Tapazole and Pregnancy

[Det788]

Hello

I am 9 wks pregnant and my new endo has just put me on Tapazole, taking me off PTU. Her explaination is that Tapazole is now more safe to take than PTU. But the endo prior to her said PTU was safer. I have been researching this and I'm still very nervous about the whole thing. Can you please explain to me which one is safer and what are the effects on my child? I'm reading all these horrible defects that could happen such as cranial defect and intellectual issues. I guess what I'm saying is that I'm not confident in what my endo says because of everything I'm reading.

Thank you so much

[Mark Lupo, M.D.]

PTU is recommended for first trimester (until week 12), then the best expert opinion at this point is to then switch to Tapazole.  The risk of rare fetal development issues / defect is very small.  The key is to minimize the dose of these medications to keep Free T4 in the upper end of normal.  If you have Graves' disease, then often in 2nd/3rd TM there is less need for medication -- then, there is a risk for rebound post-partum.  

This is a very difficult area of thyroid medicine without definite answers.  We do the best we can with limited available data and the comments above reflect this current understanding of the dilemma.

[Det788]

I just reviewed tha manufacturer's website in regards to Tapazole and the warnings clearly state that Cretinism is definitely a possibility with some rare instances of Aplasia. They also state that PTU would be the better of the two for the first TM. I'm wondering why my endo would disregard such horrible effects.
Those are some serious odds to be playing and I think it has swayed our decision on going forward. I thank you for your opinion and I understand this is a difficult area. Hopefully medical science can gather more accurate information in the future for other people going through this.

Thank you again