An old friend, who is a longtime LLL Leader, called tonight to say she has
been diagnosed with Grave's Disease.  She has been suffering frrom shakiness,
weakness and palpitations for about a month now.  (She has just started
Inderol for heart palpitations.)  Normal values for thyroxine (T4) are 5-12,
  but  hers is at 25.

She has 3 breastfed children, the youngest of which is 3 months old.  This
devoted breastfeeding mom is frantic to continue breastfeeding.  Her family
doctor wants her to begin immediately on radioactive iodine treatment (to
destroy the thyroid) so that she can begin medication.

Breastfeeding and Human Lactation states "radioiodine studies should not be
performed in women who wish to continue breastfeeding.  Although radioiodine
uptake may be considered necessary for establishing the treatment dose for
hyperthyroidism, the uptake dose and agent then become irrelevant because
breastfeeding must be discontinued when the woman is treated."

The radioiodine will not be used for studies, but for treatment.  I believe
this radioiodine treatment may preclude breastfeeding.

My experience with hyperthroidism in breastfeeding mothers has been with the
physician using drugs such as Propylthiouracil (PTU) to antagonize the
effects of thyroid hormone and to reduce the output of thyroid hormone,
waiting to see if the woman develops a spontaneous remission of the
hyperthyroidism.  (Statistics show that about 50% do experience this
remission.)

This mom has read much of the breastfeeding literature today.  She knows that
 propylthiouracil (PTU) is the treatment of choice for lactating women with
hyperthyroidism; it is compatible with breastfeeding.

She would like to find an endocrinologist, for a second opinion, that would
be supportive of breastfeeding.  (Anyone know of an endocrinologist in
central, northcentral, or southcentral Ohio having some experience with
hyperthyroidism and breastfeeding mothers?  Please e-mail me privately.)

We also discussed the possibility of pregnancy-induced hyperthroidism which
may occur for the first time postpartum.  She first started noticing symptoms
when the baby was about 6-8 weeks old.

Can anyone give me more information??

Thanks,

Carolyn Zara, RN, BSN, IBCLC
Mansfield, Ohio