Mean Levels Of Thyroid-stimulating Hormone Research Articles

Evaluation of Thyroid Function of HIV Patients in Umunze, Anambra State, Nigeria

Background: Abnormal thyroid function tests have been detected at various phases in people living with Human immunodeficiency virus (HIV) and the effect of highly active antiretroviral therapy (HAART) not well understood. However, there is insufficient study among Nigerians living with HIV.
 Objective: This study is aimed to determine thyroid hormones in HIV positive individuals compared with HIV negative individuals in Umunze, Anambra State, Nigeria.
 Materials and Methods: This cross-sectional study was carried out over a period of six months among 95 HIV positive and 30 HIV negative individuals attending USAID/FHI clinic of Immaculate Heart Hospital in Umunze, Nigeria. The subjects were divided into three groups on the basis of HAART (those on HAART [48] – GROUP 1, HAART naïve [47] – GROUP 2 and Control [30] – GROUP 3). The subjects were interviewed, examined and blood sample collected for determination of thyroid function parameters which include thyroid stimulating hormone (TSH), free triiodothyronine (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4).
 Results: Among the 125 subjects recruited for the study 67.2% were females and 32.8% males. The mean levels of TSH and fT3 was found to be higher in group 1 subjects than in group 2 and the group 3 subjects. The mean level of T4 was significantly higher in group 2 subjects than group 1 and the group 3 subjects. The level of T3 was significantly lower in control subjects in comparison to both HAART and non-HAART subjects. Primary hypothyroidism is the commonest pattern of thyroid dysfunction among the HIV positive patients followed by isolated low fT4.
 Conclusion: Serum levels of thyroid hormones as shown in this study may be used as baseline periodic markers during antiretroviral therapy while people living with HIV may benefit from supplementation if appropriate. There is also need for a larger study to identify the risk factors for progression to overt thyroid disease in HIV infected subjects with thyroid autoimmunity.

Assessment Of The Effect Of Menopause On Thyroid Function In South East,Nigeria

Menopause marks the end of a woman’s reproductive life and is associated with significant physiological changes. The thyroid gland plays an important role in regulating overall body metabolism including sexual development and reproductive function. Worldwide, thyroid gland diseases are among the most common endocrine disorders in females, especially those in menopause. This study evaluated the effect of menopause on thyroid function. Methodology: It was a case-control study among post-menopausal women in Nnewi, Anambra, Nigeria with pre-menopausal women serving as controls. Sampling was by simple random method and comprised 45 post-menopausal women matched with 45 premenopausal women in a ratio of 1:1. Data was obtained with the use of a semi-structured questionnaire. The subjects’ blood samples were taken and assayed for thyroid stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) by ELISA technique. Their body mass index (BMI) and blood pressure were obtained using standard procedures. Result: The mean serum levels of free T4 and TSH in the menopausal individuals were significantly higher compared to the premenopausal group. Following linear regression analyses with adjustment for age and BMI, the the average level of TSH and free T4 were higher in the study group, while free T3 level was lower. Also, systolic and diastolic blood pressure was significantly higher in the study group than in the control group. Conclusion: The findings suggest that menopause is associated with reduced thyroid function and could as a result play a role in cardiovascular disease play a role in cardiovascular dysfunction among women

Assessment of Thyroid Functions and its Relationship With Semen Quality in Men

Introduction: In recent years, a partial relationship has been discovered between thyroid hormones and the formation of germ cells and the process of spermatogenesis. The current study aimed to assess thyroid hormone levels and the relationship between those levels and semen quality. Methods: Forty-seven infertile males, as the treatment group, and 25 healthy individuals, as the control group, were enrolled in this study. Thyroid-stimulating hormone (TSH), triiodothyronine (T3) hormone, and tetraiodothyronine (T4) hormone were calculated, and the parameters of seminal fluid (count, motility, and morphology) were assessed for semen quality. Results: The results demonstrated that sperm counts, sperm motility%, and normal morphology% were significantly lower in the infertile male group compared with the healthy group. The results further represented a highly significant level of TSH and total T3, while the total T4 was negligible in the infertile male group in comparison with the healthy group. The infertile male group was divided into subgroups based on sperm abnormalities, including asthenozoospermia, oligozoospermia, and azoospermia. Based on the findings, there was a significant reduction in TSH, T3, and T4 levels in oligozoospermia compared with the other groups. However, the levels of TSH, T3, and T4 were significantly higher in asthenozoospermia compared with the other groups, demonstrating the existence of a relationship between thyroid indicators and Asthenozoospermia. Conclusion: Overall, the mean serum levels of TSH, T3, and T4 were significantly lower in the infertile male group compared with the healthy group. Thus, they were negatively associated with sperm counts, motility%, and normal morphology%. Hence, these negative impacts on thyroid hormones were associated with different sperm abnormalities and semen quality in the infertile males group.

Iodine status in pregnant women in northern Spain. Effect of iodised salt and iodine supplements on thyroid function

IntroductionIodine deficiency is linked to thyroid dysfunction, particularly in pregnant women. The objective of this study was to ascertain the iodine levels of women in the second trimester of pregnancy, analysing the influence of iodine ingestion on urinary iodine concentration (UIC) and maternal thyroid function. MethodsA prospective observational study of pregnant women from Health Area IV of Asturias (northern Spain) recruited before 13 weeks of gestation between May and June 2017. A questionnaire on iodine intake was completed at the first visit, and urine and serum samples were collected at baseline and again during the second trimester. UIC, thyroid stimulating hormone (TSH) and free thyroxine (FT4) obtained in the second trimester of gestation were analysed and related to iodine intake. Thyroid autoimmunity was also analysed in half of the pregnant women at baseline. ResultsA total of 241 pregnant women were studied. Of these, 56.7% used iodised salt, 46.7% consumed ≥2 servings of dairy products daily and 88.1% took iodine supplements. Median UIC was 191μg/l (135.3–294μg/l), with 68.1% of the women having UIC ≥150μg/l. Only iodised salt consumption provided protection against iodine deficiency (odds ratio 0.35 [0.20–0.63], p=0.001). In women with no autoimmune thyroid disease (n=88), mean levels of TSH were lower in those that consumed iodised salt than in those that did not (respectively, 2.08±0.89mIU/l vs. 2.56±1.02mIU/l, p=0.025). In women with autoimmune thyroid disease (n=30), mean levels of TSH were higher in those that took iodine supplements than in those that did not (respectively, 2.97±1.25mIU/l vs. 1.16±0.41mIU/l, p=0.002). ConclusionsThe pregnant women studied from Health Area IV in Asturias maintain adequate nutritional iodine status in the second trimester of gestation. In our sample, only the consumption of iodised salt was associated with adequate iodine nutrition, without affecting maternal thyroid function. Most of the women used iodine supplements, which was linked to higher levels of TSH in pregnant women with autoimmune thyroid disease.

Calcium and Magnesium Levels in Subclinical and Overt Hypothyroidism: A Cross-sectional Study

Introduction: Hypothyroidism, one of the most common thyroid gland disorders, can cause electrolyte disturbances in the body. Hypothyroidism can alter mineral metabolism by changing the levels of serum calcium and magnesium. Therefore, it is essential to study any abnormalities in calcium and magnesium metabolism in patients with hypothyroidism. Aim: The aim of this study was to assess the levels of calcium and magnesium in patients with hypothyroidism and to study the correlation between Thyroid Stimulating Hormone (TSH), fT3, and fT4 with calcium and magnesium in subclinical and Overt Hypothyroidism (OH). Materials and Methods: This cross-sectional study was held from August 2019 to January 2020 in the Department of Biochemistry, BS Medical College, Bankura. A total of 150 subjects were included in the study, distributed equally among three groups: euthyroidism, subclinical hypothyroidism, and OH. Serum TSH, fT3, fT4, calcium, and magnesium levels were determined in the laboratory, and the data obtained were statistically analysed using ANOVA test and Pearson’s correlation test. Results: Out of a total of 150 subjects, 61 were female, among whom 23 had subclinical hypothyroidism and 21 had OH. There were significant differences in the mean levels of TSH, fT3, fT4, calcium, and magnesium between the SCH, OH, and euthyroid groups. The study showed that the mean serum calcium level was significantly lower in SCH and OH compared to euthyroids, while the level of serum magnesium was significantly increased in SCH and OH compared to euthyroid. There was a statistically significant negative correlation between TSH and serum calcium in both OH and SCH, while a statistically significant positive correlation was observed between TSH and serum magnesium levels in both groups. Conclusion: The present study revealed that serum magnesium levels were high while serum calcium levels were low in both subclinical hypothyroidism and OH when compared to euthyroid subjects. Additionally, calcium levels negatively correlated with TSH, while magnesium levels positively correlated with TSH levels.

Iodine status in pregnant women in northern Spain. Effect of iodised salt and iodine supplements on thyroid function

IntroductionIodine deficiency is linked to thyroid dysfunction, particularly in pregnant women. The objective of this study was to ascertain the iodine levels of women in the second trimester of pregnancy, analysing the influence of iodine ingestion on urinary iodine concentration (UIC) and maternal thyroid function. MethodsA prospective observational study of pregnant women from Health Area IV of Asturias (northern Spain) recruited before 13 weeks of gestation between May and June 2017. A questionnaire on iodine intake was completed at the first visit, and urine and serum samples were collected at baseline and again during the second trimester. UIC, thyroid stimulating hormone (TSH) and free thyroxine (FT4) obtained in the second trimester of gestation were analysed and related to iodine intake. Thyroid autoimmunity was also analysed in half of the pregnant women at baseline. ResultsA total of 241 pregnant women were studied. Of these, 56.7% used iodised salt, 46.7% consumed ≥2 servings of dairy products daily and 88.1% took iodine supplements. Median UIC was 191μg/l (135.3–294μg/l), with 68.1% of the women having UIC ≥150μg/l. Only iodised salt consumption provided protection against iodine deficiency (odds ratio 0.35 [0.20–0.63], p=0.001). In women with no autoimmune thyroid disease (n=88), mean levels of TSH were lower in those that consumed iodised salt than in those that did not (respectively, 2.08±0.89mIU/l vs. 2.56±1.02mIU/l, p=0.025). In women with autoimmune thyroid disease (n=30), mean levels of TSH were higher in those that took iodine supplements than in those that did not (respectively, 2.97±1.25mIU/l vs. 1.16±0.41mIU/l, p=0.002). ConclusionsThe pregnant women studied from Health Area IV in Asturias maintain adequate nutritional iodine status in the second trimester of gestation. In our sample, only the consumption of iodised salt was associated with adequate iodine nutrition, without affecting maternal thyroid function. Most of the women used iodine supplements, which was linked to higher levels of TSH in pregnant women with autoimmune thyroid disease.

Role of ferritin, vitamin D, and thyroid dysfunction in telogen effluvium among the hospital population in Western Saudi Arabia: a case–control study

Background and aim This case–control study was conducted to evaluate serum ferritin, vitamin D, and thyroid functions in patients with telogen effluvium (TE) in comparison with controls and to find if they can be used as diagnostic biomarkers of TE. Patients and methods A retrospective matched case–control study was performed using data from Hera Hospital database, Makkah, Saudi Arabia. The case records of 100 women diagnosed with TE and treated in the dermatology outpatient clinic were analyzed retrospectively. To obtain appropriate controls, records were searched for age-matched and sex-matched women who came to the hospital for a condition other than TE during the same period. Results The mean levels of patients’ serum ferritin and vitamin D were significantly lower than those of the controls. With respect to thyroid function tests, the mean levels of thyroid-stimulating hormone, thyroxine, and triiodothyronine showed no statistically significant differences between patients and controls. Although nonsignificant, 7% of patients with TE had laboratory evidence of hypothyroidism compared with 2% of controls, and 16% had subclinical hypothyroidism compared with 10% of controls, suggesting a role of thyroid dysfunction in TE. Conclusions Low serum ferritin, vitamin D deficiency, and thyroid dysfunction could be the risk factors for TE and can be used as diagnostic biomarkers of TE; hence, treating such patients with iron, vitamin D, and correction of thyroid dysfunction would be valuable. Prospective clinical studies with a larger number of participants are required to further address the risk factors for TE.

The role of beliefs about the impact of illness on fertility and close relationships for psychopathological symptoms in women treated for hypothyroidism.

As demonstrated in a pilot study, hypothyroidism has a highly stressful impact on some areas of functioning. This study aims to evaluate the connection between illness-related beliefs (IRBs) and the impact of hypothyroidism on fertility and close relationships, which were the strongest stressors, and the level of depressive, anxiety, and anger symptoms. Two hundred and thirteenwomen being treated for hypothyroidism took part in an online survey and completed the modified Hospital Anxiety and Depression Scale, Hypothyroidism Symptoms Severity rating scales, and a measure of IRBs. Other relevant clinical data were also collected. Mean levels of thyroid-stimulating hormone indicated that the women were euthyroid. Four groups of participants were identified based on IRBs. The group holding a strong IRB about the negative impact of illness only on close relationships scored significantly higher on depressive symptoms than women in the other groups. The group holding strong IRBs about the negative impact of illness on both close relationships and fertility scored significantly higher on anxiety symptoms than the women in the other groups. Regression analysis showed that IRBs about the negative impact of hypothyroidism predicted anxiety, depressive, and anger symptoms. Negative IRBs about the impact of illness on fertility and close relationships contribute to increased levels of emotional distress symptoms in women being treated for hypothyroidism.

The Effect of Vitamin D Replacement on Patient with Subclinical Hypothyroidism: A Pilot Randomized Clinical Trial.

Background: Subclinical hypothyroidism (SCH) is characterized by an elevated Thyroid Stimulating Hormone (TSH) with a normal T4. The prevalence of Vitamin D deficiency in patients SCH is high. Some studies suggested that Vitamin D supplements could be reduced serum concentration of TSH so improve SCH and prevent overt hypothyroidism. This study aims to explore the effect of vitamin D replacement on subclinical hypothyroidism. Materials and Methods: Fifty-nine patients, diagnosed with both subclinical hypothyroidism and Vitamin D deficiency by the Endocrinology outpatient clinics between January 2018 and March 2019, were included in this trial. The patients with overt hypothyroidism, cardiovascular risk factors, or positive TPO antibody, abnormal T4, and pregnant women were excluded from this study. The 40 subjects were investigated who received vitamin D supplements for two months. Analyses were conducted through paired-samples t-test and independent-samples t-test using SPSS 24 (Armonk, NY: IBM Corp). Results: The mean serum levels of TSH was decreased from 6.89 mIU/l in the pre-test to 3.34 mIU/l in the post-test, and the difference was found to be statistically significant at P<0.001. Conclusion: We found that the TSH mean level significantly dropped through the use of vitamin D supplements. Thus, it is recommended that all the patients with subclinical hypothyroidism be screened and treated with vitamin D supplements.

The Effect of Vitamin D Replacement on Patient with Subclinical Hypothyroidism: A Pilot Randomized Clinical Trial

Background: Subclinical hypothyroidism (SCH) is characterized by an elevated Thyroid Stimulating Hormone (TSH) with a normal T4. The prevalence of Vitamin D deficiency in patients SCH is high. Some studies suggested that Vitamin D supplements could be reduced serum concentration of TSH so improve SCH and prevent overt hypothyroidism. This study aims to explore the effect of vitamin D replacement on subclinical hypothyroidism. Materials and Methods: Fifty-nine patients, diagnosed with both subclinical hypothyroidism and Vitamin D deficiency by the Endocrinology outpatient clinics between January 2018 and March 2019, were included in this trial. The patients with overt hypothyroidism, cardiovascular risk factors, or positive TPO antibody, abnormal T4, and pregnant women were excluded from this study. The 40 subjects were investigated who received vitamin D supplements for two months. Analyses were conducted through paired-samples t-test and independent-samples t-test using SPSS 24 (Armonk, NY: IBM Corp). Results: The mean serum levels of TSH was decreased from 6.89 mIU/l in the pre-test to 3.34 mIU/l in the post-test, and the difference was found to be statistically significant at P&lt;0.001. Conclusion: We found that the TSH mean level significantly dropped through the use of vitamin D supplements. Thus, it is recommended that all the patients with subclinical hypothyroidism be screened and treated with vitamin D supplements. [GMJ.2020;9:e1592]

Gender Influences the Clinical Presentation and Long-Term Outcome of Graves Disease

The outcome of antithyroid drug (ATD) treatment for Graves disease (GD) is difficult to predict. In this study, we investigated whether male gender, besides other factors usually associated with a poor outcome of ATD treatment, may affect disease presentation and predict the response to medical treatment in subjects with GD. We studied 294 patients with a first diagnosis of GD. In all patients, ATD treatment was started. Clinical features, thyroid volume, and eye involvement were recorded at baseline. Serum levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), and TSH-receptor antibodies (TRAb) were measured at baseline and during the follow-up. Treatment outcome (FT4, FT3, and TSH serum levels and further treatments for GD after ATD withdrawal) was evaluated. When compared to women, men showed a significantly larger thyroid volume and a higher family positivity for autoimmune diseases. During ATD, the mean serum levels of TSH, FT4, FT3, and TRAb did not differ between groups. Within 1 year after ATD discontinuation, relapse of hyperthyroidism was significantly more frequent in men than in women. Within the 5-year follow-up period, the prevalence of men suffering a late relapse was higher compared with that of women. The outcome at the end of the 5-year follow-up period was significantly associated with gender and TRAb levels at disease onset. Male patients with GD have a poorer prognosis when submitted to medical treatment with ATDs. A larger goiter at presentation and a stronger genetic autoimmune background might explain this gender difference in patients with GD. ATD = antithyroid drug FT3 = free triiodothyronine FT4 = free thyroxine GD = Graves disease GO = Graves orbitopathy RAI = radioiodine TRAb = thyroid-stimulating hormone-receptor antibody TSH = thyroid-stimulating hormone.

The Relationship between Thyroid Function and Depressive Symptoms-the FIN-D2D Population-Based Study.

The association between thyroid function and depression is controversial. Both conditions express many similar symptoms, but the studies done give conflicting results. This study draws on a random, population-based sample of 4500 subjects aged 45–75 years old from Finland. The basic clinical study was done in 2007 for 1396 men and 1500 women (64% participation rate). Thyroid stimulating hormone (TSH), free thyroxine (F-T4), and free triiodothyronine (F-T3) were measured in 2013 from frozen samples. The 21-item Beck Depression Inventory (BDI-21) was applied to assess depressive symptoms (score ≥10 points). The prevalence of depressive symptoms was 17.5% in women and 12.5% in men. In women, the mean levels of TSH, F-T4, and F-T3 without depressive symptoms vs. with the presence of depressive symptoms were 1.92/1.97 mU/L, 13.1/13.1 pmol/L, and 3.91/3.87 pmol/L (NS), respectively. In men, the levels were 1.87/1.94 mU/L, 13.5/13.7 pmol/L, and 4.18/4.12 pmol/L (NS), respectively. In multiple regression analysis, TSH had no relationship to BDI-21 total score. We found no association between depressive symptoms and thyroid values.

Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?

It is believed that gastric pH interferes in levothyroxine absorption. Omeprazole, which acts by blocking the secretion of gastric acid, might interfere in hypothyroidism control in patients using levothyroxine and this effect could be dose dependent. The present study aimed to investigate this possibility. Twenty-one patients with primary hypothyroidism who had been using a stabilized levothyroxine dosage for at least one year were selected and randomly assigned to take omeprazole at the dosage of 40 mg or 20 mg per day. The mean levels of thyroid-stimulating hormone (TSH) before and 3 months after omeprazole usage were compared in the entire sample and in each group. Ten patients concluded the entire treatment protocol in the 20 mg group and nine patients in the 40 mg group. There was no significant difference in TSH levels before and 3 months after omeprazole treatment in the entire patient sample (median levels: 2.28 vs. 2.30 mU/L, respectively: p = 0.56). Analysis of each subgroup (20 and 40 mg) showed no significant variation in TSH levels before and 3 months after omeprazole treatment (median levels: 2.24 vs. 2.42 mU/L, p = 0.62, and 2.28 vs. 2.30 mU/L, p = 0.82, respectively). No significant difference in the absolute (p = 0.93) or relative (p = 0.87) delta were observed between the two subgroups. Omeprazole in the dosage of 20 or 40 mg/day does not interfere in a clinically relevant manner in the treatment of patients with hypothyroidism that was previously under control.

Assessment of thyroid functions in patients with chronic obstructive pulmonary disease

BackgroundChronic obstructive pulmonary disease (COPD) is no longer considered to affect only the lungs and airways but also the rest of the body. The systemic manifestations of COPD include a number of endocrine disorders, such as those involving the pituitary, the thyroid, the gonads, the adrenals and the pancreas. The severity of airway obstruction in chronic obstructive pulmonary diseases (COPD) is associated with the impairment of thyroid gland function. Aim of workThis study was carried out to evaluate thyroid abnormalities in patients with COPD and relationship between pulmonary function tests, arterial blood gases and thyroid functions. Patients and methodsSerum free triiodothyronine (ft3), free thyroxin (ft4), and thyroid stimulating hormone(TSH) were measured in 50 patients with COPD and 50 healthy volunteers (control group) and its relation to some ventilatory function tests (FEV1/FVC, FEV1, FVC%, and FEF25-75) and ABG parameters (PH, Paco2, Pao2, Hco3 and O2 saturation) were studied. ResultsThere was no significant difference in mean levels of TSH, FT3 and FT4 between COPD and control group. The mean values of free T3, free T4, and TSH were within normal limits in both groups however, free T3 values in the case group were toward upper normal limits and the mean values of free T3 were increased in the case group compared to their values in the control group. The mean values of free T3 of the cases were significantly increasing with increased severity of COPD. Significant negative correlations were present between free T3 levels and pulmonary function tests of the cases. Significant negative correlations were present between free T3 levels and both PaO2 and SO2 of the cases and also show a significant positive correlation between free T3 levels and PaCO2 of the cases. ConclusionThyroid function tests among COPD patients showed a significant increase of the mean free T3 values and a non significant decrease of the mean free T4 and TSH values compared to the control group. With increasing severity of COPD, the mean free T3 values showed a significant increase. Significant negative correlations were noticed between free T3 levels and both PaO2 and SO2 of the cases. A significant positive correlation was observed between free T3 levels and PaCO2 of the cases. Significant negative correlations were observed between free T3 levels and pulmonary function tests of the cases.

Acute radiation thyroiditis

Purpose: Radiation-induced thyroid dysfunction is considered a late effect. We prospectively assessed acute reactions of thyroid to external neck irradiation.Methods and Materials: This study included 22 patients in whom the thyroid was incidentally exposed to therapeutic does of radiation. Thyroid function tests included measurements of serum thyroid stimulating hormone (TSH), free and total triiodothyronine (T3) and thyroxine (T4), thyroglobulin, and antithyroid antibodies. These tests were performed before radiotherapy, and 3 and 6 months after the beginning of radiotherapy.Results: Mean serum levels of TSH were 1.53, 0.55, 0.78, 2.14, and 7.57 μU/ml before radiotherapy, after 40 Gy irradiation, 2 weeks after the end of radiotherapy, and 3 and 6 months after radiotherapy, respectively. Thus, levels of TSH exhibited two phases: a significant decrease during radiotherapy (thyroxic phase) and an increase after radiotherapy (hypothyroid phase) (baseline vs. 40 Gy: p < 0.0001, baseline vs. 6 months:p = 0.003). Increases of thyroid hormones were subtle during radiotherapy.Conclusions: We believe that radiation promotes release of excessive amounts of thyroid hormones during radiotherapy owing to suppression of TSH secretion. In addition to the late damage (hypothyroidism), thyrotoxicosis occurs when the thyroid gland receives a therapeutic doses of external radiation.