Controversies in Management of Hyperthyroidism during Pregnancy

T he importance of normal thyroid function during pregnancy has compelled the American Thyroid Association to revise its 2011 guidelines1 to a new set of guidelines in 2016, published in the Thyroid.2 The new guidelines contain many important recommendations based on some 􀁖􀁆􀁌􀁈􀁑􀁗􀁌􀂿􀁆􀀃􀁈􀁙􀁌􀁇􀁈􀁑􀁆􀁈􀀏􀀃􀁓􀁕􀁈􀁖􀁈􀁑􀁗􀁈􀁇􀀃􀁌􀁑􀀃􀁗􀁋􀁈􀀃􀁏􀁄􀁖􀁗􀀃􀂿􀁙􀁈􀀃􀁜􀁈􀁄􀁕􀁖􀀃􀁄􀁑􀁇􀀃􀁗􀁋􀁈􀀃􀀤􀀷􀀤􀀃 appointed scientists responsible for this should be congratulated for this commendable piece of work. Like many other sets of recommendations, however, the 2016 Guidelines of the ATA for “Diagnosis and Management of Thyroid Disease during Pregnancy” suffer from some recommendations that are based mostly on “expert opinion”, and are pointed out as “Weak recommendation, Low quality evidence”. One section that suffers more from weak recommendations is section VIII: Thyrotoxicosis in pregnancy. With all due respect, we would like to express our views on some of these recommendations.