Triphasic Changes in Thyroid Function in a Patient with Primary Hypothyroidism in the Course of Pregnancy and the Early Post-Partum Period.

Ohguni, Satoshi; Notsu, Kazumi; Kato, Yuzuru

doi:10.1507/endocrj.44.581

Cited by 3 publications

(1 citation statement)

References 26 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 The goals of maternal treatment are to maintain free thyroxine (T 4 ) at the upper level of the normal range with the minimal possible doses of antithyroid drugs. In fact, in about 30% of women antithyroid drugs may be discontinued in the last few weeks of pregnancy.…”

Section: Hyperthyroidism In Pregnancymentioning

confidence: 99%

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy: The Knowledge Gaps

Koren¹

2006

Therapeutic Drug Monitoring

View full text Add to dashboard Cite

Despite being a common condition in pregnancy, and despite propylthiouracil (PTU) being perceived as safer than methimazole, there are virtually no epidemiological controlled studies on malformation rate an neurobehavioral outcomes with the former. This knowledge gap must be filled to ensure fetal safety. Keywordsantithyroid; therapeutic drug monitoring; malformations; pregnancy; thyrotoxicosis Because the thalidomide era there is a commonly held perception among both patients and physicians that many drugs are a human teratogens. In studies conducted in our institution we have shown that women exposed to non-teratogenic drugs believe they have a 25% risk of major malformations, which is a risk equal in magnitude to that of thalidomide. 1 In reality, the risk for major malformations in the general population ranges between 1-3%. As a result of this misperception, a large number of women refuse to take drugs in pregnancy, even if such refusal may endanger their lives.The Motherisk Program at the Hospital for Sick Children and the University of Toronto counsels women and health professionals on the safety/risk of medicinal drugs, chemicals, radiation and infection during pregnancy and lactation. Presently we deal with up to 200 calls daily from women, their families and health professionals. 2 Over the years we have become painfully aware of large knowledge gaps related to thyroid diseases and their treatments during pregnancy and lactation. In this report we briefly review these issues and identify critical unanswered questions. Hyperthyroidism in PregnancyHyperthyroidism is second only to diabetes as a common endocrinopathy in pregnancy. 3 Large numbers of women need antithyroid drugs to ensure their well being, yet these medications, if they cross the human placenta, may disrupt fetal thyroid development similarly to their disruption of the function of the adult thyroid. This illustrates a potential maternalfetal conflict, because untreated thyrotoxicosis in pregnancy is associated with increased rates of various complications (Table 1).Typically, thyrotoxicosis tends to be aggravated in the first trimester of pregnancy, improve in the second, and recur within one year postpartum. 4 The goals of maternal treatment are to maintain free thyroxine (T 4 ) at the upper level of the normal range with the minimal possible doses of antithyroid drugs. In fact, in about 30% of women antithyroid drugs may be discontinued in the last few weeks of pregnancy. Maternal-Fetal Pharmacokinetics of Antithyroid DrugsThe critical first question that must be addressed is whether the main antithyroid drugs, propylthiouracil (PTU) and methimazole (MMI), cross the human placenta. Experiments with the dually perfused human term placenta documented transfer at both low and high levels of PTU (4 and 40 mcg/gmL and MMI (1.5 and 15 mcg/mL). Both drugs documented relatively similar transfer and placental clearance rates, corresponding to similar clinically documented effects on maternal and fetal thyroid function. 5In studying the p...

show abstract

Section: Hyperthyroidism In Pregnancymentioning

confidence: 99%

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy: The Knowledge Gaps

Koren¹

2006

Therapeutic Drug Monitoring

View full text Add to dashboard Cite

show abstract

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy

Koren¹

2006

Therapeutic Drug Monitoring

View full text Add to dashboard Cite

show abstract

The effects of recombinant human growth hormone therapy on thyroid function in pediatric patients with growth hormone deficiency

Yao¹,

Zheng²,

Hou³

et al. 2021

Transl Pediatr

View full text Add to dashboard Cite

Background: Recombinant human growth hormone (rhGH) was approved for the therapy of pediatric patients with growth hormone deficiency (GHD) by the Food and Drug Administration (FDA) of the United States in 1985. This study aims to evaluate the effects of rhGH therapy on thyroid function in pediatric patients with GHD.Methods: A total of 55 pediatric patients, who had been diagnosed with GHD and received rhGH therapy for 6-24 months, and who could regularly come to our hospital for outpatient visits from May 1, 2014 to April 30, 2017, were selected for the study. All of the patients were treated for at least six months, among which 44 patients were treated for 12 months, and 32 patients were treated for 18 months, and 16 patients were treated for 24 months.Results: (I) During the course of the rhGH therapy, none of the patients had a free thyroxine (FT4) level lower than the normal lower limit. (II) The FT4 level decreased during the course of the therapy, when compared to the level at baseline, and the difference was statistically significant after 24 months of therapy. In the puberty group, the FT4 level had significantly decreased by the 12 th month of therapy, when compared to the baseline, but there was no significant change in the FT4 and thyroid-stimulating hormone (TSH) levels at the remaining observation time points of treatment.Conclusions: Growth hormone (GH) replacement therapy may affect the metabolism of the thyroid hormone in pediatric patients with GHD. During the course of treatment, the changes in thyroid function in pediatric patients with GHD should be regularly monitored in order to identify any abnormal thyroid function in its early stages.

show abstract

Triphasic Changes in Thyroid Function in a Patient with Primary Hypothyroidism in the Course of Pregnancy and the Early Post-Partum Period.

Cited by 3 publications

References 26 publications

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy: The Knowledge Gaps

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy: The Knowledge Gaps

Therapeutic Drug Monitoring of Antithyroid Drugs in Pregnancy

The effects of recombinant human growth hormone therapy on thyroid function in pediatric patients with growth hormone deficiency

Contact Info

Product

Resources

About