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Does PTU treatment have adverse effects during pregnancy?

Q: I am 25 years old and have recently been diagnosed with hyperthyroidism. I have been asked to take PTU (Propylthiouracil) 50 mg tablets four times a day. The doctor said that PTU is safe during pregnancy ideally than taking any medicine. Now that we are planning to have a child, will taking PTU during pregnancy result in any birth defects in the child? What are the effects / problems of taking PTU during pregnancy? Also, if I go for radioactive iodine (RAI) treatment, will I have hypothyroidism for the rest of my life? How long should I wait to plan pregnancy after RAI treatment? My thyroid levels after six weeks of treatment with PTU are as follows: T4, free - 1.3; T3, free - 422 and TSH 3PD generation - 0.01. My thyroid levels before treatment with PTU were as follows: T4, free - 4.3; T3, free - 1280 and TSH, 3PD generation - 0.01. Can you please help clear my doubts?

A:In many cases, hyperthyroidism gets remitted during pregnancy, but comes back immediately after delivery. The aim is to control thyroid hormones values. Drugs are also safe; however, PTU is preferred. Radioablation is not preferred these days, because remission rate with proper drug therapy (which is 18 months) under the care of an Endocrinologist is very high (up to 90 per cent). Radioablation is done if one is allergic to the drugs, cannot afford the drugs, cannot take medicines regularly or is too old to follow the medical treatment of his/her own. Once radioablation is done every year, the thyroid function continues to go down and down.


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