Comparison of calculated and measured free thyroid hormones in serum in health and in abnormal states.

1982 ◽  
Vol 28 (6) ◽  
pp. 1325-1329 ◽  
Author(s):  
G Fresco ◽  
G Curti ◽  
A Biggi ◽  
B Fontana

Abstract To evaluate a theoretical model for calculating free thyroid hormones, based on the law of mass action, we compared values for both calculated and measured free thyroxin and free triiodothyronine in a group of normal subjects. To determine whether the concentrations of circulating free hormones were also predictable from equilibrium considerations in abnormal states, we compared calculated and measured free thyroid hormone values in an additional population including pregnant women and hyperthyroid, hypothyroid, and "sick euthyroid" patients. Predictions based on the model were accurate in all these states except pregnancy, where there was some discrepancy between calculated and measured values for both hormones. In pregnant women with large abnormalities in thyroid-hormone-binding proteins, euthyroidism was accompanied by significantly lower free hormone concentrations, leading us to conclude that, in pregnancy, equilibrium may be reached at concentrations lower than those in other healthy subjects. Values for calculated and measured free thyroid hormones in "sick euthyroids" showed no discrepancy; however, we cannot exclude the possibility that non-dialyzable compounds are present that interfere with the hormone-protein binding.

2009 ◽  
Vol 55 (7) ◽  
pp. 1380-1388 ◽  
Author(s):  
Jacqueline Jonklaas ◽  
Natasa Kahric-Janicic ◽  
Offie P Soldin ◽  
Steven J Soldin

Abstract Background: Accurate measurement of free thyroid hormones is important for managing thyroid disorders. Ultrafiltration liquid chromatography tandem mass spectrometry (LC-MS/MS) can reliably measure the concentrations of small molecules, including thyroid hormones. Our study was designed to compare free thyroid hormone measurements performed with immunoassay and LC-MS/MS. Methods: We studied the performance of LC-MS/MS in 4 different populations comprising pediatric patients, euthyroid adults, and healthy nonpregnant and pregnant women. The samples obtained from each population numbered 38, 200, 28, and 128, respectively. Free thyroxine, free triiodothyronine, and thyroid-stimulating hormone (TSH) concentrations were documented. Results: LC-MS/MS measurement of free thyroid hormones provided better correlation with log-transformed serum TSH in each population and also the populations combined. The correlations between free thyroxine measured by LC-MS/MS and log TSH in the pediatric outpatients and healthy adults were −0.90 and −0.77, respectively. The correlations for immunoassay were −0.82 and −0.48. The correlations between free triiodothyronine measured by LC-MS/MS and TSH for both pediatric and healthy adult populations were −0.72 and −0.68, respectively. Conclusions: Free thyroid hormone concentrations measured by LC-MS/MS correlate to a greater degree with log TSH values compared to concentrations measured by immunoassay. This correlation was maintained across the patient populations we studied and may reflect the accuracy and specificity of LC-MS/MS. The superior ability of LC-MS/MS to enable documentation of the well-known thyroid hormone–TSH relationship supports the use of this measurement technique in a variety of clinical situations.


1986 ◽  
Vol 32 (4) ◽  
pp. 585-592 ◽  
Author(s):  
T J Wilke

Abstract A multiplicity of tests have come into routine use for the estimation of the concentrations of free thyroid hormones in serum and plasma since the introduction, almost three decades ago, of the hypothesis that only the free thyroid hormone is metabolically active. Most of these tests give estimates of considerable diagnostic value, although results may be unreliable in some clinical situations. This review outlines the methods currently available for estimating free thyroid hormones and highlights the extrathyroidal and physiological factors influencing the results of such tests, particularly for the analog-based techniques.


Author(s):  
J A Franklyn ◽  
D B Ramsden ◽  
M C Sheppard

Serum concentrations of total thyroid hormones, thyroid hormone binding proteins, free thyroid hormones and thyroid stimulating hormone (TSH) were measured in a large group of healthy normal subjects ( n = 218) to determine the influence of age and sex on tests of thyroid function. No effect of age on measurements of total thyroxine (T4), total triiodothyronine (T3) or reverse T3 was evident. Concentrations of free T4, free T3 and TSH were similarly unaffected, suggesting that increasing age alone does not significantly influence thyroid hormone measurements. There was, however, a rise in thyroxine-binding globulin (TBG) concentration with increasing age and a fall in thyroxine-binding prealbumin (TBPA). An influence of sex on tests of thyroid function was clearly evident. Levels of total T4, total T3, free T4 and the T4: TBG ratio were lower in women between 16 and 49 years than in men, despite an increase in TBG. Lower levels of free T3 were confined to the group of women aged 16–29 years. TSH values were unaffected by sex. These results suggest that sex hormone status in the pre-menopausal female subject may result in an increase in TBG concentration, and in addition may have an opposing effect on circulating thyroid hormone concentrations.


2021 ◽  
Vol 53 (04) ◽  
pp. 272-279
Author(s):  
Chaochao Ma ◽  
Xiaoqi Li ◽  
Lixin Liu ◽  
Xinqi Cheng ◽  
Fang Xue ◽  
...  

AbstractThyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  

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.


2020 ◽  
Vol 11 ◽  
pp. 204201882092268
Author(s):  
Qian Sun ◽  
Lívia Avallone ◽  
Brian Stolze ◽  
Katherine A. Araque ◽  
Yesim Özarda ◽  
...  

Background: There has been a wide range of reference intervals proposed in previous literature for thyroid hormones due to large between-assay variability of immunoassays, as well as lack of correction for collection time. We provided the diurnal reference intervals for five thyroid hormones, namely total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), free triiodothyronine (FT3), and reverse T3 (rT3), measured in serum samples of healthy participants using a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. Methods: Couplet serum samples (a.m. and p.m.) were collected from 110 healthy females and 49 healthy males. Healthy volunteers were recruited from four participating centers between 2016 and 2018. Measurements of thyroid hormones were obtained by LC-MS/MS analysis. Results: Our study revealed significant uptrend in AM to PM FT4 ( p < 0.0001) samples, downtrend in AM to PM TT3 ( p = 0.0004) and FT3 samples ( p < 0.0001), and AM to PM uptrend in rT3 samples ( p < 0.0001). No difference was observed for TT4 between AM and PM. No significant sex differences were seen for any of the five thyroid hormones. Conclusion: When diagnosing thyroid disorders, it is important to have accurate measurement of thyroid hormones, and to acknowledge the diurnal fluctuation found, especially for FT3. Our study highlights the importance of standardization of collection times and implementation of LC-MS/MS in thyroid hormone measurement.


2020 ◽  
Vol 52 (12) ◽  
pp. 850-855
Author(s):  
Eva Steinberger ◽  
Stefan Pilz ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Markus Reichhartinger ◽  
...  

AbstractResting heart rate (RHR) is associated with increased risk of cardiovascular morbidity and mortality. Thyroid hormones exert several effects on the cardiovascular system, but the relation between thyroid function and RHR remains to be further established. We evaluated whether measures of thyroid hormone status are associated with RHR in patients referred to coronary angiography. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxin (FT4), and RHR were determined in 2795 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Median (25th to 75th percentile) serum concentrations were 1.25 (0.76–1.92) mU/l for TSH, 4.8 (4.2–5.3) pmol/l for FT3 and 17.1 (15.4-19.0) pmol/l for FT4, and mean (±standard deviation) RHR was 68.8 (±11.7) beats/min. Comparing the highest versus the lowest quartile, RHR (beats/min) was significantly higher in the fourth FT4 quartile [3.48, 95% confidence interval (CI): 2.23–4.73; p <0.001] and in the fourth FT3 quartile (2.30, 95% CI: 1.06–3.55; p <0.001), but there was no significant difference for TSH quartiles. In multiple linear regression analyses adjusting for various potential confounders, FT3 and FT4 were significant predictors of RHR (p <0.001 for both). In subgroups restricted to TSH, FT3, and FT4 values within the reference range, both FT3 and FT4 remained significant predictors of RHR (p <0.001 for all). In conclusion, in patients referred to coronary angiography, FT3 and FT4 but not TSH were positively associated with RHR. The relationship between free thyroid hormones and RHR warrants further investigations regarding its diagnostic and therapeutic implications.


1999 ◽  
pp. 625-629 ◽  
Author(s):  
M Tamura ◽  
B Matsuura ◽  
S Miyauchi ◽  
M Onji

We previously reported that serum interleukin-12 (IL-12) levels were significantly increased in patients with hyperthyroid Graves' disease and in normal subjects after administration of thyroid hormone. In the present study, we investigated which cells produce IL-12 and the interactions between IL-12 and thyroid hormones, using a hyperthyroid mouse model. Thyroid hormones induced IL-12 production, and IL-12 was mainly produced by dendritic cells outside the thyroid glands in a hyperthyroid state.


2020 ◽  
Vol 11 ◽  
Author(s):  
Ting-Ting Lin ◽  
Chen Zhang ◽  
Han-Qiu Zhang ◽  
Yu Wang ◽  
Lei Chen ◽  
...  

PurposeCOVID-19 (Coronavirus Disease 2019) was first reported in December 2019 and quickly swept across China and around the world. Levels of anxiety and depression were increased among pregnant women during this infectious pandemic. Thyroid function is altered during stressful experiences, and any abnormality during early pregnancy may significantly affect fetal development and pregnancy outcomes. This study aimed to determine whether the COVID-19 pandemic induces thyroid hormone changes in early pregnant women.MethodsThis study comprised two groups of pregnant women in Shanghai in their first trimester – those pregnant women before the COVID-19 outbreak from January 20, 2019, to March 31, 2019 (Group 1) and those pregnant during the COVID-19 outbreak from January 20, 2020, to March 31, 2020 (Group 2). All women were included if they had early pregnancy thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) concentrations, thyroid peroxidase (TPO) antibody or thyroglobulin antibody (TgAb) available and did not have a history of thyroid diseases or received thyroid treatment before or during pregnancy. We used propensity score matching to form a cohort in which patients had similar baseline characteristics.ResultsAmong 3338 eligible pregnant women, 727 women in Group 1 and 727 in Group 2 had similar propensity scores and were included in the analyses. Pregnant women in Group 2 had significantly higher FT3 (5.7 vs. 5.2 pmol/L, P&lt;0.001) and lower FT4 (12.8 vs. 13.2 pmol/L, P&lt;0.001) concentrations compared with those in Group 1. Pregnant women in Group 2 were more likely to develop isolated hypothyroxinemia (11.6% vs. 6.9%, OR, 1.75 [95% CI, 1.20–2.53], P=0.003) than those in Group 1 but had a significantly lower risk of TgAb positivity (12.0% vs. 19.0%, OR, 0.58 [95% CI, 0.43–0.78], P&lt;0.001).ConclusionPregnant women in their first trimester in Shanghai during the COVID-19 outbreak were at an increased risk of having higher FT3 concentrations, lower FT4 concentrations, and isolated hypothyroxinemia. The association between thyroid hormones, pregnancy outcomes, and the COVID-19 outbreak should be explored further.


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