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Levothyroxine is safe to use during pregnancy and necessary for the health of the baby. [4] Women with Hashimoto's disease or an underactive thyroid who are taking levothyroxine before pregnancy may need a higher dose to maintain normal thyroid function. Clinicians may check thyroid function every 6 to 8 weeks during pregnancy.
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
The recommendation is stronger in pregnant women with subclinical hypothyroidism (defined as TSH 2.5–10 mIU/L) who are anti-TPO positive, in view of the risk of overt hypothyroidism. If a decision is made not to treat, close monitoring of the thyroid function (every 4 weeks in the first 20 weeks of pregnancy) is recommended.
As such, pregnant women are recommended to increase to nine doses of levothyroxine each week, rather than the usual seven, as soon as their pregnancy is confirmed. [14] Repeat thyroid function tests should be done five weeks after the dosage is increased.
Thyroid disease is a medical condition that affects the function of the thyroid gland.The thyroid gland is located at the front of the neck and produces thyroid hormones [1] that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ.
Women are 4-5 times more likely to develop a clot during pregnancy and in the postpartum period than when they are not pregnant. [25] Hypercoagulability in pregnancy likely evolved to protect women from hemorrhage at the time of miscarriage or childbirth. In developing countries, the leading cause of maternal death is still hemorrhage. [25]
For patients taking levothyroxine, TSH may be boosted by discontinuing levothyroxine for 3–6 weeks. [6] This long period of hormone withdrawal is required because of levothyroxine's relatively long biological half-life, and may result in symptoms of hypothyroidism in the patient. The shorter half-life of liothyronine permits a withdrawal ...
It also shouldn't be done during pregnancy, and pregnancy should be put off until at least 6–12 months after treatment. [ 49 ] [ 50 ] A common outcome following radioiodine is a swing from hyperthyroidism to the easily treatable hypothyroidism, which occurs in 78% of those treated for Graves' thyrotoxicosis and in 40% of those with toxic ...