scholarly journals Biochemical Investigation of Foetal and Neonatal Thyroid Function Using the ACS-180SE Analyser: Clinical Application

2001 ◽  
Vol 38 (5) ◽  
pp. 520-526 ◽  
Author(s):  
Jean Guibourdenche ◽  
Michèle Noël ◽  
Didier Chevenne ◽  
Edith Vuillard ◽  
Jean Luc Voluménie ◽  
...  
Keyword(s):  
Cord Blood ◽  
Gestational Age ◽  
Treatment Efficacy ◽  
Thyroid Dysfunction ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Biochemical Investigation ◽  
Neonatal Thyroid Function ◽  
Serum Tsh ◽  
Tsh Levels

Despite sonographic detection of foetal goitre, uncertainty persists in the initial diagnosis of thyrotoxicosis and hypothyroidism. The aim of this study was to establish foetal and neonatal iodothyronine and thyrotrophin reference values for the ACS-180SE analyser. From 22 to 36 weeks of gestation, median foetal serum free thyroxine (FT4) levels increased from 6·0 pmol/L to 14·3 pmol/L, while free triiodothyronine (FT3) levels increased from 0·7 pmoI/L to 1·9 pmol/L and mean thyrotrophin (TSH) levels remained stable (10·2±3·8 mU/L; n=33). At birth, concentrations were independent of gender and gestational age. Among the 10 cases of sonographically detected foetal goitre, serum TSH and FT4 were measured in five, showing hypothyroidism (3/5) or hyperthyroidism (2/5). Cord blood TSH levels reflected the efficacy of prenatal therapy. Measurement of foetal FT4 and TSH can be used to confirm foetal thyroid dysfunction, whereas treatment efficacy can be assessed sonographically and confirmed by measurement of TSH assay at birth.

Effects of Age and Health on the Euthyroid Reference Ranges for Serum Free Thyroxine and Free Triiodothyronine

1985 ◽  
Vol 24 (02) ◽  
pp. 57-65 ◽  
Author(s):  
J. E. M. Midgley ◽  
K. R. Gruner
Keyword(s):  
Lower Limit ◽  
Healthy Subjects ◽  
Thyroid Dysfunction ◽  
Reference Range ◽  
Free Thyroxine ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Young Subjects ◽  
Age Range

SummaryAge-related trends in serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations were measured in 7248 euthyroid subjects (age-range 3 months to 106 years). 5700 were patients referred to hospitals for investigation of suspected thyroid dysfunction, but who were diagnosed euthyroid. 1548 were healthy blood donors (age-range 18-63 years) with no indication of thyroid dysfunction. FT4 concentrations were little affected by the age, the sex or the state of health of the subjects in either group. Serum FT3 concentrations were significantly affected by both age and health factors. The upper limit of the euthyroid reference range for young subjects up to 15 years was about 20% higher (10.4 pmol/1) than for adult subjects older than 25 years (8.8 pmol/1). The change in the upper limits typical of young subjects to that typical of adults occurred steadily over the decade 15–25 years. After this age, little further change occurred, especially in healthy subjects. Additionally, the lower limit of the euthyroid range for FT3 was extended by the inclusion in the reference group of patients referred to hospitals. Compared with the lower limit of the FT3 range for healthy subjects (5 pmol/1), the corresponding limit for referred subjects (young or adult) was 3.5–3.8 pmol/1. Broadening of the FT3 reference range was probably brought about by a significant number of patients in the hospital-referred group with the “1OW-T3 syndrome” of mild non-thyroidal illness. Accordingly, FT3 was inferior to FT4 in the discrimination of hypothyroidism, as FT4 was unaffected by this phenomenon. Effects of age and non-thyroidal illness on serum FT3 concentrations require great care when selecting subjects for a laboratory euthyroid reference range typical of the routine workload. Constraints on the choice of subjects for FT4 reference ranges are less stringent.

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.

scholarly journals The pituitary-thyroid axis in healthy men living under subarctic climatological conditions

2001 ◽  
Vol 169 (1) ◽  
pp. 195-203 ◽  
Author(s):  
J Hassi ◽  
K Sikkila ◽  
A Ruokonen ◽  
J Leppaluoto
Keyword(s):  
Thyroid Hormones ◽  
Climatic Factors ◽  
Feedback Mechanism ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Healthy Men ◽  
Non Invasive ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Serum Tsh

In order to evaluate the effects of climatic factors on the secretion of thyroid hormones and TSH in a high latitude population, we have taken serum and urine samples from 20 healthy men from northern Finland (67 degrees -68 degrees N) every 2 months for a period of 14 months. Serum free triiodothyronine (T(3)) levels were lower in February than in August (3.9 vs 4.4 pmol/l, P<0.05) and TSH levels were higher in December than during other months (2.1 vs 1.5-1.7 mU/l, P<0.01). Serum total and free thyroxine (T(4)), total T(3) and reverse T(3) levels and urinary T(4) levels were unchanged. Urinary T(3) levels were significantly higher in winter than in summer. Serum free T(3) correlated highly significantly with the outdoor temperature integrated backwards weekly for 7-56 days (r=0.26 for 1-56 days) from the day when the blood samples were taken. Serum TSH did not show any significant correlation with the thyroid hormones or with the integrated temperature of the previous days, but it did show an inverse and significant correlation (r=-0.31) with the ambient luminosity integrated backwards for 7 days from the day when the blood sample was taken. The gradually increasing correlation between outdoor temperatures and serum free T(3) suggests that the disposal of thyroid hormones is accelerated in winter, leading to low serum free T(3) levels and a high urinary free T(3) excretion. Since there was no correlation between thyroid hormones and serum TSH, the feedback mechanism between TSH and thyroid hormones may not be the only contributing factor, and other factors such as ambient luminosity may at least partly determine serum TSH in these conditions. Also urinary free T(3) appears to be a novel and non-invasive indicator for thyroid physiology.

scholarly journals Decreased serum TSH levels are not associated with mortality in the adult northeast German population

2010 ◽  
Vol 162 (3) ◽  
pp. 579-585 ◽  
Author(s):  
Till Ittermann ◽  
Robin Haring ◽  
Sybille Sauer ◽  
Henri Wallaschofski ◽  
Marcus Dörr ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
German Population ◽  
Free Triiodothyronine ◽  
Meta Analyses ◽  
Serum Tsh ◽  
Tsh Levels

ObjectiveResults of cohort studies on the association between decreased serum TSH levels and mortality are conflicting. Some studies demonstrated an increased mortality risk in subjects with decreased serum TSH levels, others did not. Even meta-analyses revealed contradictory results. We undertook the present study to investigate the association between decreased serum TSH levels and mortality in the large population-based Study of Health in Pomerania (SHIP).Design and methodsData from 3651 individuals from SHIP without known thyroid disorders or thyroid treatment were analyzed. Serum TSH, free triiodothyronine, and free thyroxine levels were determined by immunochemiluminescent procedures. Decreased TSH was defined as serum TSH levels below 0.25 mIU/l. Cox regression was used to associate decreased TSH levels with mortality.ResultsThe median duration of follow-up was 8.5 years (30 126 person years). During follow-up, 299 individuals (6.9%) died corresponding to a death rate of 9.92 deaths per 1000 person years. Survival time was shorter in subjects with decreased serum TSH levels compared to euthyroid individuals. After adjustment for age and sex, however, there was no association between decreased serum TSH levels and all-cause mortality (hazard ratio: 0.95; 95% confidence interval: 0.67; 1.36). Likewise, decreased serum TSH levels were neither associated with cardiovascular nor with cancer mortality.ConclusionsThere is no independent association of decreased serum TSH levels with all-cause, cardiovascular, and cancer mortality in the adult northeast German population. Although our study has some strengths, we cannot finally conclude on therapeutical implications in individuals with subclinical thyroid diseases.

Circadian thyrotropin variations are preserved in normal pregnant women

1995 ◽  
Vol 133 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Elio Roti ◽  
Luigi Bartalena ◽  
Roberta Minelli ◽  
Mario Salvi ◽  
Eliana Gardini ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Pregnant Women ◽  
Free Thyroxine ◽  
Third Trimester ◽  
Circadian Variations ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Trimester Pregnancy ◽  
Serum Tsh ◽  
Serum Free Thyroxine

Roti E, Bartalena L, Minelli R, Salvi M, Gardini E, Pistolesi A, Martino E, Braverman LE. Circadian thyrotropin variations are preserved in normal pregnant women. Eur J Endocrinol 1995;133:71–4. ISSN 0804–4643 Serum thyrotropin (TSH) concentration circadian rhythm is abolished in many endocrine and nonendocrine diseases. In the present study we have measured serum TSH concentration over 24 h every 2 h in second and third trimester pregnant women. During the 24-h period, serum free thyroxine and free triiodothyronine concentrations did not change significantly. In contrast, serum TSH concentrations demonstrated significant circadian variations both in the second and third trimester pregnant women (p<0.02 and p <0.005, respectively). In summary, second and third trimester pregnancy is associated with a normal circadian TSH rhythm. Elio Roti, Centro per lo Studio, Prevenzione, Diagnosi e Cura delle Tireopatie, University of Parma, via Gramsci 14, 1-43100 Parma, Italy

scholarly journals Association between Thyroid Stimulating Hormone and Respiratory Distress Syndrome of Newborn in the Preterm Infants

2020 ◽  
Author(s):  
Young Jin Kim ◽  
Byoung Kook Kim ◽  
Yong Hyuk Kim
Keyword(s):  
Thyroid Hormone ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Control Group ◽  
Lower Serum ◽  
Significant Difference ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

scholarly journals Age and Menopausal Status Affect Osteoprotegerin and Osteocalcin Levels in Women Differently, Irrespective of Thyroid Function

2014 ◽  
Vol 7 ◽  
pp. CMED.S15466 ◽  
Author(s):  
Alexander D. Shinkov ◽  
Anna-Maria I. Borissova ◽  
Roussanka D. Kovatcheva ◽  
lliana B. Atanassova ◽  
Jordan D. Vlahov ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Thyroid Function ◽  
Vascular Function ◽  
Thyroid Dysfunction ◽  
Bone Cells ◽  
Menopausal Status ◽  
Thyroid Stimulating Hormone ◽  
Multiple Factors ◽  
Serum Tsh ◽  
Tsh Levels

Osteoprotegerin (OPG) and osteocalcin (OC) are essential bone proteins. Recent studies have demonstrated that they are not secreted solely by bone cells; they play roles in the vascular function and energy metabolism, and they are influenced by multiple factors. The aim of the current study was to investigate the influence of menopause and age on OPG and OC in women with different thyroid-stimulating hormone (TSH) levels. Material and Methods We studied 49 women with elevated TSH, 26 with suppressed TSH, and 67 age-matched euthyroid controls. Of them 64 were menstruating and 78 postmenopausal. Body weight, height, waist circumference (WC), body mass index (BMI), serum TSH, free thyroxin (FT4), OPG, and OC were measured. Results Generally, both OPG and OC were higher in the postmenopausal women than in the menstruating subjects (OPG 3.85 ± 1.49 pmol/L vs. 5.84 ± 2.42 pmol/L, P < 0.001; OC 8.84 ± 3.70 ng/dL vs. 12.87 ± 6.45 ng/dL, P < 0.001), and within the two thyroid dysfunction subgroups and the controls (all P < 0.05). OPG correlated with age (postmenopausal rho = 0.57, P < 0.001; premenopausal rho = 0.31, P = 0.015). Among the premenopausal subjects, OPG was higher in those with low TSH than in the controls ( P = 0.048). OC correlated negatively with BMI and WC in the postmenopausal group (Spearman rho = –-0.25, P = 0.03 and rho = –-0.42, P < 0.001 respectively). OC was higher in the postmenopausal subjects with low TSH than in those with elevated TSH ( P = 0.024), and correlated positively with FT4 (rho = 0.40, P = 0.002) and negatively with TSH (rho = -0.29, P = 0.013). CONCLUSIONS In women, OPG and OC depended differently on age and menopause and, to a lesser extent, on the thyroid function and body composition.

scholarly journals Familial Dysalbuminemic Hyperthyroxinemia in a Japanese Man Caused by a Point Albumin Gene Mutation (R218P)

2016 ◽  
Vol 7 ◽  
pp. JCM.S38990 ◽  
Author(s):  
Yoshinori Osaki ◽  
Yoshitaka Hayashi ◽  
Yoshinori Nakagawa ◽  
Katsumi Yoshida ◽  
Hiroshi Ozaki ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Autosomal Dominant ◽  
Japanese Patients ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Albumin Gene ◽  
Dominant Disease ◽  
Euthyroid Hyperthyroxinemia ◽  
Aomori Prefecture ◽  
Tsh Levels

Familial dysalbuminemic hyperthyroxinemia (FDH) is a familial autosomal dominant disease caused by mutation in the albumin gene that produces a condition of euthyroid hyperthyroxinemia. In patients with FDH, serum-free thyroxine (FT4) and free triiodothyronine (FT3) concentrations as measured by several commercial methods are often falsely increased with normal thyrotropin (TSH). Therefore, several diagnostic steps are needed to differentiate TSH-secreting tumor or generalized resistance to thyroid hormone from FDH. We herein report a case of a Japanese man born in Aomori prefecture, with FDH caused by a mutant albumin gene (R218P). We found that a large number of FDH patients reported in Japan to date might have been born in Aomori prefecture and have shown the R218P mutation. In conclusion, FDH needs to be considered among the differential diagnoses in Japanese patients born in Aomori prefecture and showing normal TSH levels and elevated FT4 levels.

scholarly journals Thyroid testing paradigm switch from thyrotropin to thyroid hormones—Future directions and opportunities in clinical medicine and research

Endocrine ◽  
2021 ◽  
Vol 74 (2) ◽  
pp. 285-289
Author(s):  
Stephen P. Fitzgerald ◽  
Nigel G. Bean ◽  
James V. Hennessey ◽  
Henrik Falhammar
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Dysfunction ◽  
Clinical Medicine ◽  
Older Individuals ◽  
Free Triiodothyronine ◽  
Thyroid State ◽  
Peripheral Tissues ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Tsh Levels

Abstract Purpose Recently published papers have demonstrated that particularly in untreated individuals, clinical parameters more often associate with thyroid hormone, particularly free thyroxine (FT4), levels than with thyrotropin (TSH) levels. Clinical and research assessments of the thyroid state of peripheral tissues would therefore be more precise if they were based on FT4 levels rather than on TSH levels. In this paper we describe implications of, and opportunities provided by, this discovery. Conclusions The FT4 level may be the best single test of thyroid function. The addition of free triiodothyronine (FT3) and TSH levels would further enhance test sensitivity and distinguish primary from secondary thyroid dysfunction respectively. There are opportunities to reconsider testing algorithms. Additional potential thyroidology research subjects include the peripheral differences between circulating FT4 and FT3 action, and outcomes in patients on thyroid replacement therapy in terms of thyroid hormone levels. Previously performed negative studies of therapy for subclinical thyroid dysfunction could be repeated using thyroid hormone levels rather than TSH levels for subject selection and the monitoring of treatment. Studies of outcomes in older individuals with treatment of high normal FT4 levels, and pregnant women with borderline high or low FT4 levels would appear to be the most likely to show positive results. There are fresh indications to critically re-analyse the physiological rationale for the current preference for TSH levels in the assessment of the thyroid state of the peripheral tissues. There may be opportunities to apply these research principles to analogous parameters in other endocrine systems.

The Effect of Metformin on Thyroid-Associated Serum Hormone Levels and Physiological Indexes: A Meta-Analysis

2019 ◽  
Vol 25 (30) ◽  
pp. 3257-3265 ◽  
Author(s):  
Junjie Wang ◽  
Jinghan Gao ◽  
Qin Fan ◽  
Hongzhuo Li ◽  
Yunhua Di
Keyword(s):  
Blood Pressure ◽  
Thyroid Function ◽  
Metformin Treatment ◽  
Free Triiodothyronine ◽  
Lower Serum ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Physiological Indices ◽  
Serum Tsh ◽  
Tsh Levels

Background: Many diseases can be treated with metformin. People with serum thyrotropin (TSH) levels higher than 10 mIU/L are at a risk of cardiovascular events. Some studies have suggested that metformin can lower serum TSH levels to a subnormal level in patients with hyperthyrotropinaemia or hypothyroidism. Objective: The objective of this analysis is to evaluate the effect of metformin treatment on serum TSH, free triiodothyronine (FT3), and free thyroxine (FT4) levels and other associated physiological indices. Methods: A comprehensive search using the PubMed, EMBASE, Web of Science and Cochrane Central databases was undertaken for controlled trials on the effect of metformin on serum TSH, FT3, and FT4 levels and associated physiological indices. The primary outcome measures were serum TSH, FT3 and FT4 levels, thyroid size, thyroid nodule size, blood pressure, heart rate, body weight, and body mass index (BMI). The final search was conducted in April 2019. Results: Six RCTs were included. A total of 494 patients met the inclusion criteria. Metformin treatment did not significantly lower the serum TSH levels at 3 or 6 months but did at 12 months. Moreover, forest plots also suggested that metformin can significantly lower the serum TSH levels in patients with normal thyroid function but cannot statistically change the serum TSH levels in patients with abnormal thyroid function. In addition, metformin treatment clearly lowered the serum FT3 levels and had no significant effect on serum FT4 levels. Lastly, metformin cannot significantly change the systolic blood pressure (SBP) or BMI but can clearly increase the diastolic blood pressure (DBP). Conclusion: Metformin treatment can significantly lower the serum TSH levels, and this effect was much clearer after a 12-month treatment duration and in people with normal thyroid function. However, metformin cannot significantly change the serum FT4 levels or lower serum FT3 levels in people with non-thyroid cancer diseases. In addition, metformin can significantly increase DBP, but it has no clear effect on SBP or BMI.

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