Significant Differences In Thyroid-stimulating Hormone Levels Research Articles

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

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

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

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

IS FIBROMYALGIA A SYNDROME OF HORMONAL IMBALANCE?

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

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

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

Alternative schedules of levothyroxine administration.

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

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.

Relationship between thyroid hormone level and the change of left ventricular function in septic patients

Objective To investigate the occurrence of thyroid disorders in septic patients and the relationship between thyroid hormone level and the change of left ventricular function.Methods A total of 63 septic patients,43 male and 20 female,aged 50 to 88 years with mean 63.3 ± 18.5,were included in the present study.The thyroid hormone levels and C-reactive protein (CRP) levels were detected in all patients on the next day of admission.Clinical information of each patient was recorded including demographics and co-existed disease,APACHE Ⅱ score at admission and the incidence of shock and subsequent multiple organ dysfunction syndrome (MODS).At 24 hours,the second week and the third week after admission,a serial trans-thoracic echocardiography were performed in all patients to observe changes of left ventricular end diastolic dimension,left ventricular eject fraction and E/A (the ratio between maximal velocity of blood flow at mitral valve orifice in the early diastolic phase and maximal velocity of blood flow of atrium in systolic phase).Another 38 patients with ordinary infections,21 male and 17 female,with mean age 58.6 ± 16.8 (48-84 years) were selected as controls for comparison.The difference in thyroid function between sepsis group and control group was analyzed.The levels of serum thyroid hormone associated with the incidence of shock and MODS were studied among different types of the left ventricular structure and function in sepsis group.Results The levels of serum free tri-iodothyronine (FT3) and free tetra-iodothyronine (FT4) in sepsis group were significantly lower than those in control group (P ＜ 0.05),but there was no difference in level of thyroid stimulating hormone (TSH) between these two groups.The patients with sepsis had three types of the left ventricular dysfunction:diastolic dysfunction without the enlargement of left ventricular (type Ⅰ) in 31 patients,the enlargement of left ventricular with diastolic dysfunction (type Ⅱ) in 18 patients and the enlargement of left ventricular with both systolic and diastolic dysfunction (type Ⅲ) in 14 patients.Compared with the other two types,the type Ⅲ patients had significantly lower levels of FT3 and FT4 and higher incidences of shock and MODS (P ＜ 0.05).No significant difference in TSH level was found among the three types.There were no significantly differences in FT3 and FT4 between type Ⅰ and type Ⅱ,but the higher incidences of shock and MODS were found in type Ⅰ (P ＞ 0.05).Conclusions Most septic patients have thyroid function disorder.Serum thyroid hormone levels in early stage of sepsis have certain role in predicting changes in left ventricular structure and function in the late stage of disease. Key words: Sepsis ; Left ventrieular; Echocardiography; Thyroxin; C-reactive protein

Cord blood thyroid‐stimulating hormone and free T4 levels in Turkish neonates: Is iodine deficiency still a continuing problem?

The objectives of this study were to determine the cord blood thyroid-stimulating hormone (TSH) and free T(4) (FT(4) ) levels in Turkish neonates and to determine whether these variables reveal iodine deficiency. We collected 818 cords from healthy mothers at parturition and measured levels of FT(4) and TSH. We also measured cord blood FT(4) and TSH levels in different stages of gestation and gender. We grouped the neonates according to cord serum TSH levels, either being less (Group A) or greater (Group B) than 10 mIU/L. Group A included 589 neonates (300 girls [51%] and 289 boys [49%]) and Group B included 229 neonates (105 girls [45%] and 124 boys [55%]). The percentage of subjects with cord blood TSH < 10 mIU/L and >10 mIU/L was 72% and 28%, respectively. Although cord TSH levels in Group B were greater than those in Group A (P < 0.001), cord blood FT(4) levels in Group B were lower than those in Group A (P < 0.05). There was no difference between both sex in terms of birthweight and maternal age. TSH and FT(4) levels did not vary according to neonate sex during gestation, except for from week 37 to 41. TSH levels of male neonates at the 41st week of gestation were higher than those of female neonates (P < 0.05). There were no effects of birthweight on TSH and FT(4) levels if the neonate was lighter than 2500 g at birth. TSH levels of male neonates were higher than those of female neonates when their birthweights were <2500 g (P < 0.05). There was no significant difference in TSH levels according to birthweights in male neonates. Our data provide the normative data for cord blood TSH and FT(4) levels in Turkish neonates and show that iodine deficiency is a still a public health problem in Turkey. These measurements can be useful for detection and verification of hypothyroidism in a screening program for congenital hypothyroidism as well as evaluation of the success of the iodination program.

Gender-specific associations between subclinical hypothyroidism and blood pressure in Chinese adults

Hypothyroidism is often related with increased blood pressure, yet, gender-specific associations between subclinical hypothyroidism (SCH) and hypertension have not been previously assessed. We conducted a large-scale, cross-sectional study from six districts of Jiangsu Province to investigate the association of SCH and blood pressure in female and male adults. In the studied population, 4725 participants (3034 women and 1691 men) aged 20-60years were included. The prevalence of hypertension was significantly higher in males as compared to females (37.34% vs. 27.39%, P<0.05), while the prevalence of SCH was much higher in women (9.36% vs. 5.32%, P<0.05). Furthermore, the hypertension rate was significantly higher in female SCH group compared to euthyroid (EUT) group(P<0.05), while no significant differences were observed between the two groups in male participants(P>0.05). After adjusting for age and body mass index (BMI), SCH was an independent predictor for increased SBP (OR=1.47, 95%CI 1.08-1.99, P=0.015) and elevated pulse pressure (OR=1.45, 95%CI 1.05-1.99, P=0.024) in females, and serum thyroid stimulating hormone (TSH) was significantly higher in female hypertensive group as compared to normotensive group (2.09 vs. 1.92 mIU/l, P=0.0004). In male participants, SCH was not independently correlated with blood pressure, and no significant difference in TSH levels between hypertensive and normotensive groups was observed (1.74 vs. 1.66 mIU/l, P=0.12). We concluded that SCH is an independent predictor of increased SBP and pulse pressure in females. Thus, thyroid function may influence blood pressure to a greater extent in females compared to males.