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Fetal wellbeing with uncontrolled hypothyroidism in mother in early pregnancy

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My wife (Age 29) is pregnant and is in 6th week of pregnancy. She has hypothroidism. She has been taking Thyronorm 75mcg since 6-7 months. When the tests were conducted 3 days back, her TSH result is 9.08. Her pregnancy is already in 6th week. I feel very worried. What needs to be done now? Can it be controlled? Will the child be absolutely normal or the thyroid level had already affected the baby? Is it completely safe to have this baby at this stage? Please reply asap. Thanks.

Category: OBGYN

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Category: Infertility Specialist
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Thanks for your query at

Severe hypothyroidism is associated with maternal complications in pregnancy such as anemia, muscle weakness and pain, raised blood pressure, premature births, low birth weight babies etc.

However, in mild hypothyroidism, there is less chance of having such issues.
Untreated and severe hypothyroidism can also lead to impairment of intellectual development of the fetus.

You have not mentioned whether her T3 and T4 levels are normal.If they are normal, and only TSH is raised, this is called subclinical hypothyroidism. This is not as dangerous for the baby as overt and severe hypothyroidism.
Ideally, TSH levels in the first trimester should be less than 2.5.

Right now, do not worry as the value is not VERY high ( overt hypothyroidism can have as high TSH levels upto a 100 or even more ) and as long as she continues taking the medication sincerely, the TSH levels will be controlled, and the pregnancy will be fine.

Recheck the levels every 4 - 6 weeks, and accordingly the dosage has to be adjusted to keep the TSH levels less than 2.5.

Also, make sure that she does not take the prenatal vitamins and folic acid / iron / calcium with the thyroxine, as it interferes with absorption.

Thyroid medication has to be taken first thing in the morning, on an empty stomach, with just a sip of water ( avoid eating for atleast half an hour after the medicine ).

All the best and do not worry about the report.
Please feel free to ask any further follow up questions.


Patient replied :

Thanks a lot for your advice. It was very helpful and I feel relaxed now. The doctor has changed the dosage of thyromorm from 75 mcg to 100 mcg. The doctor also told us that there is nothing to worry as in pregnancy the dosage increases by 25%. The gynaec has told only to take folic acid tablet as of now and then we have to go for rescan in 12 weeks. I have a question that suddenly since 2-3 days my wife is feeling pain in the hip region. The pain is in inside region and she is not able to stand for long time. The pain is increasing. Do I need to see a doctor? Please advice soon. Thanks.

Hi again,

Yes, thyroxine requirement is increased in pregnancy, so the dosage prescribed to you is fine.
If your wife is unable to stand, then yes, you do need to see a doctor right away.
During pregnancy, due to deficiency of calcium and / or vitamin D, bony pain maybe experienced.
You can start calcium and vitamin D supplements only after the 12th week, till then, she should increase her intake of dairy products ( milk, curd, paneer, tofu ) and increase exposure to sunlight.
Rarely, B 12 deficiency in pregnancy might cause such pain.
These conditions are easily diagnosed by blood tests, and injections of Vitamin B 12 would solve the problem.
During pregnancy, as the uterus grows, there is pressure on surrounding areas, and hip and pelvic pain is common.
ALso, the joints and muscles loosen during pregnancy due to hormonal changes so such changes are also common.
However, if the pain is not letting her even stand properly, then you need to see a doctor for the necessary tests and treatment accordingly.

Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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