Thyroid Function During Pregnancy and The Postpartum Period: Iodine Metabolism and Disease States

Fernández-Soto, María Luisa; Jovanovič, Lois; González-Jiménez, Amalia; Lobón-Hernández, Jose Antonio; Escobar-Jiménez, Fernándo; López-Cózar, Luis Navarrete; Barredo-Acedo, Francisco; Campos-Pastor, Maria Mar; López-Medina, J.

doi:10.4158/ep.4.2.97

Cited by 15 publications

(7 citation statements)

References 34 publications

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“…The prevalence of HTP was 0.3% in the study and this figure is higher than the previously reported rates [1]. The explanation may be the combination of hyperthyroidism, mainly Graves' disease before conception and thyrotoxicosis of pregnancy due to the physiological action of b-HCG at the TSH receptor, i.e.…”

Section: Discussioncontrasting

confidence: 69%

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Possible association between hyperthyroidism in pregnant women and obstructive congenital abnormalities of urinary tract in their offspring – a population-based case–control study

Bánhidy

Puhó

Czeizel

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussioncontrasting

confidence: 69%

“…The prevalence of hyperthyroidism in pregnant women was found between 0.05% and 0.2% in different studies [1]. The typical symptoms of hyperthyroidism, i.e.…”

Section: Introductionmentioning

confidence: 98%

Possible association between hyperthyroidism in pregnant women and obstructive congenital abnormalities of urinary tract in their offspring – a population-based case–control study

Bánhidy

Puhó

Czeizel

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Autoantigens, TPO in the thyroid and lactoperoxidases in the breast, are required for organification of iodine to produce iodoproteins [32], as they catalyze H 2 O 2 production to oxidize I - [33]. Previously reported potential association between TPOAb or TgAb and breast cancer was arguable and the results were summarized in Table 5[4,18,34-36].…”

Section: Discussionmentioning

confidence: 99%

TSH receptor antibodies have predictive value for breast cancer – retrospective analysis

Szychta

Gesing

et al. 2013

Thyroid Res

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BackgroundAssociations between breast cancer and thyroid disorders are reported in numerous studies. Relationships between thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and breast cancer have been previously demonstrated. However, no analysis has been performed concerning an association between thyrotropin (TSH) receptor antibodies (TSHRAb) and breast cancer. The aim of the study was to evaluate the prevalence of breast cancer or benign breast tumors in patients with Graves’ disease and to analyze a possible relationship between Graves’ disease and these two groups of breast diseases with emphasis to epidemiology and laboratory findings.Patients and methodsClinical and laboratory details of 2003 women hospitalized for endocrine disorders were retrospectively analyzed, using an unpaired Student’s t-test, logistic regression analysis, χ2 test of independence or the two-sided ratio comparison test.ResultsThe coexistence of Graves’ disease and breast cancer was statistically significant. We observed TSHRAb and TgAb more frequently in patients with breast cancer. We found that TSHRAb is the only variable possessing predictive value for breast cancer.ConclusionsThe strong relationship between Graves’ disease and breast cancer is proposed. We suggest that TSHRAb could be described as a positive determinant of breast cancer. The present data call attention to the usefulness of screening for breast cancer in long-term follow-up of patients with autoimmune thyroid disorders, especially of those with Graves’ disease. Similarly, screening for autoimmune thyroid disorders should be performed in patients with nodular breast disease. Additionally, the article draws ideas for further research in order to develop targeted treatment for more successful outcome in patients with breast cancer.

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“…The transplacental passage of maternal thyroid hormones, the increased turnover of maternal T 4 under the influence of D3, and an increased maternal renal clearance of T 4 probably maintain the increased demands for thyroid hormone that are sustained until term. 11,12 Finally, there is the previously mentioned transient elevation of hCG during the first trimester. As a result of the stimulation of the maternal thyroid machinery, there is an increased thyroidal uptake of iodine.…”

mentioning

confidence: 87%

Thyroid Medications During Pregnancy

Bach-Huynh

Jonklaas²

2006

Therapeutic Drug Monitoring

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Euthyroid women experience dramatic changes in their thyroid physiology in order to accommodate the presence of placental and fetal tissues. These adaptations to the pregnant state make it crucial to develop reliable trimester-specific intervals for thyroid parameters. Use of non-pregnant reference intervals could lead to erroneous assessment of thyroid status in this rapidly changing hormonal environment. Only with a full appreciation of physiologic changes in thyroid parameters during a euthyroid pregnancy, can thyroid dysfunction be appropriately diagnosed and managed. Iodine sufficiency during pregnancy can be achieved with supplementation using a multivitamin. Both hypothyroidism and hyperthyroidism should be diagnosed using the appropriate reference intervals for pregnancy. Hypothyroid women are best treated with a specific brand of levothyroxine. Hypothyroidism should ideally be treated prior to conception. If newly recognized during pregnancy, it should be fully treated as early as possible. Frequent monitoring of thyroid status is essential as many women demonstrate an increased requirement for thyroid hormone during the first trimester. Although mild hyperthyroidism may be well tolerated during pregnancy, overt hyperthyroidism requires treatment. Thionamides are the mainstay of therapy. Following their initiation, close monitoring is required to avoid maternal and fetal hypothyroidism. There are occasional circumstances when other medical therapy or surgical therapy may be employed for hyperthyroidism. Thyroidectomy is generally safe in the second trimester in an appropriately prepared woman. There is limited data about the role and safety of oral contrast agents, iodine, amiodarone, and perchlorate. Radioiodine therapy is contradicted during pregnancy.

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Thyroid Function During Pregnancy and The Postpartum Period: Iodine Metabolism and Disease States

Cited by 15 publications

References 34 publications

Possible association between hyperthyroidism in pregnant women and obstructive congenital abnormalities of urinary tract in their offspring – a population-based case–control study

Possible association between hyperthyroidism in pregnant women and obstructive congenital abnormalities of urinary tract in their offspring – a population-based case–control study

TSH receptor antibodies have predictive value for breast cancer – retrospective analysis

Thyroid Medications During Pregnancy

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