Editing Hypothyroidism (section)

===Pregnancy===
During pregnancy, the thyroid gland must produce 50% more thyroid hormone to provide enough thyroid hormone for the developing fetus and the expectant mother.<ref name="Negro2014">{{cite journal | vauthors = Negro R, Stagnaro-Green A | title = Diagnosis and management of subclinical hypothyroidism in pregnancy | journal = BMJ | volume = 349 | issue = 10 | pages = g4929 | date = October 2014 | pmid = 25288580 | doi = 10.1136/bmj.g4929 | s2cid = 21104809 }}</ref>  In pregnancy, free thyroxine levels may be lower than anticipated due to increased binding to [[thyroid binding globulin]] and decreased binding to [[albumin]]. They should either be corrected for the stage of pregnancy,<ref name=Stagnaro/> or total thyroxine levels should be used instead for diagnosis.<ref name=Garber/> TSH values may also be lower than normal (particularly in the [[first trimester]]) and the normal range should be adjusted for the stage of pregnancy.<ref name=Garber/><ref name=Stagnaro/>

In pregnancy, subclinical hypothyroidism is defined as a TSH between 2.5 and 10&nbsp;mIU/L with a normal thyroxine level, while those with TSH above 10&nbsp;mIU/L are considered to be overtly hypothyroid even if the thyroxine level is normal.<ref name=Stagnaro/> Antibodies against TPO may be important in making treatment decisions, and should, therefore, be determined in women with abnormal thyroid function tests.<ref name=Garber/> Determination of TPO antibodies may be considered as part of the assessment of [[recurrent miscarriage]], as subtle thyroid dysfunction can be associated with pregnancy loss,<ref name="Garber" /> but this recommendation is not universal,<ref>{{cite journal | title = Evaluation and treatment of recurrent pregnancy loss: a committee opinion | journal = Fertility and Sterility | volume = 98 | issue = 5 | pages = 1103–11 | date = November 2012 | pmid = 22835448 | doi = 10.1016/j.fertnstert.2012.06.048 | author1 = Practice Committee of the American Society for Reproductive Medicine | s2cid = 30527688 | doi-access = free }}</ref> and the presence of thyroid antibodies may not predict future outcomes.<ref name="RCOG">{{cite web |title=Recurrent Miscarriage, Investigation and Treatment of Couples |url=https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg17/ |website=Royal College of Obstetricians & Gynaecologists }}</ref>