Last update Dec. 8, 2017

Maternal Hypothyroidism

Compatible

Safe product and/or breastfeeding is the best option.

Maternal hypothyroidism may be prior to pregnancy and childbirth or secondary to postpartum thyroiditis with an incidence of 3 to 16% and most of the time is temporary, limited to about 6 months (Serrano 2014, Muller 2001).
Thyroiditis can occur in two phases, hyperthyroidism followed by hypothyroidism, but almost half of the time the symptoms are exclusively hypothyroidism (Stagnaro 2012).
There is no data to recommend universal screening, but it does exist in women with type 1 diabetes mellitus or associated depression (Abalovich 2007).

Due to its sharing common symptoms, hypothyroidism can be confused with postpartum depression (Serrano 2014) but no significant link has been proven between them (Stagnaro 2012, Lucas 2001).
Although there is not much evidence, it is believed that maternal hypothyroidism can cause hypogalactia (Serrano 2014). However, cases of galactorrhea without hyperprolactinemia have been reported in women affected with hypothyroidism (Oana 2015, Takai 1987).

The treatment of hypothyroidism with hormone replacement is compatible with breastfeeding (Alexander 2017, Serrano 2014).

The concentration of liothyronine (T3) in breast milk is much higher than that of levothyroxine (T4), which is usually very low or undetectable (Jansson 1983, Sato 1979). Therefore, and because of greater experience, levothyroxine is more recommended than liothyronine for the treatment of hypothyroidism in general and during breastfeeding (Alexander 2017, Serrano 2014, Carney 2014, Yazbeck 2012, Stagnaro 2011, Okosieme 2008, Nava 2004).

During pregnancy, the need for treatment with replacement hormone usually increases, decreasing sharply after delivery, so it is necessary to return to the usual dose taken prior to pregnancy (Serrano 2014).


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Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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References

  1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Abstract Full text (link to original source) Full text (in our servers)
  2. Oana Maria P, Deepti C, Shridhar D. Galactorrhoea:Report of Two Cases. Maedica (Buchar). 2015 Abstract
  3. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015 Jan 20;144(2):73-9. Abstract
  4. Carney LA, Quinlan JD, West JM. Thyroid disease in pregnancy. Am Fam Physician. 2014 Abstract
  5. Stagnaro-Green A. Approach to the patient with postpartum thyroiditis. J Clin Endocrinol Metab. 2012 Abstract
  6. Yazbeck CF, Sullivan SD. Thyroid disorders during pregnancy. Med Clin North Am. 2012 Abstract
  7. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W; American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum.. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011 Abstract Full text (link to original source) Full text (in our servers)
  8. Okosieme OE, Marx H, Lazarus JH. Medical management of thyroid dysfunction in pregnancy and the postpartum. Expert Opin Pharmacother. 2008 Abstract
  9. Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, Mandel SJ, Stagnaro-Green A. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2007 Abstract Full text (link to original source) Full text (in our servers)
  10. Nava-Ocampo AA, Soldin OP, Koren G. Hypothyroidism during pregnancy. Can Fam Physician. 2004 Abstract
  11. Muller AF, Drexhage HA, Berghout A. Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care. Endocr Rev. 2001 Abstract Full text (link to original source) Full text (in our servers)
  12. Lucas A, Pizarro E, Granada ML, Salinas I, Sanmartí A. Postpartum thyroid dysfunction and postpartum depression: are they two linked disorders? Clin Endocrinol (Oxf). 2001 Abstract
  13. Takai T, Yamamoto K, Saito K, Ando K, Saito T, Kuzuya T. Galactorrhea in subclinical hypothyroidism. Endocrinol Jpn. 1987 Abstract
  14. Jansson L, Ivarsson S, Larsson I, Ekman R. Tri-iodothyronine and thyroxine in human milk. Acta Paediatr Scand. 1983 Abstract
  15. Sato T, Suzuki Y. Presence of triiodothyronine, no detectable thyroxine and reverse triiodothyronine in human milk. Endocrinol Jpn. 1979 Abstract

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