Levothyroxine Therapy Achieves Physiological FT3/FT4 Ratios at Higher than Normal TSH Levels: A Novel Justification for T3 Supplementation?

2018 ◽  
Vol 50 (11) ◽  
pp. 827-831 ◽  
Author(s):  
David Strich ◽  
Cherut Chay ◽  
Gilad Karavani ◽  
Shalom Edri ◽  
David Gillis
Keyword(s):  
Female Gender ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Community Clinics ◽  
Cross Sectional ◽  
Age And Gender ◽  
And Gender ◽  
Levothyroxine Treatment ◽  
Tsh Levels ◽  
Better Than

AbstractIn euthyroidism, as thyroid Stimulating hormone (TSH) levels increase, the free triiodothyronine (FT3) to free thyroxine (FT4) ratio increases. The aim of this study was to assess if beyond the euthyroid range of TSH levels FT3/FT4 ratio continues to increase and if levothyroxine treatment reduces this ratio, possibly through TSH suppression. This cross sectional retrospective study included a total of 77 832 patients [age 22.76±15.17 years (4 days to 112 years)] evaluated and treated in community clinics between January 2009 and September 2013. Blood samples drawn in community clinics for which TSH, FT4, FT3, age, and gender were available were included. Tests with TSH below 0.5 IU/l were excluded as were samples taken during pregnancy. The FT3/FT4 ratio continued to increase significantly even with TSH above 50 mIU/l (p for trend<0.001) with an increase of more than 50% over the entire TSH range. With increasing age and female gender, the phenomenon was less prominent (p<0.001). Levothyroxine treated patients had significantly lower FT3/FT4 ratios in comparison to untreated patients up to TSH levels of 5.0 mIU/l. In conclusion, increasing TSH increases FT3/FT4 ratio even with severe hypothyroidism, less so with aging. With levothyroxine therapy, a ratio similar to untreated patients is achieved at TSH of above 5.0 mIU/l. Since T3 suppresses TSH better than T4, administration of T3 would likely normalize the FT3/FT4 ratio at a lower, ostensibly more physiological, TSH level. This could be seen as a rationale for add-on T3 therapy.

scholarly journals Cigarette smoking is associated with higher thyroid hormone and lower TSH levels: the PREVEND study

Endocrine ◽  
2019 ◽  
Vol 67 (3) ◽  
pp. 613-622 ◽  
Author(s):  
Eke G. Gruppen ◽  
Jenny Kootstra-Ros ◽  
Anneke Muller Kobold ◽  
Margery A. Connelly ◽  
Daan Touw ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Cigarette Smoking ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Self Report ◽  
Free Triiodothyronine ◽  
Cross Sectional ◽  
Current Smoking ◽  
Urinary Cotinine ◽  
Tsh Levels

Abstract Purpose The extent to which smoking is associated with thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) when taking account of clinical variables including alcohol consumption is unclear. We aimed to determine associations of TSH, FT4, and FT3 levels with current smoking. Methods A cross-sectional study was performed in 5766 euthyroid participants (Prevention of Renal and Vascular End-Stage Disease cohort). Current smoking was determined by self-report, categorized as never, former, and current (≤20 and >20 cigarettes per day). Smoke exposure was determined by urinary cotinine. Results Current smoking of ≤20 and >20 cigarettes per day was associated with lower TSH and higher FT3 levels. FT4 levels were higher in subjects smoking <20 cigarettes per day vs. never and former smokers. Current smokers also consumed more alcohol. Multivariable linear regression analyses adjusted for age, sex, anti-TPO autoantibody positivity, alcohol consumption, and other variables demonstrated that lower TSH, higher FT4 and higher FT3 were associated with smoking ≤20 cigarettes per day vs. subjects who never smoked (P < 0.001, P = 0.018, and P < 0.001, respectively) without a further significant incremental effect of smoking >20 cigarettes per day. In agreement, TSH was inversely, whereas FT4 and FT3 levels were positively associated with urinary cotinine (P < 0.001 for each). In contrast, alcohol consumption >30 g per day conferred higher TSH and lower FT3 levels. Conclusions Cigarette smoking is associated with modestly higher FT4 and FT3, and lower TSH levels, partly opposing effects of alcohol consumption.

Screening of thyroid disorders in age and gender groups in a teaching hospital of Nowshera

2021 ◽  
Vol 15 (1) ◽  
pp. 27-30
Author(s):  
Hamzullah Khan ◽  
Fawad Khan ◽  
Zahid Khan ◽  
Naseer Ahmed ◽  
Waseemyar Khan
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Skewed Distribution ◽  
Thyroid Disorders ◽  
Chi Square ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
Age And Gender ◽  
The Difference ◽  
And Gender ◽  
Gender Groups

 Background: In Pakistan 28.7% of the population had some degree of goiter. Out of those 40% of the nodules behaved hyperthyroidism based on the lower-than-normal values of thyroid stimulating hormones (TSH). Present study was designed as to determine the screening of thyroid disorders on the basis Thyroid Stimulating Hormone (TSH) in age and gender groups in a hospital-based study. Patients and methods: This cross-sectional study was conducted in Qazi Hussain Ahmed Medical Complex Nowshera from March 2019 to Jan 2020. Total 392 cases, 167 (42.6%) males and 225 (57.4%) females were included. All patients referred to pathology laboratory for measurement of TSH levels irrespective of age and gender were included to measure incidence of hyper, hypo or euthyroid status. Exclusion criteria were patients taking medications or iodine supplementation. Numerical variables like age and TSH values were presented with Mean with SD, Median and range. Inferential statistics and correlation statistics (chi-Square, ANOVA, Mann-Whitney U test and Spearman correlation) were used to determine the difference of TSH values in gender and age groups. Results: Mean age of the patients was 31+8.1 years. Mean TSH was 5.22+16.5 ng/ml. The difference of TSH values in the age categories using one way ANOVA statistics was insignificant (p = 0.15). Mann Whitney U Test confirmed that the distribution of TSH is the same across the categories of gender (p=0.001). Total 55 (14%) patients were hyperthyroid, and 23 (5.9%) mild hypothyroid and 30 (7.7%) hypothyroid. Chi square test showed the relation of gender with hypo and hyperthyroidism as statistically isignificant ( p= 0.18, p=0.8) respectively. Spearman ranked correlation test showed a mild to moderate inverse correlation of hypothyroidism with increase in age categories (p=0.88, r=-0.47) and a moderate uphill correlation of hyperthyroidism with increase in age categories, again statistically insignificant (p= 0.31, r=0.51). Conclusion: We observed a skewed distribution of TSH in our population. On the basis of the TSH values the thyroid disorders were categorized in hyper and hypothyroidism. There was a negative correlation of Hypothyroidsim (TSH<0.4) with age. While a positive correlation of age was noted with hyperthyroidism. While no significant relationship of hyper or hypothyroidism was noted in gender groups.

scholarly journals An Analytical Study to Explore Iron Stores in a Population of Nowshera Based on Age and Gender Perspective

2022 ◽  
Vol 9 (1) ◽  
pp. 33-38
Author(s):  
Hamzullah Khan ◽  
Mohammad Basharat Khan ◽  
Shahtaj Khan ◽  
Saiqa Zahoor ◽  
Anwar Khan Wazir
Keyword(s):  
Ferritin Level ◽  
Age Groups ◽  
Female Gender ◽  
Cross Sectional ◽  
Total Study Population ◽  
Age And Gender ◽  
Iron Stores ◽  
Significant Difference ◽  
And Gender ◽  
The Impact

OBJECTIVES:  To analyze the impact of age and gender on iron stores in a population of the Nowshera region. METHODOLOGY: This cross sectional study was conducted in the Department of Pathology Qazi Hussain Ahmed Medical Complex Nowshera from 1st January 2019 to 31st March 2020. All patients were selected by convenience sampling in the Pathology department irrespective of age and gender.   Both descriptive and inferential statistics were applied to analyze data by the latest SPSS version 25.  RESULTS: Out of the total study population males were 70 (27.1%) and females 188 (77.9%) with median age 30 years.  The median ferritin level was 12.8 ng/ml. Out of total, 142 (55%) of cases were with serum ferritin less than 15ng/ml. A significant (p=0.03) gender based median ferritin level difference was observed with 1.5 times more probability of low iron stores in females as compared to males (OR=1.5). No statistically significant difference in body iron stores exists in different age groups. CONCLUSION:  A significant difference was noted in the iron stores in gender groups and the probability of depleted/low iron stores was higher in female gender as compared to male gender in all age groups in our population.    

scholarly journals Comparison of bioelectrical body and visceral fat indices with anthropometric measures and optimal cutoffs in relation to hypertension by age and gender among Chinese adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Binbin Zhang ◽  
Yaqi Fan ◽  
Yuxue Wang ◽  
Li Zhang ◽  
Chunjun Li ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Youden Index ◽  
Health Examination ◽  
Cross Sectional Survey ◽  
Anthropometric Measures ◽  
Visceral Fat Area ◽  
Cross Sectional ◽  
Age And Gender ◽  
And Gender ◽  
Better Than

Abstract Background Few studies have compared bioelectrical body and visceral fat indices with anthropometric measures, or evaluated their optimal cutoffs in relation to hypertension among Asians. We compared the efficiencies of bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for hypertension and re-evaluated the optimal cutoffs of each index by age and gender. Methods We conducted a cross-sectional survey among 8234 adults for health examination. PBF, VFA, BMI, WHR, and data on hypertension and behaviors were collected. Receiver operating characteristic (ROC) curve and areas under curves (AUCs) were used to analyze the efficiencies of the indices for hypertension, optimal cutoffs were estimated using the Youden index. Results A total of 8234 individuals aged 21–91 with median age 44 (interquartile range [IQR] 33–56) years were included and 40.56% were men. The overall prevalence of hypertension was 27.47%. The studied indices were all associated with hypertension in all age-specific groups both among men and women except for WHR in 21–29 years old men and PBF in in 21–29 years old women. Among males, there were no statistical differences in powers of four indices for hypertension in all age-specific groups, except for 40–49 years, in which WHR was better than VFA. Among females, no differences were found among the indices in 30–39 and 70–79 years groups, while WHR was the best in 21–29 years group, VFA was better than PBF in 30–39 and 50–59 years groups, BMI was better than PBF and WHR in 60–69 years group. The optimal cutoffs of PBF, VFA, BMI and WHR ranged from 23.9 to 28.7%, 86.4 to 106.9cm2, 23.5 to 27.1 kg/m2, 0.92 to 0.96 across the age categories in males, and 32.8 to 36.3%, 75.9 to 130.9cm2, 21.9 to 26.4 kg/m2, 0.84 to 0.95 across the age categories in females, respectively. Conclusions The obesity indices’ efficiencies for hypertension varied by age and gender, and their cutoff values varied across the age categories and gender. Specific indices and cutoffs based on person’s age and gender should be used to identify individuals with hypertension.

scholarly journals Association between Hyperhomocysteinemia and Thyroid Hormones in Euthyroid Diabetic Subjects

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Yun Zhang ◽  
Qiong Wang ◽  
Quanzhong Li ◽  
Ping Lu
Keyword(s):  
Blood Pressure ◽  
Fasting Glucose ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Diabetic Patients ◽  
Biomedical Data ◽  
Sectional Study ◽  
Free Triiodothyronine ◽  
Cross Sectional ◽  
Elderly Males

Objectives. The concept now emerging is that higher thyroid-stimulating hormone (TSH) and lower thyroid hormone levels within the euthyroid range may adversely affect atherosclerosis. The present study aimed to investigate the potential associations between thyroid parameters and hyperhomocysteinaemia in a cohort of euthyroid diabetic subjects.Material and Methods. Two hundred and seventy-three euthyroid diabetic subjects (167 males and 106 females) were consecutively recruited in this cross-sectional study. Clinical and biomedical data was collected.Results. TSH level was higher in females than males. Compared to normal-homocysteine group, hyperhomocysteinaemia group was more likely to be elderly, males, with longer diabetes history, and with lower diastolic blood pressure. Free thyroxine (FT4) level was lower in hyperhomocysteinaemia group than in normal-homocysteine group; however, it was not statistically significant. Adjusted for age, sex, body mass index, duration of diabetes, blood pressure, fasting glucose, total cholesterol, and triglyceride in logistic regression analyses, hyperhomocysteinaemia was significantly correlated with FT4 (P=0.021). No significant association was found with TSH or free triiodothyronine. When analyzed in subjects with TSH < 2.5 uIU/mL separately, we got similar results.Conclusions. In conclusion, we identified a relation between hyperhomocysteinemia and FT4 in a group of euthyroid diabetic patients.

scholarly journals Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 311
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
Rasha A. Almubark ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
National Level ◽  
Sampling Technique ◽  
Health Conditions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age And Gender ◽  
Prevalence Of Obesity ◽  
And Gender ◽  
Colon Diseases

The global prevalence of obesity is increasing. Obesity is associated with many chronic diseases and health conditions. This study aims to estimate the current prevalence of obesity in Saudi Arabia and described the current national-level status of the association between obesity and various health conditions. This study is a nationwide cross-sectional survey conducted over phone-interviews in June 2020. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and the obesity was determined as BMI ≥ 30. Logistic regression adjusted for age and gender was used for exploring current associations between obesity and health conditions. Of the 6239 participants contacted, 4709 participants responded and completed the interview with a response rate of 75.48%. Of them, 50.1% were female, the mean age was 36.4 ± 13.5 (Range: 18–90), and the median age was 36. The national weighted prevalence of obesity (BMI ≥ 30) was 24.7%, and the prevalence in the sample (unweighted) was 21.7%. Obesity was significantly associated with type 2 diabetes [Odd ratio, (OR) = 1.52], hypercholesterolemia (OR = 1.69), hypertension (OR = 1.61), lung diseases (OR = 1.69), rheumatoid arthritis (OR = 1.57), sleep apnea (OR = 1.82), colon diseases (OR = 1.31), and thyroid disorders (OR = 1.8). This study provides an update on the recent prevalence of obesity in Saudi Arabia. It also shows the variation in prevalence rates between different regions, which might be explored further. Although obesity shows a decreasing trend, almost one-quarter of this study sample were obese. Obesity is currently associated with many health conditions that can affect the individuals’ quality of life, impose stress on the healthcare system and impose an economic burden on the country. This evidence highlights the need for action to focus more on obesity in Saudi Arabia.

Evaluation of the Fibromyalgia and Related Risk Factors in Patients with Advanced Kidney Failure Undergoing Hemodialysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Seyed Mostafa Seyedmardani ◽  
Saeed Abkhiz ◽  
Azadeh Megrazi ◽  
Aarefeh Jafarzade ◽  
Golshan Kamali Zonouz
Keyword(s):  
Risk Factors ◽  
Kidney Failure ◽  
Fibromyalgia Syndrome ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Age And Gender ◽  
Significant Difference ◽  
Symptom Severity Score ◽  
And Gender

Background : Fibromyalgia syndrome (FMS) is defined as widespread and persistent pain in the musculoskeletal system. There are limited reports regarding the prevalence of fibromyalgia syndrome in patients with advanced kidney failure undergoing regular hemodialysis. Therefore, this study aimed to evaluate the prevalence of fibromyalgia syndrome and its risk factors in a large proportion of patients under the hemodialysis condition. Materials and Methods: In this cross-sectional study, 293 patients who were admitted to the hemodialysis ward were evaluated for fibromyalgia syndrome in an educational hospital. The questionnaire was designed according to symptom severity score (SS score) and widespread pain index (WPI) criteria. The correlation between FMS and various variables, including demographic, clinical, and biochemistry biomarkers, was also precisely calculated by logistic regression. Data were analyzed using SPSS v.17 statistics software. Results: The results showed that, of 293 hemodialysis patients, 130 patients (44.4%) had fibromyalgia, the mean age of patients with and without fibromyalgia was 61.09 ± 15.36 and 53.49 ± 15.38 years old, respectively (P = 0.001). Moreover, there was a significant difference in terms of gender among patients with fibromyalgia syndrome (P = 0.001). To note, there was no significant relationship between the kidney failure etiopathogenesis, duration of dialysis, body mass index (BMI), Kt/v index, history of peritoneal dialysis, and laboratory parameters with fibromyalgia in hemodialysis patients (P > 0.05). However, our findings revealed that both age and gender could be considered as the predictor variables associated with fibromyalgia in patients undergoing hemodialysis. Conclusion: Taken together, in this study, we found that age and gender would be the critical factors in terms of the fibromyalgia syndrome in patients undergoing hemodialysis.

Prevalence of Colorectal Carcinoma With Respect to Age and Gender

2021 ◽  
Vol 15 (12) ◽  
pp. 3198-3199
Author(s):  
Pervez Muhammad ◽  
Sajjad Muhammad ◽  
Muhammad Tariq ◽  
Amir Khan ◽  
Akhtar Munir ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Colorectal Adenocarcinoma ◽  
Cross Sectional Study ◽  
Medical Institute ◽  
Cross Sectional ◽  
Age And Gender ◽  
Medical College ◽  
Gender Study ◽  
The Mean ◽  
And Gender

Aim: Prevalence of colorectal carcinoma with respect to age and gender Study design: Observational / cross sectional study. Place and duration of study: This study was conducted at the Department of Pathology and Surgery, Post Graduate Medical Institute Lahore and Jinnah Medical College Peshawar from July, 2013 to February, 2015 Methodology: Surgical specimens of 60 histopathologically diagnosed cases of colorectal adenocarcinoma were included in this study. Age and sex were evaluated in CRC. Results: The mean±sd of age was 54.4±19.7 yrs. Out of 60 cases, 6 (10%) were between 16-29 yrs, 9 (15%) cases were between 30-49 yrs, 34 cases (56.7%) were of 50-69 yrs and 11 cases (18.33%) were of 70 yrs. Out of sixty cases, males were 33 (55%) and females were 27(45%). Conclusion: There are 34 out of 60(56.7%) patients were 50-69 years and 33 out of 60 (55%) cases were males i.e. males dominance. Keywords: Colorectal adenocarcinoma, immunohistochemistry, gender

scholarly journals Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

scholarly journals Patients’ general satisfaction with the appearance of anterior maxillary teeth

2017 ◽  
Vol 74 (6) ◽  
pp. 520-525 ◽  
Author(s):  
Vlatka Lajnert ◽  
Daniela Kovacevic-Pavicic ◽  
Hrvoje Pezo ◽  
Aleksandra Stevanovic ◽  
Tatjana Jovic ◽  
...  
Keyword(s):  
Dental Plaque ◽  
Negative Influence ◽  
Cross Sectional ◽  
Age And Gender ◽  
Tooth Shape ◽  
General Satisfaction ◽  
Anterior Teeth ◽  
Dental Appearance ◽  
And Gender ◽  
The Impact

Background/Aim. Dental appearance plays an important role in practically all personal social interactions. The main factors that define the dental appearance are tooth colour, shape and position, quality of restoration, and the general position of the teeth in arch, especially in the anterior region. The aim of this study was to evaluate the impact of dental status (tooth shape, fracture, dental and prosthetic restorations and presence of plaque) on patient''s satisfaction with the dental appearance, controlling for the age and gender. Methods. A total of 700 Caucasian subjects (439 women) aged 18?86 (median 45 years) participated in the cross-sectional study. Study included clinical examination and self-administrated questionnaire based on selfperceived aesthetics and satisfaction with the appearance of their maxillary anterior teeth. Results. A regression analysis demonstrated that presence of dental plaque, tooth fracture, composite fillings and crowns had significant independent contribution and were negative predictors of satisfaction with teeth appearance. Participants with presence of plaque on upper teeth (p < 0.001), fractures (p = 0.005), composite fillings (p < 0.001) and crowns (p = 0.032) were less satisfied than those without it. Model explains 12% or variance of general satisfaction with the appearance of maxillary frontal teeth (p < 0.001) and the major contributors are composite fillings (5.3%) and plaque (3.2%). Tooth shape, age and gender were not significant predictors of satisfaction. Conclusion. Satisfaction with the teeth appearance is under the influence of many factors with significant negative influence of presence of dental plaque, fractures, composite restorations, and crowns.

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