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Hypothyroidism has been diagnosed in up to 17% of pregnant women with DM1, and postpartum thyroiditis occurs three times more frequently in women with DM1 [6]

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Sener G, Ekiolu-Demiralp E, Cetiner M, Ercan F, Sirvanci S, Gedik N, et al L-Carnitine ameliorates methotrexate-induced oxidative organ injury and inhibits leukocyte death Cell Biol Toxicol

The absence of human teratogenicity data means risk cannot be quantified, but early first-trimester exposure (gestational weeks 38) coincides with organogenesis when developmental signaling is most vulnerable to external modulators