Clinical · Special populations · continued

Pregnancy and pregnancy planning: contraindication and washout posts 31–60

Clinical › Special populations pregnancy & planning bariatric surgery history chronic kidney disease disordered eating Closed

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

blank_injectionTL2Analytical chemist2 Feb 2026#31

c.silva, post #25: Source for the pregnancy and pregnancy planning figure, since it was asked for. It is in the discussion rather than the abstract, which is why the version circulating is stronger than the paper is. Reading the surrounding paragraph is worth the two minutes. The authors are more careful than their summarisers. Go to post

Having read the whole pregnancy and pregnancy planning thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead.

2 likes in reply to #25 6mo

h.iyerTL23 Feb 2026#32

Bookmarking this. I will come back when I have something worth adding.

0 likes 6mo

forest_plotTL3Evidence synthesis5 Feb 2026#33

Post #31 describes the usual case. This is about the unusual one.

Post-surgical populations, particularly after procedures affecting the gastrointestinal tract, interact with a delayed-emptying mechanism in ways that need specialist input.

19 likes 6mo

n.villalobosTL26 Feb 2026#34

Adding the measurement that post #31 says would settle it.

Pregnancy and pregnancy planning looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.

8 likes 6mo

hana.satoTL4 Moderator7 Feb 2026#35

baseline_peak, post #24: Nothing to add, except that this is the answer I would give if asked. Go to post

Small methodological point on pregnancy and pregnancy planning: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.

0 likes in reply to #24 6mo

f.amankwahTL28 Feb 2026#36

Genetic and ancestry-related differences in response are asked about regularly and the published evidence is thin enough that the honest answer is short.

Not a strong opinion, just a consistent one.

0 likes 6mo

p.iyer_pharmdTL3Pharmacist9 Feb 2026#37

On pregnancy and pregnancy planning the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that.

13 likes 6mo

n.okwuosaTL210 Feb 2026#38

The arithmetic in post #35 is right; the assumption feeding it is the part to check.

Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.

4 likes 6mo

p.novotnyTL2Regular11 Feb 2026#39

Same experience here, different supplier, so it is at least not unique to one of them.

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z.cardosoTL212 Feb 2026#40

Building on post #38 rather than restating it.

Pregnancy and pregnancy planning: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which.

27 likes 5mo

t.steenkampTL2Member13 Feb 2026#41

Confirming post #40 from a second method, which matters more than confirming it from a second person.

Dedicated trials in under-studied populations are the only real remedy and several are ongoing, which is worth saying rather than speculating.

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ak.kravchenkoTL214 Feb 2026#42

Noted, and I have changed what I was going to do on the strength of it.

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ambient_draftTL3Regular15 Feb 2026 · edited#43

A definition problem is doing most of the work in this pregnancy and pregnancy planning discussion. Once the term is pinned down I suspect the disagreement mostly goes away and what is left is small.

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mi.amankwahTL216 Feb 2026#44

n.dziedzic, post #9: Genetic and ancestry-related differences in response are asked about regularly and the published evidence is thin enough that the honest answer is short. Go to post

Post #43 describes the usual case. This is about the unusual one.

What I would check first on pregnancy and pregnancy planning is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

27 likes in reply to #9 5mo

LJankowiakTL3Regular17 Feb 2026#45

s.dziedzic, post #20: Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance. This has been discussed before and I could not find the thread, so, again. Go to post

Post #44 is the version of this I will quote in future. One addition.

The most useful contribution here is usually a citation to whichever published document comes closest, with a plain statement of how far it is from the question.

0 likes in reply to #20 5mo

a.cardosoTL218 Feb 2026#46

Where I part company with post #43, and it is a narrow parting.

Nothing in this subcategory is medical advice and the questions asked here are precisely the ones that need an individual assessment.

2 likes 5mo

buffer_reviewTL3Regular19 Feb 2026#47

The reason pregnancy and pregnancy planning is hard to answer is that the obvious measurement and the relevant quantity are not the same thing, and substituting one for the other is silent.

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a.norgaardTL220 Feb 2026#48

h.castellanos, post #5: The version of pregnancy and pregnancy planning that I was taught turned out to be a teaching simplification. Useful, and not true in the way I had assumed it was. Go to post

Two sentences on pregnancy and pregnancy planning and then I will stop, because the rest is speculation and the thread is better without mine.

What is documented is narrow. What is inferred from it is broad. The gap between them is where every argument here lives.

20 likes in reply to #5 5mo

trough_indexTL3Regular21 Feb 2026#49

n.laurent, post #16: Post #13 is right about the mechanism and I think understates the practical bit. Dedicated trials in under-studied populations are the only real remedy and several are ongoing, which is worth saying rather than speculating. It reads as pedantry until the day it does not. Go to post

Post-surgical populations, particularly after procedures affecting the gastrointestinal tract, interact with a delayed-emptying mechanism in ways that need specialist input.

That holds under the stated conditions and I have stated them.

4 likes in reply to #16 5mo

f.novakTL221 Feb 2026#50

I read post #46 twice before replying, because I had assumed the opposite.

Pregnancy and pregnancy planning is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring.

12 likes 5mo

d.oyelaranTL3Pharmacist22 Feb 2026#51

m.ndiaye, post #3: The most useful contribution here is usually a citation to whichever published document comes closest, with a plain statement of how far it is from the question. Go to post

What I can speak to on pregnancy and pregnancy planning is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.

0 likes in reply to #3 5mo

j.petrovTL223 Feb 2026#52

ambient_draft, post #43: A definition problem is doing most of the work in this pregnancy and pregnancy planning discussion. Once the term is pinned down I suspect the disagreement mostly goes away and what is left is small. Go to post

Post #49 answers the question as asked. The question underneath it is different.

Genetic and ancestry-related differences in response are asked about regularly and the published evidence is thin enough that the honest answer is short.

25 likes in reply to #43 5mo

KLindqvistTL4 Moderator24 Feb 2026#53

Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance.

I have separated what I observed from what I concluded, which does not always happen.

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f.kimaniTL225 Feb 2026#54

Since pregnancy and pregnancy planning keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.

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bias_varianceTL4Biostatistician26 Feb 2026#55

j.petrov, post #52: Post #49 answers the question as asked. The question underneath it is different. Genetic and ancestry-related differences in response are asked about regularly and the published evidence is thin enough that the honest answer is short. Go to post

On pregnancy and pregnancy planning I would separate what is worth knowing from what is worth acting on. The first list is long and the second is short, and conflating them is how threads get heated.

0 likes in reply to #52 5mo

id.almeidaTL227 Feb 2026#56

t.steenkamp, post #41: Confirming post #40 from a second method, which matters more than confirming it from a second person. Dedicated trials in under-studied populations are the only real remedy and several are ongoing, which is worth saying rather than speculating. Go to post

Acknowledging rather than arguing. The reasoning holds as far as I can follow it.

18 likes in reply to #41 5mo

baseline_driftTL2Analytical chemist28 Feb 2026 · edited#57

Post #53 put the caveat in the right place and I want to underline it.

Body weight at the extremes of the studied range affects exposure and the trials rarely reported enough to say by how much.

The general answer and the answer for your case may diverge here.

7 likes 5mo

n.krastevTL21 Mar 2026#58

Pregnancy and breastfeeding are the clearest cases where the answer is that the trials excluded them and the labelling reflects that exclusion.

Adding this to the thread rather than to the wiki, because I am not confident enough for the wiki.

1 like 5mo

two_year_lineTL3Regular2 Mar 2026#59

f.novak, post #50: I read post #46 twice before replying, because I had assumed the opposite. Pregnancy and pregnancy planning is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring. Go to post

I had written a reply contradicting post #57 and deleted it. Here is what survived.

Being outside the studied population does not mean a treatment is unsafe. It means the usual evidence is not available and the reasoning has to be explicit.

I would put this at better than even and not much better.

1 like in reply to #50 5mo

s.kuuselaTL23 Mar 2026#60

I have no financial interest in anything named in this thread and I want to say so before I comment on pregnancy and pregnancy planning, because it is the sort of subject where it matters.

0 likes 5mo