What TSH cut off do you use to determine the need for levothyroxine supplementation in a pregnant patient with positive TPO antibodies?

Current ATA pregnancy guidelines recommend measuring TPO antibodies to determine the need for levothyroxine initiation in mildly hypothyroid pregnant women. However, the most recent data do not support this approach. The upcoming revision to the ATA pregnancy guidelines will no longer factor in TPO ...

Levothyroxine supplementation is recommended by the American Thyroid Association (ATA) in preganant patients with + TPO ab when the TSH level is above 4.0 mIU/L, and treatment should be considered when TSH is between 2.5 mIU/L and 4.0 mIU/L. Therefore, I keep the TSH < 2.5 during pregnancy.