Hypothyroidism In Pregnancy

What's hypothyroidism?

Hypothyroidism is a condition that develops while the thyroid gland makes very little thyroid hormone. Thyroid hormones help manipulate body temperature, heart rate, increase, and how you benefit or shed pounds.
What reasons hypothyroidism?

The subsequent situations may purpose or boom your danger of hypothyroidism:

    autoimmune ailment: a trouble with the immune machine can also make your body assault your thyroid gland. Hashimoto's disorder is the most not unusual autoimmune sickness that causes hypothyroidism.
    Drugs: sure drug treatments can reason hypothyroidism. Ask your healthcare provider if any of the drug treatments you are taking can reason hypothyroidism.
    Remedies: radiation remedy used to treat cancers of the pinnacle and neck can wreck your thyroid gland. Thyroid surgical treatment also makes you more likely to develop hypothyroidism.
    Thyroid troubles: a past history of hypothyroidism or other thyroid problems can also growth your danger of hypothyroidism in the course of being pregnant. An enlarged or swollen thyroid, lumps because of infections, or thyroid cancer can have an effect on how your thyroid works.
    Own family history: your hazard is greater if a family member has hypothyroidism or an autoimmune disease.
    Low iodine stages: iodine is an critical mineral used by the thyroid gland to work efficaciously and make thyroid hormones. Low iodine degrees in the course of your pregnancy increases your toddler's hazard of hypothyroidism.

What are the signs and symptoms and signs of hypothyroidism all through pregnancy?

The signs and symptoms and symptoms of hypothyroidism may start slowly, and you may now not note any adjustments.

•     Excessive fatigue
•     sensitivity to cold
•     constipation
•     dry, flaky pores and skin, or brittle fingernails
•     thin hair
•     muscle ache or weak point
•     swollen thyroid gland
•     despair or irritability

How is hypothyroidism identified?

Your healthcare issuer will ask about your symptoms and look at you. He'll ask what medicines you are taking. He'll ask about your scientific records and if all of us on your circle of relatives has hypothyroidism. You may have blood tests to check your thyroid hormone level.
How is hypothyroidism treated?

Thyroid medicinal drug will deliver your thyroid hormone level lower back to everyday. Ask your healthcare provider for extra statistics on other medicines you could want.
What are the risks of hypothyroidism at some point of pregnancy?

Pregnancy causes an multiplied want for thyroid hormone and iodine inside the frame. Low thyroid hormone stages might also motive serious fitness troubles. You could preserve to benefit weight. You could have body pains, and suppose, circulate, and speak slowly. You may additionally expand myxedema, that is a dangerous situation. Myxedema can also purpose swelling on your legs, ankles, lungs, or around your coronary heart. You could have seizures, or pass right into a deep coma and die if you do no longer get hospital treatment quickly. You may have multiplied blood stress and have vomiting, blurring of imaginative and prescient, and really awful bleeding in your womb. Your infant may be born with delivery defects, have a low start weight, or even die inside the womb. You could additionally give beginning in advance than expected.

Whilst must i touch my healthcare provider?

•     You are losing weight with out attempting.
•     You've got a fever.
•     You have got chills, a cough, or experience susceptible and achy.
•     You've got ache, redness, and swelling to your muscle groups and joints.
•     Your pores and skin is itchy, swollen, or has a rash.
•     You do now not have any extra thyroid medicine, otherwise you stopped taking it with out your healthcare provider's advice.

When ought to i seek instantaneous care or call 911?

•     You faint or have a seizure.
•     You sense your toddler is stressed and always kicking, or is very still and now not shifting in any respect.
•     You have surprising chest pains or trouble breathing, or swelling to your legs, ankles, or feet.
•     You have got diarrhea, tremors, or problem sleeping.
•     Your water breaks, or you're bleeding out of your vagina.
•     Your signs and symptoms and symptoms go back or come to be worse.

Care agreement
You have got the right to assist plan your care. Find out about your health condition and how it may be treated. Speak treatment alternatives together with your caregivers to determine what care you need to acquire. You usually have the proper to refuse treatment. The above information is an educational useful resource simplest. It isn't always intended as scientific recommendation for individual situations or remedies. Talk to your medical doctor, nurse or pharmacist earlier than following any scientific routine to peer if it's far secure and powerful for you.

Medroxyprogesterone injection for contraception

Type of medicine	Used for	Also called	Available as
A progestogen (female hormone)	Contraception	Depo-Provera®; SAYANA PRESS®	Intramuscular injection (Depo-Provera®), and subcutaneous injection (SAYANA PRESS®)

Medroxyprogesterone is a progestogen, which is a female hormone. It is used to prevent pregnancy. It is a very effective and safe form of contraception. Medroxyprogesterone is either injected into a muscle (Depo-Provera®) or under the skin (SAYANA PRESS®). It is then slowly released into your body. The injection will provide contraception for three months. Its advantages are that it is very effective as a contraceptive and you do not have to remember to take tablets. Also, it can be used when breast-feeding. The downsides are that your periods may become irregular and there may be a delay in your return to normal fertility after you finish using it. Also, the injection cannot be removed once it has been given so any side-effects can last for 2-3 months. Medroxyprogesterone works mainly by stopping the release of an egg from the ovary (ovulation). It also changes the lining of your womb (uterus) to make it less likely that an egg would attach to it, even if an egg were to fertilise. In addition, the mucus which forms a plug in the neck of the womb (your cervix) becomes thicker. This stops sperm getting through to the uterus to fertilise an egg. 

Before having a medroxyprogesterone injection

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you have a medroxyprogesterone injection it is important that your doctor or nurse knows:

• If you think you could already be pregnant.
• If you have any vaginal bleeding other than your normal monthly period.
• If you have any problems with the way your liver works.
• If you have a problem with your arteries, called arterial disease.
• If you have an inflammatory condition called systemic lupus erythematosus (SLE).
• If you have developed yellowing of your skin or the whites of your eyes (jaundice), severe itching, or a skin condition called pemphigoid gestationis during a pregnancy.
• If you have had breast cancer or a cancer that you have been told is dependent on a sex hormone.
• If you have a rare inherited blood disorder called porphyria.
• If you have ever had an allergic reaction to a medicine.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.

How medroxyprogesterone injection is given

• Before you are given the injection you will be asked to read a printed information leaflet from the manufacturer. The manufacturer's leaflet will give you important information about the injection and will provide a full list of the side-effects which you may experience from having it. Before you have the injection, please discuss with your doctor/nurse any questions you have as a result of reading the leaflet. You will be given the leaflet to take home.
• The injection will be given to you by your doctor or nurse. The first injection will usually be given during the first five days after the beginning of a normal menstrual period and when given in this way, you will be protected from pregnancy straightaway. If you are having medroxyprogesterone injection after recently giving birth, your doctor will advise you on the best time to have the injection.
• Depo-Provera® is usually given as a single injection into the muscle in your buttock. It can sometimes be given into the upper arm.
• SAYANA PRESS® is given as an injection under the skin of your outer thigh or your tummy (abdomen).

Getting the most from your treatment

• The timing of the injections is important, so remember to keep your scheduled clinic appointments. Your next injection will be due in 12 weeks time if you have had Depo-Provera® and it will be due in 13 weeks time if you have had SAYANA PRESS®. If you are more than five days late for your next Depo-Provera® injection, or more than seven days late for your next SAYANA PRESS® injection, you may be at risk of getting pregnant. If this happens, your doctor will want to be sure that you are not pregnant before giving you another injection. You also may need to use an additional form of contraception such as a condom for 14 days until this next injection takes effect.
• Your periods are likely to change. Spotting, breakthrough bleeding and delayed periods may occur. Some women have irregular bleeding which can be heavier and longer than normal.
• You may gain a little weight. Eating a well-balanced diet and taking regular exercise can help to keep this to a minimum but if this is a concern to you, you should discuss it with your doctor.
• Regularly check your breasts for any lumps or bumps. Speak with your doctor if you notice any changes.
• Please note: the injection will not protect you against HIV (AIDS) or any other sexually transmitted infections.
• If you are having any medical tests you should tell the person doing the test that you are using medroxyprogesterone as a contraceptive. This is because this form of contraception may affect the results of some tests, including cervical smears.
• If you have diabetes you may need to check your blood glucose more frequently, as medroxyprogesterone can affect the levels of sugar in your blood. Your doctor will be able to advise you about this.
• If you wish to use medroxyprogesterone injection for more than two years, your doctor will want to discuss this with you, as there may be other options more suitable for you. This is because using medroxyprogesterone can lead to a gradual loss of bone mineral density.
• If you wish to try for a baby you may find that it can take up to a year after stopping using medroxyprogesterone injection before you are able to conceive, although this takes different times in different women. Some women have become pregnant within one month of stopping the injection; for others, it takes longer.

Ibuprofen, Uses, Dosage & Side Effect

What is ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury.

Ibuprofen is used in adults and children who are at least 6 months old.

Important information

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
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Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

Do not take more than your recommended dose. An ibuprofen overdose can damage your stomach or intestines. Use only the smallest amount of medication needed to get relief from your pain, swelling, or fever.

Before taking this medicine

Ibuprofen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using ibuprofen, especially in older adults.

You should not use ibuprofen if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

    heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

    a history of heart attack, stroke, or blood clot;

    a history of stomach ulcers or bleeding;

    asthma;

    liver or kidney disease;

    fluid retention; or

    a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, or lupus.
Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby.Do not use this medicine without a doctor's advice if you are pregnant.

It is not known whether ibuprofen passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.

Do not give ibuprofen to a child younger than 2 years old without the advice of a doctor.

How should I take ibuprofen?

Use ibuprofen exactly as directed on the label, or as prescribed by your doctor. Do not use in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Do not take more than your recommended dose. An ibuprofen overdose can damage your stomach or intestines. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount needed to get relief from your pain, swelling, or fever.

A child's dose of ibuprofen is based on the age and weight of the child. Carefully follow the dosing instructions provided with your child's medicine for the age and weight of your child. Ask a doctor or pharmacist if you have questions.

Take ibuprofen with food or milk to lessen stomach upset.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

The ibuprofen chewable tablet must be chewed before you swallow it.

If you use this medicine long-term, you may need frequent medical tests.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

See also: Dosage Information (in more detail)
What happens if I miss a dose?

Since ibuprofen is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

What should I avoid while taking ibuprofen?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin while you are taking ibuprofen.

Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form).

Ask a doctor or pharmacist before using any cold, allergy, or pain medicine. Many medicines available over the counter contain aspirin or other medicines similar to ibuprofen. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Ibuprofen side effects

Get emergency medical help if you have signs of an allergic reaction to ibuprofen: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using ibuprofen and call your doctor at once if you have:

•     changes in your vision;
•     shortness of breath (even with mild exertion);
•     swelling or rapid weight gain;
•     the first sign of any skin rash, no matter how mild;
•     signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
•     liver problems - nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
•     kidney problems - little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;
•     low red blood cells (anemia) - pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or
•     severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common ibuprofen side effects may include:

•     upset stomach, mild heartburn, nausea, vomiting;
•     bloating, gas, diarrhea, constipation;
•     dizziness, headache, nervousness;
•     mild itching or rash; or
•     ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ibuprofen could reduce smokers' risk of death from lung cancer

Ibuprofen is a medication commonly used to reduce pain and inflammation, but a new study suggests its benefits do not stop there. Researchers have found that the drug may also reduce the risk of death from lung cancer among former and current smokers.

Study co-author Dr. Marisa Bittoni, of The Ohio State University, and colleagues recently presented their findings at the IASLC 17th World Conference on Lung Cancer (WCLC) in Vienna, Austria.


Lung cancer is one of the most common cancers in the United States, accounting for around 14 percent of new cancer cases.


This year, it is estimated that around 224,390 people in the U.S. will be diagnosed with lung cancer, and more than 158,000 Americans will die from the disease, making it the leading cause of cancer death in both men and women.


Smoking is the primary cause of lung cancer, associated with around 80-90 percent of lung cancer cases in the U.S.


According to the Centers for Disease Control and Prevention (CDC), people who smoke are 15-30 times more likely to develop lung cancer or die from the disease than nonsmokers.


Previous studies have shown that chronic inflammation is associated with increased risk of lung cancer. Since ibuprofen is a medication that reduces inflammation, Dr. Bittoni and colleagues set out to investigate whether the drug might benefit people with a history of smoking

Ibuprofen reduced lung cancer death risk by 48 percent

To reach their findings, the team analyzed the data of 10,735 adults who were part of the Third National Health and Nutrition Examination Survey (NHANES III), enrolling between 1988-1994.

Subjects' smoking status, use of ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), and information on other lifestyle factors were gathered at study baseline.


Participants were followed-up for an average of 18 years, and the researchers pinpointed their cause-specific mortality status using data from the National Death Index up until 2006.


The researchers used Cox proportional hazards regression models to estimate how NSAID use was associated with the risk of lung cancer death.


During follow-up, 269 of the participants died from lung cancer, of whom 252 had a history of smoking.


Because the vast majority of lung cancer cases were among past or current smokers, the team also calculated the effects of NSAIDs in a further sample of 5,882 adults with a history of smoking.

Overall, the team found that former or current smokers who regularly used ibuprofen were 48 percent less likely to die from lung cancer than those who did not use the drug.

The link between lung cancer death risk and the use of aspirin - another common NSAID - was not statistically significant, the authors report.


Quitting smoking and adopting a healthy lifestyle remain the best ways to lower lung cancer risk. However, Dr. Bittoni and colleagues believe their findings suggest regular ibuprofen use might be valuable for some people.

ACE Inhibitors

For what conditions are ACE inhibitors used?

    ACE inhibitors are used for
        controlling acute and chronic high blood pressure,
        treating left ventricular dysfunction and heart failure,
        preventing strokes, and
        preventing and treating kidney disease (nephropathy) in people with hypertension or diabetes.
    ACE inhibitors also improve survival after heart attacks. In studies, individuals with hypertension, heart failure, or prior heart attacks who were treated with an ACE inhibitor lived longer than patients who did not take an ACE inhibitor.
    ACE inhibitors are an important group of drugs because they prevent early death resulting from hypertension, heart failure or heart attacks.
    Some individuals with hypertension do not respond sufficiently to ACE inhibitors alone. In these cases, other drugs often are used in combination with ACE inhibitors.

Are there any differences among the different types of ACE inhibitors?

ACE inhibitors are very similar. However, they differ in how they are eliminated from the body and their doses. Some ACE inhibitors remain in the body longer than others, and are given once a day. Some ACE inhibitors need to be converted into an active form in the body before they work. In addition, some ACE inhibitors may work more on ACE that is found in tissues than on ACE that is present in the blood. The importance of this difference or whether one ACE inhibitor is better than another has not been determined.

ACE Inhibitors

What are the side effects of ACE inhibitors?

ACE inhibitors are well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors.

ACE inhibitors usually are not prescribed for pregnant women because they may cause birth defects.

Individuals with bilateral renal artery stenosis (narrowing of the arteries that supply the kidneys) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them.

The most common side effects are:

    Cough
    Elevated blood potassium levels
    Low blood pressure,
    dizziness
    Headache
    Drowsiness
    Weakness
    Abnormal taste (metallic or salty taste)
    Rash
    Chest pain
    Increased uric acid levels
    Sun sensitivity
    Increased BUN and creatinine levels

It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too.

The most serious, but rare, side effects of ACE inhibitors are:

    kidney failure,
    allergic reactions,
    pancreatitis
    liver dysfunction
    a decrease in white blood cells, and
    swelling of tissues (angioedema).