scholarly journals Ablation of Thyroid Residues with 30 mCi 131I: A Comparison in Thyroid Cancer Patients Prepared with Recombinant Human TSH or Thyroid Hormone Withdrawal

2002 ◽  
Vol 87 (9) ◽  
pp. 4063-4068 ◽  
Author(s):  
Furio Pacini ◽  
Eleonora Molinaro ◽  
Maria Grazia Castagna ◽  
Francesco Lippi ◽  
Claudia Ceccarelli ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Dose Rate ◽  
Initial Dose ◽  
Standard Dose ◽  
Basal Serum ◽  
Recombinant Human Tsh ◽  
Thyroid Ablation ◽  
Serum Tsh ◽  
The Eu

The aim of the study was to assess whether stimulation by recombinant human TSH (rhTSH) may be used in patients with differentiated thyroid carcinoma for postsurgical ablation of thyroid remnants using a 30-mCi standard dose of 131I during thyroid hormone therapy. The rate of ablation was prospectively compared in three groups of patients consecutively assigned to one of three treatment arms: in the first arm, patients (n = 50) were treated while hypothyroid (HYPO); in the second arm, patients (n = 42) were treated while HYPO and stimulated in addition with rhTSH (HYPO + rhTSH); in the third arm, patients (n = 70) were treated while euthyroid (EU) on thyroid hormone therapy and stimulated with rhTSH (EU + rhTSH). The outcome of thyroid ablation was assessed by conventional HYPO 131I scan performed in HYPO state 6–10 months after ablation. Basal serum TSH was elevated in the HYPO and HYPO + rhTSH groups. In the EU + rhTSH group, basal serum TSH was 1.3 ± 2.5 μU/ml (range, <0.005–11.9 μU/ml). After rhTSH, serum TSH significantly increased in the HYPO + rhTSH group and the EU + rhTSH group. Basal 24-h radioiodine thyroid bed uptake was 5.8 ± 5.7% (range, 0.2–21%) and 5.4 ± 5.7% (range, 0.2–26%) in the HYPO and HYPO + rhTSH groups, respectively. In the HYPO + rhTSH group, mean 24-h thyroid bed uptake rose to 9.4 ± 9.5% (range, 0.2–46%) after rhTSH (P < 0.0001). The 24-h uptake after rhTSH in the EU + rhTSH group was 2.5 ± 4.3% (range, 0.1–32%), significantly lower (P < 0.0001) than that found in the HYPO and HYPO + rhTSH groups. The rate of successful ablation was similar in the HYPO and HYPO + rhTSH groups (84% and 78.5%, respectively). A significantly lower rate of ablation (54%) was achieved in the EU + rhTSH group. Mean initial dose rate (the radiation dose delivered during the first hour after treatment) was significantly lower in the EU + rhTSH group (10.7 ± 12.6 Gy/h) compared with the HYPO + rhTSH group (48.5 ± 43 Gy/h) and the HYPO group (27.1 ± 42.5 Gy/h). In conclusion, our study indicates that by using stimulation with rhTSH, a 30-mCi standard dose of radioiodine is not sufficient for a satisfactory thyroid ablation rate. Possible reasons for this failure may be the low 24-h radioiodine uptake, the low initial dose rate delivered to the residues, and the accelerated iodine clearance observed in EU patients. Possible alternatives for obtaining a satisfactory rate of thyroid ablation with rhTSH may consist of increasing the dose of radioiodine or using different protocols of rhTSH administration producing more prolonged thyroid cells stimulation.

Linear modulation of serum thyrotrophin by thyroid hormone treatment in hypothyroidism

1980 ◽  
Vol 95 (4) ◽  
pp. 472-478 ◽  
Author(s):  
A. Eugene Pekary ◽  
Jerome M. Hershman ◽  
Clark T. Sawin
Keyword(s):  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Hormone Treatment ◽  
Significant Negative Correlation ◽  
Thyroid Hormone Replacement ◽  
Basal Serum ◽  
Thyroid Hormone Levels ◽  
Peak Versus ◽  
Hypothyroid Patients ◽  
Serum Tsh

Abstract. Basal serum TSH and the peak TSH response to a 500 μg TRH bolus were measured in 57 euthyroid and in 29 hypothyroid subjects either receiving graded thyroid hormone replacement or acutely removed from full replacement therapy. Serum TSH, total T4 and T3 were determined by sensitive radioimmunoassay methods. The peak versus basal TSH data for hypothyroid patients were linear within individuals. The regression slope of the peak versus basal TSH data for all hypothyroid subjects did not differ significantly from the corresponding slope for all euthyroid subjects. Basal and peak TSH versus T3 and T4 data for hypothyroid patients were also linear within each individual. Moreover, the regression of the basal TSH values averaged over the non-replacement to full replacement state against the TSH versus T3 slope had a significant negative correlation. This trend leads to an array of regression lines which average to the familiar hyperbolic relationship between thyrotrophin and thyroid hormone levels in man.

THYROID HORMONE THERAPY AND TREATMENT FOR WOMEN’S ABOVE 30 YEAR OLD WITH HYPOTHYROIDISM

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
N Rawat ◽  
S Saxena
Keyword(s):  
Immune System ◽  
Thyroid Hormone ◽  
Side Effects ◽  
Thyroid Hormones ◽  
Hormone Therapy ◽  
Free Thyroxine ◽  
Substitution Treatment ◽  
Free Triiodothyronine ◽  
Typical Condition ◽  
Serum Tsh

Thyroid hormones impact every single significant organ/frameworks and sufficient levels are significant for ideal capacity. Thyroid brokenness is a typical condition that effects somewhere in the range of 3 and 21% of the populace with predominance being increasingly regular in ladies and in more established people. Hypothyroidism is characterized by the expansion in thyroid-animating hormone (TSH) values, joined by diminished coursing free triiodothyronine (FT3) and free thyroxine (FT4). TSH is the most solid marker of sufficiency of substitution treatment, and an incentive inside the reference run (0.4–4.0 mIU/L) ought to be viewed as the helpful objective" have serum TSH esteems somewhere in the range of 0.4 and 2.5 mU/L. It is thusly contended that TSH esteems > 2.5 mU/L reflect hidden immune system thyroid ailment and add to the slanted TSH dissemination bend, a view additionally bolstered by the way that such people have a higher danger of movement to ensuing hypothyroidism. In this way, side effects of hypothyroidism are inadequate and vague in more established individuals. This prompts thyroid capacity tests being as often as possible mentioned. Then again, high thyroid capacity, as confirm by a low TSH level needs cautious observing and treatment considered if there is proof of end-organ harm, (for example, osteoporosis or AF), or if serum TSH is stifled. Keywords: TSH, Thyroid hormones, Hypothyroidism, FT4.

SERUM TSH LEVELS IN THYROIDECTOMIZED PATIENTS AFTER WITHDRAWAL OF THYROID HORMONE THERAPY OR ORAL ADMINISTRATION OF TRH

1973 ◽  
Vol 71 (4_Suppl) ◽  
pp. S15 ◽  
Author(s):  
K. W. Wenzel ◽  
H. Meinhold ◽  
U. Bogner ◽  
F. Adlkofer ◽  
H. Schleusener
Keyword(s):  
Thyroid Hormone ◽  
Oral Administration ◽  
Hormone Therapy ◽  
Serum Tsh ◽  
Tsh Levels

EFFECTS OF INCREASING DOSES OF PYROGLUTAMYL-HISTIDYL-PROLINE AMIDE ON SERUM THYROTROPHIN LEVELS IN NORMAL SUBJECTS

1972 ◽  
Vol 70 (1) ◽  
pp. 196-208 ◽  
Author(s):  
Bengt Karlberg ◽  
Sven Almqvist
Keyword(s):  
Normal Saline ◽  
Standard Dose ◽  
Normal Subjects ◽  
Response Curves ◽  
Clinical Observations ◽  
Trh Stimulation ◽  
Stimulation Tests ◽  
Serial Measurements ◽  
Serum Tsh ◽  
Stimulation Of

ABSTRACT The effects of the administration of normal saline in four normal subjects and the single iv injections of synthetic pyroglutamyl-histidyl-proline amide (TRH) in doses of 6.25, 12.5, 25, 50, 100, 200 and 400 μg in 12 healthy subjects were evaluated by clinical observations and serial measurements from −10 to + 360 minutes of serum TSH, PBI, STH, cholesterol, glucose and insulin. Normal saline and TRH 6.25 μg iv did not change the serum TSH level. The minimum iv dose of TRH increasing serum TSH within 10 minutes was 12.5 μg. Nine of 12 subjects gave maximal increases of serum TSH after TRH 100 μg and all after 200 and 400 μg. The time for the peak response varied with the dose from 15 to 60 minutes. The dose-response curves, average and individual, were complex and not linear. This was interpreted as a varying degree of stimulation of both pituitary synthesis and release of TSH by TRH. PBI changes were measured at 2 h and 6 h. Minimum dose for a significant increase of PBI was 12.5 μg and 6.25 μg of TRH for the respective times. No change in basal STH-levels occurred in 53 of 65 TRH-stimulation tests. Nine of the 12 changes in serum STH occurred in four subjects with varying basal STH-levels. No changes were found in serum cholesterol, glucose or insulin. Our results show that 50 μg of TRH can be used as a standard dose for the single iv stimulation of pituitary release of TSH. TRH stimulated both TSH and STH release in 18% of our tests.

THYROID HORMONE THERAPY

InPharma ◽  
1975 ◽  
Vol 13 (1) ◽  
pp. 16-16 ◽  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Therapy

scholarly journals Correlation of Serum Prolactin and Thyroid Hormone in Female Infertility

2019 ◽  
Vol 17 (2) ◽  
pp. 32-34
Author(s):  
Fahat Banu
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Dysfunction ◽  
Female Infertility ◽  
Serum Prolactin ◽  
Psychological Consequences ◽  
Medical College ◽  
Hormone Profile ◽  
Hormonal Imbalance ◽  
High Incidence ◽  
Serum Tsh

Background: Infertility is a growing problem with adverse medical, social and psychological consequences globally. Apart from several causes of infertility, hormonal imbalance especially thyroid dysfunction and hyperprolactinemia can lead to female infertility. Both these conditions are treatable so Proper management of hormonal imbalance can result in restoration of normal fertility. Aims and objectives: Correlation of serum Prolactin and Thyroid hormone in female infertility. Materials and methods: Descriptive hospital based study was conducted at Nepalgunj medical college and teaching hospital, Nepalgunj, Banke, Nepal. The data was collected from September 2018 to August 2019. Total 30 cases of females of primary and secondary infertility attending outpatient department of gynecology department of Nepalgunj medical college were included in the study. A detailed history and clinical evaluation was done along with estimation of serum Prolactin and Thyroid hormone profile. Result: Hormonal status of subjects showed 15 i.e. 50% participants were thyroid whereas 11 (36.33%) were hypothyroid and 4 (13.33%) were hyperthyroid. Serum Prolactin was raised in 17 (57%) and normal in 13 (43%). Serum TSH and prolactin were found to be significantly positively correlated in female infertility (r=0.507, p =0.004). Conclusion: There is a high incidence of hyperprolactinaemia and thyroid dysfunction in female infertility.

scholarly journals Challenges in the functional diagnosis of thyroid nodules before surgery for TSH-producing pituitary adenoma

2021 ◽  
Vol 2021 ◽  
Author(s):  
Keita Tatsushima ◽  
Akira Takeshita ◽  
Shuji Fukata ◽  
Noriaki Fukuhara ◽  
Mitsuo Yamaguchi-Okada ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Thyroid Hormone ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Somatostatin Analogue ◽  
Postoperative Phase ◽  
List Type ◽  
Thyroid Scintigraphy ◽  
Serum Tsh

Summary A 50-year-old woman with thyroid-stimulating hormone (TSH)-producing pituitary adenoma (TSHoma) was diagnosed due to symptoms of thyrotoxicosis. Preoperatively, she showed thyrotoxicosis with the syndrome of inappropriate secretion of TSH (SITSH) and had a 5 cm nodule in her thyroid gland. Octreotide was administered preoperatively, which helped lower her serum TSH level but not her thyroid hormone level. These findings were atypical for a patient with TSHoma. The TSHoma was completely resected, and the TSH level dropped below the sensitivity limit shortly after surgery. Interestingly, however, thyroid hormone levels remained high. A clear clue to the aetiology was provided by consecutive thyroid scintigraphy. Although preoperative thyroid scintigraphy did not show a hot nodule and the mass was thought to be a non-functional thyroid nodule, the nodule was found to be hot in the postoperative phase of TSH suppression. By focusing on the atypical postoperative course of the TSHoma, we were able to conclude that this was a case of TSHoma combined with an autonomously functioning thyroid nodule (AFTN). Learning points The diagnosis of autonomously functioning thyroid nodules (AFTNs) depends on suppressed serum TSH levels. If thyroid hormones are resistant to somatostatin analogue therapy or surgery for TSHoma, complications of AFTN as well as destructive thyroiditis need to be considered. It is important to revisit the basics when facing diagnostic difficulties and not to give up on understanding the pathology.

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