Mean Serum Thyroid-stimulating Hormone Levels Research Articles

Prevalence of Subclinical Hypothyroidism in Obese Adults Population

Objective: Determination of frequency of occurrence of subclinical hypothyroidism (SCH) in a local population of obese adults Study design: A cross-sectional study Place and Duration: This study was conducted at Sindh Government Lyari General Hospital Karachi from March 2022 to March2023 Methodology: The patients aged between 18 years to 55 years. All the participants had a body mass index (BMI)of more than 29 kg/m2. As per the exclusion criteria, those patients having kidney failure, liver failure, or already diagnosed with thyroid dysfunction, were not added to the study. Patients taking cholesterol-lowering drugs were also not considered in the study. A blood sample of all the patients was collected for the measurement of serum thyroxine levels and serum thyroid stimulating hormone (TSH) levels. Results: A total of 150 obese adults were considered in the study. The mean age of the participants was 35.7±8.1 years. Overall69 (46%) patients were male while 81 (54%) patients were females. The mean BMI of the patients was 32.1±2.1 kg/m2. The mean serum thyroxine level in the given population was 1.09±0.24 ng/dl and the mean serum TSH level was 3.12±1.09 mIU/L. A total of 24 (16%) patients were detected with subclinical hypothyroidism. Conclusion: Subclinical hypothyroidism is vastly prevalent in the obese adult population, particularly in adults with a BMI of more than 29 kg/m2. However, there is room for further studies to examine the correlation between obesity and SCH. Keywords: Subclinical Hypothyroidism, Obesity, TSH, Thyroxine, Body mass index

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.

P–711 The association between thyroid autoimmunity and serum level of anti-Müllerian hormone in infertile patients with normal ovarian reserve undergoing in vitro fertilisation

Abstract Study question Is there a relationship between thyroid autoimmunity and serum level of anti-müllerian hormon (AMH) in infertile women with normal ovarian reserve undergoing in vitro fertilisation (IVF)? Summary answer In infertile women with normal ovarian reserve serum AMH level above 5ng/ml is associated with higher level of thyroid hormones and less frequent thyroid autoimmunity What is known already Previous studies suggest that thyroid autoimmunity is associated with a decreased ovarian reserve. Moreover, it was reported that thyroid hormone administration could improve serum AMH level. However, the relationship between serum AMH level and thyroid autoimmunity and function in infertile women with normal ovarian reserve undergoing IVF is largely unknown. Since in IVF the serum AMH level is an important marker which dictate the management of the couple, the identification of all the factors possibly related to this parameter is very important. Study design, size, duration: We performed a retrospective study in the Department of Reproductive Medicine of a private hospital. The medical records of all consecutive patients who underwent IVF between January 2015 and December 2018 with all causes of infertility were reviewed. Study group included 581patients with a mean age of 34.4±4.1 years, mean AMH of 3.78±2.4 ng/mL, mean serum TSH level of 1.89±1 microUI/ml and mean serum free T4 level of 1.05±0.98 ng/dl. Participants/materials, setting, methods Patients with known thyroid disorders or under thyroid hormone treatment at the moment of evaluation were excluded. Only patients with serum level of thyroid stimulating hormone (TSH), free tyroxine (free T4), anti thyroid peroxidase antibodies (ATPO,) anti thyroglobulin antibodies (ATG), AMH and age available for analysis were included in the study. This parameters are evaluated on a systematic basis in all the patients undergoing IVF in our Department, except very few cases. Main results and the role of chance Patients were divided according to their serum AMH level in two groups: group 1 with AMH level 5 ng/ml and below (n = 450 patients) and group 2 with AMH above 5 ng/ml (n = 131 patients). When the two groups were compared we found that patients in group 2 were younger in comparison with patients in group 1 (32.9±3.8 versus 35±4 years, p &amp;lt; 0.0001). After adjustment for age, patients in group 2 had significantly higher serum free T4 level (1.07±0.12 versus 1.04±0.14 ng/dl, p = 0.015), lower ATG (17.59±41.8 UI/ml versus 39.4±136.16 UI/ml, p &amp;lt; 0.018) and presented less frequently with high ATPO antibodies (35% versus 41.8%, p = 0.047). In a logistic regression model with AMH as a dependent variable, free T4, but not TSH was independently and positively associated with higher AMH levels (above 5 ng/ml) (p = 0.025) after adjustment for anti thyroid antibodies levels. Morever, in this logistic model the presence of high ATPO, but not ATG, were negatively related to higher AMH level (p = 0.037). Limitations, reasons for caution Patients included in this study are infertile patients with indication for IVF treatment. Therefore, the results of this study should be used with caution in other populations Wider implications of the findings: Our study suggest that serum AMH level might be related to thyroid autoimmunity, but also to thyroid hormones levels. If confirmed by further studies, this findings could offer a way to improve serum AMH level and to better understand the markers of ovarian reserve in an IVF setting. Trial registration number NA

Optimal Serum Thyroid-Stimulating Hormone Level for Patients With Papillary Thyroid Carcinoma After Lobectomy

Background: The optimal serum thyroid-stimulating hormone (TSH) level for post-lobectomy papillary thyroid carcinoma (PTC) patients is unclear. The objective of this study was to examine the association of TSH and recurrence in post-lobectomy patients. Methods: Patients who underwent lobectomy for PTC in a single tertiary hospital from January 2000 to December 2014 were enrolled. The mean TSH score of a patient was calculated based on each serum TSH value during follow-up. The TSH value of each follow-up visit was scored as 0-20 with an interval of 0.5 mU/L, and the mean TSH score (MTS) was calculated as the average of all available scores for a patient. The reference range of serum TSH was 0.5-4.0 mU/L (MTS 0-7). Univariate and multivariable analyses were performed with Cox proportional hazards models. Restricted cubic spline (RCS) functions were used to model relationships between MTS and recurrence-free survival (RFS). Results: A total of 2297 patients (median age, 42 years; 1750 (76.2%) female) were analyzed. MTS below (≤0.5), in the lower half (0.5-3), in the upper half (3-7) and above (>7) the reference range were observed in 415 (18.1%), 1376 (59.9%), 409 (17.8%), and 97 (4.2%) patients, respectively. According to the Cox model and RCS, no association was observed between MTS and RFS (adjusted P=0.5071, adjusted P for nonlinear=0.5182). The only RFS difference observed in the stratified univariate analysis was between patients with MTS in the lower half (n=793) and above the reference range (n=54) in the intermediate- to high-risk group (10-year RFS by Kaplan-Meier 82.1% vs 70.5%, log rank p=0.023). Conclusions: Mean serum TSH levels are not associated with recurrence. A normal TSH reference range is recommended for post-lobectomy PTC patients. Funding Information: The study was funded by the CAMS Innovation Fund for Medical Sciences (CIFMS) (Grant no.2016-I2m-1-002) and Beijing Hope Run Special Fund of Cancer Foundation of China (Grant no.LC2018A26) Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: The study was approved by the Ethics Committee of the Cancer Hospital, Chinese Academy of Medical Sciences. Informed consent was obtained at the time of surgery with surgical consent for general use of clinical information for future studies.

The Effect of ThyroidߚStimulating Hormone on Stage of Differentiated Thyroid Carcinoma

IntroductionThyroid cancer is the most common endocrine malignancy, and it has the fastest increase rate in incidence in both sexes, with a yearly increase of 3% over the last decade. Thyroid‐stimulating hormone (TSH) is the main driver for the thyroid gland to produce thyroid hormone. The main purpose of this study was to assess the relationship between serum TSH level and the stage of malignancy in patients with differentiated thyroid cancer.MethodsThis cross‐sectional study was performed on 77 patients with thyroid cancer. The demographic characteristics, TSH level and stage of malignancy were recorded for all patients in the data collection form. The data analysis was conducted by descriptive statistics using SPSS 20.0 software.ResultsThe results show a significant relationship (p‐value = .025) between the malignancy stage and serum TSH level. The mean TSH level in patients of stage 3 (5.70 ± 2.03) was significantly higher than patients in stage 2 (2.58 ± 0.52) and stage 1 (2.33 ± 0.28). No significant relationship was observed between the age of patients and serum TSH level. Although the mean serum TSH level in men (3.61 ± 0.98) was higher than in women (2.52 ± 0.25), the difference was not statistically significant.ConclusionsAccording to the results of this study, serum TSH level can be considered as a predictor of the stage of differentiated thyroid cancer. Therefore, it can be used to predict the likelihood of cancer and improve the outcome and extent of thyroidectomy in patients with thyroid cancer.

Association between Thyroid Function and Gall Stone Disease

Background: There was a long term perception that gall stone disease may have a hidden association to alteration of thyroid function.&#x0D; Objective: To find out the association between thyroid function status in gall stone disease.&#x0D; Materials and Methods: This case control study was conducted in department of Surgery, Bangabandhu Sheikh Mujib Medical University Hospital from July 2017 to June 2018. This study recruited 152 gall stone patients diagnosed with Ultrasonography (USG). The control group underwent USG to exclude any asymptomatic cholelithiasis. Fasting blood samples were taken from all participants for measurements of Fasting Blood Sugar (FBS), serum free thyroxine (FT4), serum thyroid stimulating hormone (TSH), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL).&#x0D; Results: The mean serum TSH levels among cases (3.56±4.6) was higher than controls (2.46±1.68) (p&lt;0.05). Subclinical hypothyroidism was noted in 11.8% of cases and all were found female and 3.8% of controls, whereas hypothyroidism was detected in 3 (3.8%) controls and 22 (14.5%) cases. The mean total cholesterol levels in cases was much higher than in controls, and was significant (p&lt;0.05).&#x0D; Conclusion: Hypothyroidism has a significant role on development of gall stone disease with increasing age especially in female.&#x0D; KYAMC Journal.2021;12(1): 36-40

Study of thyroid profile in relation to glycemic control in type 2 diabetes mellitus patients

Diabetes mellitus is an endocrine metabolic disorder that causes significant morbidity and mortality around the world. Thyroid gland dysfunction is a significant problem in diabetic patients. In diabetics, hypothyroidism is the most common thyroid abnormality. When compared to healthy people, diabetic patients have a higher incidence of thyroid abnormalities. Diabetes mellitus treatment can be complicated due to irregular thyroid activity. A total of 120 people were studied, with 60 patients with type 2 diabetes mellitus (Cases group) and 60 healthy people (Control group). Patients with and without strong diabetic control are represented in 60 cases. Both subjects had their fasting venous blood samples taken. In both the cases and control groups, fasting blood sugar, HbA1c, serum T3 (Triiodothyronine), serum T4 (Thyroxine), and serum TSH (Thyroid-stimulating hormone) were measured.The thyroid abnormality was significantly seen in diabetic patients when compared to healthy individuals. The abnormality was more significant in patients with poor glycemic control. When comparing cases to controls, mean serum TSH levels were significantly higher, whereas mean serum T3 and T4 levels were significantly lower. Thyroid hormone levels in type 2 diabetics are abnormal due to a change in the hypothalamic–pituitary–thyroid axis. This in turn produces significant metabolic disturbances. This is more significant in diabetics with poor glycemic control. Routine screening for thyroid function should be done in diabetics, which helps in preventing complications. This contributes to improved treatment by lowering morbidity and improving quality of life.

Evaluation of the Activities of Thyroid Hormones Among Pre- and Post-menopausal Euthyroid Women: A Cross-sectional Study from a Tertiary Care Teaching Hospital in India.

IntroductionAging brings about several changes in humans that include both physiological and anatomical changes. As individuals' age, the activity of the thyroid gland and its hormones decline, causing significant metabolic disorders. Most thyroid gland disorders have been noted among young and middle-aged women. Very little is known regarding the activities of thyroid hormones among older aged women.MethodsThe study included 350 young to middle-aged pre-menopausal women between 25 and 49 years and 350 older post-menopausal women above 50 years of age. The study was conducted in the department of biochemistry, Prathima Institute of Medical Sciences (PIMS), Nagunur, Karimnagar, Telangana, India. The subjects included in the study were euthyroid (not having any signs and symptoms of thyroid disorder) and were not on any medication. The thyroid profile, including thyroid stimulating hormone (TSH), tri-iodothyronine (T3), and tetra-iodothyronine (T4), was analyzed in all the study subjects using the chemiluminescence immunoassay (CLIA) technique on a completely automated Abbott i1000SR Architect Plus instrument (Abbott Core Laboratory, Illinois‎, US).ResultsThere was no statistically significant difference in thyroid hormone activities in the two age groups compared, as noted by the unpaired student's ‘t’ test. The mean serum TSH levels in the older post-menopausal women (3.39+2.45) were found to be higher than those noted in pre-menopausal women (2.60+1.31). The activities of T3 and T4 showed no difference in both groups (p=0.8397).ConclusionThe study results clearly indicate an increase in the activities of TSH among the older-aged post-menopausal women.

Serum TSH level in obese children and its correlations with atherogenic lipid indicators and carotid intima media thickness.

Objective: Moderately elevated level of thyroid-stimulating hormone accompanied by normal serum concentrations of free thyroxine, suggesting subclinical hypothyroidism, is the most common hormonal abnormality in obese children. Controversy remains, whether a thyroid dysfunction related to obesity has an influence on the cardiovascular risk factors. The aim of the study was to assess correlation between thyroid-stimulating hormone and free thyroxine and chosen atherogenic lipid indicators, and carotid intima media thickness in obese children and adolescents. Methods: A study group consisted of 110 obese children (11.5 ± 2.9 years) and 38 healthy children (13.4 ± 2.6 years). Obesity was defined using International Obesity Task Force criteria. In each patient anthropometric measurements, thyroid-stimulating hormone, free thyroxine, a lipid profile were evaluated. Carotid intima-media thickness was measured in 74 obese children and 28 lean children. The resulting data were used to calculate indicators of atherogenesis: total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio and LDL cholesterol to HDL cholesterol ratio. Results: Obese children had higher mean serum thyroid-stimulating hormone levels compared to their lean peers and an adverse atherogenic lipid profile. Serum free thyroxine concentrations were comparable between the groups. Serum thyroid-stimulating hormone values correlated with total cholesterol to HDL cholesterol ratio; triglycerides to HDL cholesterol ratio, LDL cholesterol to HDL cholesterol ratio, and intima-media thickness. In a multivariate regression analysis, thyroid-stimulating hormone weakly correlated only with intima-media thickness after adjustment for age, gender and Body Mass Index (β = 0.249, p = 0.04). This relationship weakened after considering a lipid profile (β = 0.242, p = 0.058). No relationship was found for free thyroxine. Conclusion: Serum level of thyroid-stimulating hormone in obese children did not seem to impact atherogenic lipid indicators and carotid intima-media thickness. Therefore, an adverse lipid profile should still be considered the main risk factor for development of cardiovascular diseases in obese children.

Changes in the thyroid hormone profiles in children with nephrotic syndrome.

PurposeWe compared thyroid hormone profiles in children with nephrotic syndrome (NS) during the nephrotic phase and after remission.MethodsThis study included 31 pediatric NS patients. The thyroid hormone profiles included serum levels of triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and free T4.ResultsOf the 31 patients, 16 (51.6%) showed abnormal thyroid hormone profiles: 6 had overt hypothyroidism, 8 had subclinical hypothyroidism, and 2 had low T3 syndrome. The mean serum T3, T4, and free T4 levels in the nephrotic phase and after remission were 82.37±23.64 and 117.88±29.49 ng/dL, 5.47±1.14 and 7.91±1.56 µg/dL, and 1.02±0.26 and 1.38±0.23 ng/dL, respectively; the levels were significantly lower in the NS nephrotic phase (P=0.0007, P<0.0001, and P=0.0002). The mean serum TSH levels during the nephrotic phase and after remission were 8.05±3.53 and 4.08±2.05 µIU/ mL, respectively; they were significantly higher in the nephrotic phase (P=0.0005). The urinary protein/ creatinine ratio during the nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin and serum T3 levels during the nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations all disappeared after remission.ConclusionAbnormal thyroid hormone profile findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.

Serum thyroid‐stimulating hormone levels and smoking status: Data from the Korean National Health and Nutrition Examination Survey VI

We aimed to evaluate differences in serum thyroid-stimulating hormone (TSH) levels according to smoking status and urine iodine concentration (UIC) in a healthy Korean population using data from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES VI). Sixth Korean National Health and Nutrition Examination Survey (2013-2015) is a nationwide, cross-sectional survey of the Korean population. Research subjects were selected by two-stage stratified cluster sampling of the population and housing census data. A total of 5639 subjects aged >18years, who were not pregnant, and had undergone thyroid function testing during the survey period, were included. The level of serum TSH according to smoking status, iodine intake and presence of TPOAb were evaluated. In the reference population, mean serum TSH level in current smokers (1.87mIU/L, 95% CI, 0.52-5.37mIU/L) was significantly lower than that in nonsmokers (2.33mIU/L, 95% CI, 0.79-6.69mIU/L, P<.001). The rate of thyroperoxidase antibody (TPOAb) positivity was higher in never smoker (7.7%) than past smokers (5.1%) and current smokers (4.7%), but sex-specific rate of TPOAb was not different according to smoking status. The lower serum TSH levels in current smokers were more apparent in iodine-deficient subjects (UIC<100μg/L), and this change was diminished in subjects with UICs between 100 and 299μg/L. The difference in serum TSH levels in current smokers disappeared in subjects with UICs≥300μg/L. Smoking is associated with a left-shift in serum TSH level that is more apparent in iodine-deficient subjects. Smoking status is not associated with the presence of TPOAb or iodine intake. The results suggest that smoking has a direct effect on thyroid function that is not mediated by autoimmune processes in the thyroid gland.

Biochemical assessments of thyroid profile, serum 25-hydroxycholecalciferol and cluster of differentiation 5 expression levels among children with autism

BackgroundThe exact pathogenesis of autism is still unknown. Both thyroid hormones and 25(OH)D are important for brain development, in addition to CD5; all have immunomodulatory actions by which their dysregulation may have a potential role in autism pathogenesis.ObjectivesThe objectives of this study were to assess the thyroid profile, serum 25(OH)D levels and CD5 expression levels among autistic patients and to find out the correlations between the measured biomarkers with each other on one side and with the disease severity on the other side.Patients and methodsThis cross-sectional case–control study has been conducted on 60 children with autism and 40 controls, recruited from Qena Governorate, Upper Egypt. Childhood Autism Rating Scale (CARS) score was used to assess the included patients. Biochemical assays of thyroid function in the form of free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) and 25(OH)D were done using commercially available enzyme-linked immunosorbent assay (ELISA) kits, while CD5 expression levels were measured using flow cytometry (FCM) analysis for all the included patients and controls.ResultsThe overall measurement results show significant higher mean serum TSH levels, mean CD5 expression levels with significant lower mean serum 25(OH)D levels among autistic children when compared with the control group (p<0.05 for all). Significant negative correlations between CD5 with FT3, FT4 and 25(OH)D were observed. CARS score showed significant negative correlations with both FT3 and 25(OH)D, while it was positively correlated with CD5 in a significant manner (p<0.05 for all).ConclusionElevated CD5 expression and decreased 25(OH)D stores could play a potential role in the pathogenesis of autism via their immune-modulator actions. High TSH serum levels among autistic children, although within the physiological range, reflect the presence of thyroid dysfunction among such children, which needs further assessment.

Evaluation of thyroid function tests of acne vulgaris patients treated with systemic isotretinoin

Background: Isotretinoin is a systemic retinoid used to treat acne and it binds receptors which are the member of steroid–thyroid hormone superfamily. Certain types of retinoids may cause abnormalities in serum thyroid function tests (sTFTs) by suppressing thyroid stimulating hormone (TSH). However, it is uncertain whether systemic isotretinoin has any effect on sTFTs.Objective: The aim of the study was to find out if there is any alteration in sTFTs of patients with acne vulgaris treated with systemic isotretinoin.Methods: A total of 51 patients (male/female: 22/29) with severe acne vulgaris treated with a total dose of 120 mg/kg isotretinoin were included into the study prospectively. Serum free T3 (fT3), free T4 (fT4) and TSH levels were measured at baseline, 3rd and 6th months of treatment.Results: Mean serum TSH levels at baseline, 3rd and 6th months of treatment were 1.57 ± 0.67, 2.07 ± 0.88 and 2.25 ± 0.86 uIU/mL, respectively. Mean serum TSH levels increased significantly following isotretinoin therapy (p < 0.01, p = 0.007 and p < 0.01, respectively). Mean serum fT3 levels at baseline, 3rd and 6th months of treatment were 3.59 ± 0.57, 3.19 ± 0.45 and 3.09 ± 0.61 pmol/L, respectively. Mean serum fT4 levels at baseline, 3rd and 6th months of treatment were 1.21 ± 0.19, 1.09 ± 0.16 and 1.11 ± 0.19 pmol/L, respectively. Mean serum fT3 and fT4 levels decreased significantly at 3rd and 6th months compared to baseline levels (p < 0.01 and p < 0.01, p < 0.01 and p = 0.001, respectively).Conclusion: Systemic isotretinoin therapy causes significant alterations in sTFTs. Dose dependent or long-term effects of systemic isotretinoin on sTFTs needs further evaluation.

Prevalence of hypothyroidism in patients with frozen shoulder

Hypothyroidism and frozen shoulder (FS) have been associated, although this relationship remains uncertain. The main objective of this study was to determine the prevalence of hypothyroidism in patients with FS. A case-control study was performed to compare FS patients (cases) with patients who visited an orthopedic service for other clinical conditions (controls). FS was diagnosed according to specific criteria based on anamnesis, physical examination, and shoulder radiographs. A specific questionnaire was applied, and measurements of serum thyroid-stimulating hormone (TSH) and free tetraiodothyronine were performed in all subjects. We evaluated 401 shoulders from 93 FS patients and 151 controls. The prevalence of hypothyroidism diagnosis was significantly higher in the FS group (27.2% vs. 10.7%; P = .001). There was also a tendency for higher prevalence of bilateral FS among patients with elevated TSH levels (P = .09). Mean serum TSH levels were higher in patients with bilateral FS compared with those with unilateral compromise (3.39 vs. 2.28; P = .05) and were higher in patients with severe FS compared with those with mild and moderate FS together (3.15 vs. 2.21; P = .03). Multivariate analysis showed that FS was independently related to a diagnosis of hypothyroidism (odds ratio, 3.1 [1.5-6.4]; P = .002). There was a trend toward independent association between high serum TSH levels and both severe (odds ratio, 3.5 [0.8-14.9]; P = .09) and bilateral (odds ratio, 11.7 [0.9-144.8]; P = .05) compromise. The prevalence of hypothyroidism was significantly higher in FS patients than in controls. The results suggest that higher serum TSH levels are associated with bilateral and severe cases of FS.

Serum thyroid-stimulating hormone level and relation with size of hippocampus in patients with mild cognitive disorders.

Background:Cognitive disorders and dementia are common problems, and Alzheimer's disease is one of the major leading causes of death worldwide. Thyroid hormone disorders as a common problem effect on hippocampus size which as a prognostic factor in dementia. The aim of the present study was to investigate the relationship between serum thyroid-stimulating hormone (TSH) level and the size of hippocampus in patients with mild cognitive disorders.Materials and Methods:In a descriptive-analytical study, 41 patients with symptoms of mild cognitive disorders whom referred to take the brain magnetic resonance image (MRI) in a radiology center under the direction of Tabriz University of Medical Sciences (Tabriz, Iran) were evaluated. The right and left hippocampal and brain volume was calculated by MRI at coronal T1-weighted. Serum TSH level was also measured in these patients. Correlation between serum TSH level and hippocampal volume size was evaluated.Results:Male to female ratio was 1.05:1 with mean age of 54.09 ± 3.11 years. Mean serum TSH level of patients was 1.55 ± 1.45 uU/ml. The right and left hippocampal volumes were 1.61 ± 0.42 and 1.62 ± 0.39 ml, respectively. There were slight negative correlations between the right and left hippocampal volumes with TSH level (r = −0.133 and r = −0.092, respectively). Correlations between the right and left hippocampal volumes with TSH level were not statistically significant (P = 0.406, P = 0.566, respectively).Conclusion:Based on findings of the present study, there was a weak negative correlation between serum level of TSH with the right and left hippocampal and brain volume ratio, but the correlation was not statistically significant. It seems that controlling of clinical or subclinical hypothyroidism may have a role in slowing of dementia progression and also have a preventive role.

Thyroid function in pregnant women with gestational diabetes: Is screening necessary?

Background: The goal of prenatal care is mother's and baby's health. Pregnancy is the time of hormonal changes, which cause endocrine disorders in pregnant woman encountering risk to the mother and fetus. Two important and more common problems in pregnancy are gestational diabetes mellitus (GDM) and thyroid disorders. Approximately 1.1-14.3% of pregnant women suffer from GDM and hypothyroidism affects 2.5-6.47% of them. There are some recommendations for diagnosis and screening of GDM but there is no clear advice about the need for performing thyroid function tests during pregnancy. In this study, we aimed to evaluate the need for measurement of thyroid function tests in pregnant women with GDM. Materials and Methods: In this case-control study, 210 pregnant women (105 with and 105 without GDM) were enrolled during 2011-2012 and serum levels of free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were compared between two groups. Results: Mean TSH levels in case and control groups were 3.43 ± 2.06 and 1.74 ± 1.47 μIU/mL, respectively and was statistically higher in case group (P = 0.023). Mean FT4 levels in case and control groups were respectively 1.41 ± 0.69 and 1.5 ± 0.61 ng/dL, which were not statistically different in both groups (P = 0.67). Among patients with GDM, 18 (17.1%) had subclinical hypothyroidism and 11 (10.48%) had clinical hypothyroidism, while among non-GDM patients, 7 (6.66%) had subclinical hypothyroidism and 4 (3.81%) had clinical hypothyroidism. Conclusion: In patients with GDM, hypothyroidism (clinical and subclinical) was obviously higher, the mean serum TSH level was higher in these women, and it was within a range that required treatment. So, it is suggested considering screening and treatment of hypothyroidism in patients with gestational diabetes.

Biochemical Association of Hyperprolactinemia with Hypothyroidism in Infertile Women

To find out the incidence of hyperprolactinemia in infertile women and to find its correlation with hypothyroidism. One hundred infertile women attending the out patient Department of Obstetrics and Gynaecology formed the subject matter of the study. Hormone levels of prolactin and thyroid stimulating hormone (TSH) were studied in all the subjects. The exclusion criterion was male factor infertility. Amongst the female factors leading to exclusion from the study were tubal factor, congenital abnormality of the urogenital tract, and any organic lesions. Of the one hundred infertile women, sixty (60%) had primary infertility and forty women (40%) had secondary infertility. Galactorrhea was present in 15% of the women. The incidence of hyperprolactinemia i.e. serum prolactin level > 15 ng/mL was 46%. Out of forty six, thirty women had primary infertility and sixteen women had secondary infertility. The mean serum prolactin level in hyperprolactinemic women was 79.40 +56.59 ng/mL (range: 25.0-230.0 ng/mL). The mean serum prolactin level was not significantly different in the primary and secondary infertile group. The incidence of hypothyroidism in hyperprolactinemia was 28.26%. The mean serum TSH level in hypothyroid women with hyperprolactinemia was 32.06 +/- 23.00 (range: 7.92-78.00 microIU/mL). The TSH level was not significantly different in primary and secondary infertile women. A high incidence of hyperprolactinemia was found in infertile women and a positive correlation was found between hyperprolactinemia and hypothyroidism.

Study on Serum Levels of Thyroid Hormones and Thyroid Stimulating Hormone in Different Trimester of Normal Pregnancy

Objective: The present study was conducted to study the changes in serum levels of thyroid hormones and thyroid stimulating hormone (TSH) in different trimesters of normal pregnancy.&#x0D; Methods: This cross-sectional study was conducted in the Department of Physiology, Rangpur Medical College Hospital over a period 1 year from July 2008 to June 2009. Apparently healthy pregnant women aged between 20 - 35 years were consecutively included in the study. Patients suffering from thyroid disorders or any other systemic diseases and lactating mothers were excluded from the study. A total of 100 subjects - 75 pregnant women (25 selected from each trimester of pregnancy) and 25 non-pregnant women were purposively selected as case and control groups respectively.&#x0D; Result: The mean age was almost identically distributed between the two groups (23.8 ± 3.9 vs. 24.9 ±4.6, p = 0.343). Lower class patient was predominant in case and control group (68% vs. 64%, p =0.756). The mean serum T3 level was higher in case group compared to control group. The mean serum T3 level was identically distributed in 1st and 3rd trimester (p = 0.536 and p = 0.145 respectively) but significant difference was found in 2nd trimester (p = 0.001). The mean serum T4 level of control group did not experience any change throughout the whole observation period. The serum T4 level was 210 nmol/L at 1st trimester then it began to increase almost a plateau at 2nd trimester and then gradually dropped 232.2 nmol/L at third trimester. The mean serum TSH level was 1.1 mIU/L at 1st trimester then it began to increase sharply assumed a mean score 1.3 mIU/L at 2nd trimester. From 2nd trimester onwards it began to decrease upto the end of observation when no change in the non-pregnant women in 1st, 2nd &amp; 3rd trimester.&#x0D; Conclusion: Thyroid hormones (T3, T4) increase in the 2nd trimester of pregnancy and fall again in the 3rdtrimester but TSH does not experience any significant change throughout the pregnancy.&#x0D; Ibrahim Cardiac Med J 2012; 2(2): 19-23

Thyroid hormones profile in students of Makerere College of Health Sciences in Kampala Uganda

Serum concentrations of thyroxine (T4), triiodothyronine (T3) and Thyroid Stimulating Hormone (TSH) are used to assess thyroid function. It is recommended that each laboratory or hospital should establish its own reference values of T4, T3 and TSH for their clients because these hormones vary with ethnicity, geographical and climatic conditions of a population. There is no documented study which has been done to determine the Thyroid hormones profile in Ugandan general population. This study is one of the first attempts to determine Thyroid hormones profile in healthy Ugandans. The main objective of this study was to determine the thyroid hormones profile of students of the Makerere College of Health Sciences in Kampala, Uganda. A cross sectional descriptive study was done involving 72 students, with the mean age of 24.17 +/- 4.48 years. Subjects who volunteered to participate in the study were interviewed; their height and body weight measured, 5 ml of blood withdrawn, and sera harvested. FT4 and T3 Radioimmuno Assay (RIA) were done and TSH was assayed using Immunoradiometric Assay (IRMA) technique. The mean serum concentration of FT4 was 17.016 +/- 3.847 mol/L. For T3, mean serum concentration was 1.43 +/- 0.825 nmol/L, and mean serum TSH level was 2.412 +/- 2.284 microIU/ml. Variations of serum concentrations of FT4, T3 and TSH with sex, age, or region of origin were not statistically significant. Serum concentration of TSH increased with increased body mass index (BMI). It was 2.073 +/- 1.907 microIU/ml for subjects with BMI of < or = 24.9 Kg/m2, 3.588 +/- 1.495 microIU/ml for subjects with BMI of 25 - 29.9 kg/m2 and 4.450 +/- 0.593 microIU/ml for subjects with BMI > or = 30 kg/m2 (P=0.009). However, BMI had no effect on serum concentrations of FT4 and T3. Serum concentrations of T4, T3 and TSH obtained from this study all differ with the values which are currently used as reference ranges in the country. We recommend a similar study involving a population representative of Ugandans to be conducted so as to establish normal reference values of T4, T3 and TSH for Ugandans. We also recommend BMI of patients to be taken into consideration during interpretation of serum TSH concentrations results.

“False-Positive” Newborn Thyroid Screen May Predict Future Subclinical Hypothyroidism

Endocrinology| September 01 2008 “False-Positive” Newborn Thyroid Screen May Predict Future Subclinical Hypothyroidism AAP Grand Rounds (2008) 20 (3): 31–32. https://doi.org/10.1542/gr.20-3-31-a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation “False-Positive” Newborn Thyroid Screen May Predict Future Subclinical Hypothyroidism. AAP Grand Rounds September 2008; 20 (3): 31–32. https://doi.org/10.1542/gr.20-3-31-a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: false-positive results, subclinical hypothyroidism, thyroid screening, thyrotropin, hyperthyrotropinemia, thyroid function tests Source: Leonardi D, Polizzotti N, Carta A, et al. Longitudinal study of thyroid function in children with mild hyperthyrotropinemia at neonatal screening for congenital hypothyroidism. J Clin Endocrin Metab. Rapid Electronic Publication first published on April 29, 2008; doi:10.1210/jc.2007-2612 To better understand the natural history of children with unexplained transient increase in thyroid stimulating hormone (TSH) in the newborn period, researchers from the University of Catania in Catania, Italy, followed children who had a “false positive” newborn thyroid screen into late childhood. This study was an extension of previously published work describing children with transient increase in TSH who, when studied at 16–44 months of age, demonstrated a high incidence (50%) of subclinical hypothyroidism.1 Infants with Down syndrome, prematurity, small for gestational age, and newborns of thyroid autoimmunity-positive mothers were excluded. Thyroid function and morphology in children with transient unexplained hyperthyrotropinemia in infancy were compared with control children who had normal newborn TSH levels at three time periods: age 16–44 months, age 4.1–6.6 years, and age 7.2–9.5 years. Measures of function included TSH, free T4 (FT4), free T3 (FT3), anti-thyroglobulin (anti-Tg), and anti-thyroperi-oxidase (anti-TPO) antibodies. Morphology was evaluated by ultrasound and thyroid volume was calculated and compared with reference values. A total of 44 children were followed until an average age of eight years. At age 16–44 months all children had a normal serum FT4, but mean serum TSH and FT3 levels were significantly higher than those of controls. Based on TSH levels at this time, children were divided in two groups: group 1 (16 patients) had normal serum TSH levels of <4.0mU/L and group 2 (28 patients) had slightly elevated serum TSH (4.0–10.1 mU/L). Levothyroxine treatment was given to reduce TSH in 20 of 28 children in group 2. At age 4.1–6.6 years, serum FT4 was within normal range in all children, with average values similar in groups 1 and 2. Serum TSH was within normal range in all 16 group 1 children and in nine of 28 group 2 children (group 2a); however, when the 25 children with normal serum TSH were compared with the control group, their average TSH levels were significantly higher. In the remaining 19 of 28 group 2 children, serum TSH was persistently elevated (group 2b). FT3 values were significantly higher compared with controls. Anti-thyroid antibodies (anti-TPO and/or anti-Tg) were slightly positive in 11 of 44 children in early childhood; however, they were weakly positive in only one child in group 2 at 30 months of age. At age 7.2–9.5 years, TSH serum values remained in the normal range in all group 1 children and in the nine group 2a children. Of the 19 group 2b children, TSH remained elevated in 14 but normalized in five children. Of the eight children treated with levothyroxine, seven had persistent elevation of TSH. Out of these seven children, six were determined to have genetic and/or morphological abnormalities of the thyroid as the possible cause of their... You do not currently have access to this content.