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The pattern of thyroid function of subclinical hypothyroid women with levothyroxine treatment during pregnancy

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Abstract

In this study, we researched the pattern of thyroid function of subclinical hypothyroid (SCH) women with levothyroxine (LT4) throughout pregnancy and determined the optimal dosages of LT4 for such women. 56 SCH pregnant women were followed regularly prospectively. They were divided into three groups: group A (n = 29. Baseline TSH between 2.5 and 5.0 mIU/L) received 50 μg/day of LT4; group B (n = 17. Baseline TSH between 5.0 and 8.0 mIU/L) received 75 μg/day of L-T4; group C (n = 10. Baseline TSH >8.0 mIU/L) received 100 μg/day of LT4. All the patients started LT4 therapy around the 8th gestational week. Serum TSH, free T4, and free T3 were measured at 4-week intervals throughout pregnancy. Among the thyroid function indexes, serum TSH changed quickly and decreased significantly 4 weeks after LT4 therapy. The change of serum FT4 responded drastically at the 12th gestational week. We also found that serum FT3 did not change much after LT4 therapy. 50, 75, and 100 μg/day can maintain serum TSH level of 79.3, 82.4, and 90.0 % of SCH women in definitive therapeutic goal in group A, B, and C, respectively. The LT4 dose need to be adjusted one or more times in 20.7, 17.6, and 10.0 % of the SCH women in group A, B, and C, respectively. The different LT4 dose can be chosen according to the baseline TSH levels of SCH women. The constant LT4 dose can maintain serum TSH levels of 79.3–90 % patients in the ideal range. A small part of patients require adjust therapy also during the second and third trimester. Therefore, careful follow-up of SCH pregnant women should be taken, and thyroid function should be tested every month until the end of pregnancy.

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Acknowledgments

We acknowledge all persons who participated in this study. The study was supported by funding from the Healthcare Industry Special Project (200802008) and the Social Development Foundation of Liaoning Province (2007225010).

Conflict of interest

All contributing authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang, 110001, China

    Xiaohui Yu, Yanyan Chen, Zhongyan Shan, Weiping Teng, Weiwei Wang, Yuanbin Li, Chenling Fan, Hong Wang, Hongmei Zhang & Rui Guo

  2. Department of Gynaecology and Obstetrics, Shenyang No. 5 People’s Hospital, Shenyang, 110023, China

    Chenyang Li & Bin Ding

  3. Department of Gynaecology and Obstetrics, Women and Infants Hospital of Shenyang, Shenyang, 110014, China

    Weiwei Zhou

  4. Department of Gynaecology and Obstetrics, Shenyang No. 4 People’s Hospital, Shenyang, 110031, China

    Bo Gao

  5. Department of Gynaecology and Obstetrics, Second Affiliated Hospital, China Medical University, Shenyang, 110004, China

    Tao Shang & Jiaren Zhou

  6. Department of Gynaecology and Obstetrics, Shenzhou Hospital of Shenyang, Shenyang, 110002, China

    Ying Ma

  7. Department of Gynaecology and Obstetrics, Shenyang No. 9 People’s Hospital, Shenyang, 110024, China

    Ying Wu

  8. Department of Gynaecology and Obstetrics, Women and Infants Hospital of Heping District of Shenyang, Shenyang, 110005, China

    Qun Liu & Hui Xu

  9. Department of Gynaecology and Obstetrics, Shenyang No. 8 People’s Hospital, Shenyang, 110024, China

    Wei Liu

  10. Department of Endocrinology and Metabolism, The Fourth Hospital of China Medical University, Shenyang, 110032, China

    Jia Li

Authors
  1. Xiaohui Yu
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  2. Yanyan Chen
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  3. Zhongyan Shan
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  4. Weiping Teng
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  5. Chenyang Li
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  6. Weiwei Zhou
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  7. Bo Gao
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  8. Tao Shang
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  9. Jiaren Zhou
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  10. Bin Ding
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  11. Ying Ma
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  12. Ying Wu
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  13. Qun Liu
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  14. Hui Xu
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  15. Wei Liu
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  16. Jia Li
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  17. Weiwei Wang
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  18. Yuanbin Li
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  19. Chenling Fan
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  20. Hong Wang
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  21. Hongmei Zhang
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  22. Rui Guo
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Corresponding authors

Correspondence to Zhongyan Shan or Weiping Teng.

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Yu, X., Chen, Y., Shan, Z. et al. The pattern of thyroid function of subclinical hypothyroid women with levothyroxine treatment during pregnancy. Endocrine 44, 710–715 (2013). https://doi.org/10.1007/s12020-013-9913-2

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  • DOI: https://doi.org/10.1007/s12020-013-9913-2

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