If you are thinking about getting pregnant, and you have a TSH that is in the "normal reference range," but you have elevated thyroid antibodies, and you're currently not on thyroid treatment, a new study will make you sit up and take notice. We already know that mild autoimmune hypothyroidism during pregnancy is linked to an increased risk of miscarriage. But researchers had, until now, not looked at whether treatment might help reduce that risk. Belgian researchers looked at a group of 75 TPO-Ab-positive (Hashimoto's disease) patients. 42 received levothyroxine treatment during pregnancy. Among the women, those who did not receive treatment had a substantially higher mean TSH level -- about 3.0 -- versus those being treated, whose TSH was around 1.
Based on these findings, to avoid the risk of hypothyroidism during pregnancy, the experts recommend thyroid supplementation for TPO-Ab-positive pregnant women with 50 micrograms of levothyroxine a day, unless the TSH levels are lower than 1 mIU/l.
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Source:Debièvea, F. et. al. "To Treat or Not to Treat Euthyroid Autoimmune Disorder during Pregnancy?" Gynecol Obstet Invest 2009;67:178-182 Online
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