Thyrotropin Research Articles

Commercially available recombinant human thyroid-stimulating hormone effectively stimulates total and free thyroxine concentrations in Quaker parrots (Myopsittamyopsitta monachus), including at low doses and after freezing.

To develop a protocol for thyroid-stimulating hormone (TSH) stimulation testing in psittacine birds using a thyrotropin alfa (Thyrogen; Sanofi). Quaker parrots (Myopsitta monachus) were randomized to receive an IM injection of freshly reconstituted high-dose recombinant human TSH (rhTSH; 8 parrots), frozen high-dose rhTSH (8), frozen low-dose rhTSH (8), or saline (8). Total T4 (TT4), free T4 (FT4), T3, and TSH were measured pre- and 4 hours postinjection. TSH stimulation testing was completed in 31 of the 32 birds. Thyroid-stimulating hormone measurement confirmed proper administration of rhTSH. Median TT4 at baseline in the population was 0.14 μg/dL (range, 0.03 to 0.33 µg/dL). Poststimulation, the median TT4 in rhTSH-treated parrots was 1.31 µg/dL (0.29 to 1.98 µg/dL) versus 0.09 µg/dL (0.04 to 0.14 µg/dL) in control parrots. All parrots administered rhTSH had an increase in TT4 (minimum, 3.5-fold) and FT4 (minimum, 2.2-fold) from baseline but not in T3. Parrots administered saline had no increase in TT4, FT4, or T3. Postinjection concentrations of TT4, but not of FT4 or T3, showed no overlap between controls and rhTSH-treated parrots. TSH stimulation testing performed with fresh and frozen rhTSH for 3 months is feasible and safe and results in a significant increase in TT4 in Quaker parrots. Total T4 should be the preferred outcome measure for TSH stimulation testing in parrots. Thyrogen can be used at doses as low as 0.01 mL (73 µg/kg) for TSH stimulation tests in Quaker parrots and can be frozen in aliquots to perform more tests per vial.

Correlation analysis of Hashimoto’s thyroiditis with papillary thyroid carcinoma occurrence and its central lymph node metastasis: a single center experience

PurposeThis study investigates the clinicopathological characteristics of papillary thyroid carcinoma (PTC) with coexisting Hashimoto’s thyroiditis (HT) and further explores the risk factors for central lymph node metastasis (CLNM) in PTC.MethodA retrospective analysis was conducted on 415 PTC patients who underwent surgical treatment for thyroid cancer at the First Affiliated Hospital of Anhui University of Chinese Medicine from 2016 to 2022. Clinicopathological features were compared between PTC patients with and without HT. Univariate and multivariate logistic regression were used to analyze the risk factors of CLNM.ResultThe PTC+HT group had a higher proportion of female patients (85.5%) than the PTC group (P<0.05). Univariate analysis revealed no statistically significant difference between the two groups in eight aspects (all P>0.05). Multivariate analysis showed that HT was positively associated with the total number of central lymph node (CLN) dissected, Thyroid-stimulating hormone (TSH), Thyroid peroxidase antibody (TPOAb), and Thyroglobulin antibodies (TgAb), while identified as a protective factor against invasion with an odds ratio of 0.422 (95%CI 0.209-0.853, P=0.016). Through univariate and multivariate logistic regression, we proved that tumor position, Capsule + Extrathyroidal extension (ETE), multifocal tumors, and the total number of CLN dissected were independent risk factors for CLNM. Multiple linear regression analysis told us that invasion (β= 0.093, p=0.048) had a positively predictive impact on CLN positive rate.ConclusionFemale PTC patients are more prone to concurrent HT, which elevates the levels of TSH, TPOAb, and TgAb. HT not only promotes the longitudinal growth of nodules and PTC development, but also reduces the risk of invasion and CLNM. Therefore, we posit that the impact of HT on PTC patients is a “double-edged sword”. Isthmus, Capsule + ETE, multifocality, age < 55 years old, and male are high-risk factors for CLNM in PTC, while HT is regarded as a protective factor. Capsule + ETE is the primary risk factor affecting the CLN positive rate.

Occult Thyroid Cancer in Autoimmune Thyroiditis: Lymph Node Ultrasound as the Sole Diagnostic Indicator of Malignancy in a Pediatric Case of Papillary Thyroid Carcinoma

Background: Autoimmune thyroiditis (AIT) is a common thyroid disorder in children, linked to an increased risk of papillary thyroid carcinoma (PTC). Characteristic ultrasonographic features of AIT can obscure PTC, delaying diagnosis. Case Presentation: An 11-year-old girl with a two-year history of AIT presented with persistently elevated thyroid-stimulating hormone (TSH) levels despite levothyroxine therapy. Examination revealed a firm, slightly enlarged right thyroid lobe. Serial thyroid ultrasounds showed typical AIT features, with no apparent tumor. However, a cervical lymph node ultrasound detected a suspicious lymph node with pathological vascularization. Fine-needle aspiration suggested possible PTC metastasis. The patient underwent total thyroidectomy with central and right lateral neck dissection. Histopathology confirmed multifocal PTC with cervical lymph node metastases (pT3aN1bM0). Postoperative radioactive iodine therapy resulted in undetectable thyroglobulin levels, indicating a biochemical response. Conclusions: Children with AIT may harbor occult PTC even without thyroid gland abnormalities suggestive of malignancy. Comprehensive ultrasound evaluation, including cervical lymph nodes, is vital for early detection and timely treatment.

Sex Differences in the Association Between Thyroid Hormone Sensitivity and Cardiovascular-Kidney-Metabolic Syndrome.

The relationship between thyroid hormone sensitivity and cardiovascular-kidney-metabolic (CKM) syndrome remains unclear. This study aims to investigate the association between thyroid hormone sensitivity and the early-stage of CKM syndrome, with a specific focus on the moderating effects of sex and age. A total of 8,391 euthyroid participants were enrolled in this cross-sectional study. Data on metabolic parameters and thyroid hormone levels were collected. Thyroid hormone sensitivity indices-thyroid feedback quantile index (TFQI), thyroid-stimulating hormone index (TSHI), TT4 resistance index (TT4RI), and free thyroxine to free triiodothyronine ratio were calculated. Logistic regression models and restricted cubic spline regression (RCS) were used to analyze the association between thyroid hormone sensitivity and stage 2 of CKM syndrome stratified by sex and age. In men, the higher TFQI, TSHI, and TT4RI values were significantly associated with increased risks of stage 2 of CKM. In women, these associations were weaker but still present, particularly for TSHI. RCS analysis also showed that the risk of CKM tended to increase with decreasing thyroid hormone sensitivity in men. However, these associations in women were not as significant as in men. Age-stratified analysis revealed that older men (>50 years) showed a stronger correlation between thyroid hormone sensitivity and CKM syndrome compared to women. This study demonstrated that impaired thyroid hormone sensitivity is significantly associated with the early-stage of CKM syndrome, particularly in older men. These findings provide the evidence of the importance of thyroid hormone sensitivity in CKM syndrome, especially in men over the age of 50.

Association between Helicobacter pylori infection, serum thyroid-stimulating hormone, and thyroxine in the National Health and Nutrition Examination Survey 1999–2000

BackgroundHelicobacter pylori has been increasingly implicated in extra-gastric diseases. Current evidence regarding the association between serum thyroid-stimulating hormone (TSH), thyroxine (T4), and H. pylori infection remains inconclusive. Consequently, this study aimed to explore the correlation between TSH and T4 levels and H. pylori infection in a US-based population sample.MethodsData from the US National Health and Nutrition Examination Survey (NHANES), comprising 971 participants aged 30–85 years from 1999 to 2000, were analyzed. Binary logistic regression was employed to analyze the correlation between H. pylori and TSH and T4 levels. The impact of TSH and T4 on H. pylori infection was further assessed using restricted cubic spline (RCS) analysis. In addition, subgroup analyses stratified by sex and age were conducted.ResultsSubjects with H. pylori seropositivity demonstrated lower serum TSH levels and higher serum T4 levels compared to those with H. pylori seronegativity. A significant positive correlation was identified between H. pylori seropositivity and T4 levels with increasing quartiles of hormonal levels in both univariate regression models (Q4 vs. Q1: OR = 1.483; 95% CI, 1.033–2.129) and multivariate regression models (Q4 vs. Q1: OR = 1.004; 95% CI, 0.981–1.026). Conversely, a negative correlation was observed between H. pylori seropositivity and TSH levels with increasing quartiles of hormonal levels in univariate regression models (Q4 vs. Q1: OR = 0.579; 95% CI, 0.403–0.831) and in multivariate regression models (Q4 vs. Q1: OR = 0.580; 95% CI, 0.389–0.866). In stratified analyses, the adjusted association of serum T4 levels with H. pylori seropositivity was statistically significant among men (T4: Q4 vs. Q1: OR = 2.253; 95% CI, 1.311–3.873), age over 68 years in TSH levels (Q4 vs. Q1: OR = 0.434; 95% CI, 0.206–0.911), and age 41–54 years in T4 levels (Q4 vs. Q1: OR = 4.965; 95% CI, 2.071–11.903). RCS analysis revealed a non-linear relationship between TSH levels and H. pylori infection. Notably, when TSH < 0.98 IU/ml, the likelihood of H. pylori infection significantly increased.ConclusionsLower TSH and higher T4 levels were associated with H. pylori infection, particularly among men and elderly individuals.

Discordance Between Thyroid Function and Thyroid-Stimulating Hormone (TSH) Receptor Antibodies in Down Syndrome Patients With Autoimmune Thyroid Disease: A Long-Term Follow-Up Study of Two Cases

Discordance Between Thyroid Function and Thyroid-Stimulating Hormone (TSH) Receptor Antibodies in Down Syndrome Patients With Autoimmune Thyroid Disease: A Long-Term Follow-Up Study of Two Cases

Abstract TP332: Assessing the Role of Thyroid Function in Ischemic Stroke: A Retrospective Analysis Across TOAST Classification

Introduction: Subclinical hyperthyroidism has been linked to an increased risk of atrial fibrillation, which elevates the likelihood of cardioembolism, cryptogenic stroke (CS), and embolic stroke of undetermined source (ESUS). However, the broader relationship between thyroid function abnormalities and acute ischemic stroke remains uncertain. This study aims to investigate whether patients with acute ischemic stroke due to cardioembolism, CS, or ESUS are more likely to have abnormal thyroid-stimulating hormone (TSH) levels compared to those with ischemic strokes from other etiologies, as classified by the TOAST criteria. Methods: Utilizing data from the Get With The Guidelines Database, we conducted a retrospective chart review of patients admitted to our single comprehensive stroke center, diagnosed with an acute ischemic stroke between August 2022 and January 2023. The Kruskal-Wallis rank sum test was employed to assess differences in TSH, Free T4, and, if available, one year follow-up TSH levels among patients with ischemic stroke etiologies of small vessel disease, large artery atherosclerosis, cardioembolism, CS, and ESUS. Results: A total of 211 patients were included in the analysis, the distribution of stroke etiologies included 33 (16%) with small vessel disease, 51 (24%) with large artery atherosclerosis, 77 (36%) with cardioembolism, 13 (6.2%) with an undetermined/cryptogenic etiology, and 25 (12%) with ESUS. The majority of patients had normal TSH levels, accounting for 82% of the total cohort, the overall mean TSH level was 2.52 (reference range 0.27-4.2uIU/mL). No significant differences were observed in the mean TSH (p = 0.066), Free T4 (p = 0.13), or follow-up TSH (p = 0.79) levels across each stroke subtype. Conclusions: Our findings suggest that thyroid function does not significantly differ across the various etiologies of acute ischemic stroke, as classified by TOAST criteria. While further large-scale studies are warranted, our results indicate that routine evaluation of thyroid function may not be essential in the determination of stroke etiology.

Modifying effects of prenatal exposure to rare earth elements on birth outcomes through maternal thyroid function in early pregnancy.

The potential health effects of exposure to rare earth elements (REEs) remain largely unexplored. This prospective cohort study aimed to elucidate the association between early pregnancy REE exposure and maternal thyroid function, as well as neonatal birth outcomes, in a cohort of pregnant women in Beijing, China. Additionally, the study explored the mediating role of thyroid homeostasis in the effects of REE exposure. Serum concentrations of fifteen REEs, along with Free Thyroxine (FT4), Thyroid Stimulating Hormone (TSH), and Thyroid Peroxidase Antibodies (TPOAb), were measured in 195 pregnant women. Multivariable linear regression analyses identified significant correlations between REE exposure and disruptions in maternal thyroid homeostasis. Specifically, Praseodymium (Pr) and Lutetium (Lu) were positively associated with FT4 levels, while Gadolinium (Gd) showed a positive correlation with TSH levels. Conversely, Thulium (Tm) was negatively associated with FT4 levels, and Yttrium (Y) was negatively correlated with TSH levels, indicating distinct interactions of specific REEs with thyroid regulation. Notably, Lu remained positively correlated with FT4 levels (β=1.39, 95% CI=0.55, 2.22) after adjusting for multiple comparisons. Regarding neonatal birth outcomes, Dysprosium (Dy) was found to be negatively associated with infant birth weight (β=-0.09, 95% CI=-0.170, -0.002). Furthermore, gender-specific analyses revealed significant associations between REE exposure and TPOAb levels among female neonates. Mediation analyses indicated that TSH significantly mediated the relationships between Terbium (Tb) and Y exposure and neonatal birth outcomes. The study suggests that REEs may disrupt endocrine function, particularly thyroid hormones, which could adversely affect neonatal growth, highlighting the need for further research on their impact in vulnerable populations.

Immunohistochemical examination of PNAd, α4β1 integrin and MUC-2 expressions in the secretary phase endometrium of women diagnosed with recurrent implantation failure.

Successful embryo implantation is contingent upon the intricate interaction between the endometrium and the blastocyst. Recurrent implantation failure (RIF) signifies the clinical challenge of failing pregnancy post-transfer of high-quality embryos, fresh or frozen, in at least three in vitro fertilization (IVF) cycles, often in women under 40 years. Recent studies identify impaired blastocyst maternal tissue communication among recurrent implantation failure causes. Despite successful embryo transfer in vitro fertilization cycles, endometrial factors persist in women with recurrent implantation failure history, underscoring implantation's complexity. The implantation window, during which the endometrium becomes receptive to the blastocyst, involves the expression of key molecules that facilitate the implantation process. When the literature was examined, it was observed that comparative immunohistochemical studies on key molecules such as α4β1 integrin, MUC-2 and PNAd, which are thought to play a critical role in the endometrium before and during implantation, were limited. In this study, we aimed to investigate, through immunohistochemical and histological analyses, the roles of adhesion molecules in the secretory phase endometrium of patients diagnosed with RIF. Twenty-one patients diagnosed with recurrent implantation failure and 21 patients with a history of previous pregnancy at the Gynecology and Obstetrics Clinic of Balcalı Hospital, Faculty of Medicine, Çukurova University were clinically evaluated between days 19-21 of the menstrual cycle and included in the study. Endometrial biopsies, prepared for light and electron microscopy, received Hematoxylin and Eosin staining and anti-α4β1 integrin, anti-MUC-2, and anti-PNAd antibodies for immunohistochemistry. Blood samples were collected on the 2nd and 3rd days of the menstrual cycle to assess serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and thyroid-stimulating hormone (TSH). While FSH, LH, and E2 levels showed no significant difference, TSH was elevated in the recurrent implantation failure group. Structural differences in the endometrium included increased microvilli cells and reduced pinopod counts in infertile women compared to controls. In women with recurrent implantation failure MUC-2 expression were found to be elevated in the endometrial surface epithelium, while PNAd expression was reduced compared to the control group. These findings suggest structural and molecular disparities during the endometrial receptivity window in recurrent implantation failure women may underlie infertility by hindering blastocyst adherence. Molecular studies are needed to elucidate the pathophysiology of the biomarkers whose presence in the endometrium we examined immunohistochemically and to discover new molecules. Changing expressions of adhesion molecules (PNAd, α4β1 and MUC-2) under the influence of steroid hormones, remodeling of intercellular connections and stromal epithelial communication play an important role in endometrial receptivity.

Newborn screening for Central Congenital Hypothyroidism: Past, Present and Future.

Congenital hypothyroidism (CH) is defined as thyroid hormone deficiency at birth and constitutes one of the most common causes of preventable intellectual disability worldwide. Central CH is caused by insufficient pituitary or hypothalamic control of thyroid function, biochemically characterized by a low serum free thyroxine (fT4), in combination with a low, normal or mildly elevated thyroid stimulating hormone (TSH). Central CH is less common than primary CH and is part of multiple pituitary hormone deficiencies (MPHD) in the majority of cases. MPHD at birth, also known as 'congenital hypopituitarism', is a potentially life-threatening condition due to the possible co-occurrence of adrenocorticotropin hormone and growth hormone deficiency that can result in severe hypoglycemia and adrenal crisis. To date, central CH is the only pituitary hormone deficiency suitable for newborn screening (NBS) providing an opportunity for early detection of MPHD. Even though the first newborn screening (NBS) programs utilized T4-based methods that were able to identify central CH, most countries have since transitioned to TSH-based approaches due to the high rate of false positives associated with T4-based strategies. Now, 50 years after the introduction of NBS for CH, only a few countries around the world have a screening program capable of detecting central CH. In this paper, we review the past, present and future of NBS for central CH. We will outline the importance of early detection of central CH and discuss the challenges and opportunities of screening for this condition.

Sex-specific differences in the relationship between thyroid hormones and neurocognition in schizophrenia: A large-scale cross-sectional study.

Sex differences in thyroid hormones, cognitive function, and psychiatric symptoms in schizophrenia remain underexplored. The study aimed to investigate the cross-sectional relationships between thyroid hormone levels, cognitive impairments, and clinical symptoms in people with chronic schizophrenia, with a focus on sex differences. We included 1007 people with schizophrenia (602 males and 405 females), and 326 healthy controls (193 males and 133 females). Cognitive function and psychiatric symptoms were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Positive and Negative Syndrome Scale (PANSS), respectively. Blood samples were collected to measure serum total thyroxine (TT4), total triiodothyronine (TT3), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Analysis of variance (ANOVA) and two-way ANOVA were used to compare clinical characteristics and sex differences. Pearson correlation and hierarchical linear regression were conducted to assess the relationships between thyroid hormone levels, cognitive impairments, and clinical symptoms. People with schizophrenia exhibited lower levels of thyroid hormones compared to the healthy control group (both P < 0.01). Male patients had higher TT3 and FT3 levels than female patients (both P < 0.01). The cognitive scores of the healthy controls were generally higher than those of people with schizophrenia (P < 0.001). Additionally, there were significant sex differences in visuospatial/constructive abilities and language (both P < 0.01) among people with schizophrenia, with males scoring higher than females. The linear regression found that in the cognitive domain, TT4 was negatively associated with Visuospatial/Constructive abilities and RBANS total scores in male patients (both P < 0.05), whereas TT4 was positively associated with these abilities and attention in female patients (all P < 0.05). Additionally, in male patients, TT3 was negatively associated with most of PANSS scale (all P < 0.05). In female, TT3 was only negatively associated with the PANSS Negative scale (P < 0.05). Sex differences exist in thyroid hormone T3 levels in people with schizophrenia. The association between thyroid hormones and cognitive performance varies by sex in chronic schizophrenia.

Transcriptomic landscape of hyperthyroidism in mice overexpressing thyroid-stimulating hormone

Transcriptomic landscape of hyperthyroidism in mice overexpressing thyroid-stimulating hormone

Reference intervals for thyroid-stimulating hormone in the adult Lebanese population: Results from the last decade

Reference intervals for thyroid-stimulating hormone in the adult Lebanese population: Results from the last decade

Development and validation of long-acting recombinant human TSH using SAFA technology.

Thyrogen, a recombinant human thyroid-stimulating hormone (rhTSH), has a short half-life in the bloodstream, which necessitates multiple doses during treatment. Therefore, we developed a new long-acting rhTSH using anti-serum albumin Fab-associated (SAFA) technology to validate its biological activity through in vitro assays, pharmacokinetic (PK) studies in healthy mice, and pharmacodynamics (PD) studies in a TSH-suppressed mouse model.SAFA-TSH was produced using a Chinese hamster ovary expression system. To verify its biological activity, we generated Nthy-ori 3-1 cells stably overexpressing TSHR and measured the production of cyclic adenosine monophosphate (cAMP). In a rat study, slow-release triiodothyronine (T3) pellets were implanted 3 days before administering Thyrogen or SAFA-TSH, to measure the amount of thyroxine (T4) release alone resulting from exogenous administration.SAFA-TSH increased cAMP production dose-dependently, but less effectively than Thyrogen at similar concentrations. SAFA-TSH required six times the dose of Thyrogen to achieve similar cAMP levels, likely due to differences in molecular weight and relative bioactivity. In a rat study, SAFA-TSH produced elevated thyroid hormone levels well after the decline in the response to Thyrogen. SAFA-TSH had significantly higher cumulative effects on T4 and free T4 levels compared with Thyrogen, as observed by a more than two-fold higher average area under the effect curve of 262.56 vs 118.89 μg×h/dL and 127.47 vs 60.75 μg×h/dL, respectively.SAFA technology created successful long-acting TSH that demonstrated bioactivity. These findings endorse the continued development of SAFA-TSH for clinical use, highlighting its potential as a significant advancement treating thyroid cancer patients.

Linking serum leptin and tyroid stimulating hormone among metabolic syndrome patients with and without hypothyroidism

The comparison of thyroid profile and serum leptin levels among patients with metabolic syndrome who did not have hypothyroidism is of interest. Hence, we recruited 40 healthy controls and 80 patients with metabolic syndrome, 40 patients had hypothyroidism and 40 patients without hypothyroidism. Blood sugar levels, thyroid profiles, lipid profiles and serum leptin levels were measured and compared between the metabolic syndrome and control groups. The serum leptin levels of patients with hypothyroidism were considerably higher (P=0.0001**) when compared to metabolic syndrome patients without hypothyroidism and controls. Furthermore, there was a substantial positive correlation between these levels and thyroid stimulating hormone. Results show that serum leptin and TSH are significantly correlated among metabolic syndrome patients with and without hypothyroidism. Thus, monitoring of leptin levels among metabolic syndrome patients with and without hypothyroidism is relevant.

Thyrotoxicosis: What is the Cause in Our Population?

Thyrotoxicosis is an endocrine disorder in which excess amount of thyroid hormone is secreted in the blood stream and causes its action at the tissue level. Thyrotoxicosis highly affects the quality of life of patients suffering from the disease in carrying out daily activities. Proper treatment of thyrotoxicosis requires an accurate diagnosis. Objective: To determine the causes of thyrotoxicosis in patients reported for evaluation and management to specialized endocrine unit. Methods: This was a descriptive cross sectional observational study conducted by convenient sampling in Outpatient Department (Endocrinology Clinic) Khyber Pakhtunkhwa in six month’s duration (15th December 2023 to 15th May 2024) having sample size n=118. Thyrotoxicosis was labeled if patient has high T3, T4 (thyroxine and/or triiodothyronine) levels and suppressed thyroid stimulating hormones TSH levels. Information was gathered from the patients regarding their clinical signs and symptoms and anthropometrics. Laboratory investigations of thyroid function tests were obtained and analyzed. Results: The mean age of 118 patients was 40.39 ± 13.69 years, 28% male and 72% female patients were in enrolled in the study. Graves’ disease was most common form thyrotoxicosis making count of 50% of patients followed by toxic adenoma, toxic MNG, thyroiditis 16% and 14 % respectively. Anti-thyroid drugs count 43% of most of the patient’s treatment offered followed by radioactive iodine 28%. Conclusions: In conclusion, the main cause of thyrotoxicosis, includes grave’s disease, toxic adenoma and toxic MNG in Pakistani population. Thyrotoxicosis was more prevalent among female population as compared to males.

Treatment of Transient Hypothyroxinemia of Prematurity Does Not Improve Neurodevelopment at Two Years of Age.

Transient hypothyroxinemia of prematurity (THOP) has been associated with suboptimal neurodevelopment. We aimed to assess neurodevelopment in very preterm infants with treated and untreated THOP. This study was a multicentre, cohort study, based on prospectively collected data in four French level III neonatal intensive care units. Infants born before 32 weeks of gestation between 2009 and 2020 who underwent a thyroid function test were included. THOP was defined as low free thyroxine and unelevated thyroid stimulating hormone. Infants were classified as no THOP, treated THOP, and untreated THOP. The primary outcome was suboptimal neurodevelopment at 2 years of age evaluated by clinical examination. Three hundred and seventy-three infants (54% male) born at a median gestational age of 28 weeks of gestation were included. There was no significant difference in neurodevelopment at 2 years of age when comparing the no THOP to the THOP group (Odds Ratio (OR) 1.4, 95% confident Interval (CI) 0.8-2.3) nor when comparing the treated with the untreated THOP group (OR 0.8, 95% CI 0.3-1.9). Results remained unchanged after adjusting for confounding factors. In very preterm infants treated THOP was not associated with improved neurodevelopment compared to untreated THOP. Numerous biases could have limited treatment effect.

Maternal hypothyroidism during pregnancy

The thyroid gland in pregnant women undergoes significant structural and physiological changes. One example is the universal enlargement of the gland in pregnant women in countries with sufficient and deficient body iodine levels. In addition, an increase of 50% occurs in both the production of the thyroid hormones and the daily need for iodine. Such alterations also continuously occur in women in general, but the pathological reactions taking place during pregnancy may lead to various aspects of dysfunction of the glans, including hypothyroidism which is commonly observed in pregnant women who might be seriously affected, along with the developing fetus. The situation can become complicated with other physiological disorders, including gestational hypertension, premature delivery, and fetal growth restriction. About 3 to 5 % of pregnant women develop hypothyroidism, making it the main form of thyroid dysfunction in this group of women. As compared to the overt form, subclinical hypothyroidism occurs in a higher frequency. It is diagnosed when the level of the thyroid-stimulating hormone (TSH) in the serum is higher compared to the pregnancy-specific reference range. Hormone levels higher than 2·5 mIU/L in the 1st trimester and 3 mIU/L in the 2nd and 3rd trimesters are also indicative of this condition. However, a number of studies reported serum TSH values of 5-10 and &gt;10 mIU/L to diagnose subclinical and overt hypothyroidism, respectively. Close monitoring is especially important during the first trimester because untreated hypothyroidism during this time might lead to irreversible disorders in the nervous system of the developing fetus.

Serum Levels of Thyroid Hormones and Thyroid Peroxidase Antibodies in Different Types of Glaucoma

Abstract Aim of this study is to analyze connection between thyroid hormones disbalance and thyroid peroxidase antibodies in serum and different types of glaucoma. This was a hospital-based, retrospective case-control study. Eighty-seven patients were recruited for outdoor department of Clinic of ophthalmology for the routine ophthalmological examination from an endocrinologist, with laboratory analysis of serum levels of thyroid hormones and thyroid peroxidase antibodies test. We specifically included patients with primary open-angle glaucoma and pseudoexfoliation glaucoma, since these two types of glaucoma are highly reported clinically. Based on laboratory analysis, we divided patients into three groups: primary open-angle glaucoma patients with hypothyroidism, pseudoexfoliation glaucoma patients with hypothyroidism and control group that included healthy subjects. In our research, we found that there were discrete differences between glaucoma patients and control subjects in serum levels of free triiodothyronine and free thyroxine. In other words, these differences were insignificant. Patients with primary open-angle glaucoma and pseudoexfoliation glaucoma had increased serum levels of thyroid stimulating hormone, when compared to patients in control group. This study highlights the interaction between thyroid hormones and glaucoma development. Laboratory analysis of glaucoma patients confirmed thyroid peroxidase antibodies levels greater than normal. Control group had physiological range of thyroid peroxidase antibodies. These findings support autoimmune theory of glaucoma development.

Excessive Iodine Intake During Lactation Is Not Related to the Incidence of Thyroid Disease: A 3-Year Follow-Up Study

Objectives: This study aimed to investigate the relationship between excessive postpartum iodine intake and the incidence of thyroid disease in mothers, as well as child growth and development. Methods: Of 1054 participants in the 2019 nationwide survey that assessed maternal postpartum iodine intake, 684 mothers participated in a follow-up study. Data on maternal thyroid disease incidence and child growth and development from infant or toddler health checkups were collected. Iodine and nutrient intake were assessed using a food frequency questionnaire, and serum thyroid hormones (triiodothyronine (T3), thyroid-stimulating hormone (TSH), and free thyroxine (free T4)) were measured. Relative risks (RRs) were estimated using Poisson regression analysis. Results: Among the 684 participants, 23 (3.4%) were diagnosed with thyroid disease by a physician during the follow-up period. The incidence of maternal thyroid disease was not significantly associated with excessive iodine intake, even after adjusting for confounding factors. Additionally, excessive maternal iodine intake was not related to subclinical hypothyroidism in mothers or child growth and development. Conclusions: After a three-year follow-up, no relationship was observed between high postpartum iodine intake and the risk of thyroid disease. Large-scale longitudinal studies are required to evaluate the long-term effects of excessive postpartum iodine intake on maternal health and child growth and development.