Differences In Thyroid-stimulating Hormone Levels Research Articles

Comparison of TSH Levels Pulmonary Tuberculosis Patients at The Phase 0 and 6 Months Treatment

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Pulmonary TB has become a health problem worldwide, including in Indonesia, because the sufferers' prevalence is increasing every year. The increase in TB drug resistance will pose a severe health threat. The continuous consumption of drugs in large quantities and high doses can affect the function of the thyroid gland. This study aimed to determine the levels of thyroid stimulating hormone (TSH) in pulmonary tuberculosis patients with treatment phases of 0 months and six months. This research is analytical observational research with a cross-sectional research design. The sampling method uses accidental sampling. A total of 42 respondents participated in this study to determine the levels of TSH in pulmonary TB. The results of the Mann-Whitney U test showed no difference in TSH levels in pulmonary TB patients with different treatment phases of 0 months and six months (p = 0.3). There was no significant difference between TSH levels in pulmonary TB patients in the 0 and 6-month treatment phases.

Thyroid Function at Age Fifty After Prenatal Famine Exposure in the Dutch Famine Birth Cohort.

BackgroundEarly-life exposures during gestation may permanently alter thyroid physiology and health in adulthood. We investigated whether exposure to the Dutch Famine (1944-1945) in late, mid, or early gestation influences thyroid function (i.e., incidence of thyroid disease, thyroid autoantibodies, thyroid stimulating hormone (TSH), and free thyroxine (FT4) levels) in adulthood. We specifically assessed whether potential effects of famine differed for men and women.MethodsThis study includes 910 men and women born as term singletons in the Wilhelmina Gasthuis in Amsterdam, the Netherlands, shortly before, during, or after the Dutch Famine. We evaluated medical histories for previous diagnosis or current treatment for thyroid dysfunction. At age 50 blood samples were drawn from 728 individuals for tests of thyroid function. We studied the prevalence of overt hypo- and hyperthyroidism and thyroid autoimmunity using medical histories, and measurements of TSH, FT4, anti-TPO and anti-TG, comparing participants exposed to famine at different pregnancy trimesters or born before or conceived after the famine. Additionally, we studied associations of TSH and FT4 levels with in utero famine exposure in a subsample of men and women free of thyroid disease that were exposed in late, mid, or early gestation.ResultsThere were no differences in thyroid dysfunction diagnosis or current treatment between participants at age 50 years who been exposed to famine during different periods of gestation and those born before or conceived after. There was no association between famine exposure and overt hypo- or hyperthyroidism or thyroid autoantibody positivity. Women who had been exposed to famine in mid gestation had slightly lower TSH levels than women who had not been exposed to famine prenatally (b=-0.06; 95%; CI=[-0.11,-0.02]; p<0.01). No differences in TSH levels were observed in men, and no differences in FT4 levels were observed in men or women.ConclusionsThere are no differences in adult thyroid disease at age 50 years according to prenatal famine exposure. However, the lower TSH levels in women exposed to famine in the second trimester suggest that there may be sex-specific effects of famine exposure during a critical period of thyroid development on hypothalamic-pituitary-thyroid axis regulation in adulthood.

Evaluation of the association between platelet tests and thyroid-stimulating hormone levels in patients with vitiligo.

Vitiligo is a common dermatological disease of unknown cause and progressing with depigmentation and affects approximately 1% of the world population. In the study, we aimed to compare plateletcrit (PCT), mean platelet volume (MPV), platelet (PLT), and thyroid-stimulating hormone (TSH) values in vitiligo patients. We retrospectively evaluated the medical data of 100 patients who were admitted to the dermatology outpatient clinic between January 2020 and December 2021 with a diagnosis of vitiligo. The control group was retrospectively constituted from medical records of 90 healthy individuals. PCT, MPV, PLT, and TSH levels of both groups were compared statistically. A total of 190 participants (100 vitiligo patients and 90healthy volunteers) were included in the study. The mean age of the patient group was 38.62±1.62, while the mean age of the control group was 41.52±1.54. There were no differences between the two groups in terms of age and gender. It was found that the mean MPV value in the patient group was lower than the control group (p=0.00). PLT and PCT values were significantly higher in the patient group than the control group (p=0.00, p=0.01, respectively). There was no statistically significant difference between the two groups in terms of TSH (p>0.05). A negative correlation between MPV and PLT values in the patient group (r=-0.218, p=0.029), and a negative correlation between MPV and TSH (r=-0.218, p=0.029), (-0.230, p=0.021). In the study, a comparison of the PCT, MPV, and PLT levels showed a difference between both groups, but no differences in TSH levels. To clarify these results, comprehensive studies with more samples are needed.

Weekly Versus Daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A Meta-Analysis.

ObjectivesDaily levothyroxine is the treatment of choice and standard of care in hypothyroidism, sufficient to restore thyroid stimulating hormone (TSH) to normal range. For many patients, daily lifelong therapy is required, making adherence a major issue. In such cases, weekly replacement may be a suitable alternative to improve adherence. In this study, we aimed to determine the efficacy and safety of weekly levothyroxine replacement among adults with hypothyroidism.MethodologyElectronic databases were searched. Two reviewers (HCC and RBL) independently screened the abstracts, reviewed full-text papers, critically appraised the quality of included studies using PRISMA guidelines. Meta-analysis was performed using the random-effects model. The primary outcome is the difference in serum TSH levels between weekly and daily administration, while secondary outcomes included adverse events and symptoms of hypothyroidism.ResultsThe primary outcome is the difference in serum TSH levels between weekly and daily administration. Secondary outcomes included adverse events and clinical symptoms. The study included two randomized trials (n=109) in the primary analysis. The difference in TSH levels was 1.78 mIU/mL higher [(95% confidence interval (CI): 1.28 to 2.28, p<0.00001] at 6 weeks and 1.22 mIU/mL higher (95% CI: 0.76 to 1.67, p<0.00001) at 12 weeks for the weekly regimen. There was no significant heterogeneity between the two groups. There was no significant difference in hypothyroid symptoms and adverse events before and after levothyroxine treatment within each group.ConclusionsWeekly levothyroxine resulted in less suppression and higher mean serum TSH levels, while still remaining within the normal reference range. It may be a suitable alternative for non-adherent patients. However, larger randomized trials with longer duration of follow-up are needed to firmly establish its role.

Daily Versus Weekly Levothyroxine Tablet Replacement in Adults With Hypothyroidism: A Meta-Analysis

Abstract Background and Objectives: Hypothyroidism is a common hormone deficiency with a prevalence ranging from 4-5% worldwide. It is a very treatable condition with treatment in the form of thyroid hormone replacement, with an overall excellent prognosis if patients are compliant to regular treatment. Daily levothyroxine (LT4) is the treatment of choice and standard of care, sufficient to restore the thyroid stimulating hormone (TSH) to the normal range. For many patients, daily and lifelong therapy is required, and compliance/adherence then becomes a major issue. In such cases, weekly replacement may be a suitable alternative in terms of improving patient compliance. In this study, we aimed to determine the efficacy and safety of weekly versus daily levothyroxine replacement in patients with hypothyroidism. Methods: Electronic databases were searched, supplemented with manual searches. Two reviewers independently screened the abstracts, reviewed full-text papers, independently critically appraised the quality of included studies and abstracted the data. A meta-analysis was performed using the random-effects model on randomized controlled trials (RCTs) that reported standard doses of daily versus weekly levothyroxine administration in the treatment of hypothyroidism. The primary outcome is the difference in serum TSH levels between daily versus weekly levothyroxine administration, while secondary outcomes included clinical symptoms and adverse events using the hypothyroidism symptom scale. Results: The study included two randomized trials (N = 109) in the primary analysis. The difference in TSH levels was 1.78 mIU/mL higher (95% CI: 1.28, 2.28; P &amp;lt; 0.00001) at 6 weeks and 1.22 mIU/mL higher (95% CI: 0.76,1.67; P &amp;lt; 0.00001) at 12 weeks for the weekly replacement regimen, respectively. There was no significant heterogeneity noted between the two groups. There was no significant difference in terms hyperthyroid symptoms and adverse events measured by the hypothyroid symptom scales and echocardiographic parameters, respectively, before and after LT4 within each group. Conclusions: Our results showed that weekly LT4 administration has less suppression of TSH levels, while still remaining within the reference range of normal. It may be an alternative for patients especially in setting of noncompliance. However, more randomized trials with larger sample sizes and a longer duration of follow-up are needed to firmly establish the definite role of weekly LT4.

Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes

Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serumaccording to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the TurnAround Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples wasperformed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), andplasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The medianof TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460)μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSHlevels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively.Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSHlevels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. MedianTSH levels of 31-40 years old age group and &gt;61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levelsshowed a higher median in the male and older group.

The Difference in Thyroid Stimulating Hormone Levels between Differentiated Carcinoma and Benign Enlargement.

Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were measured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidectomy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement ( p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19–36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.

Thyroid-Stimulating Hormone Reference Ranges for Preterm Infants.

Many newborn screening (NBS) programs now perform repeat or serial NBS to detect congenital hypothyroidism. There is wide variation in thyroid-stimulating hormone (TSH) cutoffs used by NBS programs. Data on TSH reference ranges in preterm infants at increasing postnatal age are limited. Our study objective was to determine TSH reference ranges for preterm infants born at <32 weeks' gestation. We analyzed serial TSH levels on NBS performed on infants born between 22 and 31 weeks' gestation from 2012 to 2016 in Wisconsin. The study cohort was divided into 2 groups (22-27 and 28-31 weeks), and TSH percentiles were defined from birth to the term equivalent gestational age. The study cohort consisted of 1022 and 2115 infants born at 22 to 27 and 28 to 31 weeks' gestation, respectively. The 95th percentile TSH level for the group born at 22 to 27 weeks' gestation gradually decreased and reached a nadir at ∼10 to 11 weeks. In contrast, for the group born at 28 to 31 weeks' gestation, the 95th percentile TSH level reached a nadir at ∼5 to 6 weeks. At 3 to 4 weeks after birth, the 95th percentile TSH level ranged from 11 to 11.8 μIU/mL for the group born at 22 to 27 weeks' gestation and ranged from 8.2 to 9 μIU/mL for the group born at 28 to 31 weeks' gestation. Using a statewide cohort of preterm infants, we constructed TSH reference charts from birth to the term equivalent gestation for preterm infants born at <32 weeks' gestation. Use of a single cutoff for all preterm infants might lead to misdiagnosis. The differences in TSH levels according to gestational-age categories might explain the increased frequency in congenital hypothyroidism diagnoses among preterm infants. These data are useful for defining age-adjusted NBS TSH cutoffs for preterm infants.

Nationwide Chinese study for establishing reference intervals for thyroid hormones and related tests

ObjectiveThis nationwide study aimed to establish Chinese specific reference intervals (RIs) for thyroid related tests: thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), total triiodothyronine (TT3), anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin antibodies (TG-Ab). MethodApparently healthy individuals (n = 2380) were recruited from Beijing, Guizhou, Urumqi, Dongying, Shenzhen, and Qiqihar in China. All the tests were measured by immunoassay testing. Ultrasonography was performed to exclude thyroid nodules. Multiple regression analysis was performed to identify sources of variation (SVs). Standard deviation ratio (SDR) was calculated by ANOVA for judging the need to partition RI by any given SV. RIs were computed by the parametric method. ResultsTPO-Ab and TG-Ab cutoffs were determined as 5 mIU/L and 2 IU/L, respectively using probability plot analysis and extrapolation of the central linear segment. Individuals with thyroid nodule and/or autoantibodies showed altered levels of thyroid hormones, and were thus excluded (n reduced to 1828). Gender difference was observed for FT3 and TT3 with females having lower levels than males. A significant relationship between age and FT3 was observed in males by Spearman correlation analysis (r = −0.231, p < .05). Although the SDR for gender difference in TSH levels was low, the difference in the upper limits of the RI was beyond allowable bias, and thus RIs (mIU/L) were partitioned by sex: females 0.72–5.50, males 0.70–4.59. ConclusionBy this nationwide study, RIs for thyroid hormones and cutoff values for anti-thyroid autoantibodies were established as matched to the Chinese population.

The Value of Decreased Thyroid Hormone for Predicting Mortality in Adult Septic Patients: A Systematic Review and Meta-Analysis

Decreased thyroid hormone (TH) has been considered as one of the potential predictors of mortality in sepsis. This study aimed to evaluate the prognostic impact of decreased TH on mortality in septic patients during intensive care unit (ICU) admission. We included studies that assessed thyroid function by measuring the serum thyroid hormone level and in-hospital mortality in adult septic patients. Reviews, case reports, editorials, letters, commentaries, animal studies, duplicate studies, and studies with irrelevant populations and inappropriate controls were excluded. A total of 1,578 patients from eight studies were included. Triiodothyronine levels in non-survivors were relatively lower than that of survivors (6 studies; standardized mean difference [SMD] 2.31; 95% confidence interval (CI), 0.52–4.10; I2 = 97%; P = 0.01). Thyroxine levels in non-survivors were also lower than that of survivors (5 studies; SMD 2.40; 95% CI, 0.91–3.89). There were no statistically significant differences in thyroid-stimulating hormone levels between non-survivors and survivors. The present meta-analysis suggested that the decreased TH during ICU admission might be associated with the increase in mortality in adult septic patients. Hence, the measurement of TH could provide prognostic information on mortality in adult septic patients.

Thyroid stimulating hormone testing in ED evaluation of patients with atrial fibrillation and various psychiatric diagnoses

BackgroundPrevious studies of thyroid stimulating hormone (TSH) levels in Emergency Department (ED) patients largely have centered on patients with atrial fibrillation (AF). In our ED patients with AF as well as patients with Psychiatric diagnoses (psych) are screened. The purpose of the present study was to compare TSH levels in the 2 groups. Our hypotheses were that an abnormal TSH and/or AF predicted the need for hospital admission and that TSH is more likely decreased in AF and increased in psych patients. MethodsOur goal in the study was to compare the use of TSH testing in two ED populations, AF vs. psych patients. The study was a cross sectional cohort of AF vs. psych patients who had TSH levels drawn in the ED over a two year period. Our laboratory ranges were used to determine high vs. low TSH. Two chart examiners collected data after a training process. Charts were reviewed extracting demographic data, TSH levels, outcome (admit vs. discharge), history of AF, thyroid disease, psych diagnoses, presence of CHF, diabetes, hypertension. We compared AF vs. Psych groups using chi square and t-tests for parametric data. Odds ratios were calculated for comparisons between the 2 groups. For non-parametric data Mann Whitney U was used. A logistic regression was performed with the outcome of admission vs. discharge to find predictors of hospital admission. Kappa was calculated for inter-rater agreement. An a priori power analysis showed 80% power with 2 groups of 100 with an absolute difference of 20% between the 2 groups. Results252 patients were included, 101 with AF and 152 Psych. Demographics differed in age only with AF patients being older. Mean TSH for AF vs. 2.4 for AF, 2.9 for psych (NS) with no differences in percentages with high or low TSH in the 2 groups. Fifty-three patients had abnormal TSH levels (21%), 27% of AF and 17% of Psych patients (NS). There were significant differences in incidence of CHF, DM, HTN, and tachycardia with more in the AF group (P < 0.001). Significantly more of the psych patients had a history of hypothyroidism (OR 2.28). Our logistic regression showed that taking into account demographics including age, the only predictors of admission were the presence of CHF (aOR 18.6) and having a diagnosis of AF (aOR 4.0). ConclusionThere were no differences in TSH levels between the 2 groups. Twenty-one percent had an abnormal level. CHF and AF predicted hospital admission on regression analysis. Many with these AF or Psych diagnoses had abnormal ED TSH levels that could be useful in diagnosis, maintenance, or continuous treatment for their conditions diagnoses.

IS FIBROMYALGIA A SYNDROME OF HORMONAL IMBALANCE?

Objectives: The present study was conducted to estimate cortisol and thyroid-stimulating hormone (TSH) levels in patients with fibromyalgia syndrome (FMS) and to find correlation if any between hormone levels and pain duration in FMS.Methods: Plasma cortisol and TSH concentration were determined by electro chemiluminescence immunoassay in 89 female patients with FMS and 74 age-matched healthy women.Results: No significant difference in TSH level was observed between FMS and healthy subjects. Ten patients had higher cortisol levels than the standard reference range, 48 patients with reduced cortisol and 31 patients with normal cortisol levels. No significant correlation was observed between pain duration and levels of cortisol.Conclusion: The study has confirmed the equivocal data regarding cortisol/hypothalamic-pituitary-adrenal axis related dysfunction in FMS. To the best of our knowledge, it is the first Indian study on FMS which assessed the cortisol and TSH levels and their correlation with pain duration if any.

Does the use of an iodine-containing contrast agent to visualise the PICC tip in preterm babies cause hypothyroidism? A randomised controlled trial

AimTo compare thyroid function tests in preterm neonates (<30 weeks and >48 hour old) exposed to iodine-based contrast with controls and ascertain the certainty of peripherally inserted central catheter (PICC)...

Effects of Methadone Maintenance Therapy on Thyroid Function of Adult Men

One of the major challenges in methadone maintenance therapy (MMT) for drug dependence is the physiological side effects on endocrine hormones. Because of the key role of the thyroid gland in the normal functioning of the human body and brain, this study examined the effect of MMT on thyroid function. Thyroid hormones (T3, T4, and thyroid-stimulating hormone (TSH)) were evaluated in normal and user treated with MMT who were referred to the Province Clinical & Pathology Center of Urmia, Iran. The study was conducted for three months using the Case Series method. A total of 270 samples were collected, 215 were from individuals who were not treated, whereas 55 were from men treated with methadone. Average levels of T3 and T4 in non-treated sample of men are 1.34 ± 0.02 ng/mL and 90.96 ± 1.38 ng/mL while the corresponding values for patients treated with methadone are 1.39 ± 0.04 ng/mL for T3 and 94.57 ± 2.72 ng/mL for T4. Mean TSH levels of the non-treated group and the methadone consuming group were 1.75 ± 0.08 µIU/mL and 3.17 ± 0.45 µIU/mL, respectively. These results indicate that although men treated with methadone had higher levels of T3, T4, and TSH than normal individuals, only the difference in TSH level was significant. The importance of this difference among individuals on methadone maintenance programs should be investigated in larger samples over long periods of time. Additionally, the effects of methadone treatment on women should be examined.

Effect of Maternal and Neonatal Factors on Neonatal Thyroid Screening Results.

Thyroid-stimulating hormone (TSH) levels are an important parameter in screening for congenital hypothyroidism (CH). This study aimed to analyze the effects of birth weight, gestational age, and delivery mode on the incidence of neonatal CH. A retrospective cohort study of neonates born in 2015 at a maternity hospital in Xiamen, China and their mothers was conducted. Differences in TSH levels, CH positivity at baseline, and the incidence of CH according to gestational age, birth weight, and delivery mode were assessed using matched neonatal and maternal data. Of the 15,615 enrolled neonates, 150 had positive CH screening results at baseline and nine had confirmed CH. Premature and low-birth-weight neonates had a significantly higher incidence of CH and lower TSH levels when compared to full-term neonates and normal-to-high birth weight neonates, respectively. Neonates delivered vaginally had significantly lower TSH levels and a reduced incidence of baseline CH positivity; cesarean section delivery (odds ratio [OR] = 2.06, p = 0.006) and a maternal TSH level >2.5 mIU/L (OR = 2.37, p = 0.002) were risk factors for CH positivity at baseline. In this study, the incidence of CH in neonates was associated with gestational age and birth weight. Neonatal baseline CH positivity was positively associated with cesarean delivery and an early-pregnancy maternal TSH level >2.5 mIU/L.

Timing of Hormone Withdrawal in Children Undergoing 131I Whole-Body Scans for Thyroid Cancer

Background: Little objective pediatric data exist to guide the optimal time needed to achieve thyroid-stimulating hormone (TSH) levels ≥30 μIU/mL prior to performing ¹³¹I or ¹²³I whole-body scan (WBS) imaging in children with thyroid cancer in the post-thyroidectomy period or after hormone discontinuation. Methods: Retrospective study of patients aged 5-19 years who underwent WBS. Patient data collection included type and duration of withdrawal (liothyronine [L-T3], levothyroxine [L-T4], or post-thyroidectomy status without hormonal replacement) and TSH measured prior to WBS (level and timing). Results: A total of 175 TSH level measurements were performed in 68 patients. Thirty-five TSH values were obtained 2-7 weeks postoperatively and 101 values were obtained 2-8 weeks post L-T4 withdrawal. One patient in each group had a TSH level <30 μIU/mL. There was no difference in TSH levels between 3 weeks and 4 weeks postoperatively (p = 0.14) or post L-T4 cessation (p = 0.21). Thirty-nine TSH measurements were obtained 1-28 days post L-T3 withdrawal. Three patients had to be rescheduled due to inadequate TSH levels, including one after 14 days L-T3 withdrawal. Conclusion: TSH levels ≥30 μIU/mL were achieved at 3 weeks post thyroidectomy or after L-T4 withdrawal and after at least 2 weeks following L-T3 cessation.

Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism.

Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment. At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p < 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p < 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.

Perinatal factors associated with neonatal thyroid-stimulating hormone in normal newborns.

PurposeThis study was to evaluate the effect of neonatal, maternal, and delivery factors on neonatal thyroid-stimulating hormone (TSH) of healthy newborns.MethodsMedical records of 705 healthy infants born through normal vaginal delivery were reviewed. Neonatal TSH levels obtained by neonatal screening tests were analyzed in relation to perinatal factors and any associations with free thyroxine (FT4) and 17-α hydroxyprogesterone (17OHP) levels.ResultsAn inverse relationship was found between TSH and sampling time after birth. Twin babies and neonates born by vacuum-assisted delivery had higher TSH levels than controls. First babies had higher TSH levels than subsequent babies. Birth weight, gestational age, maternal age and duration from the rupture of the membrane to birth were not related to neonatal TSH. There were no significant differences in TSH level according to sex, Apgar scores, labor induction, the presence of maternal disease and maternal medications. There was a positive association between TSH and 17OHP level but not between TSH and FT4 level. Multiple linear regression analyses showed that sampling time, mode of delivery, birth order, and 17OHP level were significant factors affecting neonatal TSH level.ConclusionNeonatal TSH levels of healthy normal newborns are related with multiple factors. Acute stress during delivery may influence the neonatal TSH level in early neonatal period.

Serum thyroid stimulating hormone levels and suicidal tendency in patients with first-episode schizophrenia: An exploratory study

Background: Neuroendocrine hormones play an important role in emotional regulation in normal individuals and those suffering from mental disorders. The objective of the study was to examine levels of thyroid stimulating hormone (TSH) and the severity of psychopathology and suicidality in patients suffering from first episode schizophrenia (FES). Materials and Methods: In 60 patients of FES, the level of TSH was measured. The level of psychopathology was assessed using the positive and negative symptoms scale for schizophrenia (PANSS) while suicidal tendency was measured using The Scale for Impact of Suicidality-Management, Assessment, and Planning of Care (SIS-MAP). Results: We found that 21% patients were hospitalized with a suicide attempt within preceding 5 days. Mean TSH level was 5.7 mIU/L, which was slightly higher than cut-off point. There was no significant difference in TSH levels between those who had attempted suicide before the admission into the hospital and those who did not. Further, the level of TSH was not found to correlate with total PANSS score, positive symptoms or negative symptoms score but with global psychopathology scale. There was a positive correlation with TSH score and SIS-MAP score. Conclusions: The present study shows the presence of higher level of TSH in FES and an inverse correlation with suicide potential in patients suffering from schizophrenia. Further, it shows the presence of high suicide risk and possibility of hypothyroid state. The study argues more careful screening for suicide in patients with FES among patients who are admitted without and the attempt of suicide.

Alternative schedules of levothyroxine administration.

Published evidence on bedtime versus prebreakfast administration of levothyroxine is reviewed. Because levothyroxine absorption has been shown to increase when the drug is administered to patients in a fasted state, the standard recommendation is that levothyroxine be taken one half to one hour prior to breakfast and at least four hours before or after potentially interacting drugs. However, compliance with this recommendation may be problematic for patients with unpredictable or variable schedules. A literature search identified four published studies of bedtime levothyroxine dosing. Two of the studies demonstrated a significant decrease in levels of thyroid-stimulating hormone (TSH) with levothyroxine administration at bedtime versus 30 minutes before breakfast, one study showed an increase in TSH when levothyroxine was taken at bedtime versus one hour before breakfast, and one study found no significant differences in TSH levels or other thyroid function monitoring limitations with bedtime versus standard dosing in subjects naive to levothyroxine therapy. The inconsistent study findings may be attributable to a number of variables, including dietary differences among the study populations, the use of potentially interacting supplements in one study, and variable intervals between levothyroxine administration and food intake. Neither dosing method correlated with substantial changes in assessments of quality of life or symptom severity; in two of the studies, patients indicated a preference for bedtime levothyroxine administration. Based on the available literature, bedtime administration of levothyroxine is an option for patients with hypothyroidism who want to avoid taking their medication with food.