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How to manage hypothyroidism during pregnancy?

Dr Anju Virmani
Consultant Endocrinologist,
Sunder Lal Jain Hospital,
New Delhi

Q: I am 27 years old and 3 months pregnant. I am a thyroid patient with TSH level of 0.053. Presently I am taking 50 mcg Eltroxin tab. I am worried whether taking thyroid tablet during this period is safe and what care should I take during pregnancy with thyroid disease? How often should the thyroid tests be done? Will the development of the fetus be absolutely normal or should abortion be done? Will I be normal and does it take a long time to normalize thyroid function? Please also let me know the causative factors for this as it is not a hereditary disease.

A:The TSH level you have mentioned is very low and your thyroxin dose shouldbe reduced. However, you have not clarified when the TSH was done and sincewhen you have been taking the Eltroxin.If you are hypothyroid then thyroxin is a must during pregnancy, of coursein the correct doses, i.e. maintaining the T4 and TSH levels within the normallimits.You will need to repeat the TSH along with T4 after 4-6 weeks of reducingthe dose and then repeat T4 and TSH every trimester.The baby's cord blood should also be tested for T4 and TSH at the timeof birth.