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| TSH Range (mIU/L) | TPO Antibody | Recommendation |
|---|---|---|
| > 4.0 | Any | Treat (Strong) |
| 2.5 – 4.0 | Positive | Treat (Recommended) |
| 2.5 – 4.0 | Negative | Consider Treat (Weak) |
| < 2.5 | Any | Monitor / No treatment |
2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.
Note: The preferred total TSH upper limit is trimester-specific (approx 2.5 for 1st trimester). TSH targets change during pregnancy due to the stimulating effects of hCG on the thyroid.