High serum thyroid-stimulating hormone (TSH) in pregnant women needs to be considered as a possible cause of clinical or subclinical hypothyroidism in pregnancy, which can be treated with oral levothyroxine under the guidance of a specialized doctor after a clear diagnosis.
Due to the effect of human chorionic gonadotropin, the upper and lower limits of the serum TSH reference range in early pregnancy will decrease to different degrees. Serum TSH gradually rises in mid-pregnancy and may even be higher than in the general population in late pregnancy. If the high TSH in pregnant women is due to physiological factors, treatment may not be necessary, please consult a medical professional for details.
If TSH is greater than the upper limit of the reference range in pregnancy, it may be clinical or subclinical hypothyroidism, and the examination of free thyroxine (FT4) should be improved under the guidance of a physician.
If TSH is high and FT4 is < the lower limit of the reference range for pregnancy, clinical hypothyroidism is considered, and levothyroxine therapy is chosen.
If high TSH is present with FT4 levels within the pregnancy-specific reference range, consider the possibility of subclinical hypothyroidism. Pregnant women with subclinical hypothyroidism may benefit from treatment; therefore, levothyroxine therapy may be indicated in pregnant women with subclinical hypothyroidism.
The above medications are recommended to be used under the supervision of a physician.