thyroid_disease_flashcards
What should be checked pre-conception for hypothyroidism?
TFTs before conception if possible.
What should be advised if TFTs are not in range pre-conception?
Advise delaying conception and using contraception until TFTs are stabilized on levothyroxine replacement.
What is the advice regarding levothyroxine during pregnancy?
Demands for levothyroxine increase during pregnancy, so the dose must be adjusted early to prevent complications.
What should a woman do when pregnancy is suspected or confirmed if she has hypothyroidism?
Seek immediate medical advice (e.g., see her GP).
What is the antenatal management for hypothyroidism?
Urgent specialist referral to a joint obstetric and endocrinology clinic.
How frequently should TFTs be checked during pregnancy for hypothyroidism?
Every 2-4 weeks to ensure biochemical euthyroidism (TSH <4mmol/L).
What is the postnatal management for hypothyroidism?
Reduce the dose of levothyroxine to pre-pregnancy dose, check TFTs at 6 weeks postpartum by GP.
What is the management for postpartum thyroiditis?
Refer to endocrinologist, propranolol for thyrotoxic phase, check TFTs 4-8 weeks after thyrotoxic phase and give levothyroxine replacement if needed.
What is the pre-conception advice for hyperthyroidism?
Referral to an endocrinology specialist for all women with overt or subclinical hyperthyroidism, delay conception and use contraception until thyroid function has normalized.
What is the antenatal management for hyperthyroidism?
Urgent specialist referral to a joint obstetric and endocrinology clinic.
How frequently should TFTs be checked during pregnancy for hyperthyroidism?
Every 2-4 weeks to ensure biochemical euthyroidism (TSH <4mmol/L).
What medications are recommended for hyperthyroidism during pregnancy?
Propylthiouracil for the first trimester, carbimazole for the second and third trimesters, with appropriate counseling.
What is contraindicated in hyperthyroidism treatment during pregnancy?
Radioactive iodine.
What should be done if hyperthyroidism treatment is required during pregnancy?
Continue carbimazole/propylthiouracil at the lowest acceptable doses according to TFTs.
What is the postnatal monitoring for hyperthyroidism?
TFTs monitoring at 6-8 weeks postnatal check with GP.
