### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello doctor,I am 10weeks pregnant and i found that am pregnant only now.This is my second pregnancy.. since i have had irregular periods for so many years and my first pregnancy was achieved with the help of metformin, clomid, injections and artificial insemination, i did not realise that i could get pregnant naturally without the help of meds.Also i have had hypothyroidism for the past 4-5 years..i took levothyroxine and had my thyroid under control during my first pregnancy..however, for reasons of moving to a different country and travelling a lot, i could not follow-up on my thyroid levels and am currently off my thyroid meds since december 2009(for the past 6 months).I am greatly concerned that i had fallen pregnant when i am off my thyroid meds. My family physician took a blood work and told me that my T4 range is normal and my TSH is slightly elevated(went from 4.7 in feb to 6 now while am in the 10th week of gestation)..She put me on Synthroid 0.88 mcg(the dosage that i was taking earlier)..but i am already 10 weeks now and am concerned if my elevated TSH has had any adverse effect on the baby..trying to find answers...please help.

### output:

Hello, and I hope I can help you today. Even though you were not taking thyroid medication, when your doctor checked your levels your T4 levels were normal. Free T4 is the most relevant to pregnancy as this is the actual hormone that crosses the placenta to provide the baby with thyroid hormone. So at the time of your blood test, your baby was not deficient of thyroid hormone. Your TSH level shows how hard your thyroid gland is working to make the hormone. In your case your TSH shows that your thyroid is working a little too hard to maintain your normal level. The additional hormone your doctor prescribed will help decrease the work the thyroid needs to do and that should make your TSH levels fall. But in summary, your fetus was not deficient in thyroid hormone in the early days of your pregnancy, so you do not need to worry about any consequences. Under the care of your physician, there is no reason that you cannot have a healthy pregnancy. I hope this adequately answers your question and that this information is reassuring. Best wishes for the rest of the pregnancy,