Decrease In Thyroid-stimulating Hormone Research Articles

Thyroid hormone homeostasis in levothyroxine-treated patients: Findings from ELSA-Brasil.

The effectiveness of levothyroxine (LT4) in restoring thyroid hormone (TH) homeostasis, particularly serum thyroxine (T4) and triiodothyronine (T3) levels, remains debatable. To assess TH homeostasis in LT4-treated individuals using data from the Longitudinal Study of Adult Health in Brazil (ELSA-Brasil) study. The ELSA-Brasil study follows 15,105 adult Brazilians (aged 35 to 74 years) over 8.2 years (2008-2019) with 3 observation points assessing health parameters including serum thyroid stimulating hormone (TSH), free T4 (FT4), and free T3 (FT3) levels. We analyzed 186 participants that initiated treatment with LT4 during the study, and 243 individuals continuously treated with LT4 therapy. Initiation of therapy with LT4 resulted in a 11-19% decrease in TSH, a ∼19% increase in FT4, and a 7% reduction in FT3 serum levels (FT3 dropped >10% in ∼40% of the LT4-treated patients). This was associated with an increase in triglyceride levels and utilization of hypolipidemic and anti-diabetic medications. Participants continuously treated with LT4 exhibited a stable elevation in serum FT4 and, a reduction in serum FT3 and TSH levels. While 115 participants (47.3%) had at least one serum FT4 levels above the control reference range (>1.52 ng/dL), 38 participants (15.6%) had at least one serum FT3 below the reference range (<0.23 ng/dL). The present results challenge the dogma that treatment with LT4 for hypothyroidism restores TH homeostasis in all patients. A substantial number of LT4-treated patients exhibit repeated FT4 and FT3 levels outside the normal reference range, despite normal TSH levels. Further studies are needed to define the clinical implications of these findings.

Clinical Evaluation of a Novel, Patented Green Coffee Bean Extract (GCB70®), Enriched in 70% Chlorogenic Acid, in Overweight Individuals

Objective Obesity and overweight are challenging health problems of the millennium that lead to diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease (NAFLD), and atherosclerosis. Green coffee bean exhibited significant promise in healthy weight management, potentiating glucose-insulin sensitization and supporting liver health. The safety and efficacy of a novel, patented water-soluble green coffee bean extract (GCB70® enriched in 70% total chlorogenic acid and <1% caffeine) was investigated in 105 participants for 12 consecutive weeks. An institutional review board and Drugs Controller General (India) (DCGI) approvals were obtained, and the study was registered at ClinicalTrials.gov. Method Body weight, body mass index (BMI), waist circumference, lipid profile, plasma leptin, glycosylated hemoglobin (HbA1c), and total blood chemistry were assessed over a period of 12 weeks of treatment. Safety was affirmed. Results GCB70 (500 mg BID) supplementation significantly reduced body weight (approximately 6%; p = 0.000**) in approximately 97% of the study population. About a 5.65% statistically significant reduction (p = 0.000**) in BMI was observed in 96% of the study volunteers. Waist circumference was significantly reduced by 6.77% and 6.62% in 98% of the male and female participants, respectively. Plasma leptin levels decreased by 13.6% in 99% of the study population as compared to the baseline value. Upon completion of 12 weeks’ treatment, fasting glucose levels decreased by 13.05% (p = 0.000**) in 79% of the study population. There was a statistically significant decrease in HbA1c levels in both male and female participants (p = 0.000**), while 86.7% of the study participants showed a statistically significant decrease in thyroid-stimulating hormone (TSH) levels (p = 0.000**). The mean decrease in TSH levels on completion of the treatment was 14.07% in the study population as compared to baseline levels. Total blood chemistry analysis exhibited broad-spectrum safety. Conclusions This investigation demonstrated that GCB70 is safe and efficacious in healthy weight management.

Subclinical Hypothyroidism and Functional Hemodynamics of the Heart

Subclinical hyperthyroidism (SHyper), a laboratory decrease in thyroid-stimulating hormone levels with peripheral thyroid hormone levels within the reference interval, is considered a medical condition, especially its impact on cardiac hemodynamics among young women. To determine the effects of subclinical thyroid dysfunction on hemodynamics in young women. clinical observation included two groups of women: (1) the main group consisted of 30 patients with subclinical hyperthyroidism, which was examined at the Family Medicine Clinic of the West Kazakhstan Marat Ospanov Medical University (Aktobe, Kazakhstan) and (2) the control group consisted of 30 practically healthy women. The groups were comparable in age (30–42), mean age 36.2±7.0 years. Blood pressure (BP) was measured, heart rate (HR) was counted, and thyroid hormones were determined. in the examined patients, clinical symptoms of pathology were not observed; laboratory tests determined a decrease in thyroid-stimulating hormone (TSH) in the main group of patients to 2.48±0.23 mIU/L in comparison with the control group 3.65±1.3 mIU/L, which was significant (p0.05) increase in blood pressure SBP/DBP from 122.34±2.7/78.3±2.7 to 127.8±3.1/83.2±2.1 mmHg and HR from 77.7±1.9 to 82.2±2.6 in 1 minute. A significant (r2 =0.482) interaction was determined between TSH -0.236 mIU/L and HP +20.3 in 1 minute, this could be a predictor of an increase in heart rate greater than the reference value (60–80 per minute), and an increased heart rate is considered a predictor of an increase in blood pressure. Subclinical hyperthyroidism may produce a significant laboratory decrease in TSH, without significant clinical symptoms of increased blood pressure. In conclusion, current observational experience suggests that small decreases in laboratory values of thyroid-stimulating hormone may affect blood pressure and heart rate.

Hormones, oxidized proteins, and lipids in alcoholism. Duration of remission

The instability of remission in alcohol dependence (AD) creates a need to search for criteria for predicting its duration. The aim of study was to determine the hormones, oxidized proteins, and lipids in patients with AD, and the possible relations between these parameters and the duration of remission. Blood samples were obtained from 49 male patients with AD after alcohol detoxification (Total group). Two groups of patients were formed: with unstable therapeutic remission up to 6 months (UTR-group); with stable therapeutic remission which lasted 12 months or longer (STR-group). The control group comprised men without AD. The levels of carbonylated proteins (CP), lipid peroxidation (TBA-RS) were determined in the blood plasma. The levels of cortisol, testosterone total, thyroid-stimulating hormone (TSH), triiodothyronine free (fT3), and thyroxine free (fT4) in the blood serum were measured. The Total group of patients showed an increase in CP, TBA-RS, Cortisol, cortisol/testosterone ratio, and a decrease in TSH, fT3, and fT3/fT4 levels. A set of parameters (T, fT3, fT4, cortisol/testosterone ratio) associated with unstable remission was identified.

Transient hyperthyroidism in a woman with hydatidiform mole: a case report on unusual clinical presentation and management

Background: Hydatidiform mole (HM) is a genetically abnormal conception involving abnormal growth of placental trophoblast. HM is sometimes accompanied by hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. This study aimed to report a case of a woman with HM complicated by transient hyperthyroidism, as well as to analyze some possible pharmacological management before the evacuation of molar tissue. Case Presentation: A 45-year-old female was referred to Dr. Soetomo Hospital Surabaya with a chief complaint of vaginal bleeding, accompanied by nausea, vomiting, frequent heart palpitations, and hand tremors. The patient had been previously diagnosed with molar pregnancy but refused to undergo curettage. At presentation, physical examination suggested incompatible uterus size with the gestational age, and the vaginal toucher indicated non-palpable ballottement. Vesicles were observed in vaginal discharge. Laboratory findings revealed elevated β-HCG, decreased thyroid stimulating hormone (TSH), and increased free thyroxine (FT4) levels. Abdominal ultrasound exhibited the presence of uterine fibroid and a honeycomb appearance. The patient was then diagnosed with molar pregnancy accompanied by hyperthyroidism; however, Burch-Warsofsky’s (BW) score (25) suggested no thyroid crisis. Before undergoing suction curettage to evacuate the hydatidiform mole, the patient received perioperative treatment for thyrotoxicosis control using methimazole, propranolol, and dexamethasone. After the surgery, hCG levels were regularly followed up until the normal range was reached. Conclusion: Despite its rarity, hyperthyroidism might become a deadly complication in molar pregnancy. Perioperative treatment to stabilize thyroid levels is prominent to prevent a thyroid storm. Treatment choice depends on the time available for preoperative preparation, the severity of the thyrotoxicosis, and the impact of any current or previous therapies. However, β-blockers should always be used unless absolutely contraindicated. Follow-up of hCG level post-operatively is critical to identify a possible occurrence of gestational trophoblastic neoplasia (GTN).

Hormonal changes in the first 24 postoperative hours after cardiac surgical procedures.

Hormone level changes after heart surgeries are a widely observed phenomenon due to neurohormonal feedback mechanisms that may affect postoperative morbidity and mortality. The current study aimed to analyze the changes in thyroid and sex hormones in the first 24 postoperative hours after heart surgery. This prospective, observational study (registered on ClinicalTrials.gov: NCT03736499; 09/11/2018) included 49 patients who underwent elective cardiac surgical procedures at a tertiary heart center between March 2019 and December 2019. Thyroid hormones, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4), and sex hormones, including prolactin (PRL) and total testosterone, were measured preoperatively and at 24 h postoperatively. Significant decreases in serum TSH (P < 0.001), T3 (P < 0.001) and total testosterone (P < 0.001) levels were noted, whereas T4 (P = 0.554) and PRL (P = 0.616) did not significantly change. Intensive care unit (ICU) hours (P < 0.001), mechanical ventilation (P < 0.001) and Vasoactive-Inotropic Score (VIS) (P = 0.006) were associated with postoperative T3 level. ICU hours were associated with postoperative T4 level (P=0.028). Postoperative and delta testosterone levels were in connection with lengths of stay in ICU (P=0.032, P = 0.010 respectively). Model for End-Stage Liver Disease (MELD) scores were associated with thyroid hormone levels and serum testosterone. T3 may represent a marker of nonthyroidal illness syndrome and testosterone may reflect hepatic dysfunction. In addition, PRL may act as astress hormone in female patients.

Comparative study of the effect of Omega-3 and the nano-loaded Propylthiouracil on thyroxine-induced hyperthyroidism in male white rats

This study was conducted to find out the therapeutic effect of Omega-3 and the zinc oxide nano-loaded propylthiouracil drug in the treatment of thyroxine-induced hyperthyroidism. The results show a significant increased (p&lt;0.05) in serum of Triiodothyronine(T3) and Thyroxine (T4) hormones with a decreased Thyroid stimulating hormone (TSH) level in T1 group compared with the control group. On the other hand, the results showed a significant decrease (P &lt; 0.05) in (T3) and (T4) with increased (TSH) levels in (T2, T3) groups compared to (T1) group. There was a significant (p &lt; 0.05) increase in the level of Malondialdehyde (MDA)with a decrease in the level of antioxidants Glutathione (GSH), Superoxide Dismutase (SOD), Catalase (CAT) in the (T1) group in comparison with the control group. Also, the results showed a significant (p &lt; 0.05) decrease in the level of MDA with an increase in the level of antioxidants (GSH, SOD, CAT) in the (T2, T3) groups as compared to the (T1) group. The results of the current study showed that there was a significant increase (P &lt; 0.05) in the level of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Alkaline phosphatase (ALP) in the (T1) group as compared to (C) group, also, these results showed a significant (p &lt; 0.05) decrease in the level of ALP, ALT, AST in the (T2, T3) groups compared to (T1) group. Several methods were used in the examination of the drug propylthiouracil nano-loaded on zinc oxide, as they included the following tests on the Fourier transform infrared Spectroscopy (FT – IR) and X-ray diffraction X-ray diffraction spectrum (XRD) as well as the use of atomic force microscope Atomic Force Microscope (AFM), the process of intercalation of the drug between layers of zinc oxide was carried out by the direct ion exchange method. This technique showed that propylthiouracil gave spectra indicating the success of the intercalation process, which was used in the subsequent stages of the study

#4846 ROXADUSTAT-INDUCED HYPOTHYROIDISM: THE EFFECT OF ROXADUSTAT ON SUPPRESSION OF THYROID FUNCTION

Abstract Background and Aims There have been only two case reports of hypothyroidism in patients treated with roxadustat, a HIF-PH inhibitor as new renal anemia drug. However, there has yet been no studies to examine the effect of roxadustat on thyroid function. Method In this study, we retrospectively examined the effects of roxadustat on thyroid-stimulating hormone (TSH) in hemodialysis patients by two blood examinations, before and during treatment with roxadustat. We included patients who had TSH levels measured after at least two consecutive weeks of roxadustat treatment and before. We excluded patients with a history of taking other HIF-PH inhibitors before roxadustat. The period was from September 2021 to November 2022 in this interim analysis. A p value of&amp;lt;0.05 was considered statistically significant. Analyses were performed using SPSS. Results 93 patients were included in this analysis. TSH levels significantly decreased after treatment with roxadustat. A total of 58.1% of patients had decreased TSH levels (2.23 ± 1.18 v.s. 1.81 ± 1.35, μIU/mL, p value = 0.040, Wilcoxon signed-rank test), and 18.3% of patients had a significant decrease below the normal range. Additionally, patients treated with thyroid hormone replacement therapy in primary hypothyroidism had a higher frequency (81.0%) of TSH decrease compared to patients without (p value = 0.013, Pearson's chi-square test). Conclusion This is the first study to examine that roxadustat has a suppressive effect on TSH secretion in hemodialysis patients. We also found that roxadustat-induced hypothyroidism is prevalent in the high frequency of TSH suppression, especially in primary hypothyroidism patients treated with thyroid hormone replacement therapy. Thyroid hormone receptor beta (THRβ), which is expressed in the hypothalamus and pituitary gland, plays an important role in regulating thyroid hormone through feedback mechanisms. Yao et al. have reported that roxadustat has a similar structure to T3 and acts as a THRβ-selective ligand, particularly activating THRβ. Therefore, it is possible that roxadustat suppresses TSH secretion through negative feedback via THRβ. It is important to monitor thyroid function in patients receiving roxadustat. Roxadustat should be avoided in patients with primary hypothyroidism, since it is inferred that roxadustat-induced hypothyroidism cannot be improved by enhancement of thyroid hormone replacement therapy.

Plasma TSH and cardiovascular disease in the general population: A Mendelian randomization study of 105,224 individuals

Background and aimsThe association between thyroid stimulating hormone (TSH) and cardiovascular disease has mainly been determined using clinical categories of disease. We tested the hypothesis that TSH on a continuous scale is associated with risk of atrial fibrillation (AF), myocardial infarction (MI), stroke, heart failure (HF), aortic valve stenosis (AVS), and major adverse cardiovascular events (MACE) and whether these associations are likely to be causal. MethodsWe first tested whether plasma TSH on a continuous scale was observationally associated with incident cardiovascular events in a prospective cohort study of 105,224 individuals from the Copenhagen General Population Study followed for a median 7 years. Next, we tested whether a genetic risk score weighted on TSH was associated with cardiovascular endpoints. Finally, using Mendelian randomization, we tested whether the observed associations were likely to be causal. ResultsUsing restricted cubic splines, lower concentrations of TSH relative to the population median (=1.53 mIU/L) were associated with higher risk of AF, MI, stroke, HF, AVS, and MACE. Comparing individuals with TSH ≤5th percentile (≤0.54 mIU/L) versus >50th percentile (>1.53 mIU/L), hazard ratios (HRs) ranged from 1.12 (1.00–1.26) for stroke to 1.27 (1.11–1.46) for HF. Genetic risk estimates per standard deviation decrease in TSH were 1.28 (1.08–1.52) for AF, 1.35 (1.06–1.71) for MI, 1.06 (0.89–1.26) for stroke, 1.19 (0.94–1.52) for HF, 1.53 (1.03–2.26) for AVS, and 1.09 (0.97–1.23) for MACE. ConclusionsIn 105,224 individuals from the general population low plasma TSH was observationally and genetically associated with increased risk of AF, MI, and AVS suggesting that these observations may reflect causal pathways.

Thyroid hormone decreasing after mechanical thrombectomy for cerebral infarction (P3-5.018)

<h3>Objective:</h3> The aim of this study wasto clarify the changes in thyroid hormone levels in the acute phase and the effects of the iodine contrast agent on thesehormones. <h3>Background:</h3> Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in patients with cerebral infarction. The use of iodine contrast agent decreases thyroid hormone levels via the so-called Wolff-Chaikoff effect. Low triiodothyronine (T3) syndrome caused by a severe illness status can contribute to decreased thyroid hormones. Reportedly, a low T3 level is associated with poor prognosis in patients with cerebral infarction. <h3>Design/Methods:</h3> This was a single-center, prospective, and single-arm trial. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were tested on admission and 24 h postoperatively in patients who were approved for MT. <h3>Results:</h3> A total of 37 patients were screened during the study period and 31 patients were enrolled. Significant decreases were observed in TSH (<i>P</i> &lt; 0.001) and FT3 (<i>P</i> &lt; 0.001) levels 24 h after MT. Moreover, there was a correlation between the decrease ratio of change in FT3 levels and the amount of iodine contrast agent used per body surface area (<i>r</i> = 0.43, <i>P</i> = 0.019), while no such correlations were detected for TSH and FT4. <h3>Conclusions:</h3> We demonstrated that decrease in TSH and FT3 levels in the acute phase after MT and that FT3 levels were associated with the amount of iodine contrast agent used. <b>Disclosure:</b> Dr. Kobayashi has nothing to disclose.

Evaluation of Afamin Level after Bariatric Surgery in Patient with Obesity.

The aim of this study is to evaluate afamin levels after weight loss in obese patients who underwent laparoscopic sleeve gastrectomy (LSG) and to investigate the relationship between them. In addition, after bariatric surgery, thyroid stimulating hormone (TSH), thyroxine (T4), low-density lipoprotein (LDL), very low-density protein (VLDL), total cholesterol, triglyceride (TG), high-density lipoprotein (HDL), insulin, and hemoglobin A1c (HgbA1c) levels were evaluated. Preoperative and postoperative 6th month venous blood samples were obtained from 43 patients included in this study. The preoperative and postoperative 6th month body mass index (BMI), TG, total cholesterol, VLDL, HDL, insulin, HgbA1c, TSH, T4, and afamin levels of the patients who underwent bariatric surgery with obesity were compared. Serum afamin levels of patients decreased at 6 months postoperatively; however, it was not statistically significant. We observed a statistically significant decrease in patients' BMI, HDL, VLDL, TG, total cholesterol, TSH, T4, HgbA1c, and insulin values (p < 0.05). There were significant increases in HDL and T4 values. The change in LDL value was statistically insignificant. Recent studies have shown that there may be a cause-effect relationship between afamin and obesity. In our study, we observed a decrease in serum afamin levels after weight loss following bariatric surgery. In addition, we think that afamin may be used as a potential marker of metabolic syndrome in the future and may lead to improvements in the medical treatment of obesity.

Post-COVID fatigue: a new era of complication by altered thyroid function

Background: Since late 2019, the development of severe acute respiratory distress syndrome (SARS) occurred, which began as a small cluster of cases in Wuhan, China and subsequently spread across the globe in the shape of a global pandemic. Coronavirus disease 2019 (COVID-19) initiates an immune response over-activity leading to release of pro-inflammatory cytokines, particularly interleukin-6 (IL-6), which leads to overt thyroid dysfunction by disruption of thyroid transport proteins. Level of triiodothyronin (T3) is inversely proportional to IL-6 with a modest decrease of thyroid stimulating hormone (TSH) and thyrotropin (T4). Fatigue is usually expressed by lack of one or more of habits or routines, particularly a lack of exercise. It is also frequently associated with depression. Fatigue might be an indication of various underlying illnesses that necessitate medical attention. COVID-19-related thyroid disorders could biochemically manifest as thyrotoxicosis, hypothyroidism, as well as non-thyroidal illness syndrome. Post-COVID fatigue has become an alarming complication which remains undiagnosed causing more complication at later stage. There are very limited knowledge regarding altered thyroid function in patients who have recovered from COVID-19. Aims of this study were to know about the derangement of thyroid hormones.&#x0D; Methods: This cross-sectional study was conducted in the Department of Biochemistry and Molecular Biology, BSMMU, Dhaka from July, 2020 to June, 2021. A total of 100 post-COVID patients (age 18 – 70 years) with fatigue were enrolled for this study. Among them, 50 were treated at home and 50 were treated in hospital. For this study, serum TSH and FT4 were measured by the automated analyser. The data were expressed as frequency and percentage, mean for normally distributed data. p value d”0.05 was considered statistically significant.&#x0D; Results: The value of TSH and FT4 in home and hospital treated patients were 1.59, 2.96 mIU/L and 9.27, 17.28 pmol/L respectively. There was significant difference of level of serum TSH (p &lt; 0.0001) and FT4 (p &lt; 0.0001) between home and hospital treated post COVID-19 patients with fatigue.&#x0D; Conclusion: Home treated post-COVID patients with fatigue expressed higher level of serum TSH and FT4 than that of hospital treated patients.&#x0D; BIRDEM Med J 2023; 13(1): 34-37

Effect of Vasanthika Vamana Karma on TSH levels - A Successful Case Series

Hypothyroidism in one among the lifestyle and metabolic disorders having great prevalence in the world wide. It occurs when the thyroid gland is not making enough hormones for good health. It effects multiple organ system so the symptoms of hypothyroidism are wide ranging and diverse. In spite of many advance techniques the allopathic management of hypothyroidism still remains unsatisfactory. Ayurveda is holistic approach particularly Panchakarma which aims at eliminating the Doshas from its root. Hence Vamana karma is found to be effective treatment in hypothyroidism due to involvement of abundant Kapha dosha with Pittanubandha and also involvement of Rasavaha, Medovaha dushti and Bahudoshavastha lakshnas. Hence in this present of 6 patients where Vamana Karma is conducted in Vasanta ritu. There was significant decrease in thyroid stimulating hormone (TSH) level and marked improvement in signs and symptoms.

RF23 | PSAT365 An Open-Label Therapeutic Efficacy Study of Tirosint (Levothyroxine Sodium) Capsules in Thyroidectomized Patients Taking Proton Pump Inhibitors

Abstract Levothyroxine sodium (LT4) absorption is known to be affected by proton pump inhibitors (PPIs). Normal gastric acid secretion is important for the subsequent intestinal absorption of LT4. A reduced gastric acidity may diminish the dissolution of the LT4 tablet in the stomach and the release of LT4 to the gut. The dissolution profile of LT4 soft capsules has been reported to be less affected by pH than that of tablets. Previous studies in healthy subjects administered with LT4 and PPIs, as well as in hypothyroid patients with atrophic gastritis confirmed little or no impact of increased gastric pH on LT4 absorption when administered in soft capsule formulation. The present study was aimed at evaluating whether LT4 soft capsules may provide better control of thyroid stimulating hormone (TSH) in thyroidectomized patients undergoing chronic replacement therapy with LT4, who were also on chronic use of PPIs.Forty-seven (47) patients were enrolled in this multicenter study. Upon switching to Tirosint capsules at the same previous dose of LT4 tablets and while maintaining the same dose of PPI, TSH (when measured on week 12 of treatment) was significantly reduced from a mean±SD of 1.34±1.51 mIU/L to 0.75±1.08 mIU/L (p&amp;lt;0.0001) in the Intention-To-Treat population analysis on original data. No significant changes were detected in the level of free and total thyroxine (T4), while slight but significant (p&amp;lt;0.05) increases were measured in free and total triiodothyronine (T3). The measured extent of TSH decrease is consonant with the extent of TSH increase previously reported by other authors upon start of PPI therapy in hypothyroid patients treated with LT4 tablets.In conclusion, these data confirm previous reports that LT4 soft capsules absorption is not affected by increased gastric pH due to PPIs. This may be relevant to improve TSH stabilization in patients who take PPIs intermittently or those with gastric pH altered by concomitant pathologies. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m., Sunday, June 12, 2022 1:00 p.m. - 1:05 p.m.

Relationship between Menopause and Complications of Hyperthyroidism in Female Patients in Iraq.

Hyperthyroidism is a health problem characterized by an overactive thyroid gland, resulting in extratriiodothyronine (T3) and thyroxine (T4) production, as well as a decrease in thyroid-stimulating hormone(TSH). The oxidative stress indicators in hyperthyroid patients and the relationship with impaired metabolism of lipid are still controversial, especially in menopausal women suffering from a lack of ovulation hormones. In this study, blood samples were withdrawn from 120 subjects, including healthy premenopausal (n=30) and postmenopausal women (n=30) as control groups (G1 and G2), as well as 30 hyperthyroid women in each group of premenopausal and postmenopausal patient groups (G3 and G4). The levels of T3, T4, and TSH, blood pressure, and lipid profiles, such as triglyceride, total cholesterol (TC), high-density lipoprotein, and low-density lipoprotein, superoxide dismutase (SOD) activity, malondialdehyde (MDA), and advanced oxidation protein products (AOPP) in the two healthy control groups and patient groups with hyperthyroidism were measured. In addition, serum progesterone levels were measured by the Bio-Merieux kit France, according to the manufacturer's instructions. The results revealed a significant decrease in SOD activity in the postmenopausal group, as compared to that in premenopausal women and control groups. Hyperthyroidism groups demonstrated a significant increase in MDA and AOPP levels, compared to control groups. Patient groups reported a decreased level of progesterone, in comparison with control groups. Moreover, there was a significant increase in T3 and T4 in patient groups (G3 and G4), compared to that in control groups (G1 and G2). There was a significant increase in systolic and diastolic blood pressure in menopausal hyperthyroidism (G4), compared to that in other groups. The TC decreased significantly in G3 and G4, compared to that in both control groups (P<0.05); nonetheless, there was no significant difference between patient groups (G3 and G4), as well as between control groups (G1 and G2). The study suggested that hyperthyroidism causes an increase in oxidative stress, which negatively affects the antioxidant system and drops levels of progesterone in both premenopausal and postmenopausal female patients. Therefore, low levels of progesterone are linked with hyperthyroidism, leading to aggravating symptoms of the disease.

Thyroid Hormones and Health-Related Quality of Life in Normal Pressure Hydrocephalus Patients before and after the Ventriculoperitoneal Shunt Surgery: A Longitudinal Study.

Objective: The aim of this study was to explore the serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3), and to correlate the hormone levels among iNPH patients with their self-reported quality of life before and three months after the surgery. Methods: Twenty-five patients (52% women), mean age 63.5 (SD 9.5) years, were operated on by inserting a VP shunt. Patients with FT3 level ≤3.34 pmol/L were diagnosed as having low T3 syndrome. Results: The changes in thyroid hormones resulted in a U-shaped curve throughout the follow-up period. The significant changes occurred the next day after the surgery, including a decrease in TSH, FT3, and an increase in FT4. Additionally, the decrease occurred in mean FT3 for six patients with preoperative low T3 syndrome. Three months after the surgery, thyroid hormones were restored to their baseline and/or normal values. All six patients with preoperative low T3 syndrome had significant improvement in all SF-36 subscales (except for the role emotional and physical). Patients with preoperative normal high FT3 and low FT4 had increased FT3/FT4 ratio which was associated with deterioration in all SF-36 subscales 3 months after the surgery. Conclusion: Routine assessment of the FT3/FT4 ratio might be a simple and effective tool for the risk stratification of iNPH patients before VP shunt surgery.

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Role of Melatonin in Temperature-Induced Activation of the Neuroendocrine Reproductive Axis in Garter Snakes

An animal’s ability to respond optimally to changing environmental conditions is paramount to successfully reproducing and thus maximizing fitness. Studies on photoperiod-induced changes in neural thyroid hormone metabolism have conclusively linked environmental cues to the neuroendocrine reproductive axis of birds and mammals. Whether this conserved mechanism also transduces changes in environmental temperature, however, has not been fully addressed. We investigated whether the hormone melatonin mediates the effects of low-temperature dormancy on thyroid hormone metabolism within the hypothalamus of red-sided garter snakes (Thamnophis sirtalis parietalis). To address this question, we used immunohistochemistry to assess changes in thyroid-stimulating hormone (TSH) in the infundibulum of the pituitary and deiodinase 3 (Dio3) and gonadotropin-releasing hormone (GnRH) in the hypothalamus. We also asked if changes in TSH, Dio3, and/or GnRH immunoreactivity are associated with changes in male courtship behavior. In contrast to our predictions, 6 weeks of dormancy at 4°C significantly decreased the number of TSH-labeled cells in the infundibulum. It is possible that the observed decrease in TSH is related to the release of snakes from temperature refractoriness, but this idea needs further testing. Treatment of snakes with the melatonin precursor 5-hydroxytryptophan during dormancy at 4°C both reversed the temperature-induced change in TSH immunoreactivity and disrupted the temporal pattern of male courtship behavior. These results suggest that TSH cells within the infundibulum are both modulated by temperature and sensitive to changes in melatonin. As predicted, male snakes hibernated at an elevated temperature of 12°C for 6 weeks and treated with vehicle showed no change in TSH-, Dio3-, or GnRH-immunoreactive cell number. Treatment of snakes with the melatonin receptor antagonist luzindole was not sufficient in rescuing the effects of dormancy at 12°C on TSH immunoreactivity or courtship behavior. However, luzindole-treated snakes showed a significant increase in GnRH-immunoreactive cell number, suggesting that melatonin exerts an inhibitory effect on GnRH in garter snakes. In summary, our results provide critical insights into the mechanisms that mediate the effects of temperature on reproductive physiology and behavior.

Effect of yogic practices on thyroid hormones: A review

The beneficial effect of Yoga on the parameters of thyroid hormone has been evaluated through the various clinical trials. Since its review has not been recorded earlier, this study has been performed to investigate the effectiveness of Yogic practices on thyroid hormones, more specifically T3, T4, and TSH. Searches were performed through February–June, 2020 using the PUBMED and GOOGLE. The keyword used for search was Yoga and thyroid or thyroid disorder. Only experimental studies were selected which were reported in English, printed in prevailed publications, and inspecting the effectiveness of the regular practice on thyroid hormones in these studies. A total of 41 studies were selected through various searches, among which 11 met criteria for the final review. Hypothyroid patients showed decrease in thyroid-stimulating hormone (TSH), hyperthyroid patients showed decrease in tetraidothyronine (T4), polar tri-idothyronine (T3) syndrome population also showed positive effect of Yoga. Perimenopausal women showed not so significant change in these parameters. Healthy middle-aged individuals showed increase in TSH in the male population and near significant increase in this hormone was shown in the female population, also there was decrease in basal T3 and T4 in both male and female. All these changes were in normal range. Other two studies on healthy individuals did not show any significant change in T3, T4 or TSH. 1 study was done on hypothyroid patients using hand mudra only, showed significant changes in level of these parameters. In conclusion, it may stated that yogic practice may regularize thyroid hormone functioning and improve total health.

Biomarker signatures in cancer patients with and without venous thromboembolism events: a substudy of CASSINI

AbstractCancer is associated with an increased risk of venous thromboembolism (VTE). In the CASSINI study, ambulatory cancer patients with a Khorana risk score ≥2 had a reduced risk of VTE while receiving rivaroxaban. This analysis used blood samples from CASSINI to compare biomarker levels between patients with and without VTE. VTE occurred in 62 patients during the 6 months of CASSINI (cases), and they were matched by age, sex, cancer type, tumor stage, and Khorana score to 62 controls. Baseline blood samples were analyzed for 280 biomarkers, and biomarker distribution was compared using the Wilcoxon rank-sum test between groups defined by VTE occurrence and vital status. Sparse Bayesian regression modeling was used to select a joint panel of potential VTE biomarkers. Biomarkers with the largest differences in baseline distribution among cancer patients with and without VTE included decreases in stromal cell–derived factor-1 (SDF-1), thyroid-stimulating hormone (TSH), and monocyte chemotactic protein 4 and increases in growth hormone (GH) and interleukin-1 receptor type 1 (IL-1R1). Between survivors and those who died, significantly different biomarkers included ST2, IL-8, and C-reactive protein. Regression analyses also identified decreases in SDF-1 and TSH. Pathway analysis indicated enrichment of cytokine and chemokine activity with IL-1R1, SDF-1, and GH, which are the strongest predictors of VTE or death. Our analyses highlight the interactions between hemostatic and inflammatory processes and identify candidate biomarkers of cancer-associated VTE. Prospective studies will determine clinical relevance of these biomarkers. This trial was registered at www.ClinicalTrials.gov as #NCT02555878.