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Levothyroxine may not increase live birth rate

Treating pregnant women with thyroid drug does not up chances of a live birth, new study suggests.

June 26, 2019

Health concerns play a major role in family planning. For women struggling specifically with thyroid problems, pregnancy is an even more of a cautious affair-- one that sometimes involves taking medication to lessen the risks of complications. Up until now, one such drug--levothyroxine--was thought to help. However, a recent study conducted at the  University of Birmingham in the United Kingdom and published this March shows that that the  thyroid medicine is ultimately ineffective in improving live birth rate, disappointing hopefuls.

The double blind study was  apparently the largest of its kind, and involved 952 women with normal thyroid function, thyroid peroxidase antibodies, and a history of miscarriage, healthcare news site MDedge says. Participants in the experiment were split into two groups, with one taking  the medication, and the other receiving a placebo. The women who were administered Levothyroxine were instructed to begin taking the medication before they conceived, and continue taking it throughout their pregnancies up until delivery.

The study concluded that both groups saw similar rates in pregnancy, live birth, and neonatal outcomes, such as weight. The number of adverse events between these two groups was also similar. In a nutshell, the differences between the placebo and medication results were found to be statistically insignificant. Researchers found no link suggesting, or otherwise proving, that the drug Levothyroxine made any positive change by improving or ensuring a successful pregnancy or birth.

In general, the  presence of thyroid peroxidase antibodies in pregnant women is heavily linked to preterm labor, miscarriage, stillbirth, and other high-risk pregnancy issues.with Levothyroxine being a type of thyroid peroxidase medicine used to treat underactive thyroid problems, as well as a multitude of other thyroid conditions. Thyroid peroxidase antibodies can indicate the possibility of having or later developing a thyroid autoimmune disorder, and usually predict a higher chance of the individual experiencing future thyroid complications. In many instances, having thyroid peroxidase antibodies can be a precursor to other difficulties, especially within pregnancy.

These antibodies are basically blood proteins. Known as immunoglobulins, their job is to attack and neutralize any foreign substance that your immune system sees as a threat to itself. Generally, having antibodies is a good thing. Think of them as the immune system’s defense guard. By counteracting pathogens, like harmful bacteria and viruses  that trigger diseases, they are essential  in maintaining  a functional immune system.

But when these blood proteins mistakenly attack other parts of the body and normal tissue, it puts a delicate system out of balance, and can wreak serious havoc on your health. Thyroid peroxidase antibodies specifically target the thyroid gland, and can cause inflammation and irregularities in thyroid function.

When thyroid levels are irregular, and the small neck gland produces too little or too much of the hormones that it’s supposed to, it throws the entire body out of wack. For pregnant women, this frightening reality also means that the fetus is at risk.

Pregnant woman having a thyroid check-up
Get the gist: Thyroid peroxidase antibodies mistakenly attack the thyroid gland, heightening the risk for a wide range of health problems, especially among pregnant women. Before the University of Birmingham study, some researchers believed that Levothyroxine might help increase live birth rates and reduce the chance of miscarriage or preterm delivery. Image found on Bulletproof.

Previous studies proved inconclusive about whether or not Levothyroxine could potentially improve live birth rates or prevent  pregnancy complications due to thyroid peroxidase antibodies, with some smaller studies suggesting that it could. Dr Rima Dhillon-Smith, lead author in the University of Birmingham study,  says, “We were surprised by the results of our study as previous small studies suggested there could be a benefit of Levothyroxine treatment in women with thyroid antibodies” (Science Daily).

Pregnant woman discussing pregnancy and birth complications with doctor
Older studies were ambiguous in their conclusions about Levothyroxine’s effect on live birth rate.

In 2017, the American Thyroid Association put out in its guidelines that pregnant women who tested positive for thyroid peroxidase antibodies be administered Levothyroxine. Despite insufficient evidence, the Association claimed that there are “potential benefits in comparison with minimal risk.” Having reached their study  results, however,researchers at the University of Birmingham are confident and hopeful that the drug will no longer be given to pregnant women with thyroid peroxidase antibodies as a preventative measure against miscarriage. While medical associations, like the American Thyroid Association, currently advise pregnant women with this condition to consider taking the medication, researchers have become wary.  Dr. Kristien Boelaert of the University of Birmingham states,"While thyroid peroxidase antibodies testing may inform about future risk of progression to thyroid disease, our research has shown its treatment with Levothyroxine does not improve pregnancy outcomes and may only generate patient anxiety and unnecessary healthcare costs.”

Boelaert urges that pregnant women stop being given this medication. Unnecessary and ineffective in relieving their particular concern, she argues, what’s the point?


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