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Thread: Thyroid and Medication questions

  1. #1
    Join Date
    May 2011
    Posts
    59

    Default Thyroid and Medication questions

    I have been diagnosed with hyperthyroidism. Has anyone ever had to deal with this and breastfeeding? I was also prescribed a beta-blocker, Toprol. I see an endocrinologist in a few weeks to see the treatment for the thyroid but I am supposed to take the beta-blocker in the meantime. I asked the cardiologist if it was safe to take while nursing but she didn't know. Has anyone else had to take a beta-blocker? I surely don't want to wean but I also don't want continued heart issues!

    Thanks in advance!
    Proud mom of two boys!

    DS1- born 1/10/03
    and
    DS2- born 3/8/11


  2. #2
    Join Date
    Sep 2011
    Location
    Dallas, TX
    Posts
    255

    Default Re: Thyroid and Medication questions

    I take lisanopril (sp) for heart issues. There are a few beta blockers that are ok and some that aren't. I was able to work with the pediatrician on which ones would be safe while nursing.

    Eta: are you having palpitations? I have thyroid problems as well, though mine is hypothyroid due to hashimotos.
    Lisa

    Mom to Aimee, born 8/22/11
    for 20 months!

  3. #3
    Join Date
    Mar 2010
    Location
    Springfield, Oregon
    Posts
    916

    Default Re: Thyroid and Medication questions

    I believe this is another name for same drug. Lactmed is a fantastic website.

    Metoprolol
    CASRN: 37350-58-6

    For other data, click on the Table of Contents


    Drug Levels and Effects:


    Summary of Use during Lactation:
    Because of the low levels of metoprolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies on the use of metoprolol during breastfeeding have found no adverse reactions in breastfed infants.


    Drug Levels:
    The excretion of beta-adrenergic blocking drugs into breastmilk is largely determined by their protein binding. Those with low binding are more extensively excreted into breastmilk.[1] Accumulation of the drugs in the infant is related to the fraction excreted in urine. With 10% protein binding, 40% renal excretion and a moderate half-life, metoprolol presents moderately low risk for accumulation in infants.

    Maternal Levels. With metoprolol doses of 50 mg orally twice daily, milk levels are usually less than 420 mcg/L.[2][3][4] Five women taking oral metoprolol 100 to 200 mg daily had average milk metoprolol levels of 316 mcg/L.[5] It is estimated that a breastfed infant would receive a dose of about 0.07 mg/kg daily in breastmilk with a maternal dose of 200 mg daily.[4]

    Peak milk levels of 106 to 689 mcg/L have been reported following doses of 100 mg orally twice daily.[4][6] Peak milk levels occurred about 30 minutes after peak serum levels, at 1.5 hours after the dose in two patients, and 6 hours after the dose in a third.[6]

    Infant Levels. Metoprolol was undetectable (<2.7 mcg/L) in the plasma of 3 infants aged 4, 10 and 60 days after maternal oral doses of 100 mg daily.[2]

    Metoprolol serum levels in 3- to 5-day-old breastfed infants ranged from 0.5 to 2.9 mcg/L after maternal doses of 50 or 100 mg twice daily.[3][7]

    A woman was taking metoprolol 100 mg daily for hypertension during pregnancy and postpartum. Her breastfed infant's serum concentrations of metoprolol and its active metabolite, alpha-hydroxymetoprolol, were undetectable on days 4 and 182 postpartum.[8]


    Effects in Breastfed Infants:
    A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. Of 6 mothers taking metoprolol, none reported adverse effects in her breastfed infant.[9][10]


    Possible Effects on Lactation:
    Relevant published information on the effects of beta-blockade or metoprolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[11]


    Alternate Drugs to Consider:
    Propranolol, Labetalol
    Baby Girl "Piper" born Feb 12th, 2010. She is a true blessing!

    And a baby who is now an Angel in Heaven Feb 7th, 2008.

  4. #4

    Default Re: Thyroid and Medication questions

    I sent a pdf of the info on metoprolol to the email address in profile. Let me know if it doesn't get to you for some reason.

    You could also try calling InfantRisk at 806-352-2519 (8am-5pm CST Mon-Fri). They'll be able to give you more information based on your specific situation.
    Karen
    Forums Admin

    Find an LLL Leader or Meeting | Get one-on-one help from a Leader online | Become a Member of LLLI

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  5. #5
    Join Date
    May 2011
    Posts
    59

    Default Re: Thyroid and Medication questions

    I got your pdf this morning LLLKaren thanks so much! And thanks for the info redpowerlady, it was very helpful. I am going to also call InfantRisk this afternoon when the baby is napping.


    @llli*pizanite - I am definitely having heart palpitations, thousands a day according to a halter monitor. The part that is worrysome to me though is that I have a constant fast heart rate, even resting. The halter monitor showed that my average heart rate was 150, and was fast even while sleeping. Due to the constant overload my heart muscle has thickened, the left ventricle is malfunctioning and I have a leaky tricuspid and mitral valve. I have to be careful what heart meds I take because I have low blood pressure and most make it lower. I 'll ask about lisinopril though, thanks. When you talked to your pediatrician did you just tell him that you were starting a beta blocker? Did they test your baby for levels?

    Thanks everyone!
    Proud mom of two boys!

    DS1- born 1/10/03
    and
    DS2- born 3/8/11


  6. #6
    Join Date
    Sep 2011
    Location
    Dallas, TX
    Posts
    255

    Default Re: Thyroid and Medication questions

    Hey there, the pediatrician asked for the specific med and dosage. I am on a low dose. They didn't test DD or anything because they said it was safe. I hope you get the heart stuff straightened out. Palpitations and a fast heart rate are no fun. I've been there.
    Lisa

    Mom to Aimee, born 8/22/11
    for 20 months!

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