Principle of medication for hypothyroidism in pregnancy: sufficient amount

Guardian's partial explanation of the contents of the picture

Let's focus on the third line. The initial dosage of expectant mothers is 2.~2.4 micrograms per kilogram of body weight every day. What is this concept? Guard, explain it to everyone.

First of all, let's talk about the initial dosage

The so-called initial dosage means that a pregnant woman did not have hypothyroidism before pregnancy, but appeared hypothyroidism after pregnancy. Need immediate medication, how much should I start with? Look at the pictures below.

The initial dose in the picture is prescribed according to TSH level, which refers to the dosage of pregnant women with subclinical hypothyroidism.

Think about it, today's girls are all thin, and they usually weigh about 5 kilograms before pregnancy. According to 2 micrograms per kilogram, you need 1 micrograms. What if it is calculated at 2.4 micrograms? That's 12 micrograms. If it is 65 kg, it should be more than 65 kg at 3 weeks of pregnancy. Then, according to the table of 2.~2.4 micrograms per day, the initial dose should be 13~156 micrograms.

if TSH level is greater than 1mIU/L, it is treated as clinical hypothyroidism. The initial dosage is generally more than 125 micrograms and can reach 225 micrograms. However, doctors often give pregnant women an initial dose of 12.5 micrograms. The guardian once saw a expectant mother who was pregnant for 14 weeks and had a serum TSH of 27.61. She was diagnosed and treated in a local hospital. The initial dose was 12.5 micrograms, and after a week, she reviewed the nail art and adjusted it to 25 micrograms. After two weeks, the reexamination increased to 5 micrograms. TSH dropped to 5.3 after four weeks' reexamination, and the doctor asked her to eat 37.5 micrograms every day. After a month, I checked the A-level, and TSH was 13.36. The pregnant woman has been 2 weeks, and TSH is still high. The doctor asked her to eat 5 micrograms a day. She stopped trusting the doctor and found me. I suggested that she eat 1 micrograms directly, supplement 15 micrograms of iodine every day, and recheck her armor work around. Later, TSH dropped to 2.12.

why do you want to emphasize 2 weeks of pregnancy? Because, when the hypothyroidism of pregnancy is completely controlled before 2 weeks of pregnancy, it has no effect on the fetus. Otherwise, it will have a certain impact. How big is the impact? No research results. This is a slight hypothyroidism from the beginning. If the medicine is used according to the standard, the nail work will be controlled normally within four weeks.

why do you want to emphasize 2 weeks of pregnancy? Because, when the hypothyroidism of pregnancy is completely controlled before 2 weeks of pregnancy, it has no effect on the fetus. Otherwise, it will have a certain impact. How big is the impact? No research results. This is a slight hypothyroidism from the beginning. If the drug is used according to the standard, the nail work will be controlled to a normal level within four weeks.

secondly, the dosage of complete substitution

the initial dosage was mentioned earlier.

The dosage required to control the normal operation of nail polish is called "complete replacement dosage" according to the kilogram weight. In other words, the concept of "complete substitution" is a professional name, which is not easy for expectant mothers to understand. Therefore, the guardian said that it was "the amount needed to control the armor work normally." In fact, "the amount needed to control the normal operation of nail polish" is the "completely substituted dose" in the eyes of doctors.

what does complete substitution mean? The output of thyroid hormone in our hypothyroid patients is not enough to meet the body's consumption. It's like the reason why you ordered a takeaway to fill your stomach when you didn't have enough food at home. Eating Eupatorium is also to supplement the body with enough thyroid hormones. When your stomach is just full, the amount of take-out is a complete replacement, and this take-out completely replaces the part of food that you lack at home.

Let's talk about TSH control target

TSH.