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My PCP did a baseline reading (as does my MW) of my TSH levels when first pregnant. I was already on Amour when I got pregnant with DD back in 2008, so my PCP just continued to monitor it for me, with a blood draw every 6-8 weeks. My dosage was continually upped during my pregnancy, until I was on almost 90mg. Currently, I take 60mg of Armour, and I love it. When I first started my thyroid meds, I was on Synthroid and Levothyroxine - I never felt as good on either of those as I do on the Armour. My PCP takes another blood draw at 6 weeks post-partum to adjust medication as necessary.