Postintervention Serum TSH Levels May Be Useful to Differentiate Patients Who Should Undergo Levothyroxine Suppressive Therapy After Thyroid Surgery for Multinodular Goiter in a Region with Moderate Iodine Deficiency

Thyroid ◽  
2000 ◽  
Vol 10 (12) ◽  
pp. 1081-1085 ◽  
Author(s):  
Mario Rotondi ◽  
Giovanni Amato ◽  
Andrea Del Buono ◽  
Gherardo Mazziotti ◽  
Giovanni Manganella ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Thyroid Surgery ◽  
Multinodular Goiter ◽  
Suppressive Therapy ◽  
Serum Tsh ◽  
Tsh Levels

RELATIONSHIP BETWEEN PEROXIDASE ACTIVITY AND SERUM TSH, T4 AND T3 LEVELS IN RATS IN THE COURSE OF IODINE DEFICIENCY

1978 ◽  
Vol 88 (3) ◽  
pp. 499-505 ◽  
Author(s):  
B. M. Nataf ◽  
P. Fragu ◽  
S. Ben Othman
Keyword(s):  
Iodine Deficiency ◽  
Peroxidase Activity ◽  
Control Diet ◽  
Early Period ◽  
Iodine Content ◽  
Thyroid Peroxidase ◽  
Wet Weight ◽  
Iodine Treatment ◽  
Serum Tsh ◽  
Tsh Levels

ABSTRACT The relationship between peroxidase activity and serum TSH, T4 and T3 levels was investigated in the course of iodine deficiency in rats. Rats were maintained either on a control diet with a relatively high iodine content (600 μg/kg of 127I), or on a low iodine diet (30 μg/kg of 127I). Twenty days after the low iodine treatment, the thyroid iodine [127I] concentration was half that of control value (647 ± 52 and 1241 ± 72 μg/g of wet weight, respectively). However, no significant changes in serum T4, T3, TSH were found at 20 days even though an early increase in peroxidase activity was observed. It was only at 35 days of iodine deficiency, when the concentration of iodine in the gland averaged 260 μg/g of wet weight that serum T4 and TSH levels started to be significantly modified. From day 35 to day 70, a significant and progressive decrease of plasma T4 concentration was observed, and it levelled off thereafter. The changes of serum T3 were much smaller than those of T4. A significant increase in serum TSH level was noted at 35 days. Thereafter TSH levels increased rapidly and progressively (205 % increase over control at 70 days and 643 % at 80 days). From day 35 until day 80 of the low iodine treatment, the thyroid peroxidase activity and the serum TSH level varied concomitantly. Our results suggest that for an iodine content between 5 and 2 μg per thyroid gland, the high cellular peroxidase activity observed could be correlated with an increase in circulating TSH, due to a decrease of T4. In contrast, in the early period of iodine deficiency, no correlation was found between peroxidase activity and serum T4, T3 and TSH levels.

A STUDY OF THE MECHANISMS INVOLVED IN THE PRODUCTION OF IODINE-DEFICIENCY GOITER

1965 ◽  
Vol 49 (4) ◽  
pp. 610-628 ◽  
Author(s):  
Hugo Studer ◽  
Monte A. Greer
Keyword(s):  
Iodine Deficiency ◽  
Elevated Serum ◽  
Extensive Study ◽  
The Body ◽  
Total Evidence ◽  
High Iodine ◽  
Tsh Secretion ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Made In

ABSTRACT An extensive study of the temporal sequence of changes in thyroid function after initiation of a low iodine regimen has been made in rats. Variables measured include: thyroid weight, 131I uptake, monoiodotyrosine/diiodotyrosine (MIT/DIT) and triiodothyronine/thyroxine (T3/T4) ratios, iodide clearance, and 127I content. Also measured were protein-bound iodine (PBI), inorganic iodide and thyrotrophin (TSH) levels in the serum. Significant thyroid hypertrophy was produced during the first week and before there was a fall in serum PBI. Temporally related to the appearance of goiter were a rise in 131I uptake, MIT/DIT ratio and iodide clearance and a fall in thyroidal 127I concentration. In contrast, a fall in total thyroidal 127I appeared later and was closely correlated with a decline in serum PBI concentration and a rise in the thyroidal T3/T4 ratio. Manipulations such as hypophysectomy, injections of iodide, thyroxine or TSH, and refeeding a high iodine diet gave results consistent with the view that changes produced by iodine deficiency involve both autonomous and TSH-dependent thyroidal mechanisms. Although elevated serum TSH levels could not be demonstrated until after the first week of the iodine-deficient regimen, the total evidence of these studies permits the conclusion that increased TSH secretion is the most important factor in producing the thyroidal response to iodine deficiency. It is shown that homeostatic mechanisms allow maintenance of a normal level of circulating thyroid hormone in an iodine-deficient state until the body iodine pool becomes too severely depleted to supply adequate iodide substrate to the thyroid. The changes observed closely resemble those found in human iodine-deficient goiters. Although the large goiters produced after several weeks of an iodine-deficient regimen were hyperplastic, they could readily be converted to typical colloid goiters by feeding a high iodine diet for a few days.

scholarly journals The role of thyroid stimulating hormone in the timing of thyroxin supplement after thyroid operations

2021 ◽  
Vol 8 (2) ◽  
pp. 44-53
Author(s):  
Basil A. S. Al-Khayyat ◽  
Anmar Jumaa Ghali ◽  
Berq J. Hadi Al-Yasseri
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Suppressive Therapy ◽  
Hashimoto's Thyroiditis ◽  
Histopathological Results ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Stimulating Hormone

Thyroid Stimulating Hormone (TSH) levels can be measured accurately down to a very low serum concentration with an immunoassay. When the serum TSH level is in the normal range, measuring the T3 and T4 levels is redundant. The objective of this study is to study the relation of TSH levels postoperatively in thyroid surgeries with the timing for thyroxin treatment as a supplemental and suppressive therapy. A prospective cohort study was done on 84 patients underwent thyroid operations in Al-Yarmouk Teaching Hospital from March 2010 through November 2012. Patients underwent different thyroid operations (lobectomy, subtotal thyroidectomy and total thyroidectomy) for different thyroid pathology. Later, they were followed up by TSH assay in periods of 2, 4, 6 and 12 months postoperatively. Variables were compared by using the analysis of variance, ANOVA test. P – values equal or less than 0.05 and 0.01 were considered to be statistically significant and highly significant, respectively. The mean age of patients was 43.30 ± 10.19 years. The females made the vast majority of study sample (85.7%). Patients were divided into six groups: simple colloid goiters (17 patients), multinodular goiters (32 patients), solitary thyroid nodules (11 patients), Hashimoto’s thyroiditis (8 patients), Graves’ disease (8 patients) and papillary and follicular carcinomas (8 patients). The study revealed that all patients with malignant thyroid nodules (i.e. those with total thyroidectomies) and the vast majority of patients with Hashimoto’s thyroiditis were in definite need for thyroxin treatment post-operatively. Other patients were variable in their need and timing of treatment according to the histopathological results and the type of operations. In conclusion; measurement of TSH level postoperatively is a good indicator for need of thyroxin treatment and for dose adjustment with the help of pathological results and the type of surgery.

scholarly journals Low serum TSH levels are associated with low values of fat-free mass and body cell mass in the elderly

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Till Ittermann ◽  
Marcello R. P. Markus ◽  
Martin Bahls ◽  
Stephan B. Felix ◽  
Antje Steveling ◽  
...  
Keyword(s):  
Body Composition ◽  
Waist Circumference ◽  
Cell Mass ◽  
The Elderly ◽  
Fat Free Mass ◽  
Body Cell Mass ◽  
Body Cell ◽  
Independent Population ◽  
Serum Tsh ◽  
Tsh Levels

AbstractPrevious studies on the association between thyroid function and body composition are conflicting and showed strong differences across age groups. Our aim was to clarify age-specific associations of serum thyroid-stimulating hormone (TSH) levels with markers of body composition including body mass index (BMI), waist circumference, fat mass (FM), fat-free mass (FFM) and body cell mass (BCM). We used data from two independent population-based cohorts within the framework of the Study of Health in Pomerania. The study population included 5656 individuals aged 20 to 90 years. Markers of body composition were measured by bioelectrical impedance analysis. Serum TSH levels were significantly positively associated with BMI (β = 0.16; 95% confidence interval [CI]: 0.06 to 0.27), waist circumference (β = 0.35; 95% CI: 0.08 to 0.62) and FM (β = 0.32; 95% CI: 0.12 to 0.52), but not with FFM and BCM. Interaction analysis revealed positive associations of serum TSH levels with BMI, waist circumference, FM, FFM and BCM in individuals older than 60 years, while no such associations were observed in younger individuals. We demonstrated that lower serum TSH levels were accompanied with lower values of BMI, waist circumference, FM, FFM, and BCM in the elderly, while no such associations were observed in younger individuals.

scholarly journals Inhibition of pituitary type 2 deiodinase by reverse triiodothyronine does not alter thyroxine-induced inhibition of thyrotropin secretion in hypothyroid rats

2005 ◽  
Vol 153 (3) ◽  
pp. 429-434 ◽  
Author(s):  
P Cettour-Rose ◽  
T J Visser ◽  
A G Burger ◽  
F Rohner-Jeanrenaud
Keyword(s):  
Specific Inhibitor ◽  
Adult Rats ◽  
Reverse T3 ◽  
Brown Adipose ◽  
Tsh Secretion ◽  
Serum T3 ◽  
Serum T4 ◽  
Serum Tsh ◽  
Tsh Levels

Objectives: Intrapituitary triiodothyronine (T3) production plays a pivotal role in the control of TSH secretion. Its production is increased in the presence of decreased serum thyroxine (T4) concentrations and the enzyme responsible, deiodinase type 2 (D2), is highest in hypothyroidism. In order to document the role of this enzyme in adult rats we developed an experimental model that inhibited this enzyme using the specific inhibitor, reverse T3 (rT3). Methods: Hypothyroidism was induced with propylthiouracil (PTU; 0.025 g/l in drinking water) which in addition blocked deiodinase type 1 (D1) activity, responsible for the rapid clearance of rT3 in vivo. During the last 7 days of the experiment, the hypothyroid rats were injected (s.c.) for 4 days with 0.4 or 0.8 nmol T4 per 100 g body weight (bw) per day. For the last 3 days, the same amount of T4 was infused via s.c. minipumps. In additional groups, 25 nmol rT3/100 g bw per day were added to the 3-day infusion of T4. Results: Infusion of 0.4 nmol T4/100 g bw per day did not affect the high serum TSH levels, 0.8 nmol T4/100 g bw per day decreased them to 57% of the hypothyroid values. The infusions of rT3 inhibited D2 activity in all organs where it was measured: the pituitary, brain cortex and brown adipose tissue (BAT). In the pituitary, the activity was 27%, to less than 15% of the activity in hypothyroidism. Despite that, serum TSH levels did not increase, serum T4 concentrations did not change and the changes in serum T3 were minimal. Conclusions: We conclude that in partly hypothyroid rats, a 3-day inhibition of D2 activity, without concomitant change in serum T4 and minimal changes in serum T3 levels, is not able to upregulate TSH secretion and we postulate that this may be a reflection of absent or only minimal changes in circulating T3 concentrations.

Homeopathic Treatment of Subclinical Hypothyroidism—A Series of 19 Cases

Homeopathy ◽  
2021 ◽  
Author(s):  
Luiz Carlos Esteves Grelle ◽  
Luiz Antonio Bastos Camacho
Keyword(s):  
Subclinical Hypothyroidism ◽  
Clinical Importance ◽  
Clinical Problem ◽  
Thyroid Stimulating Hormone ◽  
Exclusion Criteria ◽  
The Mean ◽  
Common Clinical Problem ◽  
Prompt Diagnosis ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background Subclinical hypothyroidism (SCH) is a common clinical problem. Controversy surrounds the definition, clinical importance, and need for prompt diagnosis and treatment of the mild form of SCH. Aim The aim of the study was to analyze the evolution of serum thyroid stimulating hormone (TSH) levels after a therapeutic homeopathic intervention in women older than 40 years with SCH. Methods This study is a retrospective series of 19 cases of SCH, with serum TSH levels between 5 and 10 mIU/L, treated exclusively with homeopathic medicines prescribed on an individualized basis. Results Nineteen patients were included according to the inclusion and exclusion criteria. Their mean age was 56 years, they were followed for a mean duration of 69 months, the mean number of serum TSH level measurements was 18, and the intervention was successful for 13 patients. Conclusion The homeopathic therapeutic intervention was successful in 68% of the patients, with serum TSH levels back within the normal range (0.5–5.0 mIU/L).

Hypertrophy and hyperplasia during goitre growth and involution in rats separate bioeffects of TSH and iodine

1987 ◽  
Vol 116 (4) ◽  
pp. 537-548 ◽  
Author(s):  
D. Stübner ◽  
R. Gärtner ◽  
W. Greil ◽  
K. Gropper ◽  
G. Brabant ◽  
...  
Keyword(s):  
Serum Level ◽  
Iodine Deficiency ◽  
Tap Water ◽  
Iodine Content ◽  
Total Dna ◽  
Thyroid Hyperplasia ◽  
Tsh Levels

Abstract. Goitre growth was investigated in rats receiving a low iodine diet (< 0.1 μg iodine/g) and either 1 g/l KClO4 or 1 g/l propylthiouracil (PTU), or a combination of KClO4 or PTU with 50.82 nmol/l T3 in tap water for 3 weeks. To investigate goitre involution, rats with iodine-deficient goitres were treated for 3 weeks either with T3 (0.5 μg T3/day = 0.768 nmol/day), iodide (0.5 or 2.7 μg KI/day) or a combination of T3 with both iodide doses. Histology together with total DNA distinguished between hypertrophy and hyperplasia of the gland. During goitre growth there was a highly significant correlation between goitre weight and TSH serum level (r = 0.93, P < 0.001). Thyroid total DNA, however, was only weakly correlated to TSH but was inversely related to the degree of iodine deficiency. During goitre regression, TSH levels were normalized, histological signs of hypertrophy had disappeared, and thyroid weight was nearly normalized in all therapy groups. Total DNA, however, was normalized only with 2.7 μg KI/day (95 ± 18 μg DNA/gland), and still elevated in all other groups. The highest DNA levels were found under T3 therapy (143 ± 21 μg DNA/gland) and under 0.5 μg KI/day (161 ± 19 μg DNA/gland). Reduction of total DNA was independent of TSH, but followed replenishment of the iodine content of the glands. We conclude that TSH mainly induces hypertrophy, whereas thyroid hyperplasia is mainly regulated by the intracellular iodine content.

Thyroid surgery in an area of iodine deficiency

Head & Neck ◽  
2005 ◽  
Vol 27 (5) ◽  
pp. 383-389 ◽  
Author(s):  
Anil K. Sarda ◽  
Man M. Kapur
Keyword(s):  
Iodine Deficiency ◽  
Thyroid Surgery

scholarly journals Effects of thyroid hormone and depression on common components of central obesity

2019 ◽  
Vol 47 (7) ◽  
pp. 3040-3049 ◽  
Author(s):  
Fu-Man Du ◽  
Hong-Yu Kuang ◽  
Bin-Hong Duan ◽  
Da-Na Liu ◽  
Xin-Yang Yu
Keyword(s):  
Central Obesity ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Epidemiological Studies ◽  
Thyroid Stimulating Hormone ◽  
Model Assessment ◽  
Free Triiodothyronine ◽  
Serum Tsh ◽  
Tsh Levels

Objective We investigated the prevalence of abnormal thyroid function and depression in centrally obese participants, and to analyze the relationship of thyroid hormones and depression with components of central obesity. Methods We randomly selected 858 centrally obese participants and 500 non-obese controls in this study. For all participants, we measured serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), body mass index (BMI), waist–hip ratio (WHR), fasting blood glucose and insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid concentrations, and blood pressure. Depression was assessed using the Center for Epidemiological Studies-Depression (CES-D) scale. Results Centrally obese participants had a higher prevalence of hypothyroidism and depression than non-obese controls. Serum FT4 levels negatively correlated with BMI and serum TSH levels and positively correlated with BMI, WHR, total triglycerides (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C). After excluding participants with hypothyroidism and hyperthyroidism, serum FT4 levels showed negative correlation and serum TSH levels showed positive correlation with BMI in the remaining centrally obese participants. CES-D scores positively correlated with BMI. Conclusion We found high prevalences of hypothyroidism and depression among centrally obese participants. FT4 and TSH are important in weight regulation. Depression positively correlated with obesity.

Major post-operative complications of thyroid surgery: Preventable or not?

2009 ◽  
Vol 34 (3) ◽  
pp. 99-103 ◽  
Author(s):  
M.A. Majid ◽  
Md. Ibrahim Siddique
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Subtotal Thyroidectomy ◽  
Permanent Hypoparathyroidism ◽  
Respiratory Obstruction ◽  
Operative Complications ◽  
Toxic Multinodular Goiter

Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern. Keywords: Complication; Post-operative; Thyroid surgeryOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1973     Bangladesh Med Res Counc Bull 2008; 34: 99-103. 

Sign in / Sign up

Export Citation Format

Share Document