Levothyroxine and pregnancy loss in TPOAb-positive patients

Leonard Wartofsky


Please note this video was recorded in 2018. Commentary is pending following new trial results published in March 2019.

Does levothyroxine therapy reduce the risk of pregnancy loss in thyroid peroxidase antibody (TPOAb)-positive euthyroid women who are newly pregnant?

Leonard Wartofsky, MD: I think there are clear data that thyroxine replacement in TPO-positive women will reduce the risk of miscarriage and fetal demise.

There are mixed data, controversial data, in regard to outcomes in other areas such as the cognitive ability or IQ of the offspring of such patients, with some studies showing better outcomes with thyroxine therapy and other studies not, which may relate to when during the pregnancy thyroxine therapy is initiated.

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