Persistent hypothyroid symptoms in a patient with a normal thyroid stimulating hormone level

Abstract Background As the incidence of secretory osteoporosis has increased, bone loss, osteoporosis and their relationships with thyroid-stimulating hormone (TSH) have received increased attention. In this study, the role of TSH in bone metabolism and its possible underlying mechanisms were investigated. Methods We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and TSH and the bone mineral density (BMD) levels of 114 men with normal thyroid function. In addition, osteoblasts from rat calvarial samples were treated with different doses of TSH for different lengths of time. The related gene and protein expression levels were investigated. Results A comparison of the BMD between the high-level and low-level serum TSH groups showed that the TSH serum concentration was positively correlated with BMD. TSH at concentrations of 10 mU/mL and 100 mU/mL significantly increased the mRNA levels of ALP, COI1 and Runx2 compared with those of the control (P < 0.05, P < 0.01). Bone morphogenetic protein (BMP)2 activity was enhanced with both increased TSH concentration and increased time. The protein levels of Runx2 and osterix were increased in a dose-dependent manner. Conclusions The circulating concentrations of TSH and BMD were positively correlated with normal thyroid function in males. TSH promoted osteoblast proliferation and differentiation in rat primary osteoblasts.

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Maternal education and newborn thyroid-stimulating hormone level in a congenital hypothyroidism screening program

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2018.1559809 ◽

2019 ◽

Vol 33 (16) ◽

pp. 2730-2734

Author(s):

Junhong Leng ◽

Ping Shao ◽

Shuang Zhang ◽

Nan Li ◽

Lei Pan ◽

...

Keyword(s):

Congenital Hypothyroidism ◽

Maternal Education ◽

Hormone Level ◽

Screening Program ◽

Thyroid Stimulating Hormone ◽

Stimulating Hormone

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Approach to Subclinical Thyroid Diseas

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v26i2.4187 ◽

1970 ◽

Vol 26 (2) ◽

pp. 91-96

Author(s):

Satya Ranjan Sutradhar

Keyword(s):

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Hormone Level ◽

Elevated Serum ◽

Thyroid Stimulating Hormone ◽

Good Evidence ◽

Reference Ranges ◽

Mineral Density ◽

Asymptomatic Patients ◽

Stimulating Hormone

Subclinical thyroid dysfunction is defined as an abnormal serum thyroid-stimulating hormone level and free thyroxine and triiodothyronine levels within their reference ranges. The prevalence of subclinical hyperthyroidism is about 2 percent. Subclinical hypothyroidism is found in approximately 4 to 8.5 percent of the population. Most national organizations recommend against routine screening of asymptomatic patients, but screening is recommended for high risk populations. The management of subclinical thyroid dysfunction is controversial. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. Patients with a serum thyroid-stimulating hormone level greater than 10 mIU/L have a higher incidence of elevated serum low density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that treatment of subclinical hypothyroidism is beneficial. A serum thyroid stimulating hormone level of less than 0.1 mIU/L is associated with progression to overt hyperthyroidism, atrial fibrillation, reduced bone mineral density, and cardiac dysfunction. There is little evidence that early treatment alters the clinical course. DOI: 10.3329/jbcps.v26i2.4187 J Bangladesh Coll Phys Surg 2008; 26: 91-96

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