Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
PTU and pregnancy
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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PTU and pregnancy

I have had hyperthyroidism for the past 8 years and have gone into remission twice; Currently I am active. My husband and I are planning to get pregnant, and my doctor has discussed PTU and RAI treatment with me. I am hesitant about RAI. I would like to hear any thoughts on which treatment people prefer. Also, I am interested in hearing from people who have taken PTU and gotten pregnant. I am curious if it is difficult to get pregnant and if there are any side effects with taking PTU towards the baby and if breast feeding on PTU is safe. Thank you.
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PTU can be safe in pregnancy - it crosses the placenta so the baby is exposed but in most cases if monitored closely the pregnancy goes well.  It is also considered safe for breast feeding.

The preferred option is to give RAI then stabilized the hypo (post-RAI) with thyroid hormone replacement then plan conception.  Conception must not be attempted prior to 6 months after the RAI.  The reason this is preferred is that it is more stable to manage the hypo during pregnancy than the hyper and safer for the baby.  

Remind the OB to check a TSI durin pregnancy -- even post-RAI there can be a stimulating immune system attack and while your thyroid will not be effected this attack can cross the placenta and cause neo-natal graves (this can happen in PTU treated patients as well of course).
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I was diagnosed with hyperthyroidism (Grave's Disease) when my son was 6 months old, and I was breastfeeding. I too was hesitant about the RAI. I started taking PTU immediately and my obstetrician told me that only very minute amounts cross into the breastmilk (with no effect to the babys thyroid because the amount is so small). She did tell me however that I could not continue taking it, if I were to become pregnant.(Could affect your baby's development and cause miscariage)
I took PTU for a total of 8 months. I opted to have surgery to have my thyroid removed. 1 month after the removal of my thyroid I was given the ok by my obstetrician to try to get pregnant. I had no trouble concieving and was pregnant within 2 months with my second child. I had frequent tests done during my pregnancy and many dose changes. I gave birth to a healthy girl in July 05 1 year and 5 months after my diagnosis.
My gynecologist was very helpful with information about the medication and the effect on Pregnancy and breastfeeding.
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Thank you for your response. I have received different information than what you describe. My primary physician, OBGYN, and 2 endocrinologists inform me that after RAI, it is necessary to wait at least 6-12 months to conceive and PTU is the thyroid drug of choice for pregnant women, so I am surprised your doctor took you off of it. Has anyone taken PTU and conceived? I would love to hear from you. Thanks!
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A related discussion, Shall I stop the medicine? was started.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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