Patient: has been hypothyroid, 6 months pregnant, has been taking one thyroid tablet, now T4 is low, I wonder if it will affect the fetus, should I adjust the dosage? Is it too late to adjust the dosage? In November, the FT4 was lower than the lower limit (the doctor told me to maintain one thyroid tablet), and now the FT4 is also lower than the lower limit, will the fetus have low intelligence? (Ultrasound examination of the fetus has no deformity, bone development is very good) Shanghai Ruijin Hospital, Department of Endocrinology and Metabolic Disease Wang Shu: hypothyroidism patients pregnant, eugenol or thyroid tablets must be replaced, the replacement amount has been reached s-TSH for 1-2 good, at least not more than 2.5. Especially in the first three months of pregnancy. However, it is not absolute, as long as the FT3 and FT4 are within the normal range, a slightly higher s-TSH is not a problem. If FT4 is low and sTSH is high in the first 1-3 months of pregnancy, correcting and replenishing it quickly can still make up for the previous deficiencies. But if the FT4 is low for a long time, it will definitely affect the development of the fetus. Your FT4 check in November was below the lower limit, you should increase the amount of thyroid hormone replacement, I don’t know how the labs are now? It is recommended to go to the hospital to adjust the dose. Patient: I am now according to the doctor’s instructions to increase the amount of medicine in the morning and evening each one, now is 6 months, the day before yesterday check T4 is still low. Wang Shu, Department of Endocrinology and Metabolism, Shanghai Ruijin Hospital: If you only take 1 # of thyroid tablets, don’t increase the dosage by 1 tablet at once, you can first take half a tablet more, and then check the thyroid function after 2 weeks, and adjust the dosage according to the thyroid function. (Thyroid tablets can become hyperthyroidism if you take too many of them.) Moreover, thyroid tablets should not be taken at night, as thyroid tablets have an excitatory effect, and taking them at night may affect your sleep. You can take one tablet in the morning on an empty stomach and half a tablet before lunch. It is better to change thyroid tablets to eugenol, because thyroid tablets contain both T3 and T4, while eugenol is pure T4, too much T3 will cause panic and other side effects. Patient: Hello, Dr. Wang! Eat 20 days of eugenol, March 8 check tsh but higher than before, original 1.5 more, now 3.17, ft4 did not change, ft3 3.72, 20 days of the amount of 1.5 pills, but also maintained at 6.24 (11.2-20.1) “indicators of low”, please ask Dr. Wang, how can adjust the amount of good medicine it? Wang Shu, Department of Endocrinology and Metabolic Diseases, Shanghai Ruijin Hospital: Increase the dosage of Eugenol, 2#/day, and review after 2 weeks. Patient: labs in April, TSH 0.13 (0.34-5.06) low, FT3 4.45 (3.67-10.43), FT4 12.32 (11.2-20.1), labs in May, TSH 0.07, FT3 4.16. FT4 11.44, April’s dosage of Eugenol 3 capsules/day, due to low TSH, reduced by 1 capsule, but May’s labs TSH is even lower, would like to ask Dr. Wang to reduce the dosage of medication TSH how to continue to fall instead of rising, how to adjust the dosage of medication? Wang Shu, Endocrinology and Metabolic Disease, Shanghai Ruijin Hospital: continue 2 capsules, and then 1 month’s lab test.