Pharmacologic treatment of hyperthyroidism during lactation

Miguel Marcelo Glatstein, Facundo Garcia-Bournissen, Norberto Giglio, Yaron Finkelstein, and Gideon Koren
Can Fam Physician Vol. 55, No. 8, August 2009, pp.797 – 798

QUESTION I have a patient who has hyperthyroidism due to Graves disease. She was taking methimazole but discontinued when she found out she was pregnant. She is currently close to delivery and might require antithyroid therapy in the postpartum period. Can methimazole cross into human milk, and is breastfeeding safe for her infant?

ANSWER The exposure of infants to methimazole or propylthiouracil through breast milk is minimal and not clinically significant. Women with hyperthyroidism using methimazole or propylthiouracil should not be discouraged from breastfeeding, as the benefits of breastfeeding largely outweigh the theoretical minimal risks.

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