Dr. Thiyagarajan. T
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My wife has had thyroid for seven years. She got pregnant three years back. She had tablets Thyronorm 100 mcg during the entire pregnancy period and before that. I am attaching two reports taken three years back. Last year she took another test, her levels were low (reports attached). The gynecologist suggested not to stop abruptly and prescribed a tablet Thyronorm 88 mcg. Yesterday we took another test for review, and the results are attached for your perusal. Kindly suggest whether she should continue or stop because the results, as you will notice, are low.
Kindly advice.
Thank you.
Hi,
Welcome to icliniq.com.
I recommend (consult with a specialist doctor, talk with him or her and take medicines with their consent) decreasing the tablet Thyronorm (Levothyroxine) dose to 50 mcg daily. I suggest you repeat TSH (thyroid-stimulating hormone levels) and FT4 )(free thyroxine) in three months. Any plans for pregnancy in the near future? If yes, then continue the same dose. If you cannot get a 50 mcg dose or have too many 88 mcg tablets with you, you can take 88 mcg only four days a week. Do you have the initial reports?
Thank you.
Patient's Query
Hi doctor,
Thanks for your response.
Hi,
Welcome back to icliniq.com.
Thanks and take care.
Patient's Query
Hi doctor,
Thank you for your reply.
My wife is 29 weeks pregnant, and this is her second pregnancy. She has had thyroid for around five years, even during her first pregnancy. Eight months back, her TSH was 0.29, which is when I consulted you about whether to reduce her dosage. You advised her to take 88 mcg & she has been taking that till now. However, during her routine test after four months, her TSH was 3.4 (results attached). Should she continue with 88 mcg or change the dosage? Kindly advice. I have also attached her GTT report. Her fasting sugar is borderline. Kindly advise what she should do to reduce.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Please continue the 88 mcg dose of Thyroxine. A TSH (thyroid stimulating hormone) of 3.4 in the second trimester is in the normal range. Please check TSH once now. As for the GTT, she has a slightly higher fasting value. I recommend having a glucometer at home and monitoring glucose - fasting one day, two hours after breakfast the next day, two hours after lunch the next day, and two hours after dinner the following day, and repeat. The goal is for fasting glucose to be less than 95 mg/dL and two hours after meals to be less than 120 mg/dL. Reduce carbohydrates in the diet and no sugar. Regular walking unless told by the doctor not to. She may need medicine (Metformin or Insulin) to decrease her fasting glucose. But first, diet, exercise, and monitoring.
Hope this helps.
Thanks and take care.
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Diabetology
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