Management of thyroxine therapy during pregnancy.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
M M Kaplan

Abstract

To review the management of thyroxine (T4) therapy in pregnant patients with hypothyroidism. The results of pertinent published studies are summarized, and practical recommendations are presented. The conditions for which T4 therapy is administered during pregnancy are the same as those in nonpregnant patients: hypothyroidism, thyrotropin or thyroid-stimulating hormone (TSH) control after surgical treatment of thyroid cancer, and, in selected patients, suppression treatment for postsurgical thyroid remnants, thyroid nodules, or goiter. Untreated hypothyroidism during pregnancy can potentially cause adverse effects in both mother and fetus. Up to 75% of T4-treated women with hypothyroidism require higher doses of T4 during pregnancy than before or after conception, to maintain serum TSH levels in the normal range. Otherwise, in a substantial percentage of these women, subnormal serum free T4 levels, TSH elevations >20 microIU/L, or both will develop. The mean T4 dose needed to correct hypothyroidism during pregnancy is about 150 microg/day, but individual dose requirements vary widely. The increment in T4 dose needed to normalize an increased TSH level in women taking T4 can be estimated from the serum TSH concentration during p...Continue Reading

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Citations

Jun 9, 2001·The New England Journal of Medicine·R D Utiger
Apr 25, 2007·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Leonardo Vieira NetoMário Vaisman
May 26, 2004·Best Practice & Research. Clinical Endocrinology & Metabolism·Jorge H Mestman
Jun 18, 2004·Obstetrics and Gynecology Clinics of North America·Shahla Nader
Aug 14, 1999·Thyroid : Official Journal of the American Thyroid Association·G A Brent

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