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Suggest treatment for hypothyroidism

Answered by
Dr.
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3631 Questions

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Posted on Wed, 8 Oct 2014 in Pregnancy
Question: Hello Doctor

My wife used prominent/primolut-N tablets for 6 days to delay her periods. After 12 days of using those tablets(7 days after missing period date), she did HCG test and it gave positive. 11 days after her missing period date, doctors did ultrasound test and they found anechoice cyst (3.5mm) and they also mentioned that there is no heart beat and it may be because of using period delay tablets.

Could you please let me know if there is really any problem because of period delay tables during pregnancy?


Doctors also discovered that she has hypothyroid (TSH = 8.7 & T3 = normal, T4 = normal) and they prescribed eltroxin 50mg. Does this also has any affect on baby?

Please let me know

Thanks XXXXXXX
doctor
Answered by Dr. Suresh Heijebu 1 hour later
Brief Answer:
primulot is strictly contraindicated in pregnancy

Detailed Answer:
Hi XXXX

I have carefully read your query and understand your concern.

Primulot N tabs are strictly contraindicated in pregnancy.


These hormonal pills can cause adverse hormonal changes for the growing fetus resulting in abortions.

It can also lead to menstrual cycle abnormalities in the post abortive period.

This drug has a special adverse effect of causing serious venous
thromboembolism.

Hypothyroid state has to be treated with Eltroxin in pregnancy.Hence eltroxin has positive effects on the baby of a hypothyroid mother.

I hope this info is useful to you,
Post your queries if any,
Thank you
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Suresh Heijebu 7 hours later
Hi XXXXXXX

Thanks for your reply.

In case, if abortion doesn't happen, Is there any affect on growing fetus like during brain/heart developement? and When will the brain & heart development will be started after missing period date?

Please let me know

Thanks
doctor
Answered by Dr. Suresh Heijebu 1 hour later
Brief Answer:
Anomaly scan is preferred

Detailed Answer:
HI,XXXX

Organ development like brain and heart happens in the 8th week of period of gestation.

This drug has no direct effects on growing fetus,but it can indirectly effects its growth by causing some implantation disturbances.

Hence i advice you have periodical scanning of your wife to detect any earliest possibilities of misconception.

An anomaly scan at 8-10 weeks and and amniocentesis at 12-14 weeks can genuinely help to detect any fetal disturbances the the earliest.

I recommend strongly you speak about these tests with your Gynecologist.

Thank you



Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Suresh Heijebu 7 hours later
Hi

Thanks again for your reply

Her last period was from 4th Aug,14 to 8th Aug 14.
How many days after the period, gestation can happen?

Her TSH level is above 8, but T3 & T4 are in normal
T3 = 103 (60-200)
T4 = 7.3 (4.5 -12)
TSH = 8.72 (0.3 - 5.5)

Should this be considered as hypothyroid? If so, how severe is it?

Should T3 & T4 be on higher side of the range or lower side of the reference range?

What are the ideal values for T3, T4 & TSH for pregnancy?


Does Thyroid problem or side effects of Primolun-N/Promotin have any affect on IQ levels of baby?

Please let me know

Thanks XXXXXXX
doctor
Answered by Dr. Suresh Heijebu 15 hours later
Brief Answer:
Hypothyroidism can l/t mental retardation in baby

Detailed Answer:
HI,XXXX

Ferlilisation can occur apprx 10 days after the last day of the menstrual period, as day 12 -14 of the cycle correspond to maximum chances of becoming pregnant.

A tsh value of 8.7 is indication of HYPOTHYROIDISM/mild,even though both t3 and t4 are in the normal range.

The normal values are:

TSH-0.34 TO 4.25mIU/dl
T3-77 TO 135 ng/ml
T4-5.4-11.7mcg/ml

In pregnancy the free t3/t4 are elevated but the total t3/t4 and tsh are in the normal range producing a euthyroid picture overall

An elevated TSH in presence of normal t3/t4 can be due primary latent hypothyroidism with defect in the thyroid gland.

Primulutin as i already said can cause withdrawal bleeds and lead to spontaneous abortions .

Hypothyroidism in contrast can cause both abortions as well as low IQ levels in the fetus and other thyroid problems if not properly treated in the mother.

Its mandate for a pregnant mother to get her hypothyroidism treated.


Thank you




Above answer was peer-reviewed by : Dr. Prasad
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