THYROTROPIN
Drugs in Pregnancy and Lactation.
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Name: THYROTROPIN
Class: Thyroid
Risk Factor: CM
Fetal Risk Summary
Thyrotropin (thyroid-stimulating hormone, TSH) does not cross the placenta (1). No correlation exists between maternal and fetal concentrations of TSH at any time during gestation (2).
Breast Feeding Summary
No reports describing the excretion of thyrotropin in human milk have been located. Levels of this hormone have been measured and compared in breast-fed and bottle-fed infants (3,4,5,6 and 7). Breast milk does not provide sufficient levothyroxine (T4) or liothyronine (T3) to prevent the effects of congenital hypothyroidism (see Levothyroxine and Liothyronine). As a consequence, serum levels of TSH in breast-fed hypothyroid infants are markedly elevated (3,4). In euthyroid babies, no differences in TSH levels have been discovered between breast-fed and bottle-fed groups (5,6 and 7).
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References
- Cohlan SQ. Fetal and neonatal hazards from drugs administered during pregnancy. NY State J Med 1964;64:493–9.
- Feely J. The physiology of thyroid function in pregnancy. Postgrad Med J 1979;55:336–9.
- Abbassi V, Steinour TA. Successful diagnosis of congenital hypothyroidism in four breast-fed neonates. J Pediatr 1980;97:259–61.
- Letarte J, Guyda H, Dussault JH, Glorieux J. Lack of protective effect of breast-feeding in congenital hypothyroidism: report of 12 cases. Pediatrics 1980;65:703–5.
- Mizuta H, Amino N, Ichihara K, Harada T, Nose O, Tanizawa O, Miyai K. Thyroid hormones in human milk and their influence on thyroid function of breast-fed babies. Pediatr Res 1983;17:468–71.
- Hahn HB Jr, Spiekerman M, Otto WR, Hossalla DE. Thyroid function tests in neonates fed human milk. Am J Dis Child 1983;137:220–2.
- Franklin R, O'Grady C, Carpenter L. Neonatal thyroid function: comparison between breast-fed and bottle-fed infants. J Pediatr 1985;106:124–6.
Q&A about Thyrotropin
Which one of the following would be an effective treatment for a patient with Hashimoto’s disease?
a. Administration of tetraiodothyronine.
b. Administration of thyroid stimulating hormone.
c. Surgical removal of the thyroid gland.
d. Administration of thyrotropin releasing hormone.
e. Increasing the level of iodine in the diet.
