Pregnancy
Pregnant women who are positive for Hashimotos thyroiditis may have decreased thyroid function or the gland may fail entirely. If a woman is TPOAb-positive, clinicians can inform her of the risks for herself and her infant if the disease goes untreated. "Thyroid peroxidase antibodies (TPOAb) are detected in 10% of pregnant women", which presents risks to those pregnancies. Women who have low thyroid function that has not been stabilized are at greater risk of having an infant with: low birth weight, neonatal respiratory distress, hydrocephalus, hypospadias, miscarriage, and preterm delivery. The embryo transplantion rate and successful pregnancy outcomes are improved when Hashimotos is treated. Recommendations are to treat pregnant women only if they are TPOAb-positive throughout the entirety of their pregnancies and to screen all pregnant women for thyroid levels. Close cooperation between the endocrinologist and obstetrician benefits the woman and the infant. The Endocrine Society recommends screening in pregnant women who are considered high-risk for thyroid autoimmune disease.Thyroid peroxides antibodies testing is recommended for women who have ever been pregnant regardless of pregnancy outcome. "[P]revious pregnancy plays a major role in development of autoimmune overt hypothyroidism in premenopausal women, and the number of previous pregnancies should be taken into account when evaluating the risk of hypothyroidism in a young women [sic]. "Hormonal changes and trophoblast expression of key immunomodulatory molecules lead to immunosuppression and fetal tolerance. Main players in regulation of the immune response are Tregs. Both cell-mediated and humoral immune responses are attenuated, resulting in immune tolerance and suppression of autoimmunity.
Drug and alcohol use can contribute to pruritus as well so it is worthwhile to gather a social history. Those who use cocaine and amphetamines may experience pruritus due to feelings of abnormal cutaneous sensations called delusions of parasitosis, also known as "meth mites". Opioid users can also experience pruritus so examining a patients medication list can be beneficial. Diagnostic criteria
The French Psychodermatology Group is a subgroup of the French Society of Dermatology made up on psychiatrists, dermatologists and psychologists. They met in 2007 to propose diagnostic criteria for this disease in hope of preventing further misdiagnosis of this condition. They believed the term "functional itch disorder" was the best phrase to describe this condition, avoiding the use of the word "psychogenic". To diagnose a patient with functional itch disorder, the patient should meet three required criteria and three of seven optional criteria.Diagnostic Criteria:
3 Required criteria
Localized or generalized pruritus without a primary skin lesion
Chronic pruritus, characterized as being greater than 6 weeks
There is no somatic cause present
7 Optional criteria (need 3 to diagnose)
A chronological relationship of pruritus with one or several life events that can have psychological consequences
Changes during the nighttime
More present during rest or inaction
There is a coupled psychological disorder
Pruritus that could be improved with pyschotropic drugs
Pruritus that could be improved by psychotherapies

Treatment
The treatment for this condition has not been well studied but the most common options are psychotherapy and medicines geared toward psychiatric conditions. Stress reduction and relaxation techniques have also been shown to be helpful for alleviating this condition.