antibodies. What risks may we exposing her to?
Miranda: The biggest risk is obviously of increasing the antibody load. A patient of mine recently had thyroid antibodies, and she was on iodine. And more than a normal dose of 270 micrograms. And it did eventuate that her baby was born with thyroid antibodies.
But also it ' s not even so much about what happens in pregnancy but more about that postpartum period. If you have driven those antibodies up really high, we ' re then, of course, at risk of thyrotoxicosis or postpartum thyroiditis where we wind up with a hyperthyroidism at around the three to six-month point postpartum, and then a big crash into hypothyroidism somewhere around that six to ninemonth point.
I can immediately think of at least five patients that I have seen in the last six months with postpartum thyroid issues, all presenting at around that six-month mark. And I think, if we dial back and look at the iodine story, it may not be the only thing going on, but I think we really need to challenge our thinking here.
Emma and Miranda concluded the podcast with a discussion of a 2023 study of the relationship between urinary iodine and testosterone levels in a large group of men aged 18 to 65, There were some significant findings that fall beyond the scope of this article, but which Miranda characterised as“ another argument of going, well, we need to be checking iodine status in men and testosterone status in men in that preconception period.”
Emma: Today, Miranda, I have taken away many clinical pearls. A couple of my top favourites are white flags for low iodine, include a T4 under 14, and increase in TSH above 1.5 to 2 as a trend and a basal body temperature under 36.3 in the luteal phase, and how critical it is to find that Goldilocks ' zone with iodine and knowing that we do prescribe it in certain conditions that you ' ve outlined and then don ' t prescribe it for other conditions. That gives us a really clear picture, so thank you.
All the show notes, full transcript, and other resources from today ' s episode are available on the fx Medicine Education Podcasts website( https:// www. bioceuticals. com. au / education / podcasts).