Treatment of post-partum thyrotoxicosis

J Endocrinol Invest. 2006 Mar;29(3):244-7. doi: 10.1007/BF03345547.

Abstract

Thyrotoxicosis occurs more frequently during the post-partum period than at other times in women of childbearing age. Graves' disease and post-partum thyroiditis are two major causes of thyrotoxicosis in this period. The major task lies in differentiation of these two diseases in the post-partum period; since throtoxicosis caused by post-partum thyroiditis usually does not require treatment. The radioiodine uptake is elevated or normal in Graves' disease and low in post-partum thyroiditis, and TSH-receptor antibodies are positive in Graves' and negative in post-partum thyroiditis. Post-partum thyrotoxicosis due to Graves' disease may be treated with radioiodine but it requires radiation safety measurements for infant and is contraindicated if the mother is breast-feeding. Antithyroid drugs are the mainstay of the treatment of post-partum thyrotoxicosis. Recent investigations conclude that neither propylthiouracil nor methimazole cause any alterations in thyroid function and physical and mental development of infants breast-fed by lactating thyrotoxic mothers, and both can be safely administered in moderately high doses during lactation.

MeSH terms

  • Antithyroid Agents / therapeutic use
  • Breast Feeding
  • Female
  • Graves Disease / complications
  • Graves Disease / diagnosis
  • Humans
  • Infant, Newborn
  • Iodine Radioisotopes / therapeutic use
  • Methimazole / therapeutic use
  • Propylthiouracil / therapeutic use
  • Puerperal Disorders / drug therapy
  • Puerperal Disorders / therapy*
  • Radiotherapy / adverse effects
  • Thyroidectomy
  • Thyroiditis / complications
  • Thyroiditis / diagnosis
  • Thyrotoxicosis / drug therapy
  • Thyrotoxicosis / etiology
  • Thyrotoxicosis / therapy*
  • Thyrotropin / blood
  • Thyroxine / blood
  • Triiodothyronine / blood

Substances

  • Antithyroid Agents
  • Iodine Radioisotopes
  • Triiodothyronine
  • Methimazole
  • Propylthiouracil
  • Thyrotropin
  • Thyroxine