Urinary Thyroid-stimulating Hormone Research Articles

The negative impact of levothyroxine treatment on urinary luteinizing hormone measurements in pediatric patients with thyroid disease.

Previous studies suggest urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements by immunofluorometric assays (IFMA) as noninvasive alternatives to serum assays for puberty assessment. However, these studies excluded patients with other endocrine disorders and those taking medications. Besides, the recent discontinuation of IFMA manufacturing is a concern. We explored the utility of luminometric assays (LIA) for urinary gonadotropins and thyroid-stimulating hormone (TSH) determinations in euthyroid patients with thyroid pathologies. We used LIA and IFMA assays to measure serum and first-morning-voided (FMV) urine LH, FSH, and TSH concentrations in euthyroid patients with various thyroid disorders. Of the 47 euthyroid patients with normal serum TSH (S-TSH) levels, 14 were receiving levothyroxine therapy. FMV total urinary LH (U-LH) concentrations correlated significantly with those measured in serum using either LIA (r=0.67, P<.001) or IFMA (r=0.83, P=.003) in patients not receiving levothyroxine treatment; however, no significant correlation could be detected in patients receiving levothyroxine regardless of the assay method (for LIA: r=0.50, P=.08 and IFMA r=0.44, P=.15). Urinary TSH (U-TSH) concentrations correlated poorly with those in serum in both the untreated and the treated groups (r=-0.13, P=.49, and r=-0.45, P=.11, respectively). FMV total U-LH determinations by LIA can be used to assess pubertal development in patients with thyroid pathology, provided the euthyroid patient is not on levothyroxine treatment. U-TSH measurements by LIA cannot replace invasive S-TSH measurements at least in patients with normal S-TSH levels. Further research may reveal the utility of U-TSH determinations in patients with elevated S-TSH levels.

Goitrogenic Anions, Thyroid-Stimulating Hormone, and Thyroid Hormone in Infants

BackgroundEnvironmental exposure of infants to perchlorate, thiocyanate, nitrate, might interfere with thyroid function. U.S. women with higher background perchlorate exposure have higher thyroid-stimulating hormone (TSH) and lower thyroxine (T4). There are no studies with individual measures of thyroid function and these goitrogens available in infants.ObjectiveWe examined the association of urinary perchlorate, nitrate, iodide, and thiocyanate with urinary T4 and TSH in infants and whether that association differed by sex or iodide status.MethodsWe used data and samples from the Study of Estrogen Activity and Development, which assessed hormone levels of full-term infants over the first 12 months of life. The study included 92 full-term infants between birth and 1 year of age seen up to four times. Perchlorate, thiocyanate, nitrate, and iodide were measured in 206 urine samples; TSH and T4 and were measured in urines and in 50 blood samples.ResultsIn separate mixed models, adjusting for creatinine, age, sex, and body mass index, infants with higher urinary perchlorate, nitrate or thiocyanate had higher urinary TSH. With all three modeled, children with higher nitrate and thiocyanate had higher TSH, but higher perchlorate was associated with TSH only in children with low iodide. Unexpectedly, exposure to the three chemicals was generally associated with higher T4.ConclusionsThe association of perchlorate exposure with increased urinary TSH in infants with low urinary iodide is consistent with previous findings. Higher thiocyanate and nitrate exposure were also associated with higher TSH in infants.

Pollutant Chemicals, Thyrotropin, and Thyroid Hormone in Infants

ISEE-0440 Background and Objective: Infants are exposed to chemicals that might interfere with thyroid function, such as perchlorate, thiocyanate, and nitrate. There are no studies available with individual measures of these chemicals and thyroid function in infants. We examined whether urinary perchlorate, nitrate, or thiocyanate is associated with urinary thyroxine (T4) and thyroid stimulating hormone (TSH) in infants. Because background perchlorate exposure has been associated with changes in thyroid hormone levels in adults, we specifically examined whether perchlorate was associated with higher TSH in infants with low iodide and in infant girls, as was seen in US females over age 12 years. Methods: The study was conducted at the Children’s Hospital of Philadelphia, the Hospital of the University of Pennsylvania, and affiliated clinics, among 92 full term infants (47 males and 45 females) between birth and 1 year of age. We used data from the Study of Estrogen Activity and Development, which was a partly cross-sectional, partly longitudinal study designed to assess hormone levels of full term infants over the first 12 months of life. We analyzed urine samples collected in that study. Main Outcome Measures: Urinary perchlorate, thiocyanate, nitrate, iodide, TSH and T4, and blood TSH and T4. Results: In models with single chemical agents, infants with higher perchlorate had higher TSH and T4. In models with all three chemical agents, infants with low iodide and higher perchlorate had higher T4 and TSH; infants with higher urinary thiocyanate or higher urinary nitrate had higher urinary TSH and T4. Conclusions: The association of perchlorate exposure with increased urinary TSH in infants with low urinary iodide is consistent with previous findings in females aged 12 and older. Higher thiocyanate and nitrate exposure is also associated with higher urinary TSH in infants. (Supported in part by the intramural research program of NIH.)

Measurement of Thyroid Stimulating Hormone(TSH) in Human Urine.

Using a highly sensitive and specific immunoradiometric assay kit for human TSH, we measured TSH concentrations in unprocessed urines in normal subjects, in patients with primary hypothyroidism, and patients with renal disease. In five of ten normal subjects TSH was detectable in urine samples (less than 20-69 microU/day). In five patients with hypothyroidism, the urinary TSH excretion was increased. In seven out of ten patients with nephrotic syndrome, eight out of nine patients with chronic renal failure and two patients with tubular dysfunction, the urinary TSH excretion was increased. The urinary TSH excretion correlated significantly with both urinary protein excretion and urinary beta 2-microglobulin excretion. These results suggest that the renal handling of TSH involves both glomerular filtration and tubular re-absorption, and that urinary TSH excretion is increased when serum TSH is increased and either glomerular or tubular function is impaired.

Concentrations of immunoreactive thyrotrophic hormone in urine of normal subjects, patients with thyroid disorders and hypopituitarism, and after infusion of human thyrotrophic hormone.

SUMMARY The urinary excretion of thyroid-stimulating hormone (TSH) has been measured by double antibody radioimmunoassay after concentration by dialysis followed by lyophilization. Among 30 normal subjects, the excretion was 5·6 ± 0·31 (s.e.m.) μu./h. No diurnal variation nor differences between sexes were discerned. In 14 primary hypothyroid subjects the urinary excretion was raised (P &lt; 0·001) to 25·1 ± 3·3 μu./h. In 14 hyperthyroid and 7 hypopituitary subjects subnormal levels of 2·6 ± 0·2 and 2·5 ± 0·22 μu./h (P &lt; 0·001) respectively, were found. Serum and urinary TSH concentrations were measured before, during and after an infusion of human pituitary TSH (MRC 70/9) in two subjects and showed a correlation. Urinary TSH measurement is thus a good discriminant between normal and hyperthyroid or hypopituitary patients.