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Hi Dr. Hale-I have breastfed our six month old daughter since birth & my Graves disease/hyperthyroidism reoccurred about two months ago. I was prescribed Methimazole again & have been on a 10 mg per day dose for about a month, but my Endo now wants me to increase the does to 15mg daily. The recommendation is to take the 15 mg all at once--is there any research that indicates it may be better (as far as less exposure to the breast milk) to break up the dose throughout the day instead? I also try to wait at least four hours before feeding/pumping after I take the med (if I have to pump earlier than that, I dump it). I am scared to go on the 15 mg dose & continue breastfeeding. We have had her blood checked once so far (that when I was on 5 mg) and she is due for it again (recommended since my dose was increased to 10). I am just trying to decide if the benefits of breastfeeding outweigh the potential risk of taking 15 mg of Methimazole. Any feedback that you can provide would be greatly appreciated. Thank you.
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Hyperthyroid mom:
Methimazole usage during breastfeeding is probably safe. There are lots of data reporting no untoward effects to the infant for periods up to 12 months. In a large study of over 134 thyrotoxic lactating mothers and their infants, even at methimazole doses of 20 mg/day, no changes in infant TSH, T4 or T3 were noted in over 12 months of study. The authors conclude that methimazole can safely be administered during lactation. However, during the first few months of therapy, monitoring of infant thyroid function is recommended. If your physician approves, taking 3 different doses will be a better option, but its probably unnecessary.
Tassneem Abdel Karim MD
InfantRisk Center
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