The metabolic vulnerability index (MVX)-a composite biomarker reflecting metabolic malnutrition and inflammation-has been linked to increased mortality risk in populations with cardiovascular disease. Thyroid function, a key regulator of metabolism and inflammation, may confound or modify this relationship, but evidence in the general population is limited. To evaluate the interplay between MVX and its subcomponents (inflammation vulnerability index, IVX and metabolic malnutrition index, MMX), thyroid function, and mortality risk in the general population. In the PREVEND prospective study, which included 5446 participants (mean age 54 years; 49.9% male), both MVX (estimated using six metabolites measured simultaneously through nuclear magnetic resonance spectroscopy) and thyroid function (FT3, FT4, TSH) were evaluated at baseline. Hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality were estimated. During a median follow-up of 14.1 years, 806 deaths were recorded. Spline analyses showed graded dose-response relationships of MVX, IVX and MMX with mortality risk. In separate analyses adjusted for several established risk factors, the HRs (95% CIs) of mortality were 1.28 (1.18-1.38), 1.23 (1.14-1.32) and 1.16 (1.07-1.25) per 1 standard deviation increment in MVX, IVX and MMX, respectively. The HRs remained consistent on further adjustment for FT3, FT4 and TSH. Sex as well as levels of FT3, FT4 and TSH did not significantly modify the associations. The MVX and its subcomponents (IVX and MMX) are independently associated with all-cause mortality, consistent with graded dose-response relationships. Thyroid function does not confound or modify these associations.

Transfusion-Dependent Thalassemia (TDT) causes severe anemia requiring chronic transfusions, leading to iron overload and endocrine complications, including hypothyroidism. Iron chelation therapy (ICT) mitigates iron toxicity, but its effects on thyroid function remain understudied in resource-limited settings like Pakistan. This cross-sectional study compared 100 TDT patients receiving ICT (deferasirox, deferoxamine, or deferiprone) for ≥ 6 months with 100 Control group who have not taken ICT. Thyroid function tests (free T3, free T4, TSH), serum ferritin, and hepatic/renal biomarkers were analyzed. Statistical analyses included t-tests, ANOVA, Pearson correlation, and multivariate regression (SPSS v25). ICT-treated patients had significantly lower TSH (3.10 ± 0.62 vs. 9.95 ± 3.19 μIU/mL, p < 0.001) and higher free T3/T4 levels than controls (p < 0.001). Deferasirox users exhibited the lowest TSH (2.43 ± 0.06 μIU/mL) among chelators (p < 0.001). Ferritin strongly correlated with TSH (r = 0.94, p < 0.001) and independently predicted TSH levels (coefficient = 0.0010, p = 0.048). ICT also preserved hepatic (ALT: 50.55 ± 41.87 vs. 291.36 ± 161.99 U/L, p < 0.001) and renal function (creatinine: 0.97 ± 0.22 vs. 1.65 ± 0.34 mg/dL, p < 0.001). ICT, particularly deferasirox, protects against thyroid dysfunction in TDT, with ferritin as a key predictor. These findings support personalized chelation strategies and routine endocrine monitoring in thalassemia management.

Background Vestibular disorders, particularly Ménière’s disease, represent significant neurological conditions affecting balance, spatial orientation, and quality of life. While endolymphatic hydrops is recognized as the pathological hallmark of Ménière’s disease, the relationship between thyroid dysfunction and vestibular pathology remains incompletely understood. Clinical observations suggest associations between hypothyroidism and vestibular symptoms, yet experimental evidence demonstrating causality is lacking. Objective To investigate whether surgically-induced hypothyroidism causes endolymphatic hydrops development in an experimental rat model and to characterize the histopathological changes in vestibular structures. Methods Twelve male Wistar albino rats were randomly allocated to total thyroidectomy ( n = 4), sham surgery ( n = 4), and control ( n = 4) groups. Thyroid function was assessed via serum thyroid-stimulating hormone (TSH) and thyroxine (T4) measurements at baseline and postoperative day 15. Animals were euthanized at 28 days post-surgery for comprehensive histopathological examination of temporal bones. Endolymphatic hydrops was evaluated using standardized semiquantitative scoring systems for Reissner’s membrane, vestibular structures, stria vascularis, and utricular macula. Results Thyroidectomized rats developed significant biochemical hypothyroidism with elevated TSH (mean difference: 0.378 μIU/mL, 95% CI: 0.183–0.573, p = 0.021) and decreased T4 levels (mean difference: −2.357 pmol/L, 95% CI: −3.521 to −1.193, p = 0.021). Histopathological examination revealed universal development of endolymphatic hydrops in all thyroidectomized animals (100% vs. 0% in controls, p &amp;lt; 0.001), affecting Reissner’s membrane, vestibular apparatus, stria vascularis, and utricular macula with varying severity. Conclusion This study provides the first direct experimental evidence that thyroid hormone deficiency induces endolymphatic hydrops in all examined vestibular structures. These findings establish a mechanistic link between hypothyroidism and vestibular pathology, with important implications for the neurological evaluation and management of patients presenting with vestibular symptoms and comorbid thyroid dysfunction.

Introduction: Papillary thyroid microcarcinoma (PTMC) is the most common subtype of thyroid cancer, generally associated with a favorable prognosis. Radiofrequency ablation (RFA) is emerging as a minimally invasive alternative to surgery, particularly for patients unsuitable for active surveillance and surgery. This report presents the first documented case of RFA for PTMC in Indonesia. Case report: A 40-year-old woman presented with a palpable thyroid nodule on the right side of her neck. Thyroid ultrasound and thyroid core needle biopsy confirmed PTMC. The patient underwent RFA using a 5-mm probe tip and 50-Watt power, employing the “moving shot” technique. The procedure was successful, with no reported complications. Follow-up assessments showed a significant reduction in tumor volume of 95.38%, from 0.264 ml to 0.012 ml, with no signs of progression at 12 months. Discussion: RFA provides a minimally invasive alternative to active surveillance with advantages, giving patient definitive treatment. Compare to surgery, this treatment have advantage such as shorter procedure time, lower procedural costs, reduced blood loss, and preservation of thyroid function, leading to faster recovery. However, wider adoption in Indonesia remains limited by the need for trained operators and access to advanced ultrasonography equipment. Strengthening workforce training, improving infrastructure, and generating long-term outcome data are essential for broader implementation. Conclusion: This case highlights RFA as a safe and effective treatment for PTMC, particularly for patients who do not wish to undergo active surveillance management for low risk thyroid cancer. Further studies are necessary to assess its long-term efficacy and feasibility.

BackgroundBenign cystic thyroid nodules are commonly encountered in clinical practice and often require intervention due to compressive symptoms or cosmetic concerns. While ethanol ablation (EA) has been widely used, radiofrequency ablation (RFA) has emerged as a promising alternative, particularly for nodules with a significant solid component. This study aimed to evaluate the short-term efficacy and safety of single-session RFA in treating purely cystic and predominantly cystic thyroid nodules (PCTNs).MethodsThis prospective study included 38 patients with benign cystic thyroid nodules (10 purely cystic and 28 PCTNs) treated with single-session RFA. Pre- and post-treatment evaluations were performed using ultrasound imaging and thyroid function tests at 1, 6, and 12 months. The primary endpoint was volume reduction rate (VRR), and therapeutic success was defined as VRR > 50%. Complications were assessed according to international image-guided tumor ablation criteria. This study was registered at ClinicalTrials.gov (identifier: NCT07115576).ResultsRFA resulted in significant volume reduction, with VRR improving from 65.97 ± 22.19% at 1 month to 83.29 ± 17.33% at 6 months and 82.49 ± 23.18% at 12 months (p = 0.004). Purely cystic nodules demonstrated higher VRR than PCTNs at all follow-up points (p < 0.05). Thyroid function remained stable post-procedure. The therapeutic success rate was 83.3% at 1 month and 86.7% at 12 months, with no major complications reported. Purely cystic nodules showed a consistently higher and more durable response than PCTNs.ConclusionSingle-session RFA appears to be a safe and effective minimally invasive treatment option for large benign thyroid nodules, although confirmation in comparative studies is needed. The technique is particularly advantageous for purely cystic nodules and offers a minimally invasive alternative to surgery or multiple EA sessions.Trial registrationClinicalTrials.gov NCT07115576

Thyroid disorders, including both thyroid dysfunction and thyroid autoimmunity (TAI), are prevalent in women of reproductive age and may impair fertility through hormonal and immune-mediated mechanisms. This review synthesizes current evidence and underlying mechanisms regarding the impact of thyroid dysfunction, particularly subclinical and overt hypothyroidism, and TAI on female fertility and outcomes of assisted reproductive technology (ART). While overt thyroid dysfunction clearly affects reproductive physiology, the role of subclinical hypothyroidism (SCH) and euthyroid TAI remains controversial. Despite limited supporting evidence, levothyroxine (LT4) is widely used in clinical practice, often initiated at TSH thresholds of 2.5 mIU/L to define SCH and commence treatment. However, recent data suggest that implementing such thresholds may not be associated with improved fertility outcomes, and there is a growing tendency to adopt higher TSH cut-offs for diagnosis and treatment in the preconception setting. ART introduces additional considerations, with thyroid status and autoimmunity potentially influencing ovarian response, embryo quality, and pregnancy outcomes. In light of these uncertainties, treatment decisions increasingly rely on individualized assessment of thyroid function, antibody status, and reproductive context.

Vulval lichen sclerosus (LS) is a chronic inflammatory dermatosis with recognised associations with autoimmune disease, including thyroid disease, vitiligo, and psoriasis. Current expert consensus guidelines recommend investigating for autoimmune disease when clinically indicated by symptoms or signs. More recently, focused screening for thyroid disease and pernicious anaemia in women with LS has been proposed. This study aimed to assess the prevalence of autoimmune disease in a tertiary multidisciplinary vulval clinic and to determine whether findings from this cohort provide support for these proposed screening recommendations. A retrospective review of electronic medical records was conducted for patients attending a tertiary women's hospital vulval dermatology service between August 2020 and June 2025 with a diagnosis of LS. Data extracted included autoimmune history, serological testing for autoimmune disease (including thyroid function and pernicious anaemia), and family history. Descriptive statistics were used for analysis. Eight hundred fifty-one patients met inclusion criteria. Autoimmune disease was recorded in 31.7%, with autoimmune thyroid disease (12.5%), lichen planus (8.23%), and psoriasis (5.05%) being most common. Inflammatory arthritis was present in 4.8% and autoimmune dermatological conditions in 18.4%. Serological screening was performed infrequently; thyroid stimulating hormone was performed in 18.4% of patients without known thyroid disease and 6.5% of these were abnormal. Vitamin B12 screening was performed in 8.9% and 10.5% were abnormal. Pernicious anaemia antibodies were performed in 0.35% and all were negative. This single-centre cohort study demonstrated a high prevalence of autoimmune disease in women with LS, particularly thyroid disease, providing support for consideration of thyroid stimulating hormone screening. Serological testing for autoimmune disease was infrequently documented in this cohort, and the limited data on pernicious anaemia were insufficient to evaluate the proposed recommendation. The findings also highlight a high burden of autoimmune arthritis and other dermatological conditions, suggesting a role for clinical assessment in these domains. Prospective multicentre studies are required to inform and refine screening recommendations.

A 55-year-old woman presented with a recurrent thunderclap headache triggered by bathing, showering, and the Valsalva maneuver. Laboratory investigations revealed hyperthyroidism, whereas magnetic resonance imaging demonstrated a convexity subarachnoid hemorrhage and vasospasm of the cerebral arteries. The patient was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS) and hyperthyroidism. The association between RCVS and hyperthyroidism has received only limited attention in literature. We herein report a case of RCVS with hyperthyroidism and discuss the association between RCVS and the thyroid function.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder affecting 5%-10% of reproductive-age women, accounting for 50%-70% of anovulatory infertility. Thyroid function, particularly the relationship between subclinical hypothyroidism (SCH) and PCOS, has garnered attention due to its potential impact on metabolic and reproductive health. This study included 143 infertile women with PCOS diagnosed based on the Rotterdam criteria. Participants underwent ovulation induction using clomiphene citrate following pretreatment with Diane-35. Serum levels of triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) were measured pre- and posttherapy. Outcomes were compared between therapy-responsive (n = 97) and nonresponsive (n = 46) groups. Receiver operating characteristic (ROC) analysis evaluated the predictive value of T3, T4, and TSH levels for treatment outcomes. Significant differences in baseline T3, T4, and TSH levels were observed between responsive and nonresponsive groups (p < 0.001). Posttreatment, serum T3 and T4 increased while TSH decreased in the responsive group, whereas no significant changes were noted in the nonresponsive group. Combined ROC analysis of T3, T4, and TSH improved predictive accuracy (AUC = 0.88, sensitivity = 76.09%, specificity = 86.60%). Endometrial thickness positively correlated with T3 and T4 and negatively with TSH. Thyroid hormones significantly influence the efficacy of ovulation induction in infertile women with PCOS. Combined T3, T4, and TSH measurements enhance predictive accuracy for therapeutic responses, providing a foundation for personalized treatment strategies.

Occupational exposure to phthalate esters and systemic clinical changes in municipal sanitation workers: Human biomonitoring and network analysis approach.

This study aims to analyze secondary metabolites of Dendrobium fimbriatum via UPLC-MS/MS; establish hyperthyroidism-induced kidney yin deficiency model with thyroid tablets to study its decoction's effects; use UPLC-MS/MS untargeted metabolomics to screen blood-entry components, biomarkers, and potential active substances; explore component-target-pathway mechanism via network pharmacology and molecular docking. One hundred thirty-eight secondary metabolites are identified. Decoction increased rat body weight/pain threshold, reduced temperature; alleviated kidney yin deficiency symptoms/pathology; regulated thyroid (T3/T4), gonad (T/E2), and nucleotide (cAMP/cGMP) functions; and changed OPLS-DA profile; 13 blood-entry components, 30 biomarkers, and 9 potential "nourishing kidney yin" substances are found-four high-binding components act on EGFR/AKT1/SRC via cancer pathogenesis, endocrine resistance, and relaxin pathways. Decoction improves model rats' metabolism; four active components (e.g., N-p-coumaroyltyramine) regulate EGFR/AKT1/SRC via key pathways, affecting biomarkers and glycerophospholipid/amino acid/linoleic acid metabolism to exert anti-inflammatory/antioxidant/antitumor/antiapoptotic effects, realizing "nourishing kidney yin"; this study supports mechanism analysis, quality evaluation, and new drug R&D of D. fimbriatum.

A scalable and cost-effective plasmonic enhanced fluorescence platform for high-sensitivity detection of thyroid function biomarkers.

Nanomaterial-based biosensors for the early diagnosis of thyroid disease.

Background: Thyroid hormones play a key role in hematopoiesis by regulating erythropoietin production and erythroid proliferation. Thyroid dysfunction is associated with anemia and other hematological abnormalities through impaired marrow activity, nutritional deficiencies, and altered iron metabolism. Aims and Objectives: To evaluate the effect of hypothyroidism and hyperthyroidism on hematological parameters and to determine the prevalence, type, and severity of anemia. Materials and Methods: A cross-sectional study was conducted from June to August 2025 at Navodaya Medical College Hospital and Research Centre, Raichur. A total of 127 participants aged 18–80 years were included and categorized into hypothyroid (n=59), hyperthyroid (n=10), and euthyroid controls (n=58) groups. Thyroid function tests were performed using the electrochemiluminescence immunoassay method. Hematological parameters were analyzed using a five-part automated analyzer, and peripheral blood smears were examined for anemia classification. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Results: Hypothyroidism was more prevalent (46.46%) than hyperthyroidism (7.87%). Hemoglobin, red blood cell count, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration showed a declining trend in thyroid dysfunction but were not statistically significant. Significant leukopenia was observed in hypothyroid patients (P=0.02), while thrombocytopenia was significant in hyperthyroid patients (P=0.03). Anemia was more common in hypothyroid (49.6%) than hyperthyroid (3.9%) patients. Microcytic hypochromic anemia was the most common type (P&lt;0.0001). Conclusion: Thyroid dysfunction, particularly hypothyroidism, is associated with hematological abnormalities and increased anemia prevalence, predominantly of the microcytic hypochromic type. Routine hematological screening can facilitate early diagnosis and improve patient outcomes.

Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder with both reproductive and metabolic manifestations. Subclinical hypothyroidism (SCH), is defined by elevated thyroid-stimulating hormone (TSH) with normal free thyroxine levels, is increasingly recognized in women with PCOS, yet its clinical impact remains debated. This study intended to explore the prevalence of SCH in PCOS and examine its influence on metabolic, hormonal, and anthropometric profiles in an Indian population. A cross-sectional study was conducted between January 2023 and January 2025 at a tertiary care center in South India. A total of 368 women with PCOS, diagnosed according to Rotterdam criteria, were enrolled and classified as either euthyroid (n = 316) or having SCH (n = 52). Comprehensive evaluations included anthropometry, blood pressure, glycemic indices, lipid profile, insulin resistance via HOMA-IR, and reproductive hormone levels. Statistical analyses included t-tests and Spearman correlation. The prevalence of SCH among women (with PCOS) was 14.13%. Compared with the euthyroid group, SCH-PCOS patients exhibited significantly higher BMI, fasting blood glucose, HbA1c, serum insulin, HOMA-IR, and adverse lipid profiles (p < 0.05). No significant diffe-rences were observed in LH, FSH, or testosterone levels. TSH demonstrated positive correlations with BMI, Glycemic markers, and HOMA-IR, underscoring its association with metabolic risk. SCH is a common and metabolically relevant comorbidity in women with PCOS, aggravating insulin resistance and dyslipi-demia without significantly affecting reproductive hormones. These findings highlight the need for routine thyroid function screening in PCOS management, especially among those with metabolic syndrome features. Further longitudinal studies are warranted to evaluate the benefits of targeted thyroid intervention in this subgroup.

Graves’ ophthalmopathy (GO), also known as thyroid eye disease, is the most common extrathyroidal autoimmune manifestation of Graves’ disease, significantly affecting visual function and patients’ quality of life. It is characterized by progressive inflammation of the extraocular muscles, orbital fat, and connective tissue, leading to proptosis, diplopia, and optic neuropathy. The pathogenesis of GO involves complex interactions among genetic, immunologic, and environmental factors, with antibodies against the thyroid-stimulating hormone receptor (TSHR-Ab) and insulin-like growth factor-1 receptor (IGF-1R) as major triggers. Diagnosis is based on clinical evaluation, thyroid function testing, and imaging such as MRI or CT scans. Management includes thyroid function control, systemic glucocorticoids, immunosuppressive therapy, radiotherapy, and orbital decompression surgery in severe cases. The prognosis varies depending on early detection, disease severity, and treatment response. Preventive strategies include smoking cessation, maintaining euthyroid status, and early detection using inflammatory biomarkers and advanced imaging technologies.

Background: This study aimed to evaluate the characteristics of non-scarring alopecia and the influencing factors in female patients presenting with hair loss. Methods: A total of 213 female patients were included. Clinical diagnoses of telogen effluvium (TE), traction alopecia (TA), and androgenetic alopecia (AGA) were established. Laboratory evaluations included thyroid function (TSH, T4), vitamin and mineral levels (vitamin D, B12, folate), ferritin, and hemoglobin. Hair styling habits, headscarf use, and dermoscopic findings were also assessed. Results: TE was the most prevalent type, observed in 75.6% of patients, with ferritin levels significantly associated with its presence. TA was identified in 41.8%, and its risk was significantly higher in individuals wearing headscarves (p

Radiofrequency Ablation for Primary Thyroid Cancer.

Thyroid dysfunction and thyroid autoimmunity during pregnancy are linked to an increased risks of adverse maternal and fetal outcomes. Guidelines recommend population‑specific thyroid hormone reference ranges in pregnancy, though adherence and effectiveness vary. We aimed to evaluate the performance of thyroid function reference ranges recommended by Polish national guidelines in pregnancy and to assess clinical and demographic factors affecting thyroid hormone levels and autoimmunity. A cohort of 1339 pregnant women across all trimesters was recruited in Poland (2007-2017). Serum levels of thyroid‑stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid peroxidase antibodies (TPOAbs), and urinary iodine concentration (UIC) were measured. Associations between thyroid status and maternal age, body mass index (BMI), gestational age, and UIC were analyzed. Over 91% of the participants had TSH concentrations within Polish trimester‑specific reference ranges. TPOAbs were positive in 12% of the cases, and were strongly associated with higher TSH and lower FT4 concentrations (P <0.001). TSH level was negatively associated with FT4 concentrations and age (P <0.001), and positively with TPOAb (P <0.001). FT4 concentrations were positively associated with TPOAb (P = 0.04) and FT3 concentrations (P <0.001), but negatively influenced by trimester, TSH, age, BMI, and pregnancy week (P <0.001). TPOAb presence correlated with elevated TSH concentrations and impaired FT4 response, which supported the role of TPOAb as a key marker in pregnancy screening. Maternal age and BMI significantly influenced FT4 levels, pointing at the new factors to be considered when interpreting thyroid function tests results. Our findings support current Polish reference ranges and emphasize the need for locally adapted criteria in thyroid management during pregnancy.

Background: Maternal hypothyroidism is one of the most common endocrine disorders during pregnancy and is associated with adverse fetal and neonatal outcomes. Early detection and management are critical, as thyroid hormone deficiency during intrauterine life may lead to irreversible neurodevelopmental impairment. Methods: This hospital-based observational study was conducted at Government Medical College, Cuddalore, from April 2023 to October 2024. A total of 100 neonates born to mothers diagnosed with hypothyroidism were enrolled. Maternal thyroid profiles were reviewed antenatally. Neonatal thyroid function tests, including serum TSH and free T4, were performed at 72 hours of life. Abnormal results were re-evaluated after two weeks. Data were analysed using STATA version 16 and Microsoft excel, employing descriptive statistics. Results: Among the neonates studied, 7.07% exhibited elevated TSH levels (&gt;10 mIU/l), and 2% required levothyroxine therapy. Preterm birth was observed in 35% of cases, and 29% required NICU admission. Low birth weight (LBW) and jaundice were the most common clinical findings. Congenital anomalies were rare, with only one case of bilateral congenital talipes equinovarus reported. Conclusions: Maternal hypothyroidism has a measurable impact on neonatal thyroid function and early neonatal outcomes. Universal antenatal thyroid screening and targeted neonatal follow-up are essential to identify transient or delayed-onset hypothyroidism and prevent long-term neurodevelopmental sequelae.