Skip to main content
SpringerLink
Log in

Thyroid Hormone Replacement During Pregnancy

  • Chapter
Hormone Replacement Therapy

Part of the book series: Contemporary Endocrinology ((COE,volume 13))

Abstract

Thyroid diseases are five to seven times more common in women than men. It has been suggested—although never proven—that multiparity could be a risk factor for such increased prevalence in thyroid pathology. In a follow-up study of women with mild thyroid abnormalities in pregnancy, thyroidal abnormalities never returned to complete normalcy following pregnancies (1). Chronic autoimmune disease, the most common etiology of thyroid pathology in areas of sufficient iodine supply, occurs frequently; however the incidence varies with the criteria for diagnosis, the decade when the study was performed and the patients studied (2). In autopsy studies, the prevalence of chronic thyroiditis varies form 5–45% in women and 1–20% in men, according to the severity of the pathologic findings (3). When thyroid antibodies are measured, the incidence is 10–13% in women and 3% in men and increases with age (4). The incidence rate of positive thyroid antibodies in asymptomatic pregnant women is between 6–19.6% (5, 6). It is two to three times higher in women with type 1 diabetes mellitus (7). Immunologic changes occurs throughout normal pregnancy, and it explains the frequent alterations in the natural history of thyroid diseases during and up to 1 yr after delivery (8). Pregnancy is associated with significant—and in most cases reversible—changes in thyroid function.Although never demonstrated with certainty that there is an increase in thyroid production from early pregnancy, laboratory parameters suggest very strongly that such an increase occurs in response to physiologic changes in thyroid economy. In most cases, there is a complete adaptation to this challenge; however, in patients with thyroid pathology, changes in thyroid tests are clearly demonstrated (9,10). The reason(s) for this increase in thyroid demands from very early in pregnancy is not clear; however, there is increasing evidence, that maternal thyroid hormones are important for development of the embryo before fetal thyroid gland becomes functional, which occurs after the 10th wk of gestation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Glinoer D, Lemone M, Bourdoux P, De Nayer P, Delange F, Kinthaert J, et al. Partial reversibility during late postpartum of thyroid abnormalities associated with pregnancy. J Clin Endocrinol Metab 1992; 74: 453–457.

    Article  PubMed  CAS  Google Scholar 

  2. Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med 1996; 335: 99–107.

    Article  PubMed  CAS  Google Scholar 

  3. Williams ED, Doniach I. The post mortem incident of focal thyroiditis. J Pathol Bacteriol 1962; 83: 255–264.

    Article  PubMed  CAS  Google Scholar 

  4. Tunbridge WMG, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community. The Whickham survey. Clin Endocrinol (Oxf) 1977; 7: 481–493.

    Article  CAS  Google Scholar 

  5. Glinoer D, Fernandez-Soto M, Bourdoux P, Lejeune B, Delange F, Lemone M, et al. Pregnancy in patients with mild thyroid abnormalities. Maternal and neonatal reprecussions. J Clin Endocrinol Metab 1991; 73: 421–427.

    Article  PubMed  CAS  Google Scholar 

  6. Stagnaro-Green A, Roman SH, Cobin RH, et al. Detection of at-risk pregnancy by means of highly sensative assays for thyroid antibodies. JAMA 1990; 264: 1422–1425.

    Article  PubMed  CAS  Google Scholar 

  7. Riley J, MacClaren NK, Lezzote DC, et al. Thyroid autoimmunity in insulin dependent diabetes mellitus. The case of routine screening. J Pediatr 1981; 98: 350–357.

    Google Scholar 

  8. Mestman JH, Goodwin TM, Montoro MN. Thyroid disorders of pregnancy. Endocrinol Metab Clin N Am 1995; 24: 41–71.

    CAS  Google Scholar 

  9. Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. N Engl J Med 1994; 331: 1072–1078.

    Article  PubMed  CAS  Google Scholar 

  10. Glinoer D: The regulation of thyroid function in pregnancy: pathways of endocrine adaption from physiology to pathology. Endocr Rev 1997; 18: 404–433.

    Article  PubMed  CAS  Google Scholar 

  11. Brent GA. Maternal thyroid function. Interpretation of thyroid function tests in pregnancy. Clin Obstet Gynecol 1997; 40: 3–15.

    Article  PubMed  CAS  Google Scholar 

  12. Ain KB, Mori Y, Refeteoff S. Reduced clearance rate of thyroxine-binding globulin (TBG) with increased sialylation. A mechanism for estrogen-induced elevation of serum TBG concentration. J Clin Endocrinol Metab 1987; 65: 686–698.

    Article  Google Scholar 

  13. Braunstein GD, Hershmann JM. Comparison of serum pituitary thyrotropin and chorionic gonadotropin concentrations throughout pregnancy. J Clin Endocrinol 1976; 42: 1123–1126.

    Article  CAS  Google Scholar 

  14. Ballabio M, Poshyachinda M, Ekins RP. Pregnancy induced chnages in thyroid function. Role of human chorionic gonadotropin as putative regulator of maternal thyroid. J Clin Endocrinol Metab 1991; 73: 824–831.

    Article  PubMed  CAS  Google Scholar 

  15. Yoshimura M, Hershman JM. Thyrotropic action of human chorionic gonadotropin. Thyroid 1995; 5: 425–434.

    Article  PubMed  CAS  Google Scholar 

  16. Goodwin TM, Hershman JM. Hyperthyroidism due to inappropriate production of human chorionic gonadotropin. Clin Obstet Gynecol 1997; 40: 32–44.

    Article  PubMed  CAS  Google Scholar 

  17. Hershman JM, Higgins HP. Hydatidiform mole: a cause of clinical hyperthyroidism. N Engl J Med 1971; 284: 573–577.

    Article  PubMed  CAS  Google Scholar 

  18. Fisher DA. Fetal thyroid function. diagnosis and management of fetal thyroid disorder. Clin Obstet Gyneco11997; 40: 16–31.

    Google Scholar 

  19. Centempre B, Jauniaux E. Calvo R, Jurkovic D, Campbell S, Morreale de Escobar G. Detection of thyroid hormone in human embryonic cavities during the first trimester of pregnancy. J Clin Endocriol Metab 1993; 77: 1719–1722.

    Article  Google Scholar 

  20. Man EB, Holden RH, Jones WS. Thyroid function in human pregnancy. Am J Obstet Gynecol 1971; 109: 12–19.

    PubMed  CAS  Google Scholar 

  21. Lui H. Momatani N, Noh JA, et al. Maternal hypothyroidism during early pregnancy and intellectual development of the progeny. Arch Intern Med 1994; 154: 785–787.

    Article  Google Scholar 

  22. Halnan KE. The radioiodine uptake of the human thyroid in pregnancy. Clin Sci 1958; 17: 281–290.

    PubMed  CAS  Google Scholar 

  23. Pharoah POD, Connolly KJ, Ekins RP, Harding AG. Maternal thyroid hormone levels in pregnancy and the subsequent congnitive and motor performance of the children. Clin Endocrinol 1984; 21: 265–270.

    Article  CAS  Google Scholar 

  24. Laurberg P. Iodine intake–what are we aiming at? J Clin Endocrinol Metab 1994; 79: 17–19.

    Article  PubMed  CAS  Google Scholar 

  25. Smyth PPA, Hetherton AMT, Smith DF, Radcliff M, O’Herlihy C. Maternal iodine status and thyroid volume during pregnancy. Correlation with nonatal iodine intake. J Clin Endocrinol Metab 1997; 82: 2840–2843.

    Article  PubMed  CAS  Google Scholar 

  26. Pedersen KM, Laurberg P, Iverson E, et al. Amelioration of some pregnancy associated variations in thyroid function by iodine supplementation. J Clin Endocrinol Metab 1993; 77: 1078–1083.

    Article  PubMed  CAS  Google Scholar 

  27. Levy RP, Newman DM, Rejall LS, Barford DAG. the myth of goiter in pregnancy. Am J Obstet Gynecol 1980; 137: 701–703.

    PubMed  CAS  Google Scholar 

  28. Berghout A, Endert E, Ross A, Hozerzeil HV, Smits NJ, Wiersinga WM. Thyroid function and thyroid size in normal pregnant women living in an iodine replete area. Clin Endocrinol (Oxf) 1994; 41: 375–379.

    Article  CAS  Google Scholar 

  29. Glinoer D, DeNayer P, Bourdoux P, et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990; 71: 276–287.

    Article  PubMed  CAS  Google Scholar 

  30. Glinoer D, De Nayer P, Delange F, et al. A randomized trial for the treatment of mild iodine deficiency during pregnancy: Maternal and neonatal effects. J Clin Endocrinol Metab 1995; 80: 158–169.

    Article  Google Scholar 

  31. Roti E, Gnudi A, Braverman LE. The placental transport, synthesis, and metabolism of hormones and drugs which affect thyroid function. Endocr Rev 1983; 4: 131–149.

    Article  PubMed  CAS  Google Scholar 

  32. Mandel SL, Larsen PR, Seely EW, et al. Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N Engl J Med 1990; 323: 91–96.

    Article  PubMed  CAS  Google Scholar 

  33. Kaplan MM. Management of women on thyroxine therapy during pregnancy. Endocr Prac 1996; 2: 281–286.

    CAS  Google Scholar 

  34. Kamijo K, Saito T, Sato M, et al. Transient subclinical hypothyroidism in early pregnancy. Endocrinol Jpn 1990: 37: 397–403.

    Article  PubMed  CAS  Google Scholar 

  35. Grun JP, Meuris S, De Nayer P, Glineor D. The thyrotropic role of human chorionic gonadotropin (hCG) in the early stages of twin (vs. single) pregnancy. Clin Endocrinol (Oxf) 1997; 46: 719–725.

    Article  CAS  Google Scholar 

  36. Hershman JM, Higgins HP. Hydatidiform mole: a cause of clinical hyperthyroidism. N Engl J Med 1971; 284: 573–577.

    Article  PubMed  CAS  Google Scholar 

  37. Bouillon R, Naesens M, Van Assche, et al. Thyroid function in patients with hyperemesis gravidarum. Am J Obstet Gynecol 1982; 143: 922–926.

    PubMed  CAS  Google Scholar 

  38. Goodwin TM, Montoro MN, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum. Clinical aspects. Am J Obstet Gynecol 1992; 167: 648–652.

    PubMed  CAS  Google Scholar 

  39. Goodwin TM, Montoro M, Mestman JH, et al. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab 1992; 75: 1333–1337.

    Article  PubMed  CAS  Google Scholar 

  40. Amino N, Kuro R, Tanizawa O, et al. Changes of serum anti-thyroid antibodies during and after pregnancy in autoimmune thyroid disease. Clini Exp Immunol 1978; 31: 30–37.

    CAS  Google Scholar 

  41. Dussault JH, Letarte J, Guyda H, et al. Lack of influence of thyroid antibodies on thyroid function in the newborn infant on a mass screening program for congenital hypothyroidism. J Pediatr 1980; 96: 385–389.

    Article  PubMed  CAS  Google Scholar 

  42. Brown-Martin K, Emerson CH. Postpartum thyroid dysfunction. Clin Obstet Gynecol 1997; 40: 90–101.

    Article  Google Scholar 

  43. Branch DW. Autoimmunity and pregnancy loss. JAMA 1990; 264: 1453–1454.

    Article  PubMed  CAS  Google Scholar 

  44. Lejeune B, Grun P, de Nayer PH, Servais G, Glinoer D. Anithyroid antibodies underlying thyroid abnormalities and miscarriage or pregnancy induced hypertension. Brit J Obstet Gynecol 1993; 100: 669–672.

    Article  CAS  Google Scholar 

  45. NcKenzie JM, Zakarija M. Fetal and neonatal hyperthyroidism and hypothyroidism due to maternal TSH receptor antibodies. Thyroid 1992; 2: 155–160.

    Article  Google Scholar 

  46. Brown RS. Autoimmune thyroid disease in pregnant women and their offspring. Endocr Pract 1996; 2: 53–61.

    PubMed  CAS  Google Scholar 

  47. Tamaki H, Amino N, Yukihiko W, et al. Radioreceptor assay of anti-TSH receptor antibody activity. Comparision of assays using unextracted serum and immunoglobulin fractions, and standardizaiton of epxression in activity. J Clin Lab Immunol 1985; 20: 1–6.

    Google Scholar 

  48. Konishi J, Yasuhiro I, Kasagi K, Misaki T, Nakashima T, Endo K, et al. Primary Myxedema with thyrotropin-binding inhibitor immunoglobulins. Ann Int Med 1985; 103: 26–31.

    PubMed  CAS  Google Scholar 

  49. Tamaki N, Yamada T, Takasu M, et al. Disappearance of thyrotropin blocking antibodies and spontaneous recovery from hypothyrodism in autoimmune thyroiditis. N Eng J Med 1992; 326: 513.

    Article  Google Scholar 

  50. Brown R, Bellisario RI, Botero D, Fournier L, Abrams CAL, Cowger M. Incidence of transient congenital hypothyroidism due to maternal thyrotropin receptor-blocking antibodies in over one million babies. J Clin Endocrinol Metab 1996; 81: l147–1151.

    Article  Google Scholar 

  51. Tamaki H, Amino N, Aozasa M, et al. Effective method for prediction of transient hypothyroidism in neonates born to mothers with chronic thyroiditis. Am J Perinatol 1989; 6: 296–303.

    Article  PubMed  CAS  Google Scholar 

  52. Skuza KA, Sills IN, Stene M, Rapaport R. Prediction of neonatal hyperthyroidism in infants born to mothers with Graves’ disease. J Pediatr 1996; 128: 264–267.

    Article  PubMed  CAS  Google Scholar 

  53. Mestman JH. Thyroid disease. In: Sciarra JJ, ed. Gynecology and Obstetrics. Lippincott-Raven, Philadelphia, 1996.

    Google Scholar 

  54. Montoro MN, Collea JV, Frasier SD, et al. Successful outcome of pregnancy in women with hypothyroidism. Ann Intern Med 1981; 94: 31–34.

    PubMed  CAS  Google Scholar 

  55. Davis LE, Leveno KJ, Cunningham FG. Hypothyroidism complicating pregnancy. Obstet Gynecol 1988; 72: 108–112.

    PubMed  CAS  Google Scholar 

  56. Leung AS, Millar LK, Koonings PP, et al. Perinatal outcome in hypothyroidpregnancies. Obstet Gynecol 1993; 81: 349–353.

    PubMed  CAS  Google Scholar 

  57. Mestman JH. Endocrine diseases in pregnancy. In: Sciarra JJ, ed. Gyncology and Obstetrics. Lippincott-Raven, Philadelphia, 1997, pp. 1–41.

    Google Scholar 

  58. Weiss RE, Balzano S, Scherberg NH, Retetoff S. Neonatal detection of generalized resistance to thyroid hormone. JAMA 1990; 264: 2245–2250.

    Article  PubMed  CAS  Google Scholar 

  59. Campbell NRC, Hassinoff BB, Stalts H, et al. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Intern Med 1992; 117: 1010–1013.

    PubMed  CAS  Google Scholar 

  60. Thomas R, Reid RL. Thyroid disease and reproductive dysfunction. A review. Obstet Gynecol 1987; 70: 789–798.

    PubMed  CAS  Google Scholar 

  61. Grennman GW, Gabrielson MD, Howard-Flanders J, Wessel MA. Thyroid dysfunction in pregnancy. Fetal loss and follow up of surviving infants. N Engl J Med 1962; 267: 426–431.

    Article  Google Scholar 

  62. Man EB. Maternal hypothyroxiinemia development of 4 and 7 year old offspring. In: Fisher DA, Burrows GN, eds. Perinatal Thyroid Physiology and Disease. Raven Press, 1975, pp. 177.

    Google Scholar 

  63. Burk K, Kerr A. Pregnancy in a patient with myxedema. Am J Obstet Gynecol 1954; 68: 1623–1626.

    PubMed  CAS  Google Scholar 

  64. Man EB, Reid WA, Hellegers AE, Jones WS. Thyroid function in human pregnancy. Am J Obstet Gynecol 1969; 103: 328–337.

    PubMed  CAS  Google Scholar 

  65. Buckshee K, Kriplani A, Kapil A, Bhargava VL, Takkar D. Hypothyroidism complicating pregnancy. Aust NZ J Obstet Gynecol 1992; 32: 240–242.

    Article  CAS  Google Scholar 

  66. Wasserstrum N, Anania CA. Perinatal consequences of maternal hypothyroidism in early pregnancy and inadequate replacemnts. Clinical Endocrinology 1995; 42: 353–358.

    Article  PubMed  CAS  Google Scholar 

  67. Montoro MN. Management of hypothyroidism during pregnancy. Clin Obstet Gynecol 1997; 40: 65–80.

    Article  PubMed  CAS  Google Scholar 

  68. Klein RZ, Haddow JE, Faix JD, et al. Prevalence of thyroid deficiency in pregnant women. Clin Endocrinol (Oxf) 1991; 35: 41–46.

    Article  CAS  Google Scholar 

  69. Irvine WJ. Autoimmunity in endocrine disease. Clin Endocrinol Metab 1979; 4: 227–235.

    Article  Google Scholar 

  70. Bright GM, Blizzard RM, Kaiser DJ, et al. Organ specific autoantibodies in children with common endocrine diseases. J Pediatr 1982; 100: 8–12.

    Article  PubMed  CAS  Google Scholar 

  71. Gray RS, Dorsey DQ, Seth J, et al. Prevalence of subclinical thyroid failure in insulin dependent diabetes. J Clin Endocrinol 1980; 50: 1034–1045.

    Article  CAS  Google Scholar 

  72. Gerstein HC. Incidence of postpartum thyroid dysfunction in patients with type I diabetes mellitus. Ann Int Med 1993; 118: 419–423.

    PubMed  CAS  Google Scholar 

  73. Alvarez-Marfany M, Roman SH, Drexler AJ, et al. Long term prospective study of postpartum thyroid dysfunction in women with insulin dependent diabetes mellitus. Clin Endocrinol Metab 1994; 79: 10–16.

    Article  CAS  Google Scholar 

  74. Jovanovic-Peterson L, Peterson CM. De novo clinical hypothyroidism in pregnancies complicated by type I diabetes, subclinical hypothyroidism, and proteinuria: a new syndrome. Am J Obstet Gynecol 1988; 159: 442–446.

    PubMed  CAS  Google Scholar 

  75. D’Armiento M, Salabe H, Vetrano G, Scucchia M, Pachi A. Decrease in thyroid antibodies during pregnancy. J. Endocrinol Invest 1980; 4: 437–438.

    Google Scholar 

  76. Fernandez-Soto L, Gonzalez A, Lobon JA, Lopez JA, Peterson CM, Escobar-Jimenez F. Thyroid peroxidase autoantibodies predict poor metabolic control and need for thyroid treatment in pregnant IDDM women. Diabetes Care 1997; 20: 1524–1528.

    Article  PubMed  CAS  Google Scholar 

  77. Bech K, Hoier-Madsen M, Feldt-Rasmussen U, Moler-Jensen B, Molsted-Pedersen L, Kuhl C. Thyroid function and autoimmune manifestations in insulin dependent diabetes mellitus during and after pregnancy. Acta Endocrinologica (Copenh) 1991; 124: 534–539.

    CAS  Google Scholar 

  78. Pekonen F, Teramo K, Ikonen E, Osterlund K, Mahnen T, Lamberg BA. Women on thyroid hormone therapy: Pregnancy course, fetal outcome, and amniotic fluid thyroid hormone level. Obstet Gynecol 1994; 63: 635–638.

    Google Scholar 

  79. Kaplan MM. Monitoring thyroxine treatment during pregnancy. Thyroid 1992; 2: 147–152.

    Article  PubMed  CAS  Google Scholar 

  80. Girling JC, de Swiet M. Thyroxine dosage during pregnancy in women with primary hypothyroidism. Br J Obstet Gynecol 1992; 99: 368–370.

    Article  CAS  Google Scholar 

  81. Spencer CA, Takeuchi M,Kasarosyan M. Current status and performance goals for serum thyrotropin (TSH) assays. Clin Chem 1996; 42: 140–145.

    PubMed  CAS  Google Scholar 

  82. Kaplan MM. Management of women on thyroxine therapy during pregnancy. Endocr Prac 1996; 2: 281–286.

    CAS  Google Scholar 

  83. Mandel SJ, Brent GA, Larsen PR. Levothyroxine therapy in patients with thyroid disease. Ann Intern Med 1993; 119: 492–502.

    PubMed  CAS  Google Scholar 

  84. Rosen JB, Walfish PG, Nikore V. Pregnancy and surgical thyroid disease. Surgery 1985; 98: 1135–1140.

    PubMed  CAS  Google Scholar 

  85. Doherty CM, Shindo ML, Rice DH, Montoro MN, Mestman JH. Management of thyroid nodules during pregnancy. Laryngoscope 1995; 105: 251–255.

    Article  PubMed  CAS  Google Scholar 

  86. Hamburger JI. Thyroid nodules in pregnancy. Thyroid 1992; 2: 165–168.

    Article  PubMed  CAS  Google Scholar 

  87. Tan GH, Gharib H, Goellner JR, van Heerden JA, Bahn RS. Management of thyroid nodules in pregnancy. Arch Intern Med. 1996; 156: 2317–2320.

    Article  PubMed  CAS  Google Scholar 

  88. Gharib H, James EM, Charboneau JQ, Naessens JM, Offord KP, Gorman CA. Suppresive therapy in levothyroxine for solitary thyroid nodules. A double blind controlled clinical study. N Engl J Med 1987;31, 770–31, 775.

    Google Scholar 

  89. Cheung PS, Lee JM, Boey JH. Thyroxine suppressive therapy of benign solitary thyroid nodules. A prospective randomized study. World J Surg 1989; 13: 818–822.

    Article  PubMed  CAS  Google Scholar 

  90. Singer PA, Cooper DS, Daniels G, et al. Guidelines for the diagnosis and management of thyroid nodules and well differentiated thyroid cancer. Arch Intern Med 1996; 156: 2165–2172.

    Article  PubMed  CAS  Google Scholar 

  91. Asa SL, Bilbao JM, Kovacs K, et al. Lymphocytic hypophysitis of pregnancy resulting in hypopituitarism. A distinct clinicopathological entity. Ann Intern Med 1981; 95: 166–171.

    PubMed  CAS  Google Scholar 

  92. Lazarus JH, Hall R, Othman S, Parkes AB, Richards CJ, McCullouch B, Harris B. The clinical spectrum of postpartum thyroid disease. Q J Med 1996; 89: 429–435.

    Article  CAS  Google Scholar 

  93. Amino N, Tada H, Hidaka Y. The spectrum of postpartum thyroid dysfunction. Diagnosis, management, and long term prognosis. Endocr Pract 1996; 2: 406–410.

    PubMed  CAS  Google Scholar 

  94. Robertson HEW. Lassitude, coldness, and hair changes following pregnancy and their responses to treatment with thyroid extract. Br Med J 1948; 2 (suppl): 93–103.

    Article  PubMed  CAS  Google Scholar 

  95. Amino N, Miyai K, Yamamoto T, et al. Transient recurrence of hyperthyroidism after delivery in Graves’ disease. J Clin Endocrinol Metab 1977; 44: 130–136.

    Article  PubMed  CAS  Google Scholar 

  96. Amino N, Kuro R, Tanizawa O, et al. Changes of serum anti-thyroid antibodies during and after pregnancy in autoimmune thyroid disease. Clin Exp Immunol 1978; 31: 30–37.

    PubMed  CAS  Google Scholar 

  97. Tachi J, Amino N, Tamaki H, Aozasa M, Iwatani Y, Miyai K. Long term follow up and HLA association in patients with postpartum hypothyroidism. J Clin Endocrinol Metab 1988; 66: 480–484.

    Article  PubMed  CAS  Google Scholar 

  98. Lazarus JH, Ammari F, Orett R, Parkes AB, Richards CJ, Harris B. Clinical aspects of recurrent postpartum thyroiditis. Br J Gen Pract 1997; 47: 305–308.

    PubMed  CAS  Google Scholar 

  99. Ekel RH, Green WL. Postpartum thyrotoxicosis in a patient with Graves’ disease. Association with low radioactive iodine uptake. JAMA 1980; 243: 1554–1456.

    Google Scholar 

Download references

Authors
  1. Jorge H. Mestman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Endocrinology and Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    A. Wayne Meikle MD

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Mestman, J.H. (1999). Thyroid Hormone Replacement During Pregnancy. In: Meikle, A.W. (eds) Hormone Replacement Therapy. Contemporary Endocrinology, vol 13. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-700-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-700-0_7

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-092-2

  • Online ISBN: 978-1-59259-700-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation