Low Thyroid Hormone Levels Research Articles

Hipotireoza - dijagnostički izazov kod dece - prikaz slučaja

Hypothyroidism is an endocrine disorder with a wide range of symptoms and multi-organ involvement. Almost all cells of the body have receptors for thyroid hormones, and the clinical picture of hypothyroidism is a result of the reduced effect of thyroid hormones on target organs and can be nonspecific, especially in children and adolescents, and thus may remain unrecognized for a longer period of time. Pericardial effusion, which occurs with a frequency of 10%-30% in adult patients with hypothyroidism, is very rare in children. Pericardial effusion, as well as all other symptoms of hypothyroidism, is reversible after the initiation of hormone replacement therapy. This is a report of a girl in whom pericardial effusion was the most significant manifestation of autoimmune thyroiditis, and in whom, at the time of diagnosis, other disorders due to the prolonged effect of low levels of thyroid hormones on target organs were also observed.

Spirometric Evaluation of Pulmonary Expiratory Flow Volume and Flow Rate in Patients with Clinical Hypothyroidism at a Tertiary Care Hospital, West Bengal, India: A Case-control Study

Introduction: Hypothyroidism is defined as a clinical condition caused by insufficient thyroid hormone secretion from the thyroid gland as a result of structural or functional defects in thyroid hormone production. Hypothyroidism can impair respiratory function and cause ventilation problems. Spirometry is used to assess pulmonary function in patients with thyroid disorders because low thyroid hormone levels can cause bronchial hyperactivity and obstructive pulmonary disease. Aim: To find out the changes of spirometric parameters in clinical hypothyroid patients compared to apparently healthy individuals. Materials and Methods: The study was a case-control study conducted in the Department of Physiology of Burdwan Medical College and Hospital on 50 cases and 50 apparently healthy subjects. Inclusion criteria were diagnosed cases of clinical hypothyroidism, Body Mass Index (BMI) under 30 kg/ m2, and age between 20 to 50 years. Serum TSH and free T4 (FT4) were measured by Quantitative EIA method using RFCL- manufactured commercial “ELISCAN-TSH”-kitand“ELISCAN- Ft4”-kit. Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC, Forced Expiratory Flow (FEF) of 25-75%, and Peak Expiratory Flow Rate (PEFR) parameters of pulmonary function test were tested by RMS Helios 401 Spirometer. Pearson’s two-tailed correlation study and student independent-test were done for analysis. Results: The present study showed that spirometric parameters FEV1, FVC, FEV1/FVC, PEFR and FEF25%-75% were significantly decreased in clinical hypothyroidism compared to control. Mean values of parameters of FEV1, FVC, FEV1/FVC, PEFR and FEF25%-75% in clinical hypothyroid cases were 85.30%, 92.42%, 90.70%, 74.86%, and 75.63%, respectively which were significantly (p<0.001) decreased compared to that of healthy individuals. Conclusion: This study concluded that clinical hypothyroidism causes significant changes in respiratory function. Thus, a proper knowledge in respect to this infection would help in management of these patients in time.

Histological and physiological determinants of hypothyroidism in patients and its relationship with lipid profile

Hypothyroidism is a disorder in which the thyroid gland does not generate enough thyroid hormone to keep the body operating correctly. Low thyroid hormone levels make it difficult for cells in the body to acquire enough thyroid hormone, causing the body's processes to slow down. There are various reasons why autoimmune illness and radiation therapy are so prevalent. Thyroiditis is caused by too much or too little iodine. Because lipids are hydrophobic (insoluble in water), they cannot transport fats like cholesterol, phospholipids, and triglycerides through the bloodstream on their own. Instead, they bind to proteins to produce lipoproteins, which carry fats such as cholesterol triglycerides, and phospholipids throughout the body. The EIA technique was utilized to assess the levels of triiodothyronine (T3), thyroxin (T4) and thyroid-stimulating hormone (TSH) in 25 patients and 25 healthy people in this study. The study found that hypothyroidism patients have higher TSH levels than healthy controls, while their T3 and T4 levels are lower than healthy controls. There is also a considerable rise when hypothyroidism patients were compared to healthy controls, there was a significant increase in the mean levels of all lipids except for high-density lipoprotein (HDL). We concluded that the TSH levels in hypothyroidism patients were significantly higher than in the control group, in addition, these patients have an abnormal lipid profile, with significantly higher levels of TC, TG, LDL, and VLDL.Atherosclerosis can result as a result of this. Because it carries cholesterol and other lipids from artery walls to the liver, it is known as a lipid transporter. HDL is known as the "good" cholesterol. A greater HDL level is linked to a lower risk of atherosclerosis.

INVESTIGATING THE PHYSIOLOGICAL RELATIONSHIP BETWEEN ISCHEMIC HEART DISEASE AND HYPOTHYROIDISM

Both hypothyroidism and hyperthyroidism, which are thyroid conditions that are extremely prevalent throughout the world, predispose to CVD in general and CAD in particular. This is especially important for people who have hypothyroidism. Heart failure progression risk and the frequency of coronary events are both raised by overt and subclinical hypothyroidism. Thyroid hormone abnormalities are a common complication of heart disease, especially ischemic heart disease, and should be taken into consideration. In actuality, it is necessary to consider low thyroid hormone levels as a cardiovascular risk factor. Regarding ischemic heart disease, thyroid hormones impact left ventricular structure, function, and geometry in the late post-myocardial infarction stage. Cardio-protection is the new goal of therapies to reduce infarct size and stop the development of heart failure following an acute ischemic event in order to enhance cardiovascular outcomes. Through TR1 binding, TH replacement therapy administered soon after myocardial infarction (or even when delayed) may enhance cardiac function. In this review we will look at the relationship between hypothyroidism and ischemic heart disease.

Transplantable human thyroid organoids generated from embryonic stem cells to rescue hypothyroidism

The thyroid gland captures iodide in order to synthesize hormones that act on almost all tissues and are essential for normal growth and metabolism. Low plasma levels of thyroid hormones lead to hypothyroidism, which is one of the most common disorder in humans and is not always satisfactorily treated by lifelong hormone replacement. Therefore, in addition to the lack of in vitro tractable models to study human thyroid development, differentiation and maturation, functional human thyroid organoids could pave the way to explore new therapeutic approaches. Here we report the generation of transplantable thyroid organoids derived from human embryonic stem cells capable of restoring plasma thyroid hormone in athyreotic mice as a proof of concept for future therapeutic development.

Analysis of rehabilitation effect of repetitive transcranial magnetic stimulation based on resting⁃state fMRI in post⁃stroke cognitive impairment patients with low thyroid hormone levels

Analysis of rehabilitation effect of repetitive transcranial magnetic stimulation based on resting⁃state fMRI in post⁃stroke cognitive impairment patients with low thyroid hormone levels

Menorrhagia as main presentation sign of severe hypothyroidism in a pediatric patient: a case report

BackgroundThe relative high frequency of menstrual irregularities in the first two–three years after menarche may lead to the risk of underestimation of associated pathological conditions, which are always to be accurately researched with careful examination and anamnesis. The association between menstrual irregularities and hypothyroidism is described in literature but the available data are scarce and mainly based on adult case series. It is described that low plasma levels of thyroid hormone can shift the hemostatic system towards a hypocoagulable and hyperfibrinolytic state and seem to lead to an increased bleeding risk.Case presentationThis case report describes the case of a thirteen years old girl who presented to our Emergency Department complaining of menorrhagia for the last fifteen days, leading to severe anemia. The objective examination revealed clinical signs of hypothyroidism and a severe short stature, lower than mid-parental height, with stunting of growth and a significant bone age delay. Blood exams and thyroid ultrasound were consistent with the diagnosis of severe hypothyroidism in autoimmune thyroiditis with acquired von Willebrand syndrome, growth hormone deficiency. Magnetic resonance showed pituitary functional hyperplasia.The substitutive therapy with levothyroxine led to the resolution of heavy bleeding after five days and following normalization of coagulative parameters and pituitary hyperplasia.ConclusionsHypothyroidism usually presents with unspecific symptoms, with consequent risk of diagnostic delay. It can influence the coagulation system and it seems to be associated to increased risk of menstrual irregularities.We underline the importance of a regular follow up of the pubertal development, including height measurements, thyroid palpation and menstrual anamnesis to intercept red flags findings for hypothyroidism.

Epidemiology of Thyroid Cancer.

Epidemiology of Thyroid Cancer.

Long-term impact of hypothyroidism during gestation and lactation on the mammary gland.

The functional differentiation of the mammary gland (MG) is fundamental for the prevention of mammary pathologies. This process occurs throughout pregnancy and lactation, making these stages key events for the study of pathologies associated with development and differentiation. Many studies have investigated the link between mammary pathologies and thyroid diseases, but most have ignored the role of thyroid hormone (TH) in the functional differentiation of the MG. In this work, we show the long-term impact of hypothyroidism in an animal model whose lactogenic differentiation occurred at low TH levels. We evaluated the ability of the MG to respond to hormonal control and regulate cell cycle progression. We found that a deficit in TH throughout pregnancy and lactation induces a long-term decrease in Rb phosphorylation, increases p53, p21, Cyclin D1 and Ki67 expression, reduces progesterone receptor expression, and induces nonmalignant lesions in mammary tissue. This paper shows the importance of TH level control during mammary differentiation and its long-term impact on mammary function.

Long Non‐coding RNAs Mediate Heart Failure with Preserved Ejection Fraction Associated with Thyroid Dysfunction

IntroductionHeart failure with preserved ejection fraction (HEpEF) carries significantly high morbidity and mortality. HFpEF is associated with preserved contractile function and can present with diastolic dysfunction, cardiac fibrosis and hypothyroidism (low levels of thyroid hormones, THs). We previously demonstrated safe, cardioprotective effects with treatment of active form of THs in multiple rodent models of cardiovascular disorders. Long‐noncoding ribonucleic acids (lncRNAs; >200 nucleotides long) account for large majority of the genome with significant transcriptional potential. However, their role in HFpEF associated with TH dysfunction is unclear. We hypothesized that lncRNAs act as mediators in development of hypothyroid HFpEF.MethodsHearts were isolated from obese ZSF1 rats that presented with HFpEF phenotype. Wild type and ZSF1 lean rats served as controls. Cardiac ultrasound and morphometric analyses were performed. RNA was isolated from left ventricular (LV) tissues and studied using Agilent LncRNA Microarray platform and analyzed using Feature Extraction and GeneSpring. Fibroblasts were isolated from wild type adult rat hearts and treated with TH receptor inhibitor. Real‐time quantitative polymerase chain reaction was used to study lncRNA expression.ResultsStudies revealed that total thyroxine TH levels significantly decreased in five‐six‐month old (early; p<0.05) ZSF1 obese rats compared to ZSF1 lean controls (45% decrease) and wild type controls (42% decrease), and this remained low at 13 months (late; p<0.05). Total tri‐iodothyronine TH levels also followed similar pattern in the early time‐point (37%‐42% decrease). ZSF1 obese rats showed increased normalized heart weight, LV weight and liver weight indicating cardiac hypertrophy and development of HF. In early obese rats, echocardiography showed preserved LV EF and significantly elevated E/E’ indicating diastolic dysfunction (p<0.05). LncRNA Microarray analysis including unsupervised hierarchical clustering showed that several unique lncRNAs were significantly altered (p<0.05; >2‐fold change) in obese LVs compared to the lean or wild type control counterparts and select lncRNA expression was validated with qPCR. Furthermore, isolated wild type adult rat cardiac fibroblasts subjected to TH receptor inhibition (mimicking hypothyroidism) in vitro showed significant increase in lncRNA expression that was also increased in obese ZSF1 hearts presenting with hypothyroidism (p<0.05).ConclusionsThese results indicate that lncRNAs may play important roles in in HFpEF pathogenesis associated with hypothyroidism. These studies will serve as significant step in identification of key lncRNAs in cardiac‐thyroid axis offering potentially valuable translational opportunities.

Is there an association between thyroid dysfunction and breast cancer?

Objective: The association between thyroid disease and breast cancer risk remains unclear. A cross-sectional study was carried out to find the association between hypothyroidism, hyperthyroidism, and breast cancer. Materials and Methods: The study included 71 diagnosed cases of breast cancer patients belonging to stage III of the disease. The mean age of controls and patients was 43-45 years. Their level of thyroid hormones was estimated. On the bases of high and low levels of thyroid hormone, women were divided into group one (hypothyroidism n= 56) and group two (hyperthyroidism n=15). Levels of neutrophils, lymphocytes, and hematocrit were estimated by the SWISS MAX analyzer. The level of thyroid hormones, TSH, 8OHG, Isoprostane, and 4-HNE was estimated by the technique of ELISA. The level of MDA was estimated spectrophotometrically. Results: It was observed that body weight was high in hypothyroid females (group 1) Levels of neutrophils, lymphocytes, and monocytes were significantly higher in group 1 of the breast cancer afflicted women, as compared to the controls and group 2. The level of thyroid hormones FT3, FT4, and TSH was also higher in group 1. The level of MDA, isoprostane, and 4-HNE was significantly high in both women with hypo and hyperthyroidism as compared to controls. Conclusions: We found an increased risk of breast cancer in women with hyporhyroidism and a slightly decreased risk in women with hyperthyroidism indicating an association between thyroid function level and breast cancer risk. Key Words: breast cancer, hypo, and hyperthyroidism, MDA, HNE, and Isoprostane

Thyroid hormone tinkering elicits integrated phenotypic changes potentially explaining rapid adaptation of color vision in cichlid fish.

Vision is critical for most vertebrates, including fish. One challenge that aquatic habitats pose is the high variability in spectral properties depending on depth and the inherent optical properties of the water. By altering opsin gene expression and chromophore usage, cichlid fish modulate visual sensitivities to maximize sensory input from the available light in their respective habitat. Thyroid hormone (TH) has been proposed to play a role in governing adaptive diversification in visual sensitivity in Nicaraguan Midas cichlids, which evolved in less than 4000 generations. As suggested by indirect measurements of TH levels (i.e., expression of deiodinases), populations adapted to short wavelength light in clear lakes have lower TH levels than ones inhabiting turbid lakes enriched in long-wavelength light. We experimentally manipulated TH levels by exposing 2-week-old Midas cichlids to exogenous TH or a TH inhibitor and measured opsin gene expression and chromophore usage (via cyp27c1 expression). Although exogenous TH induces long-wavelength sensitivity by changing opsin gene expression and chromophore usage in a concerted manner, TH-inhibited fish exhibit a visual phenotype with sensitivities shifted to shorter wavelengths. Tinkering with TH levels in eyes results in concerted phenotypic changes that can provide a rapid mechanism of adaptation to novel light environments.

Worse Outcomes in Patients With Depression Linked to Low Thyroid Hormones

Worse Outcomes in Patients With Depression Linked to Low Thyroid Hormones

Association of thyroid hormones and thyroid-stimulating hormone with mortality in adults admitted to the intensive care unit: A systematic review and meta-analysis.

Thyroid hormones (THs) and thyroid-stimulating hormone (TSH) seem to show high potential in predicting the clinical death outcome of patients admitted to the intensive care unit (ICU). However, diverse studies on this topic are conflicting. A search was conducted by two investigators involved in this research in the PubMed, Embase, and Cochrane databases (all last launched on July 12, 2021). The quality of the included studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). Subgroup analyses were performed to determine the sources of heterogeneity. Sensitivity and publication bias analyses were also assessed. A total of 27 studies (4970 participants) were included based on the eligibility criteria. Compared with survivors, nonsurvivors were found to have lower levels of THs (T3, T4, fT3, and fT4), whereas no significant difference was found in TSH levels (13 studies for T3: standardized mean differences [SMD], -0.78; 95% CI, -1.36 to -0.20; I2 = 96%; p = 0.008; 11 studies for T4: SMD = -0.79; 95% CI, -1.31 to -0.28; I2 =95%; p = 0.0002; 14 studies for fT3: SMD = -0.76; 95% CI, -1.21 to -0.32; I2 = 95%; p = 0.0008; 17 studies for fT4: SMD = -0.60; 95% CI, -0.99 to -0.22; I2 = 95%; p = 0.002; 20 studies for TSH: SMD = 0.00; 93% CI, -0.29 to 0.29; I2 = 93%; p = 0.98). Nonsurvivors were associated with lower levels of THs (T3, T4, fT3, and fT4) than survivors. THs show great application potential in predicting ICU patients' death outcomes and improving already widely used prognostic scores in the ICU (ie, Acute Physiological and Chronic Health Evaluation [APACHE] II and Therapeutic Intervention Scoring System).

Hashimoto’s Disease: Associated Thyroid Gland Disorders, Pharmacological, and Nutritional Interventions

Hashimoto’s disease is a condition that occurs when an affected person’s immune system attacks their thyroid gland and produces an immune response that results in low levels of thyroid hormones in the blood. These hormones are important in maintaining the body’s metabolic processes and the lack of thyroid hormones causes the symptoms of Hashimoto’s disease that include weight gain, paleness, coldness, birth defect, infertility, menorrhagia, and even death in rare cases of uncontrolled hypothyroidism. The disease requires a blood test to determine the levels of circulating thyroid hormones in the blood or the presence of specific antibodies. Thyroid hormone replacement is used to raise the levels of thyroid hormones in the body, if the hormone test shows that they are deficient. People who are middle aged, female, and have or are predisposed to an autoimmune disorder are most at risk for developing the disease. In recent times, the notion that the antidote for managing Hashimoto’s disease may be found in common food and supplements has grown among endocrinologists and caregivers. This review is intended to investigate the various aspects of the disease that include its pathogenesis, associated disorders, pharmacological and nutritional interventions.

Placental Cryoextract Corrects the Level of Thyroid Hormones in Rats

Effectiveness of cryopreserved placental drug ‘Placental cryoextract’ to correct the reproductive system disorders, occurring against the background of low levels of thyroid hormones, was studied in 50 male rats with mercazolyl hypothyroidism. Using standard test systems for animals, the level of total and free forms of thyroid hormones, total testosterone and estradiol was determined. The morphofunctional state of sperm (number, motility, pathological forms) was traditionally assessed. It was shown that the introduction of the biological product (at a dose of 50–150 μl / kg) restored the functional activity of the thyroid gland of animals, and the lowest dose was more effective. Placental cryoextract also had a dose-dependent effect on the reproductive system of animals with hypothyroidism: the most effective dose was 150 μl / kg, which maximally restored the morphofunctional parameters of sperm and stimulated testosterone production as well as normalized the Ts / E2 ratio. Cryopreserved placenta extract can be considered as a potential drug for the correction of hypothyroidism and reproductive disorders of endocrine origin in male rats.

Prevalence of transient congenital hypothyroidism among neonates

ObjectivePersistence of low levels of thyroid hormone from the time of birth is one of the significant causes of the mental retardation. The aim of this study was to determine the prevalence of transient congenital hypothyroidism among neonates in (XXX). MethodsThis cross-sectional study, neonates aged 3–5 days who were referred to our center for checkup were screened for thyroid stimulating hormone. Those with TSH < 5mIU/l were, infants were subjected to retesting after one week for TSH and T4 levels. A questionnaire consisting of test results, demographic characteristics, place of sampling, gender, need for re-sampling after the second week for TSH level, birth weight, type of hypothyroidism and prematurity was filled for all the neonates. ResultsOf 3600 neonates screened, 126 were presented with had TSH above 5 mIU/l, of which 7 had high TSH and low T4 and were diagnosed with transient hypothyroidism (5.3%). The mean weight of the neonates with hypothyroidism of significantly lower, p = 0.001. However, the type of delivery was not associated with the prevalence of hypothyroidism, p = 0.999. The relationship between maternal hypothyroidism, preterm birth and intake of antithyroid drugs and transient hypothyroidism was statistically significant, p < 0.001, respectively. ConclusionsThe incidence of congenital hypothyroidism was 1 in 514 births and was significantly associated with preterm birth, mean weight, maternal hypothyroidism and intake of antithyroid drugs. Routine screening in high prevalence regions are therefore importance, considering the associated factors.

Chrysin restores memory deficit in hypothyroidism mice: Behavioral, neurochemical and computational approaches involving the neurotrophinergic system

Hypothyroidism is a condition that affects multiple systems, including the central nervous system, causing, for example, cognitive deficits closely related to Alzheimer's disease. The flavonoid chrysin is a natural compound associated with neuronal improvement in several experimental models. Here, we evaluated the effect of chrysin on cognitive impairment in hypothyroid female mice by exploring neuroplasticity. Hypothyroidism was induced by continuous exposure to 0.1% methimazole (MTZ) in drinking water for 31 days. On the 32nd day, the animals showed low plasma levels of thyroid hormones (hypothyroid mice) than the control group (euthyroid mice). Subsequently, mice were intragastrically administered with vehicle or chrysin (20 mg/kg) once a day for 28 consecutive days. At the end of the treatments, behavioral tests were performed: open-field test (OFT) and morris water maze (MWM). Then, the levels of neurotrophins (BDNF and NGF) in the hippocampus and prefrontal cortex were measured and tested the affinity of chrysin with neurotrophinergic receptors through molecular docking. Hypothyroid mice showed memory deficit in the MWM and reduced neurotrophins levels in the hippocampus and prefrontal cortex, meanwhile, the chrysin treatment was able to reversed the deficit of spatial memory function and increased the levels of BDNF in hipocamppus and NGF in both structures. Additionally, molecular docking analysis showed that chrysin potentially binds to the active site of the TrkA, TrkB, and p75NTR receptors. Together, these findings suggest that chrysin reversed behavioral and neurochemical alterations associated with memory deficit induced by hypothyroidism, possibly by modulating synaptic plasticity in the neurotrophinergic system.

The effects of cannabis and cannabinoids on the endocrine system

With the increase in cannabis use due to policy changes and areas of decriminalization, it is important to recognize the potential impact of these substances on endocrine processes. Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in the normal functioning of nearly every organ and consists of the body's natural endocannabinoids, the cannabinoid receptors, and the enzymes and processes that regulate endocannabinoids. Exogenous cannabinoids such as Δ9-tetrahydrocannabinol (THC) are known to act through cannabinoid type 1 and 2 receptors, and have been shown to mimic endocannabinoid signaling and affect receptor expression. This review summarizes the known impacts of cannabis on thyroid, adrenal, and gonadal function in addition to glucose control, lipids, and bone metabolism, including: reduced female fertility, increased risk of adverse pregnancy outcomes, reduced sperm counts and function, lower thyroid hormone levels with acute use, blunting of stress response with chronic use, increased risk of prediabetes but lower risk of diabetes, suggested improvement of high density lipoproteins and triglycerides, and modest increase in fracture risk. The known properties of endocannabinoids, animal data, population data, and the possible benefits and concerns of cannabinoid use on hormonal function are discussed. The interconnectivity of the endocrine and endocannabinoid systems suggests opportunities for future therapeutic modalities which are an area of active investigation.

Higher serum homocysteine and lower thyroid hormone levels in pregnant women are associated with neural tube defects

BackgroundThis study tested the hypothesis that abnormal maternal metabolism of both homocysteine and thyroid hormone network in pregnant women is associated with neural tube defects (NTDs) in a part of China with high NTD prevalence. MethodsA case–control study was performed between 2007 and 2009 in Lüliang Mountains, Shanxi Province. This study included 83 pregnant women who had fetuses with NTDs (cases) and 90 pregnant women with normal fetuses (controls). In addition, a cell model to illustrate the epidemiological findings was established. ResultsFetuses of mother who had both high total homocysteine (tHcy) and inadequate free thyroxine were 3 times more at risk of developing NTDs (adjusted odds ratio = 3.5; 95 % confidence interval = 1.2–10.4; cases vs. controls) using multivariate logistic regression models. Furthermore, biological interaction between metabolisms of Hcy and thyroid hormones was demonstrated in vitro. In homocysteine thiolactone of a metabolite of Hcy-treated mouse embryonic neural stem NE4C cells, genes (Bmp7, Ctnnb1, Notch 1, Gli2, and Rxra) related to both neural tube closure and thyroid hormone network were shown to be regulated by H3K79 homocysteinylation, which increased their expression levels. ConclusionsThe effect of maternal serum high tHcy on risk of developing NTDs is depended on maternal serum level of thyroxine. Meanwhile, a higher level of tHcy might also affect both maternal metabolism of thyroid hormone and neural tube closure in embryogenesis through homocysteinylation of histones.