can interfere with the ongoing pregnancy and with my unjustified weight gain.
I forgot to tell you that I turned 40 last July 2013 and that I have always done a lot of sport (gym, walking/biking/step) today I limit myself to walking/step/biking and walking in the water) I trust in your kind reply,
as I’m very worried.
Cordial greetings.

Dear Mrs,

for subclinical hypothyroidism there are not many tests to do, the dosage of thyroid hormones and anti-thyroid antibodies and thyroid ultrasound are sufficient to make a diagnosis. A TSH of 4.08 is considered normal in a non-pregnant woman, while during pregnancy we give coverage with thyroid hormone in order to bring the TSH back to around 2.5 (it’s just a precaution). a TSH check approximately every 2-2.5 months and a check two months after delivery.

As far as body weight is concerned, a TSH of 4 does not justify a tendency to gain weight.

Because hypothyroidism causes a slowdown in metabolism such that you increase without eating more you need to have a very high TSH (for example 50) and hormones (FT3 and FT4) well below the normal limit.

Metabolism is influenced by many other factors, first of all pregnancy. The body goes into “energy saving” mode and tries to accumulate as much fat as possible in view of childbirth and breastfeeding.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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