Dr.Guttler’s Thyroid Patient Blog Post: Postpartum T4 dose Adjustment in Pregnant Hypothyroid patients
1. Women need higher doses during the pregnancy to prevent adverse outcomes. Monitoring during pregnancy to keep TSH <2.5. TSH of <2.0 for cancer patients.
2. Postpartum dose adjustments were studied by Gao X. at al. Endo practice 28(2022) 578.
3. Subclinical hypothyroid patients stopped the thyroid, and 60% restarted thyroid at one year.Careful monitoring is needed to see if they will need thyroid in the future especially if the are TPO Ab positive.
4. Overt hypothyroid patients had monitored dosing resulting in a reduced dose postpartum.
5.Overall the reduction of the dose was 27-50% postpartum. The lowest reduction was in women with papillary thyroid cancer surgery.
6. Reduction of T4 by 50% except for cancer patients which is 25%.
7. One year monitoring postpartum for all is needed.
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