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Effectiveness of L-thyroxine treatment on TSH suppression during pregnancy in patients with a history of thyroid carcinoma after total thyroidectomy and radioiodine ablation.

Krhin B, Besic N - Radiol Oncol (2012)

Bottom Line: The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide.TSH was adequately suppressed in only 25% of pregnancies.The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Diagnostics, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Introduction: There are scarce data about the optimal increase of L-thyroxine dose during pregnancy in patients with a history of thyroid carcinoma. The first aim of the study was to find out if routine therapeutic measures enable adequate TSH suppression in pregnancy. The other aim was to find out the optimal dose of L-thyroxine for TSH suppression in pregnant women.

Patients and methods: In this retrospective observational study, we analysed 36 pregnancies of 32 women with a history of thyroid carcinoma. Before pregnancy, all of them underwent total thyroidectomy and radioiodine ablation of thyroid remnant, and they were on suppressive doses of L-thyroxine. Thyroid function tests were obtained before, during and after pregnancy.

Results: Mean L-thyroxine dose before pregnancy, in the first, second and, third trimester and after delivery was 149, 147, 155, 165 and 158 micrograms daily, respectively. TSH concentration remained suppressed in 9 pregnancies, it was within normal range in 22 and elevated in 5 pregnancies. The mean dose of L-thyroxine in patients with suppressed TSH before pregnancy, in the first, second and, third trimester and after delivery was 154, 154, 164, 160 and 161 micrograms daily, respectively. When the dose had to be changed, the mean increase of the dose was 31.5 micrograms daily.

Conclusions: The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide. TSH was adequately suppressed in only 25% of pregnancies. The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively.

No MeSH data available.


Related in: MedlinePlus

Changes of TSH during 36 pregnancies. The bottom and top of the box are the 25th and 75th percentile (the lower and upper quartiles, respectively), and the band near the middle of the box is the 50th percentile (the median). The ends of the whiskers represent the minimum and maximum of all the data.
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f1-rado-46-02-160: Changes of TSH during 36 pregnancies. The bottom and top of the box are the 25th and 75th percentile (the lower and upper quartiles, respectively), and the band near the middle of the box is the 50th percentile (the median). The ends of the whiskers represent the minimum and maximum of all the data.

Mentions: The mean concentration of TSH, freeT4 and free T3 before pregnancy, in the first, second and third trimester and after delivery are presented in Table 1. The concentration of TSH during the first, second and third trimester were higher in comparison to the TSH concentration before pregnancy (p<0.001). The changes of TSH concentration during pregnancy are presented in Figure 1. In none of our patients, a decrease of TSH was observed in the first 16 weeks of pregnancy.


Effectiveness of L-thyroxine treatment on TSH suppression during pregnancy in patients with a history of thyroid carcinoma after total thyroidectomy and radioiodine ablation.

Krhin B, Besic N - Radiol Oncol (2012)

Changes of TSH during 36 pregnancies. The bottom and top of the box are the 25th and 75th percentile (the lower and upper quartiles, respectively), and the band near the middle of the box is the 50th percentile (the median). The ends of the whiskers represent the minimum and maximum of all the data.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472936&req=5

f1-rado-46-02-160: Changes of TSH during 36 pregnancies. The bottom and top of the box are the 25th and 75th percentile (the lower and upper quartiles, respectively), and the band near the middle of the box is the 50th percentile (the median). The ends of the whiskers represent the minimum and maximum of all the data.
Mentions: The mean concentration of TSH, freeT4 and free T3 before pregnancy, in the first, second and third trimester and after delivery are presented in Table 1. The concentration of TSH during the first, second and third trimester were higher in comparison to the TSH concentration before pregnancy (p<0.001). The changes of TSH concentration during pregnancy are presented in Figure 1. In none of our patients, a decrease of TSH was observed in the first 16 weeks of pregnancy.

Bottom Line: The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide.TSH was adequately suppressed in only 25% of pregnancies.The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Diagnostics, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

ABSTRACT

Introduction: There are scarce data about the optimal increase of L-thyroxine dose during pregnancy in patients with a history of thyroid carcinoma. The first aim of the study was to find out if routine therapeutic measures enable adequate TSH suppression in pregnancy. The other aim was to find out the optimal dose of L-thyroxine for TSH suppression in pregnant women.

Patients and methods: In this retrospective observational study, we analysed 36 pregnancies of 32 women with a history of thyroid carcinoma. Before pregnancy, all of them underwent total thyroidectomy and radioiodine ablation of thyroid remnant, and they were on suppressive doses of L-thyroxine. Thyroid function tests were obtained before, during and after pregnancy.

Results: Mean L-thyroxine dose before pregnancy, in the first, second and, third trimester and after delivery was 149, 147, 155, 165 and 158 micrograms daily, respectively. TSH concentration remained suppressed in 9 pregnancies, it was within normal range in 22 and elevated in 5 pregnancies. The mean dose of L-thyroxine in patients with suppressed TSH before pregnancy, in the first, second and, third trimester and after delivery was 154, 154, 164, 160 and 161 micrograms daily, respectively. When the dose had to be changed, the mean increase of the dose was 31.5 micrograms daily.

Conclusions: The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide. TSH was adequately suppressed in only 25% of pregnancies. The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively.

No MeSH data available.


Related in: MedlinePlus