Pregnancy hyperthyroidism

The drug is contraindicated in die presence of an allergy to die drug, pregnancy (Category C), lactation, and phenylketonuria (oral form only). Linezolid is used cautiously in patients with bone marrow depression, hepatic dysfunction, renal impairment, hypertension, and hyperthyroidism. 

Classic beri-beri, rarely seen in the United States and Europe, except in alcoholism (P4), is endemic in the Far East because of the prevalent diet of decorticated rice (F6). It occurs in two forms wet beri-beri, characterized by edema and cardiovascular symptoms (G6), and dry beri-beri with peripheral neuritis, paralysis, and atrophy of the muscles. Conditions which may predispose to deficiency by increasing thiamine requirements are pregnancy (see section 2.4), and lactation, hyperthyroidism, malignant disease, febrile conditions, increased muscular activity, high carbohydrate diets, and parenteral administration of glucose solutions. A constant supply of thiamine is required for optimal nutrition because storage in the liver and elsewhere is limited. Thiamine is synthesized by bacteria in the intestinal tract of various animals, but this is not a dependable source for man. 

Increased = Decreased N = Normal X = Contraindicated Pregnancy Primary hypothyroidism Secondary hypothyroidism Hyperthyroidism... 

Hyperthyroid effects In rare instances, the administration of thyroid hormone may precipitate a hyperthyroid state or may aggravate existing hyperthyroidism. Pregnancy Category A. 

Pregnancy may be adversely affected by poorly controlled hyperthyroidism, with an increased rate of fetal loss. The goal of treatment during pregnancy is to maintain euthyroidism, using the smallest doses of anti thyroid drugs possible. 

Mestman JH. Hyperthyroidism in pregnancy. Endocrinol Metab Clin North Am 1998 27 127. 

Radiation destruction of thyroid parenchyma Hyperthyroidism patients should be euthyroid or on blockers before RAI avoid in pregnancy or in nursing mothers Oral half-life 5 days onset of 6-12 weeks maximum effect in 3-6 months Toxicity Sore throat, sialitis, hypothyroidism... 

A 3-year-old child, whose mother had been treated for Graves hyperthyroidism with thiamazole throughout pregnancy, had two scalp lesions and other abnormalities of tissues of ectodermal origin, including dystrophic nails and syndactyly. 

Choanal atresia has been described in an infant whose mother presented in early pregnancy with Graves hyperthyroidism and who took carbimazole in doses up to 60 mg/day in the first trimester (102). She was also clinically and biochemically severely hyperthyroid at this time. 

Neonatal hypothyroidism has been reported after maternal use of antithyroid drugs (106,107). Transient neonatal hyperthyroidism in a female child born to a mother who had been treated with potassium iodide and carbimazole during pregnancy was followed by sexual precocity (108). 

Half-life. Plasma half-life, 6 to 7 days which may be increased in pregnancy or myxoedema and decreased in hyperthyroidism. 

Pregnancy. If a pregnant woman has hyperthyroidism (2/1000 pregnancies) she should be treated with the smallest possible amount of these drugs because they cross the placenta with overtreatment fetal goitre occurs. Surgery in the second trimester may be preferred to continued drug therapy. 

Humans cannot synthesise vitamins in the body except some vitamin D in the skin and nicotinamide from tryptophan. Lack of a particular vitamin may lead to a specific deficiency syndrome. This may be primary (inadequate diet), or secondary, due to failure of absorption (intestinal abnormality or chronic diarrhoea), or to increased metabolic need (growth, pregnancy, lactation, hyperthyroidism). 

Differential diagnosis Palmar erythema is also found in pregnancy, in hyperthyroidism, collagen diseases, endocarditis, long-standing feverish conditions, tuberculosis, diabetes mellitus, malignant tumours, chronic polyarthritis and in cases of malnutrition — as well as in healthy people. 

---