Abnormal Serum Thyroid Stimulating Hormone Research Articles

Edible mushrooms as a potent therapeutics of subclinical thyroid dysfunction among adults, especially in obese individuals: a prospective cohort study

BackgroundMushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases. We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction (SCTD). Therefore, we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults. MethodsThis prospective cohort study investigated 6631 participants (mean age: (45.0 ± 10.2) years; 55.1 % men). Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire. SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine. Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD. ResultsDuring follow-up period, a total of 262 new cases of SCTD were identified, the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years. After adjusting potential confounding factors, the multivariable hazard ratios (95 % confidence intervals) for subclinical hypothyroidism were 1.00 (reference) for almost never, 0.53 (0.29, 0.97) for 1–3 times/week and 0.30 (0.10, 0.87) for ≥ 4 times/week (P for trend = 0.02). It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals, the final hazard ratios (95 % confidence intervals) were 0.14 (0.03, 0.73) (P for trend < 0.01). Conclusionshis population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population, especially in obese individuals.

Thyroid Function in Neonates with Hypoxic Ischemic Encephalopathy.

We aimed to examine heel prick (capillary) and serum thyroid function test (TFT) results in neonates with hypoxic ischemic encephalopathy (HIE) to evaluate the effect of asphyxia and therapeutic hypothermia (TH) on thyroid functions. This retrospective chart review included infants who were born after 34 weeks of gestation, were diagnosed and treated for HIE. The patients were divided into those who did and did not undergo TH and the groups were compared in terms of demographic characteristics, laboratory results, capillary thyroid-stimulating hormone (cTSH) levels, and serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels. A total of 111 neonates were included in the study. There was no difference between the TH group (n = 90) and the nonhypothermia group (n = 21) in terms of median gestational age (38.3 ± 2.1 weeks vs. 38.6 ± 1.8 weeks, p = 0.42) or birth weight (3182 ± 509 g vs. 3174 ± 573 g, p = 0.72). Serum TFT was performed at a median of 10 days (range, 2-43) and capillary TSH analyzed at a median of 6 days (range, 1-26). Capillary TSH at 96 hours was analyzed in 36 patients in the TH group and 19 patients in the nonhypothermia group. Serum TSH and fT4 levels were similar in both groups (p = 0.29, p = 0.1). Overall cTSH and cTSH obtained in the first 4 days were 2.2 (0.5-10) and 4.3 (0.5-94), p = 0.059; 2 (0.5-22) and 5 (0.5-94), p = 0.04, respectively, whereas cTSH obtained after day 4 was similar in both groups (p = 0.058). Abnormal serum TSH (>5.5 mU/mL) was more frequent in the hypothermia group (44.4% vs. 19%, p = 0.026). Our results suggest that TH may cause some alterations on TFTs. Therefore, it may be reasonable to repeat TSH screening after TH.

Association Between Serum Thyroid-Stimulating Hormone Levels and Salivary Microbiome Shifts.

High serum thyroid-stimulating hormone (TSH) levels are linked to many metabolic disorders, but the effects of TSH levels on the oral microbiota are still largely unknown. This study aimed to explore the association between the salivary microbiome in adults and serum TSH levels. Saliva and fasting blood samples were obtained from a health census conducted in Southeast China. All participants were divided according to serum TSH levels. The microbial genetic profiles and changes were acquired by 16S rDNA sequencing and bioinformatics analysis. Relevant anthropometric and biochemical measurements such as insulin resistance, blood lipids, and body composition were evaluated with laboratory tests and physical examinations. The salivary microbiome in individuals with higher TSH level showed significantly higher taxa diversity. Principal coordinates analysis and partial least squares discriminant analysis showed distinct clustering in the Abnormal and Normal Groups (Adonis, P=0.0320). Granulicatella was identified as a discriminative genus for comparison of the two groups. Fasting serum insulin, Homeostatic Model Assessment for Insulin Resistance, and hemoglobin A1 were elevated in the Abnormal Group (P<0.05), showing the presence of insulin resistance in individuals with abnormal higher serum TSH levels. Distance-based redundancy analysis revealed the association of this distinctive difference with salivary microbiome. In conclusion, shifts in microbial profile were observed in the saliva of individuals with different serum TSH levels, and insulin resistance may play an important role in the biochemical and microbial alteration.

The Correlation Between Metabolic Disorders And Tpoab/Tgab: A Cross-Sectional Population-Based Study

Studies have shown that metabolic abnormalities influence the immune system. Because the prevalence of metabolic and autoimmune thyroid diseases has increased synchronously, the correlation between them was worth exploring. The study objective was to investigate the relationship between metabolic disorders and thyroid auto-antibodies in euthyroid subjects. Data were obtained from the Thyroid Diseases and Diabetes Mellitus project survey of 55,891 subjects from 31 provinces in China. The body mass index (BMI), waist circumference (WC), blood pressure, thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), thyroid-stimulating hormone (TSH), urinary iodine concentration, blood glucose, lipid profile, and uric acid levels were evaluated. Free thyroxine and free triiodothyronine levels were measured in patients with abnormal serum TSH levels. In males, the BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), and 2-hour post-glucose oral glucose tolerance test results of the TPOAb-/TgAb-positive group were significantly higher than those of the TPOAb-/TgAb-negative group. In females, the BMI, WC, SBP, DBP, total cholesterol, and low-density-lipoprotein cholesterol (LDL-C) in the TPOAb-/TgAb-positive group were significantly increased compared to the TPOAb-/TgAb-negative group. Multivariate analysis showed that in males, the odds ratio (OR) of positive TgAbs in the abdominal obesity group was 1.175 (95% confidence interval [CI], 1.016 to 1.359; P = .03), and the OR of positive TPOAbs in the hyperuricemia group was 1.195 (95% CI, 1.041 to 1.372; P = .011). In females, the OR of positive TgAbs was 1.19 (95% CI, 1.068 to 1.326; P = .002) in the high LDL-C group. Obesity, high LDL-C, and hyperuricemia were positively correlated with the prevalence of positive thyroid autoantibodies in euthyroid subjects in a gender-dependent manner. This cross-sectional survey showed that metabolic disorders are associated with increased positive thyroid autoantibody levels in euthyroid subjects in a gender-dependent manner. AIT = autoimmune thyroiditis; BMI = body mass index; CI = confidence interval; DBP = diastolic blood pressure; FPG = fasting plasma glucose; FT3 = free triiodothyronine; FT4 = free thyroxine; HbA1c = glycated hemoglobin; HDL-C = high-density-lipoprotein cholesterol; LDL-C = low-density-lipoprotein cholesterol; OGTT2hPG = oral glucose tolerance test 2-hours post-glucose; OR = odds ratio; SBP = systolic blood pressure; TC = total cholesterol; TG = triglycerides; TgAb = thyroglobulin antibody; TPOAb = thyroid peroxidase antibody; TSH = thyroid-stimulating hormone; UA = uric acid; WC = waist circumference.

Screening and analysis of the serum thyroid stimulating hormone (TSH) of rural pregestational women In Yunnan province

Objective Through screening the serum TSH in rural pregestational women, fo find out the high incidence area and high risk population of thyroid disease in Yunnan province, to reduce the probability of infertility and abnormal pregnancy and provide important reference basis for prenatal aristogenesis. Methods The serum TSH level of 30 163 rural pregestational women(20-49 yeas old) which from 16 different areas and 16 different ethnicities of Yunnan province was detected by using TSH3-Ultra (TSH3-UL) reagent on a Siemens centar-XP automatic chemiluminescence apparatus. Results 1 797 women were found with abnormal serum TSH level, the abnormal rate was 5.96%. Among them, the proportion of women with decreased TSH was 3.09% and increased TSH was 2.87%, compared with the normal reference range. And there was a significant difference of abnormal serum TSH rate between pregestational women from different areas and ethnicities. Moreover, in the 16 tested areas, the highest abnormal serum TSH rate was 8.90% from Ximeng county, the lowest was 3.60% from Diqing state. However in the 16 tested ethnicities, the highest abnormal serum TSH rate was 9.73% from Lisu ethnic minority and the lowest was 3.60% from Tibetan ethnic minority. Conclusions The results inferred that ethnic and regional factors both to some extent affect the prevalence of thyroid disease in pregestational women and it is a small probability event that high occurrence of TSH decreased or increased situation simultaneously happened in one area or one ethnicity. Key words: Thyroid stimulating hormone; Pregestational Women; Rural areas; Minority of Yunnan Province

Association of thyroid dysfunction with ocular surface damage in thyroid dysfunction patients without thyroid ophthalmopathy

Background It is determined that the patients with thyroid-associated ophthalmopathy (TAO) often occur dry-eye related symptoms due to increasing tear evaporation caused by exophthalmos.However, more than half of thyroid dysfunction patients without TAO appear ocular surface inflammation.It is very important for us to understand the association of thyroid dysfunction patients without TAO with ocular damage. Objective This study was to observe the ocular surface changes in thyroid dysfunction patients without TAO. Methods A prospective cohort study was performed.Thirty-one patients who were initially diagnosed as thyroid dysfunction without TAO were included in the Second Hospital of Tianjin Medical University from January 2015 to May 2016 as the thyroid dysfunction group, and 16 helthy subjects were simutenniously selected as the control group under the informed consent of all the individuals.The peripheral blood was collected to detect the thyroid function-related indexes.Then the patients with thyroid dysfunction were divided into thyroid stimulating hormone (TSH) reduced group (18 patients) versus TSH elevated group (13 patients) and thyrotrophin receptor antibody (TRAb)+ group (20 patients) versus TRAb- group (11 patients). Exophthalmos degree, Schirmer Ⅰtest (SⅠt), tear film break-up time (BUT), fluorescent integral, ocular surface disease index (OSDI) and corneal inflammation index were examined and intergrouply compared.The correlations of thyroid function indexes with ocular surface examination results were analyzed. Results There were no significant differences in exophthalmos degree and SⅠt values between thyroid dysfunction group and control group (t=0.037, P=0.971; t=0.815, P=0.419). The BUT values were (7.74±1.45)seconds and (10.56±1.40)seconds, fluorescent integral scores were 5.00 (1.50) and 2.50 (2.38), OSDI scores were 45.58±9.23 and 19.47±6.25, and corneal inflammation index scores were 0.11 (0.22) and 0.00 (0.06) in the thyroid dysfunction group and the control group, respectively, showing significant differences between the two groups (all at P 0.05); and significant differences were seen in fluorescent integral scores (4.00[1.50]vs.5.50[1.50]) and OSDI scores ([39.18±6.25]vs.[46.78±8.76]). Corneal inflammation index scores were positive correlated with serum TSH (R2=0.520, P=0.000), and fluorescent integral scores, OSDI scores and corneal inflammation index scores were positive correlated with serum TRAb (R2=0.587, P=0.000; R2=0.329, P=0.024; R2=0.400, P=0.005). Conclusions Thyroid dysfunction patients without TAO have ocular surface dysfunction, which probably is associated with abnormal serum TSH and TRAb. Key words: Thyroid dysfunction; Thyroid associated ophthalmopathy; Ocular surface; Thyroid stimulating hormone; Thyrotrophin receptor antibody

Subclinical hypothyroidism &amp; infertility: a review

Subclinical hypothyroidism (SCH) may be of greater clinical importance in women with “unexplained” infertility, especially when the luteal phase is inadequate, and such patients should be investigated for thyroid dysfunction in detail. To date, studies investigating the association between SCH and infertility are still based on the high serum thyroid stimulating hormone (TSH) levels while some older studies are based on the presence of an abnormal serum TSH after a thyrotropin releasing hormone (TRH) stimulation test. The recommendation in the current guidelines to treat subclinical hypothyroidism is based on minimal evidence and it is thought that with treatment the potential benefits outweigh the potential risks. Thyroxine-replacement therapy should be started in patients with SCH caused by conditions which are at high risk of progression to overt hypothyroidism.Ibrahim Med. Coll. J. 2014; 8(1): 17-24

Subclinical thyroid disorders: significance and clinical impact

Subclinical thyroid diseases are defined by abnormal serum thyroid stimulating hormone (TSH) levels associated with normal thyroid hormone concentrations. The diagnosis of these conditions depends on defining the ‘normal’ euthyroid...

Should women with abnormal serum thyroid stimulating hormone undergo screening for anemia

Should women with abnormal serum thyroid stimulating hormone undergo screening for anemia

Hypothyroidism after Sunitinib Treatment for Patients with Gastrointestinal Stromal Tumors

Sunitinib malate is an oral tyrosine kinase inhibitor recently approved for the treatment of gastrointestinal stromal tumors and renal cell carcinoma. Because the ret proto-oncogene is also inhibited by this agent, clinical evaluation of thyroid function was performed. To describe the prevalence and clinical presentation of thyroid dysfunction related to sunitinib therapy. Prospective, observational cohort study. Tertiary care hospital. 42 patients treated for a median of 37 weeks (range, 10 to 167 weeks). Following analysis of serial thyroid-stimulating hormone (TSH) measurements collected prospectively during a clinical trial of sunitinib, the authors determined the proportion of patients with thyroid dysfunction. Abnormal serum TSH concentrations were documented in 26 of 42 patients (62%): 15 (36%) developed persistent, primary hypothyroidism; 4 (10%) developed isolated TSH suppression; and 7 (17%) experienced transient, mild TSH elevations. The risk for hypothyroidism increased with the duration of sunitinib therapy. Six of 15 (40%) hypothyroid patients had suppressed TSH concentrations before developing hypothyroidism, suggesting thyroiditis. Two hypothyroid patients evaluated with thyroid ultrasonography had no visualized thyroid tissue despite normal baseline thyroid function. The exploratory nature of this study precluded more frequent biochemical and sonographic analysis that may better define the mechanism of sunitinib-associated thyroid dysfunction. Hypothyroidism is a frequent complication of sunitinib therapy. Regular surveillance of thyroid function is warranted in patients receiving the drug. Although the mechanism by which this complication occurs is unknown, the observations of preceding TSH suppression and subsequent absence of visualized thyroid tissue in some patients suggest that sunitinib may induce a destructive thyroiditis through follicular cell apoptosis. This provides a rationale for further investigation of sunitinib treatment in patients with advanced thyroid cancer.

Subclinical thyroid disease

Subclinical thyroid dysfunction is defined as an abnormal serum thyroid-stimulating hormone level (reference range: 0.45 to 4.50 microU per mL) and free thyroxine and triiodothyronine levels within their reference ranges. The management of subclinical thyroid dysfunction is controversial. The prevalence of subclinical hypothyroidism is about 4 to 8.5 percent, and may be as high as 20 percent in women older than 60 years. Subclinical hyperthyroidism is found in approximately 2 percent of the population. Most national organizations recommend against routine screening of asymptomatic patients, but screening is recommended for high-risk populations. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. Patients with a serum thyroid-stimulating hormone level greater than 10 microU per mL have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that treatment of subclinical hypothyroidism is beneficial. A serum thyroid-stimulating hormone level of less than 0.1 microU per mL is associated with progression to overt hyperthyroidism, atrial fibrillation, reduced bone mineral density, and cardiac dysfunction. There is little evidence that early treatment alters the clinical course.

Clinical and Subclinical Thyroid Disorders Associated With Pernicious Anemia

of 162 patients with pernicious anemia whom we studies, 24.1% had clinical thyroid disease; 11.7% were hypothyroid and 8.6% were hyperthyroid. When abnormal serum thyroid-stimulating hormone (TSH) levels were also considered, thyroid disorders existed in 48.3% of 143 patients. Increased or decreased TSH levels as the sole dysfunction occurred in 14.7% and 6.3% of cases, respectively, and were often associated with thyroid antibodies. The high TSH group fits the picture of subclinical hypothyroidism. The nature of the low TSH group remains to be defined. We conclude that TSH screening in patients with pernicious anemia uncovers frequent abnormalities, which are superimposed on a higher coincidence of overt thyroid disease than previously described. Interestingly, also, eight of nine hyperthyroid patients and all seven patients with low TSH levels had blood type O, contrasting significantly with hypothyroid subjects, who more often had blood type A, and with patients without thyroid disorders.

Approach to Subclinical Thyroid Diseas

Subclinical thyroid dysfunction is defined as an abnormal serum thyroid-stimulating hormone level and free thyroxine and triiodothyronine levels within their reference ranges. The prevalence of subclinical hyperthyroidism is about 2 percent. Subclinical hypothyroidism is found in approximately 4 to 8.5 percent of the population. Most national organizations recommend against routine screening of asymptomatic patients, but screening is recommended for high risk populations. The management of subclinical thyroid dysfunction is controversial. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. Patients with a serum thyroid-stimulating hormone level greater than 10 mIU/L have a higher incidence of elevated serum low density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that treatment of subclinical hypothyroidism is beneficial. A serum thyroid stimulating hormone level of less than 0.1 mIU/L is associated with progression to overt hyperthyroidism, atrial fibrillation, reduced bone mineral density, and cardiac dysfunction. There is little evidence that early treatment alters the clinical course. DOI: 10.3329/jbcps.v26i2.4187 J Bangladesh Coll Phys Surg 2008; 26: 91-96