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Old 03-07-2006, 10:21 PM   #1
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Levothyroxine & Breastfeeding

Hello. This is my first time here - I'm a little worried about something and thought I'd post to get some opinions. I have an 8 week old who I am breastfeeding. I'm hypothyroid, and have been taking Levothyroxine. My levels fluctuated a little during pregnancy, any my dosage was upped. I asked to be tested a couple weeks ago, thinking things may have changed again post-partum. Sure enough, my TSH was down to .10. Normally I'm around 2. My very uninvolved primary care physician wrote on the lab results that it's low, but to continue on the same dosage. Well, my need for a new doctor and a new prescription is another issue, which I'll be working on right away, but here's why I'm here: I know that a hypothyroid mom who is taking the proper dosage of hormone replacement can breastfeed just fine, but what if I'm taking too much? The reason I'm worried is my daughter has a terrible time sleeping - she's extremely restless and jumpy. It's gotten progressively worse. I told my husband that she acts like she's feeling the same way I felt when my bonehead doctor accidentally gave me a prescription for a much higher dosage than I needed. Obviously I'm going to talk to my doctor about this, but I'm wondering if my medicine could be affecting her. Any thoughts on this? I've been researching on the web all evening and can't really find anything on point. Thanks in advance.

 
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Old 03-08-2006, 06:14 AM   #2
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Re: Levothyroxine & Breastfeeding

First... Congratulations on the new baby! You're in a lovely time of life, and I'm happy for you.

Just because your TSH is low doesn't mean you are overmedicated. My own TSH has been .02 for two years, and I'm not overmedicated or hyper. So... The biggest question is - How do you feel? Do you have signs like shakiness, fast bowels, insatiable appetite, extreme weight loss, etc? If you don't have any signs beyond the bit of nervousness that's normal for any new mother, you can't say you're overmedicated.

Then... even if you are taking slightly too much levoT, only a small fraction of it crosses into the breast milk. I found information from an article in Pediatrics magazine 2001;108:776-89, titled "The transfer of drugs and other chemicals into human milk". It says that the amount of thyroid hormone transferred into human milk is too low to affect blood thyroid hormone levels in newborns. The American Academy of Pediatrics considers levoT compatible with breastfeeding and has reported that no observable change is seen in nursing infants whose mothers are taking it.

If the baby is jumpy and restless, it could be just the way she's neurologically wired, or she could be sensing your own agitation and reacting to it.

I guess this doesn't really help you that much... But truthfully, neither does watching just your TSH. Unless you know your free thyroid hormone levels as well, you can't truly know if you're overmedicated or not. If the MD won't test your thyroid levels, you then have to fall back on your signs and symptoms instead, and that isn't very scientific.

 
Old 03-10-2006, 10:24 AM   #3
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Re: Levothyroxine & Breastfeeding

Thank you for your kind response. I have been feeling the effects a little, not too bad. I definitely want to get my dosage regulated a little better and will push for more thorough testing.

But in the meantime, I feel a little better about this little one! Hopefully she's just going through a stage, or getting used to being in the world.

Thanks again,
Lori

 
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