Subclinical Hypothyroidism Research Articles

Impact of Thyroid Status on Incident Kidney Dysfunction and Chronic Kidney Disease Progression in a Nationally Representative Cohort

ObjectiveTo examine the relationship between thyroid status and incident kidney dysfunction/chronic kidney disease (CKD) progression. Patients and MethodsWe examined incident thyroid status, ascertained by serum thyrotropin (TSH) levels measured from January 1, 2007, through December 31, 2018, among 4,152,830 patients from the Optum Labs Data Warehouse, containing deidentified retrospective administrative claims data from a large national health insurance plan and electronic health record data from a nationwide network of provider groups. Associations of thyroid status, categorized as hypothyroidism, euthyroidism, or hyperthyroidism (TSH levels >5.0, 0.5-5.0, and <0.5 mIU/L, respectively), with the composite end point of incident kidney dysfunction in patients without baseline kidney dysfunction and CKD progression in those with baseline CKD were examined using Cox models. ResultsPatients with hypothyroidism and hyperthyroidism had higher risk of incident kidney dysfunction/CKD progression in expanded case-mix analyses (reference: euthyroidism): adjusted hazard ratios (aHRs) (95% CIs) were 1.37 (1.34 to 1.40) and 1.42 (1.39 to 1.45), respectively. Incrementally higher TSH levels in the upper reference range and TSH ranges for subclinical, mild overt, and overt hypothyroidism (≥3.0-5.0, >5.0-10.0, >10.0-20.0, and >20.0 mIU/L, respectively) were associated with increasingly higher risk of the composite end point (reference: TSH level, 0.5 to <3.0 mIU/L): aHRs (95% CIs) were 1.10 (1.09 to 1.11), 1.37 (1.34 to 1.40), 1.70 (1.59 to 1.83), and 1.70 (1.50 to 1.93), respectively. Incrementally lower TSH levels in the subclinical (<0.5 mIU/L) and overt (<0.1 mIU/L) hyperthyroid ranges were also associated with the composite end point: aHRs (95% CIs) were 1.44 (1.41 to 1.47) and 1.48 (1.39 to 1.59), respectively. ConclusionIn a national cohort, TSH levels in the upper reference range or higher (≥3.0 mIU/L) and below the reference range (<0.5 mIU/L) were associated with incident kidney dysfunction/CKD progression.

Overall, sex-and race/ethnicity-specific prevalence of thyroid dysfunction in US adolescents aged 12-18 years.

Thyroid dysfunction significantly affects the health and development of adolescents. However, comprehensive studies on its prevalence and characteristics in US adolescents are lacking. We investigated the prevalence of thyroid dysfunction in US adolescents aged 12-18 years using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2002 and 2007-2012 cycles. Thyroid dysfunction was assessed using serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) measurements. We analyzed the prevalence across demographic subgroups and identified associated risk factors. The study included 2,182 participants, representing an estimated 12.97 million adolescents. The group had a weighted mean age of 15.1 ± 0.06 years, with males constituting 51.4%. Subclinical hyperthyroidism emerged as the most prevalent thyroid dysfunction, affecting 4.4% of the population. From 2001-2002 to 2011-2012, subclinical hyperthyroidism remained consistent at 4.99% vs. 5.13% in the overall cohort. Subclinical and overt hypothyroidism was found in 0.41 and 1.03% of adolescents respectively, and overt hyperthyroidism was rare (0.04%). The prevalence of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) positivity in the overall population were 5.8 and 9.8%, respectively. Positivity for TgAb was risk factors for hypothyroidism, while older age, female and Black Americans were risk factors for hyperthyroidism. Female adolescents and adolescents with an older age were more likely to be positive for TPOAb and TgAb, while Black and Mexican Americans had a lower risk of TPOAb and TgAb positivity. Subclinical hyperthyroidism was the most common form of thyroid dysfunction, and its prevalence remained stable from 2001-2002 to 2011-2012. Notable disparities in the prevalence of hyperthyroidism and antibody positivity were observed among different age, sex and racial/ethnic groups.

Clinical and laboratory features of subclinical hypothyroidism in 7—12 years old children

Clinical and laboratory features of subclinical hypothyroidism in 7—12 years old children

Dietary Iodine Intake and Pattern of Thyroid Disorders among the Ethnic Population of Eastern Himalayan Ranges of India

Background and Aim: In the present study, dietary iodine intake and thyroid functioning were assessed among the ethnic adolescent group of Eastern Himalayan range with the hypothesis that insufficient iodine intake negatively affects normal thyroid functions. The aim of the study was to see the prevalence and relation between iodine deficiency and thyroid functioning. Materials and Methods: It is a hospital-based study conducted in the health care facilities of Dima Hasao district, Assam, from April 2021 to March 2022. The study included 821 subjects including both male and female of adolescent age group (10–19 years). The thyroid profiling, anti-Thyroid peroxidase antibody (anti-TPO Ab), and urinary iodine content (UIC) were carried out. Thyroid hormone analysis was carried out by chemiluminescence assay. The anti-TPO Ab was determined using the electrochemiluminescence immunoassay analyzer. The dietary iodine intake was measured on the basis of UIC and was determined by arsenic cerium catalytic spectrophotometry method by the Sandell-Kolthoff reaction. Results: The prevalence of thyroid disorder among the studied population was found to be 13.8%. Among different conditions of thyroid disorders, hypothyroidism was present in 10.6% and hyperthyroidism in 3.13%. 4.18% had elevated anti-TPO Ab. Among the euthyroid subjects with different thyroid disorders, 1.48% and 21% had anti-TPO Ab positivity, respectively. The median UIC was 99.97 µg/l. 25.78% of the population had iodine deficiency. Thyroid disorders were common in subjects with iodine deficiency (61.34%) than iodine sufficient subjects (20%). Conclusion: The work was an attempt to demonstrate how the dietary iodine intake influences thyroid functioning among the adolescent ethnic population of Eastern Himalayas which is manifested as high prevalence of subclinical hypothyroidism with iodine deficiency. The work underscores region specific recommendation on iodine supplementation for populations living in geographically remote locations.

A case of subclinical hypothyroidism managed effectively with homoeopathic remedy

A case of subclinical hypothyroidism managed effectively with homoeopathic remedy

Subclinical hypothyroidism managed with homoeopathy: A case report

Subclinical hypothyroidism managed with homoeopathy: A case report

Evaluation of the risk of hypothyroidism and its clinical manifestations using the Zulewski scale.

Globally, clinical hypothyroidism affects an estimated 0.5 to 5% of the population, while subclinical hypothyroidism affects 5-20%. Limited data is available on the prevalence of thyroid disease within the Mexican population. The objective of this study was to describe the characteristics of people screened for hypothyroidism in Mexico during 2022 using the Zulewski scale. A cross-sectional analysis was conducted using data obtained from a digital survey administered by an e-Health platform. This study included participants of all genders, aged 18 years and older (n = 31,449). Descriptive statistics (frequencies and percentages) were sued to describe the data. Differences between groups were assessed through the chi-square or Fischer's exact test. Information gathered was subjected to hierarchical segmentation analysis to explore trends and patterns. Statistical significance was set as <0.05. Among the participants, 87.7% were women, and 80% fell within the age group 18 and 44 years. According to the Zulewski scale, 27% of the participants had a low risk of hypothyroidism, 37.4% were classified as having an intermediate risk, and 35.6% were at a high risk. In people at high risk of hypothyroidism, the most common symptom was constipation (29.2%) whereas the most common sign was decreased speed of movement (26.2%). Inquiry of slow movements, dry skin, and facial edema allowed the identification of 90.2% of participants at high risk of hypothyroidism. In Mexico, a significant portion of the population is at an intermediate or high risk of hypothyroidism, requiring confirmatory diagnostic tests.

Study of Feto-Maternal Outcome in Pregnancy with Subclinical Hypothyroidism

Background: Hypothyroidism has a great impact on pregnancy. But there is a controversy about the maternal and perinatal outcomes of subclinical hypothyroidism (SCH). This study was placed to know the significant effects. Methods and Materials: A descriptive longitudinal study was held in Z. H. Sikder Women’s Medical College &amp; Hospital, Dhaka, Bangladesh. 400 pregnant women were included in this study with purposive sampling. All antenatal patients from booking visit at 1st trimester to delivery were monitored by serum TSH and serum FT4 levels in each trimester and fetal outcomes were also monitored. 200 pregnant women were diagnosed as subclinical hypothyroidism (SCH) with random screening of initial thyroid function tests. Another 200 pregnant women were euthyroid. The study period was 3 years, from January 2020 to December 2022. To evaluate the thyroid status, maternal serum samples were collected in each trimester, total three times. Maternal outcomes, which we studied, were gestational hypertension, gestational diabetes mellitus, maternal anemia, antepartum hemorrhage, postpartum hemorrhage, placental abruption, preterm delivery, premature rupture of membranes (PROM), caesarean deliveries; perinatal outcomes were low birth weight (LBW), intrauterine growth restriction (IUGR), low Apgar score, stillbirth, congenital anomaly and NICU admission. Result: This study includes 400 pregnant women, among which 200 were euthyroid and 200 were with SCH. The mean age was 27.12 ± 0.05 years in pregnancy with euthyroid group and 26.31 ± 0.25 in pregnancy with SCH group. Among the pregnancy with euthyroid group, 141 women were nullipara and 59 women were nullipara. Among the pregnancy with SCH group, 87 women were nullipara and 113 women were nullipara. Serum TSH level was 4.44 ± 0.11 in 1st trimester, 4.74 ± 0.19 in 2nd trimester, 5.45 ± 0.17 in 3rd trimester. Serum free T4 level was 8.29 ± 0.13 in 1st trimester, 6.65 ± 0.15 in 2nd trimester, 6.67 ± 0.34 in 3rd trimester. In pregnancy with SCH group gestational hypertension, miscarriage, placental abruption and premature rupture of membranes (PROM) were significantly higher (p&lt;0.001). Antepartum hemorrhage (APH), preterm delivery and Caesarian deliveries were also higher in this group (p&lt;0.05). Among the neonatal outcomes, low birth weight and intrauterine growth restriction (IUGR) babies were more born in pregnancy with SCH group. Anti TPO antibody titer was significantly higher in pregnant women with SCH. Conclusion: Subclinical hypothyroidism (SCH) is associated with increased risk of gestational hypertension, premature rupture of membranes (PROM), abruptio placentae and fetuses have more risk of IUGR and LBW. Therefore, routine maternal thyroid function test should be done to protect from adverse maternal and fetal outcome.

Prevalence of Subclinical Hypothyroidism in Patients with Recurrent Miscarriages

Background: Subclinical hypothyroidism poses a concealed threat to reproductive health. With evidence hinting at its prevalence in recurrent miscarriages, this study delves into unraveling the intricacies of this relationship for comprehensive understanding and improved clinical outcomes. Objective: To determine prevalence of subclinical hypothyroidism in patients with recurrent miscarriages. Study Design: Descriptive cross-sectional study. Settings: This study was conducted at the Department of Medicine, DHQ Teaching Hospital, KMU Institute of Medical Sciences, Kohat Pakistan. Duration: 6 months period from Jan-Jun, 2023. Methods: A total of 224 women meeting inclusion criteria were included in the study after taking informed written consent. Blood samples were taken as per standard hygiene protocol and send hospital lab for thyroid profile. Subclinical hypothyroidism was labeled when serum TSH level was ≥4.0 mIU/L and the patients didn’t have clinical symptoms of hypothyroidism. All the data was collected in a predesigned format and data analysis was done using SPSS 27.0. Results: Mean age of the patients in this study was 29.01±6.61 years wherein 58.0% (n=130) patients were in the age group of 18-30 years while remaining 42% (n=94) were in the age group of 31-40 years. As regards parity, 50.9% (n=114) patients were nulliparas, 28.1% (n=63) were primiparas and 21.0% (n=47) were multiparas. Mean BMI of the study sample was 24.87±3.7 kg/m2 wherein 52.7% (n=118) participants were normal weight, 37.9% (n=85) were overweight and only 9.4% (n=21) were obese. Previous number of miscarriages were almost same amount all the three groups as 3 miscarriages (33.5%), 4 miscarriages (35.7%) and 5 miscarriages (30.8%). Subclinical hypothyroidism was observed in 18.3% (n=41) patients. Frequency of mischarge was stratified on the basis of age, parity, BMI and previous number of miscarriage, it produced insignificant different for all the subgroups (p-value=0.05). Conclusion: In conclusion, our study highlights a consistent prevalence of subclinical hypothyroidism (18.3%) in women with recurrent miscarriage. This aligns with global findings, emphasizing the significance of thyroid dysfunction. These insights underscore the importance of routine thyroid screening in the management of recurrent miscarriage, guiding targeted interventions for improved reproductive outcomes.

Prepubertal ve Pubertal Hastalarda Hashimoto Tiroiditi’nin Dağılımı, Klinik Özellikleri ve Laboratuvar Bulguları

Aims:Hashimoto's thyroiditis (HT) is the most common cause of acquired hypothyroidism in childhood. This disease, which develops on an autoimmune basis, often appears in adolescence. However, in recent years, However, in recent years, cases diagnosed with this disease in prepubertal and infant period have been reported. This is considered to regarding early exposure to environmental factors that disrupt the endocrine system and trigger autoimmunity. We aimed to evaluate the distribution, clinical features, and laboratory findings of our patients diagnosed with Hashimoto's thyroiditis in our clinic in prepubertal and pubertal periods. Material and Method:In the study, the cases diagnosed with Hashimoto's Thyroiditis in Ankara City Hospital Pediatric Endocrinology 5th outpatient clinic between August 2019 and May 2022 were divided into two groups prepubertal (Tanner stage 1) and pubertal (Tanner stage 2-3-4-5). The two groups were compared retrospectively in terms of clinical, laboratory, and ultrasound findings. Results: The mean±SDS of 134 patients diagnosed with HT was 12.4±3.4 years. While 25% (n:33) of the cases were prepubertal, 75% (n:101) were pubertal. The cases' female/male ratio (F/M) was 4.1/1, F/M: 2.3/1 in the prepubertal period, and F/M: 5.3/1 in the pubertal period. The euthyroid phase was detected most frequently in all cases at diagnosis. While the rate of euthyroid and subclinical hypothyroidism was the same in the prepubertal group, it was most detected in these two phases. In the pubertal group, it was mostly detected in the euthyroid phase. When we compared the prepubertal and pubertal groups, it was seen that subclinical hypothyroidism and hypothyroidism were most common in the prepubertal group. In contrast, subclinical hyperthyroidism and hyperthyroidism were more common in the pubertal group. Conclusion:In our study, HT is more prevalent in boys at the prepubertal stage than in the pubertal stage. While the patients in the prepubertal period applied in the hypothyroid phase, it was remarkable that the pubertal group had hyperthyroidism in their admissions.

Prevalence of Thyroid Disorders among Pregnant Women at Birat Medical College Teaching Hospital

Background: Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. TD is known to be associated with adverse maternal and fetal outcomes.&#x0D; Materials and Methods: This was a hospital based descriptive cross-sectional study. All the pregnant women attending the antenatal clinic at Birat Medical College Teaching Hospital from 1st July 2021 to 30th June 2022 were enrolled in the study, irrespective of their gestational age and gravida status. Pregnant women with diagnosed thyroid disorder and are on medication, multiple gestation, Diabetes mellitus, Hypertension and pregnant women with age more than 35 years were excluded from study. Thyroid function status of pregnant women was assessed by measuring serum levels of thyroid stimulating hormone (TSH) and if the TSH value was deranged then they underwent free T3 and free T4 level. Based on the TFT reports they will be classified as euthyroid, subclinical hypothyroidism and overt hypothyroidism, subclinical hyperthyroidism and overt hyperthyroidism.&#x0D; Results: A total of 395 pregnant women were enrolled in this study. The mean age and standard deviation of pregnant women was 25.25± 4.76 years. Among 395 pregnant women 93(23.6%) pregnant women have thyroid disorder. Subclinical hypothyroidism and Overt hypothyroidism were 19% and 1.8% respectively. Subclinical and Overt hyperthyroidism were 1.5% and 1.3% respectively.&#x0D; Conclusion: The prevalence of thyroid disorder in pregnancy was 23.6%. The most common thyroid disorder observed was Subclinical hypothyroidism comprising 19% cases followed by overt hypothyroidism comprising 1.8% cases followed by Subclinical and Overt hyperthyroidism 1.5% and 1.3% cases respectively.

The Relationship Between Homocysteine and Autoimmune Subclinical Hypothyroidism

Objectives: The present study was to correlate the association of homocysteine level with various profile of autoimmune subclinical hypothyroidism patients. Methods: A 40 subclinical hypothyroidism patients and 40 healthy control subjects were enrolled. The relevant laboratory parameters of patients who had been diagnosed with subclinical hypothyroidism due to Hashimoto’s thyroiditis in the clinic and were in follow-up, and whose homocysteine level had been tested in addition to assessment of thyroid function, thyroid autoantibodies, lipid parameters, thyroid ultrasonography, and hs-CRP were recorded. Patients with a thyroid-stimulating hormone (TSH) level above the normal range but with a free thyroxin (fT4) level within the normal range were considered to have subclinical hypothyroidism. Results: Mean TSH level of case and control group subjects were 6.71±1.23 and 2.11±o.34 µIU/mL respectively. Which is extremely significant (p&lt;0.0001). Mean FT4 (ng/dL) level of case and control group subjects were 1.3±0.38 and 1.4±0.43 ng/dL respectively. Which is not significant differences(p=0.273). Anti-Tg level of case and control group subjects were 221.6±06.65 and 12.2±04.24 IU/mL) respectively. Which is extremely significant (p&lt;0.0001). There was significant higher anti-Tg level in subclinical hypothyroidism patients as compared to control subjects. Similarly, anti-TPO level of subclinical hypothyroidism (165.8±05.17) patients were extremely significant (p &lt;0.0001) as compared to control (6.7±02.65) subjects. Homocysteine was significantly associated with TSH level (p=0.028), FT4 level (p=0.017), anti-TPO level (p=0.000), anti-Tg (p=0.024) and Hs-CRP level (p=0.011) in subclinical hypothyroidism patients. Conclusions: Increased level of homocysteine is an independent factors for the diagnosis of autoimmune subclinical hypothyroidism. Key words: Autoimmune Subclinical Hypothyroidism, Homocysteine, TSH level.

Bone mineral density in the various regions of the skeleton in women with subclinical hypothyroidism: the effect of biological factors, bone turnover markers and physical activity

Abstract Study aim: This cross-sectional study examined the relationship between biological factors, physical activity (PA), bone turnover markers (BTMs) and bone mineral density (BMD) in women with subclinical hypothyroidism (SCH) and healthy. Material and methods: The study included 135 women. Bone parameters were measured by the densitometry. Calcium, phosphorus, osteocalcin (OC), total alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), vitamin D and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) were measured in blood serum. PA were evaluated by metabolic equivalent of task (MET). Results: Women with SCH had lower BMD in hip and lumbar spine, calcium, vitamin D and higher values of ICTP than the healthy group. In women with SCH, the affecting BMD in the femoral neck were ICTP (µg/l), (η² = 0.083), and also 25(OH)D (ng/ml), (η² = 0.080) and PA level (I/S), (η² = 0.115). BMD in the spine was affected by PA level (I/S), (η² = 0.173). The parameters affecting BMC in the femoral neck were 25(OH)D (ng/ml), (η² = 0.073). In all women sufficient levels of PA determined higher BMD. Conclusions: PA and BTMs significantly determine BMD levels. PA can be an important area of rehabilitation and physical therapy as an available measure to counteract BMD loss in postmenopausal healthy women and those with SCH.

Subclinical hypothyroidism in the infertile female population: a guideline

There is controversy regarding whether to treat subtle abnormalities of thyroid function in infertile female patients. This guideline document reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage, as well as obstetric and neonatal outcomes in this population.

Функція щитоподібної залози у вагітних з антитілами до тиреоїдної пероксидази

Purpose - to study the function of the thyroid gland (TG) in pregnant women with antibodies to thyroid peroxidase (AB-TPO) during pregnancy. Materials and methods. The clinical group included 158 patients. The Group I - 69 pregnant women with a level of AB-TPO&lt;350 IU/ml, the Group II - 59 pregnant women with a level of AB-TPO&gt;350 IU/ml, the Control group - 30 conditionally healthy women without an elevated level of AB-TPO and with a physiological course of pregnancy. To determine the volume of TG the J. Brunn formula was used during ultrasound examination. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. It was established that the level of thyroid-stimulating hormone (TSH) in the I trimester has a physiologically low value - 1.2 (0.9; 1.4) mIU/l; during pregnancy its level increased to 1.6 (1.3; 1.8) mIU/l; p&lt;0.001. The median indicator of free thyroxine (FT4) at 7-8 weeks was at the level of 18.2 (16.2; 20.7) pmol/l; by the II trimester, it increased by 12.00% from the baseline, was 20.1 (16.2; 22.8) pmol/l; p&lt;0.001; by the end of pregnancy - 19.6 (17.6; 20.1) pmol/l; p=0.17. The median indicator of free triiodothyronine (FT3) in the II trimester was higher by 13.6% than in the early stages of pregnancy, p=0.01. It was established that 27.5% of patients of the Group I and 30.5% of pregnant women of the Group II had laboratory signs of subclinical hypothyroidism (TSH&gt;3.5 mIU/l) before the III trimester; p&lt;0.05. A decrease in the production of FT3 and FT4 reflects the exhaustion of the compensatory capabilities of TG in pregnant women carriers of AB-TPO at a concentration above 350 IU/ml. Before the end of pregnancy, 17.4% of patients of the Group I and 20.3% of pregnant women of the Group II were diagnosed with manifest hypothyroidism. Conclusions. In pregnant women with a normal level of AB-TPO in the early stages of pregnancy, a physiological decrease in the level of TSH with subsequent normalization in the II and III trimesters is determined; FT4 and FT3 levels increase with increasing gestational age; the volume of TG physiologically increased by 15.2% from the indicators of the early periods, which requires regular monitoring of the thyroid status in the dynamics of pregnancy and timely correction. Тhe research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research. No conflict of interests was declared by the authors.

Correlation of subclinical hypothyroidism with sarcopenia and its components in the Chinese older adults.

To identify the correlation of thyroid function and subclinical hypothyroidism (SCH) with sarcopenia and its components in the older Chinese adults. Older adults were recruited and divided into SCH group and non-SCH group. Free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured by electrochemiluminescence. Appendicular skeletal muscle mass (ASM) was measured, and skeletal muscle index (SMI) was further calculated. Grip strength was measured. Physical performance was graded by the Short Physical Performance Battery (SPPB) scores of the gait speed test, chair stand test and balance test. Of the 240 older adults included, 48 (20.00%) presented with SCH. The prevalence of sarcopenia in SCH group was higher than that in non-SCH group (33.33% v.s. 18.75%). Grip strength was significantly lower in patients with SCH than those without sarcopenia. In terms of physical performance, 6-meter gait speed and SPPB score were lower in subjects with SCH than those without SCH, while 5 sit-to-stand movements was longer score in subjects with SCH than those without SCH. SCH was significantly correlated with sarcopenia, while FT3, FT4, and TSH levels were not. SCH was significantly correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3 level was positively correlated with grip strength and SMI. TSH level was negatively correlated with grip strength, 6-meter gait speed, and SPPB score, but positively correlated with the time of 5 sit-to-stand movements. SCH is a risk factor for sarcopenia in the older adults and correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3, FT4 and TSH levels are associated with sarcopenia components, but not with sarcopenia.

Subclinical Hypothyroidism in Patients with Obesity and Metabolic Syndrome: A Narrative Review.

The literature on the connection between obesity, metabolic syndrome, and subclinical hypothyroidism is critically analyzed in this narrative review. These conditions are frequently observed among adult populations and various studies and meta-analyses have assessed their association. The prevalence of subclinical hypothyroidism in obese individuals is higher than in non-obese subjects and this trend is more pronounced in unhealthy obesity phenotypes. However, the diagnosis and treatment of subclinical hypothyroidism can be difficult in obese patients. Exaggerated body fat is linked to thyroid hypoechogenicity as evident through ultrasonography and euthyroid obese people have greater TSH, FT3, and FT3/FT4 ratios than non-obese individuals in a euthyroid condition. Moreover, a reduced expression of the TSH receptor and altered function of deiodinases has been found in the adipose tissue of obese patients. Current data do not support the necessity of a pharmacological correction of the isolated hyperthyrotropinemia in euthyroid obese patients because treatment with thyroid hormone does not significantly improve weight loss and the increase in serum TSH can be reversible after hypocaloric diet or bariatric surgery. On the other hand, obesity is linked to elevated leptin levels. Inflammation can raise the risk of Hashimoto thyroiditis, which increases the likelihood that obese patients will experience overt or subclinical hypothyroidism. Both metabolic syndrome and subclinical hypothyroidism are associated with atherosclerosis, liver and kidney disease. Hence, the association of these two illnesses may potentiate the adverse effects noted in each of them. Subclinical hypothyroidism should be identified in patients with obesity and treated with appropriate doses of L-thyroxine according to the lean body mass and body weight. Randomized controlled trials are necessary to verify whether treatment of thyroid deficiency could counteract the expected risks.

Thyroid Autoimmune Disease among Emirati Patients: A Retrospective Analysis of the Patients’ Characteristics

Background: Autoimmune thyroid disease (AITD) is a serious and treatable disease that could be associated with other autoimmune disorders. It is a common cause of hypothyroidism in adult females. The diagnosis is established by detecting serum antithyroid antibodies. The disease slowly progresses, and the treatment includes thyroid hormone replacement in cases of hypothyroidism. Objective: The aim of this study is to investigate the clinical presentation, laboratory findings, and comorbidity factors involved in autoimmune thyroid disease among Emirati citizens in the UAE. Methods: Medical records from Advanced Cure Diagnostic Centers were reviewed in a retrospective study over the period of four years from 2018 to 2022. The patients population included those who attended the Endocrinology Unit and others seen by the rest of the medical staff. Patients were considered to have AITD if they tested positive for thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), or both. The data collected was evaluated using descriptive analysis to provide a basic summary of the patients sample and dataset. Unpaired t-test was used to compare the mean value of elevated autoantibodies in males and females. Results: Of the 366 Emirati nationals who were tested for autoimmune thyroiditis, 220 (60%) had an abnormal result for TPOAb and/or TgAb. Among the 220 patients who had an abnormal result for TPOAb and/or TgAb, 188 (85.5%) were females, and 100 patients (45.5%) were in the age group between 31 and 40 years. 42% were in a euthyroid state and 42% presented with hypothyroidism. Only 7% presented with hyperthyroidism, 5% with subclinical hypothyroidism, and 2% with subclinical hyperthyroidism. An analysis of the comorbidity factors revealed that 142 (65%) patients with obesity, 82 (37%) with a family history of thyroid disease, 77 (35%) with hyperlipidemia, 14 (6%) with hypertension, and 11 (5%) with diabetes. Conclusion: This is the first publication intended to address AITD in Emirati citizens. Our findings concur with the international data regarding the prevalence among middle-aged females. Eighty-four percent of the positive patients either presented with no abnormality of their thyroid gland function or with hypothyroidism. With the alarming increase of obesity in the UAE, we found it to be the single most important and preventable comorbidity factor present in 65% of the studied population. This is followed by a family history of first-degree relatives with thyroid disease in 37% of the participants, due to the high rate of consanguineous marriages in the UAE.

Identifying Thyroid Dysfunction Using Standard Laboratory Testings – A Systematic Review

Thyroid dysfunction includes various thyroid-related illnesses, with subclinical hypothyroidism or hyperthyroidism at the initial stage. Blood TSH and T4 levels indicate a neutral ground between clinical conditions. Following guidelines for levothyroxine administration based on thyroid hormonal levels is beneficial for hypothyroid patients. TSH, a measurable signal, is crucial for assessing thyroid activity, with reference ranges determined by testing facilities. However, elevated TSH levels require consideration of the patient's history and lifestyle before intervention. A Machine Learning-based Thyroid Dysfunction Identification (ML-TDI) model was developed to screen individuals for medicinal intervention. Despite its prevalence and health consequences, thyroid dysfunction often goes undiagnosed. The study used standard laboratory data and machine learning algorithms to identify thyroid dysfunction, suggesting the potential for technology-driven screenings during routine medical procedures. However, assessing the benefits and risks of widespread thyroid illness evaluation requires well-conducted randomized trials.

Exploring The Link Between Obesity And Hypothyroidism.

Obesity and hypothyroidism are two common clinical conditions that are often connected. This connection is now more important because of an exceptional rise in the prevalence of obesity around the world. Both of these conditions have a noteworthy impact on human health and well-being. The main objective of this study was to determine the frequency of hypothyroidism in obese patients presenting at Ayub Teaching Hospital, Abbottabad. This cross-sectional study was carried out on 242 patients in the Department of Medicine of Ayub Teaching Hospital, Abbottabad from 1st March to 31st August 2022. SPSS version 23.0 was used for data analysis. In this study, 242 obese patients were included. The mean age of the patients was 39.55±9.361 years. The mean BMI was 41.62±8.099kg/m2 ranging from 31 to 61kg/m2, the mean TSH level was 3.04±2.604mU/l, the mean T4 level was 8.53±2.215pmol/L and the mean T3 level was 1.2195±0.35795nmol/L. Out of a total of 242 patients, 34 (14.0%) were male and 208(86.0%) were female patients. Patients found with overt hypothyroidism were 11 (4.5%), subclinical hypothyroidism were 31 (12.8%) and euthyroid were 200 (82.6%). The proportion of hypothyroidism among the obese patients was quite less in our setup and not significantly associated with age and gender of the patients.