What are the ATA guidelines for the treatment of hypothyroidism in pregnant women?

Updated: Mar 03, 2021
  • Author: Philip R Orlander, MD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

The updated guidelines on hypothyroidism issued by the American Thyroid Association in 2014 concerning hypothyroidism treatment in pregnant women are as follows: [7, 8]

  • Pregnant women with overt hypothyroidism should receive levothyroxine replacement therapy with the dose titrated to achieve a TSH concentration within the trimester-specific reference range.

  • Serial serum TSH levels should be assessed every 4 weeks during the first half of pregnancy to adjust levothyroxine dosing to maintain TSH within the trimester-specific range.

  • Serum TSH should be reassessed during the second half of pregnancy.

  • In women already taking levothyroxine, 2 additional doses per week of the current levothyroxine dose, given as one extra dose twice weekly with several days’ separation, may be started as soon as pregnancy is confirmed.


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