The impact of socioeconomic factors and survivorship on radiation induced hypothyroidism in a single institution cohort study.

e24065 Background: To determine factors associated with the development of post-treatment hypothyroidism (HY) in the head and neck (HN) population as well as evaluate the impact of socio-economic factors and survivorship program. Methods: We collected demographics, insurance coverage, disease staging, treatment characteristics, and details of thyroid function measurement as well as supplementation for all HN oncology patients (n = 608) who presented between January 2011 and January 2019 at Levine Cancer Institute, Charlotte, North Carolina. Insurance was categorized as Government (Medicaid or Medicare), Private, or Uninsured. Patient malignancies were grouped as oropharynx, oral cavity, larynx/hypopharynx, nasopharynx, nasal cavity/sinus, or primary salivary gland. Thyroid function was evaluated by use of laboratory thyroid stimulating hormone (TSH) values. Timing of thyroid supplementation was standardized to start of treatment. Details of thyroid hormone supplementation was collected. Data was analyzed with Chi-square and ANOVA methods, using SAS 9.4 (Cary, NC). Results: 483 patients (79%) had post treatment surveillance with TSH. The patients (n = 125, 21%) with no identifiable thyroid surveillance did not have any racial or socioeconomic disparities identified. Caucasian and African American thyroid surveillance rates were similar at 79% and 81%, respectively. There was no difference based on insurance: Government 81%, Uninsured 81%, and Private 76%. Of patients with thyroid surveillance, 203 (42%) developed post-treatment HY. The mean and median time frame until HY identification was 544 days and 450 days, respectively. A mean and median dose of thyroid hormone supplementation of 75 mcg of levothyroxine. Most patients had lower rates of thyroid dysfunction with TSH levels between 5-10. Fewer African Americans (24%) developed HY than Caucasians (47%). Patients with laryngeal cancer were at greatest risk to develop HY (57%), followed by oropharynx (40%) and oral cavity (40%). Staging did not demonstrate a significant difference between development of HY. Conclusions: This study is the largest cohort of HN patients to be evaluated for post HN treatment induced HY. Oncology team providers and primary care physicians should be aware of the significant rates of HY. In our institution we identified a consistency of care provided regardless of socioeconomic and racial factors.

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Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels

International Journal of Molecular Sciences ◽

10.3390/ijms22126521 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6521

Author(s):

Mirjana Babić Babić Leko ◽

Ivana Gunjača ◽

Nikolina Pleić ◽

Tatijana Zemunik

Keyword(s):

Thyroid Hormone ◽

Environmental Factors ◽

Thyroid Hormones ◽

Thyroid Function ◽

Lifestyle Factors ◽

Thyroid Stimulating Hormone ◽

Hormone Levels ◽

Thyroid Hormone Levels ◽

The Impact ◽

Tsh Levels

Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene–environment interactions underlying the pathology of thyroid diseases.

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A REVIEW: MECHANISTIC INSIGHTS INTO THE EFFECT OF THYROID DISORDERS ON ESTROGEN LEVEL AND BONE MINERAL DENSITY

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2019v11i10.34447 ◽

2019 ◽

pp. 9-17

Author(s):

MINAKSHI JOSHI ◽

SHRADHA BISHT ◽

MAMTA F. SINGH

Keyword(s):

Bone Mineral Density ◽

Thyroid Hormone ◽

Bone Turnover ◽

Bone Mineral ◽

Thyroid Stimulating Hormone ◽

Thyroid Disorders ◽

Hypothyroid Patient ◽

Mineral Density ◽

Estrogen Level ◽

The Impact

Thyroid hormone serves as an indispensable component for the optimum functioning of various biological systems. They curb body’s metabolism, regulates the estrogen level, regulates bone turnover, essential for skeletal development and mineralization. Within the scope of knowledge, it is intimately familiar that thyroid disorders have widespread systemic manifestations, among which in hypothyroidism, even though elevated TSH (thyroid-stimulating hormone) may reduce estrogen level which in turn stimulates osteoclasts and thus cause osteoporosis, while hyperthyroidism accelerates bone turnover. Hypothyroidism does not directly interfere with the skeletal integrity, but treatment with levothyroxine for the suppression of TSH to bring the hypothyroid patient to euthyroid state for a long haul; lead to simultaneous reduction in bone mass and in (bone mineral density) BMD. After the initial relevation of the correlation between thyroid disorders and osteoporosis in numerous studies have emphasized that both hypo and hyperthyroidism either directly or indirectly affects the bone mineral density or leads to the progression of osteoporosis. Therefore the present study is aimed and so designed to review all the possible associations between them and the impact of thyroid disorders on estrogen level and bone mineral density. The main findings of this review indicate that both excesses as well as deficiency of thyroid hormone can be potentially deleterious for bone tissue.

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Iodide Metabolism and Effects

Diagnosing and Managing Hashimoto’s Disease - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-9655-4.ch004 ◽

2020 ◽

pp. 25-33

Keyword(s):

Thyroid Hormone ◽

Thyroid Gland ◽

Thyroid Hormones ◽

Dietary Supplement ◽

Thyroid Function ◽

Thyroid Stimulating Hormone ◽

Hormone Synthesis ◽

Serum Tsh ◽

Tsh Stimulation ◽

Sensitive Marker

Iodine (I2) is essential in the synthesis of thyroid hormones T4 and T3 and functioning of the thyroid gland. Both T3 and T4 are metabolically active, but T3 is four times more potent than T4. Our body contains 20-30 mg of I2, which is mainly stored in the thyroid gland. Iodine is naturally present in some foods, added to others, and available as a dietary supplement. Serum thyroid stimulating hormone (TSH) level is a sensitive marker of thyroid function. Serum TSH is increased in hypothyroidism as in Hashimoto's thyroiditis. In addition to regulation of thyroid function, TSH promotes thyroid growth. If thyroid hormone synthesis is chronically impaired, TSH stimulation eventually may lead to the development of a goiter. This chapter explores the iodide metabolism and effects of Hashimoto's disease.

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Sea water desalination and removal of iodine: effect on thyroid function

Journal of Water and Health ◽

10.2166/wh.2018.372 ◽

2018 ◽

Vol 16 (3) ◽

pp. 472-475

Author(s):

Gideon Koren ◽

Yona Amitai ◽

Meital Shlezinger ◽

Rachel Katz ◽

Varda Shalev

Keyword(s):

Thyroid Function ◽

Sea Water ◽

Population Based ◽

Thyroid Stimulating Hormone ◽

Water Desalination ◽

Thyroid Function Tests ◽

School Aged Children ◽

Before And After ◽

Using Data ◽

The Impact

Abstract In Israel, about 55% of drinking water is derived from desalination (DSW) which removes all iodine. A recent study from Israel demonstrated high rates of iodine deficiency among school-aged children and pregnant women. There are concerns that low iodine may lead to impaired thyroid function. However, to date, the impact of consuming DSW on body iodine status has not been studied. The objective was to assess whether the increased use of DSW is associated with increased rates of hypothyroidism. Using data from a large health fund in Israel, we compared proportions of patients with higher than normal thyroid stimulating hormone (TSH), and lower than normal T3 and T4 levels before and after a massive desalination project became operational in August 2013 in areas with high vs. low use of DSW. Over 400,000 cases were compared in 2010–2013 vs. 2014–2016. Overall, there was no increase in the proportion of individuals with higher than normal TSH levels, or lower than normal T3 and T4 levels. In conclusion, in this population-based study, following the introduction of DSW, there was no evidence of increased incidence of low thyroid function tests, and the trends were similar in both areas highly consuming, or not consuming, DSW.

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Feather Corticosterone Measurements of Greater Flamingos Living under Different Forms of Flight Restraint

Animals ◽

10.3390/ani10040605 ◽

2020 ◽

Vol 10 (4) ◽

pp. 605 ◽

Cited By ~ 1

Author(s):

Lukas Reese ◽

Katrin Baumgartner ◽

Lorenzo von Fersen ◽

Roswitha Merle ◽

Mechthild Ladwig-Wiegard ◽

...

Keyword(s):

Animal Welfare ◽

Time Frame ◽

High Variability ◽

Housing Conditions ◽

Measurable Effect ◽

Behavioral Observations ◽

Significant Difference ◽

The Impact ◽

Greater Flamingos ◽

Feather Corticosterone

Deflighting zoo birds is a practice that receives increasing criticism due to its presumed incompatibility with animal welfare. To our knowledge, this is the first approach to address this problem in a scientific way. To do this, we compared feather corticosterone (CORTf) from Greater Flamingos (Phoenicopterus roseus, n = 151) of different flight status (i.e., pinioned, feather clipped, airworthy) from twelve different zoological institutions. To complement the hormone measurements, behavioral observations (scan samplings) were conducted prior to feather sampling within the presumed time frame of feather growth. We hypothesized that CORTf of the deflighted flamingos would differ from CORTf of their airworthy conspecifics. No significant difference in CORTf was found between the three groups, and our hypothesis was rejected. However, the impact of the institution itself (i.e., the housing conditions) proved to be the most dominant variable (variance between the institutions = 53.82%). Due to high variability, the behavioral observations were evaluated descriptively but did not give rise to doubt the findings in CORTf. Therefore, we assume that the method of flight restraint of Greater Flamingos does not have a measurable effect on CORTf. We consider this model for evaluating animal welfare of zoo birds a useful tool and provide ideas for further adjustments for consecutive studies.

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Screening for New Markers to Assess Thyroid Hormone Action by OMICs Analysis of Human Samples

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-1144-2636 ◽

2020 ◽

Vol 128 (06/07) ◽

pp. 479-487 ◽

Cited By ~ 1

Author(s):

Nele Friedrich ◽

Maik Pietzner ◽

Beatrice Engelmann ◽

Georg Homuth ◽

Dagmar Führer ◽

...

Keyword(s):

Thyroid Hormone ◽

Thyroid Function ◽

Clinical Symptoms ◽

Pituitary Tumors ◽

Population Based ◽

Thyroid Stimulating Hormone ◽

Central Hypothyroidism ◽

Free Thyroid Hormones ◽

Molecular Alterations ◽

Novel Biomarkers

ABSTRACTDetermination of the levels of thyroid-stimulating hormone (TSH) and free thyroid hormones (fTHs) is crucial for assessing thyroid function. However, as a result of inter-individual genetic variability and different environmental factors individual set points exist for TSH and fTHs and display considerable variation. Furthermore, under specific pathophysiological conditions like central hypothyroidism, TSH secreting pituitary tumors, or thyroid hormone resistance the established markers TSH and fTH fail to reliably predict thyroid function and adequate supply of TH to peripheral organs. Even in case of overt hyper- and hypothyroidism circulating fTH concentrations do not correlate with clinical symptoms. Therefore, there is a clear need for novel, more specific biomarkers to diagnose and monitor thyroid function. OMICs screening approaches allow parallel profiling of hundreds to thousands of molecules and thus comprehensive monitoring of molecular alterations in tissues and body fluids that might be associated with changes in thyroid function. These techniques thus constitute promising tools for the identification of urgently needed novel biomarkers. This mini review summarizes the findings of OMICs studies in thyroid research with a particular focus on population-based and patient studies as well as interventional approaches investigating the effects of thyroid hormone administration.

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ABNORMAL REGULATION OF THYROID FUNCTION IN PATIENTS WITH CHRONIC CHAGA'S DISEASE

Acta Endocrinologica ◽

10.1530/acta.0.0530162 ◽

1966 ◽

Vol 53 (1) ◽

pp. 162-176 ◽

Cited By ~ 6

Author(s):

D. A. Lomonaco ◽

H. L. Oliveira ◽

J. Kieffer ◽

R. R. Pieroni

Keyword(s):

Thyroid Hormone ◽

Chagas Disease ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Functional Study ◽

Control Groups ◽

Chronic Form ◽

Significant Difference ◽

The Difference ◽

Chronic Chagas Disease

ABSTRACT The problem of thyroid dysfunction in Chagas' disease is discussed on the basis of the functional study of three series of patients with the chronic form of the disease. There was no significant association between Chagas' disease and goiter. No significant difference was found between the average plasma PBI in the groups of patients and that of the control groups. However, the values in the Chagas groups showed a much wider dispersion than those of the non Chagas controls; the difference between the corresponding variances was statistically significant. A loss of efficiency of the mechanisms concerned with the homeostasis of circulating thyroid hormone seems to occur in chronic Chagas' disease. This is interpreted as a possible result of the nervous lesion characteristic of the disease, which might involve neuronal links of homeostatic circuits responsible for the release of TSH.

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Iodine and Pregnancy

Journal of Thyroid Research ◽

10.4061/2011/934104 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 25

Author(s):

Christina Yarrington ◽

Elizabeth N. Pearce

Keyword(s):

Thyroid Hormone ◽

Pregnant Women ◽

Thyroid Function ◽

Environmental Contaminants ◽

Iodine Status ◽

Nutritional Recommendations ◽

Iodine Metabolism ◽

The Impact ◽

In Pregnancy

Iodine is a necessary element for the production of thyroid hormone. We will review the impact of dietary iodine status on thyroid function in pregnancy. We will discuss iodine metabolism, homeostasis, and nutritional recommendations for pregnancy. We will also discuss the possible effects of environmental contaminants on iodine utilization in pregnant women.

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Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-00279 ◽

2018 ◽

Vol 103 (8) ◽

pp. 2988-2997 ◽

Cited By ~ 16

Author(s):

Manuel R Blum ◽

Baris Gencer ◽

Luise Adam ◽

Martin Feller ◽

Tinh-Hai Collet ◽

...

Keyword(s):

Thyroid Hormone ◽

Subclinical Hypothyroidism ◽

Carotid Plaque ◽

Carotid Atherosclerosis ◽

Controlled Trial ◽

Hormone Replacement ◽

Intima Media Thickness ◽

Thyroid Stimulating Hormone ◽

Double Blind ◽

The Impact

Abstract Context Subclinical hypothyroidism (SHypo) has been associated with atherosclerosis, but no conclusive clinical trials assessing the levothyroxine impact on carotid atherosclerosis exist. Objective To assess the impact of treatment of SHypo with levothyroxine on carotid atherosclerosis. Design and Setting Randomized, double-blind, placebo-controlled trial nested within the Thyroid Hormone Replacement for Subclinical Hypothyroidism trial. Participants Participants aged ≥65 years with SHypo [thyroid-stimulating hormone (TSH), 4.60 to 19.99 mIU/L; free thyroxine level within reference range]. Intervention Levothyroxine dose-titrated to achieve TSH normalization or placebo, including mock titrations. Main Outcome Measures Carotid intima media thickness (CIMT), maximum plaque thickness measured with ultrasound. Results One hundred eighty-five participants (mean age 74.1 years, 47% women, 96 randomized to levothyroxine) underwent carotid ultrasound. Overall mean TSH ± SD was 6.35 ± 1.95 mIU/L at baseline and decreased to 3.55 ± 2.14 mIU/L with levothyroxine compared with 5.29 ± 2.21 mIU/L with placebo (P < 0.001). After a median treatment of 18.4 months (interquartile range 12.2 to 30.0 months), mean CIMT was 0.85 ± 0.14 mm under levothyroxine and 0.82 ± 0.13 mm under placebo [between-group difference = 0.02 mm; 95% CI, −0.01 to 0.06; P = 0.30]. The proportion of carotid plaque was similar (n = 135; 70.8% under levothyroxine and 75.3% under placebo; P = 0.46). Maximum carotid plaque thickness was 2.38 ± 0.92 mm under levothyroxine and 2.37 ± 0.91 mm under placebo (between-group difference −0.03; 95% CI, −0.34 to 0.29; P = 0.86). There were no significant interactions between levothyroxine treatment and mean CIMT, according to sex, baseline TSH (categories 4.6 to 6.9, 7.0 to 9.9, and ≥10 mIU/L), or established cardiovascular disease (all P for interaction ≥ 0.14). Conclusion Normalization of TSH with levothyroxine was associated with no difference in CIMT and carotid atherosclerosis in older persons with SHypo.

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Relationship between Different Psoriasis Types and Thyroid Dysfunction: A Retrospective Analysis

Scanning ◽

10.1155/2021/1834556 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Juan Du ◽

Chunyue Ma ◽

Runnan Wang ◽

Lanmei Lin ◽

Luhui Gao ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Hormone Levels ◽

Significant Difference ◽

Total Thyroxine

Objective. The aim of this study was to investigate the relationship between different psoriasis types and thyroid dysfunction. Methods. The data of patients diagnosed with psoriasis between January 2013 and October 2018 who underwent thyroid function tests were collected. Free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) were measured. The thyroid function of patients with psoriasis vulgaris, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis was evaluated, and the differences in hormone levels and antibodies in the pituitary-thyroid axis with psoriasis type were analyzed. Results. The data of a total of 468 patients were analyzed in this study. The proportion of normal hormone levels was higher among vulgaris patients ( P < 0.001 ), while the erythrodermic patients were more likely to have decreased FT3 or FT4 but normal TSH ( P < 0.001 ). FT3 levels were lower in pustular patients ( P < 0.05 ), FT4 levels were lower in erythrodermic patients ( P < 0.05 ), and TSH levels were higher in patients with psoriatic arthritis ( P < 0.05 ). TPOAb levels were higher than normal in all patients, but there was no significant difference in the levels of TPOAb and TGAb among 4 types of the patients. Conclusion. Psoriasis is related to thyroid dysfunction, especially in patients with atypical psoriasis types. The possibility of complications should be considered in erythrodermic patients.

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