Hypothyrodism and pregnant

Patient

Q: I am 17 week pregnant, current on 50mcg levothyroxin to treat my hypothyrodism.Last month my TSH was 2.68 mIU/L that was normal and this month i get it tested again TSH is 4.12 mIU/L. T3 is 16pmoI/L and T4 is 4.4pmoI/L. I am really worried and i read on internet that TSH range in second trimester should be below 2.95. Please suggest me what should i do
Should i increase dose-How much?
What is normal range during second trimester?
Please reply soon
Thank you so much!!

Doctor

A:   Thank you for your question. We do no recommend you change your Levothyroixine dosage until you consult your prescribing physician and ob/gyn before doing so. The normal TSH range for a woman in their second trimester is 0.3-3.0. During pregnancy, the thyroid gland is producing 50% more thyroid hormone (T3,T4) and consequently, thyroid stimulating hormone (TSH) secretion from pituitary gland of the brain will be less.
Your T4 level (if this measurement is Total T4) is within normal range. According to current guidelines, your thyroid disease is considered subclinical and further laboratory testing is required to test for a specific antibody called antithyroid peroxidase antibody. If this antibody is found, you will be required to have your medication readjusted. We recommend that you follow up with your doctor as soon as you can determine whether you need further treatment.

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