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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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[The Thyroid and Pregnancy].

Viktoria Florentine Koehler1, Christoph Josef Auernhammer1, Christine Spitzweg1

  • 1Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München.

Deutsche Medizinische Wochenschrift (1946)
|December 3, 2019
PubMed
Summary
This summary is machine-generated.

Thyroid function during pregnancy requires trimester-specific reference intervals. Levothyroxine (LT4) therapy is recommended for overt hypothyroidism and may be considered for subclinical hypothyroidism with positive thyroid antibodies to improve pregnancy outcomes.

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Obstetrics

Background:

  • Pregnancy significantly alters thyroid gland function, necessitating specialized assessment.
  • The impact of overt thyroid disorders is clear, but subclinical disorders and antibodies' roles are debated.
  • Thyroid dysfunction in pregnancy can lead to adverse outcomes if not managed appropriately.

Purpose of the Study:

  • To provide guidance on managing thyroid disorders during pregnancy based on current guidelines.
  • To clarify the role of thyroid antibodies and subclinical hypothyroidism in pregnancy outcomes.
  • To outline therapeutic strategies for hypothyroidism and hyperthyroidism in pregnant individuals.

Main Methods:

  • Review of current American Thyroid Association (ATA) and European Thyroid Association (ETA) guidelines.
  • Analysis of recently published literature on thyroid function in pregnancy.
  • Synthesis of evidence to inform clinical decision-making for thyroid management.

Main Results:

  • Trimester-specific reference intervals are crucial for interpreting thyroid function tests in pregnancy.
  • Levothyroxine (LT4) therapy is indicated for overt hypothyroidism and judiciously for subclinical hypothyroidism with positive thyroid antibodies, especially with recurrent abortions.
  • Transient gestational thyrotoxicosis typically does not require treatment, while other hyperthyroid states need careful management with antithyroid drugs.

Conclusions:

  • Individualized treatment decisions, considering thyroid antibody status, are essential for managing thyroid dysfunction in pregnancy.
  • Liberal initiation of LT4 therapy for subclinical hypothyroidism with positive thyroid peroxidase antibodies (TPO-Ab) is recommended.
  • Management of hyperthyroidism requires careful consideration of antithyroid drugs and interdisciplinary collaboration.