Thyroid use while Breastfeeding

Drugs containing Thyroid: Armour Thyroid, Nature-Throid, Thyroid Porcine, Westhroid, NP Thyroid, Bio-Throid

Thyroid Levels and Effects while Breastfeeding

Summary of Use during Lactation

Thyroid is an animal-derived mixture of levothyroxine (T4) and liothyronine (T3), which are normal components of human milk. Limited data on exogenous replacement doses of levothyroxine during breastfeeding indicate no adverse effects in infants. No information is available on the use of exogenous liothyronine during breastfeeding. If thyroid is required by the mother, it is not a reason to discontinue breastfeeding. Thyroid dosage requirement may be increased in the postpartum period compared to prepregnancy requirements patients with Hashimoto's thyroiditis.[1]

Drug Levels

Although somewhat controversial, it appears that levothyroxine passes into milk poorly and that liothyronine might pass into milk in amounts that affect infant thyroid status.[2][3][4][5][6]

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Effects of exogenous thyroid hormone administration to mothers on their infant have not been reported. One case of apparent mitigation of cretinism in hypothyroid infants by breastfeeding has been reported, but the amounts of thyroid hormones in milk are not optimal,[7] and this result has been disputed.[8] The thyroid hormone content of human milk from the mothers of very preterm infants appears not to be sufficient to affect the infants' thyroid status.[9] The amounts of thyroid hormones in milk are apparently not sufficient to interfere with diagnosis of hypothyroidism.[10]

In a telephone follow-up study, 5 nursing mothers reported taking levothyroxine (dosage unspecified). The mothers reported no adverse reactions in their infants.[11]

One mother with who had undergone a thyroidectomy was taking levothyroxine 100 mcg daily as well as calcium carbonate and calcitriol. Her breastfed infant was reportedly "thriving" at 3 months of age.[12]

Possible Effects on Lactation

Adequate thyroid hormone serum levels are required for normal lactation. Replacing deficient thyroid levels should improve milk production caused by hypothyroidism. Supraphysiologic doses would not be expected to further improve lactation.

References

1. Galofre JC, Haber RS, Mitchell AA, Pessah R, Davies TF. Increased postpartum thyroxine replacement in Hashimoto's thyroiditis. Thyroid. 2010;20:901-8. PMID: 20615129

2. Sato T, Suzuki Y. Presence of triiodothyronine, no detectable thyroxine and reverse triiodothyronine in human milk. Endocrinol Jpn. 1979;26:507-13. PMID: 499092

3. Varma SK, Collins M, Row A et al. Thyroxine, tri-iodothyronine, and reverse tri-iodothyronine concentrations in human milk. J Pediatr. 1978;93:803-6. PMID: 712487

4. Mallol J, Obregon MJ, Morreale de Escobar GM. Analytical artifacts in radioimmunoassay of L-thyroxin in human milk. Clin Chem. 1982;28:1277-82. PMID: 7074933

5. Oberkotter LV, Tenore A. Separation and radioimmunoassay of T3 and T4 in human breast milk. Horm Res. 1983;17:11-8. PMID: 6551313

6. Koldovsky O. Hormones in milk. Vitam Horm. 1995;50:77-149. PMID: 7709605

7. Bode HH, Vanjonack WJ, Crawford JD. Mitigation of cretinism by breast-feeding. Pediatrics. 1978;62:13-6. PMID: 683777

8. Letarte J, Guyda H, Dussault JH et al. Lack of protective effect of breast-feeding in congenital hypothyroidism: report of 12 cases. Pediatrics. 1980;65:703-5. PMID: 7367075

9. van Wassenaer AG, Stulp MR, Valianpour F et al. The quantity of thyroid hormone in human milk is too low to influence plasma thyroid hormone levels in the very preterm infant. Clin Endocrinol. 2002;56:621-7. PMID: 12030913

10. Abbassi V, Steinour A. Successful diagnosis of congenital hypothroidism in four breast- fed neonates. J Pediatr. 1980;97:259-61. PMID: 7400893

11. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418

12. Caplan RH, Wickus GG. Reduced calcitriol requirements for treating hypoparathyroidism during lactation. A case report. J Reprod Med. 1993;38:914-8. PMID: 8277494

Thyroid Identification

Substance Name

Thyroid

CAS Registry Number

8028-36-2

Drug Class

  • Thyroid Hormones

Administrative Information

LactMed Record Number

832

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-09-07

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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