scholarly journals The Risk of Preeclampsia According to High Thyroid Function in Pregnancy Differs by hCG Concentration

2016 ◽  
Vol 101 (12) ◽  
pp. 5037-5043 ◽  
Author(s):  
Tim I. M. Korevaar ◽  
Eric A. P. Steegers ◽  
Layal Chaker ◽  
Marco Medici ◽  
Vincent W. V. Jaddoe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Outcome Measure ◽  
High Body Mass Index ◽  
Population Based ◽  
Additional Measurement ◽  
Free T4 ◽  
Normal Thyroid Function ◽  
General Community ◽  
Risk Of Preeclampsia

Context: During pregnancy, there is an increased demand for thyroid hormone. The pregnancy hormone human chorionic gonadotropin (hCG) is an important physiological stimulator of thyroid function. Already high-normal maternal free T4 concentrations are associated with a higher risk of preeclampsia. Objective: The objective of the investigation was to study our hypothesis that hCG concentrations can distinguish a physiological form of high thyroid function from a more pathological form of high thyroid function and that the risk of preeclampsia would differ accordingly. Design: TSH, free T4, hCG, or thyroperoxidase antibody concentrations were determined in pregnant women participating in a population-based prospective cohort study. Setting: The study was conducted in the general community. Participants: A nonselected sample of 5146 pregnant women participated in the study. Interventions: There were no interventions. Main Outcome Measure(s): Preeclampsia was measured. Results: Women with high hCG-associated high thyroid function did not have a higher risk of preeclampsia than women with normal thyroid function. In contrast, women with low hCG and high thyroid function had a 3.4- to 11.1-fold higher risk of preeclampsia. These risk estimates were amplified in women with a high body mass index. Women with a low hCG and suppressed TSH (<0.10 mU/L) had a 3.2- to 8.9-fold higher risk of preeclampsia. hCG was not associated with preeclampsia, and results remained similar after exclusion of thyroperoxidase antibody-positive women. Conclusion: This study suggests that, in contrast to women with a high hCG associated high thyroid function, women with low hCG and high thyroid function during pregnancy are at a higher risk of developing preeclampsia. The additional measurement of hCG may therefore help to distinguish a more pathological form of high thyroid function and women at a high risk of preeclampsia.

scholarly journals Maternal Thyroid Function during the Second Half of Pregnancy and Child Neurodevelopment at 6, 12, 24, and 60 Months of Age

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Jonathan Chevrier ◽  
Kim G. Harley ◽  
Katherine Kogut ◽  
Nina Holland ◽  
Caroline Johnson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Equilibrium Dialysis ◽  
Convincing Evidence ◽  
Free T4 ◽  
Impaired Child ◽  
Motor Functioning ◽  
Child Neurodevelopment ◽  
Maternal Thyroid ◽  
And Behavior

Although evidence suggests that maternal hypothyroidism and mild hypothyroxinemia during the first half of pregnancy alters fetal neurodevelopment among euthyroid offspring, little data are available from later in gestation. In this study, we measured free T4 using direct equilibrium dialysis, as well as total T4 and TSH in 287 pregnant women at 27 weeks' gestation. We also assessed cognition, memory, language, motor functioning, and behavior in their children at 6, 12, 24, and 60 months of age. Increasing maternal TSH was related to better performance on tests of cognition and language at 12 months but not at later ages. At 60 months, there was inconsistent evidence that higher TSH was related to improved attention. We found no convincing evidence that maternal TH during the second half of pregnancy was related to impaired child neurodevelopment.

scholarly journals Perchlorate and Thiocyanate Exposure and Thyroid Function in First-Trimester Pregnant Women

2010 ◽  
Vol 95 (7) ◽  
pp. 3207-3215 ◽  
Author(s):  
Elizabeth N. Pearce ◽  
John H. Lazarus ◽  
Peter P. A. Smyth ◽  
Xuemei He ◽  
Daniela Dall'Amico ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Sodium Iodide ◽  
Urinary Iodine ◽  
First Trimester ◽  
Iodine Intake ◽  
Sodium Iodide Symporter ◽  
Free T4 ◽  
Cross Sectional ◽  
Serum Tsh

Context: Thyroid hormone, requiring adequate maternal iodine intake, is critical for fetal neurodevelopment. Perchlorate decreases thyroidal iodine uptake by competitively inhibiting the sodium/iodide symporter. It is unclear whether environmental perchlorate exposure adversely affects thyroid function in pregnant women. Thiocyanate, derived from foods and cigarette smoke, is a less potent competitive sodium/iodide symporter inhibitor than perchlorate. Objective: Our objective was to determine whether environmental perchlorate and/or thiocyanate exposure is associated with alterations in thyroid function in pregnancy. Design and Setting: We conducted a cross-sectional study at health centers in Cardiff, Wales, and Turin, Italy. Patients: During 2002–2006, 22,000 women at less than 16 wk gestation were enrolled in the Controlled Antenatal Thyroid Screening Study. Subsets of 261 hypothyroid/hypothyroxinemic and 526 euthyroid women from Turin and 374 hypothyroid/hypothyroxinemic and 480 euthyroid women from Cardiff were selected based on availability of stored urine samples and thyroid function data. Main Outcome Measures: Urinary iodine, thiocyanate, and perchlorate and serum TSH, free T4 (FT4), and thyroperoxidase antibody were measured. Results: Urinary iodine was low: median 98 μg/liter in Cardiff and 52 μg/liter in Turin. Urine perchlorate was detectable in all women. The median (range) urinary perchlorate concentration was 5 μg/liter (0.04–168 μg/liter) in Turin and 2 μg/liter (0.02–368 μg/liter) in Cardiff. There were no associations between urine perchlorate concentrations and serum TSH or FT4 in the individual euthyroid or hypothyroid/hypothyroxinemic cohorts. In multivariable linear analyses, log perchlorate was not a predictor of serum FT4 or TSH. Conclusions: Low-level perchlorate exposure is ubiquitous but did not affect thyroid function in this cohort of iodine-deficient pregnant women.

scholarly journals Morphological and Functional Assessment of Thyroid in Individuals with Down Syndrome

2021 ◽  
Author(s):  
Celia Neder Kalil Mangabeira ◽  
Rafael Kalil Mangabeira ◽  
Luis Jesuino de Oliveira Andrade
Keyword(s):  
Down Syndrome ◽  
Thyroid Function ◽  
Autoimmune Thyroiditis ◽  
Thyroid Dysfunction ◽  
Cross Sectional Study ◽  
Free T4 ◽  
Cross Sectional ◽  
Key Words Down Syndrome ◽  
Normal Thyroid Function ◽  
Increased Risk

Individuals with Down syndrome (DS) present increased risk for thyroid dysfunction, especially hypothyroidism, due in increased expression of the DYRK1A gene. Objective: The aim of this study was to make a morphological functional thyroid assessment in individuals with DS. Materials and Methods: This is a descriptive cross-sectional study, consisting of 29 individuals with DS, with a mean age of 12,3 (0.66 / 36.00) years, 16 women (55.2%) and 13 men (44.8%), with a morphological/functional thyroid assessment being made comprising hormonal dose (Free T4, TSH), antithyroid antibody (TPOAb and TgAb) and ultrasonography of the thyroid. Results: Twenty-three (79.3%) individuals presented normal thyroid function while 6 (20.7%) presented with thyroid dysfunction, 4 with hypothyroidism and 2 with hyperthyroidism. Autoimmune thyroiditis and goiter were present in 27.6% of the individuals. Conclusion: Thyroid function should be assessed periodically in individuals with DS, in view of the high prevalence of thyroid dysfunction, especially autoimmune thyroiditis with consequent hypothyroidism. Key Words: Down Syndrome, thyroid, ultrasonography, thyroid dysfunction.

scholarly journals Thyroid Storm: A Rare Paraneoplastic Syndrome in an Infant With Hepatoblastoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A964-A964
Author(s):  
Neha Vyas ◽  
Arino Neto ◽  
Mauri Carakushansky ◽  
Shilpa Gurnurkar
Keyword(s):  
Thyroid Function ◽  
Germ Cell Tumors ◽  
Vital Signs ◽  
Lower Lobe ◽  
Thyroid Storm ◽  
Free T4 ◽  
Initial Manifestation ◽  
Normal Thyroid Function ◽  
Oncology Unit ◽  
Primary Hyperthyroidism

Abstract Background: Graves disease (GD) is the most common cause of pediatric hyperthyroidism. Thyroid storm (TS) is a rare initial manifestation of GD and is typically triggered by an underlying stressor such as infection, trauma or surgery in a patient with underlying GD and poorly controlled hyperthyroidism. Clinical Case: A previously healthy 21-month-old Hispanic male presented to our ER due to concerns of acute abdominal pain. He was noted to have diffuse abdominal tenderness, unremitting anxiety and mild exophthalmos. Vital signs revealed tachycardia and hypertension. Initial lab evaluation was suggestive of primary hyperthyroidism (TSH<0.02 mcU/mL, n 0.5-4.5 mcU/mL, and free T4 at 5.8 ng/dL, n 0.8-2 ng/dL). His Burch-Wartofsky point scale score was 45, indicating high likelihood of TS. He was aggressively treated with methimazole, potassium iodide and propranolol. Five days later, there was a significant improvement in symptoms and labs (TSH<0.02 mcU/mL, n 0.5-4.5 mcU/mL, and free T4 2.3 ng/dL, n 0.8-2 ng/dL) and he was discharged home on methimazole and propranolol. Interestingly, all thyroid autoantibodies were negative including TSI, TRAb, anti-thyroglobulin and anti-TPO antibodies. His thyroid function continued to improve and propranolol was discontinued. Three weeks after his initial hospital admission, he developed a diffuse urticarial rash and the methimazole was held and propranolol restarted. Within a few days, he developed persistent fevers for which he was readmitted. His total T4 at that time was elevated at 23 mcg/dL (n 4.5-11 mcg/dL) and because the rash was improving, methimazole was restarted. In the following weeks, the patient continued to have intermittent fevers, diffuse waxing and waning rash, decreased activity, and reduced appetite. He was seen by his pediatrician who noted hepatomegaly. Abdominal CT and ultrasound revealed a liver mass (11 x 10 x 10 cm) and a 7 mm peripherally placed pulmonary nodule in the left lower lobe. The patient was admitted to the hematology/oncology unit for further evaluation. He was found to have an elevated alpha-fetoprotein level (AFP) of 43,051 ng/mL, n<6 ng/mL, which was concerning for hepatoblastoma (HB) that was confirmed by tissue biopsy. He was subsequently initiated on neoadjuvant chemotherapy. Methimazole dose requirements gradually decreased with eventual discontinuation 1 week after initiation of chemotherapy. He has remained clinically euthyroid off methimazole for almost 3 months with normal thyroid function. Conclusion: We report an unusual case of transient hyperthyroidism that initially presented as TS in a 21 month old male who was subsequently diagnosed with HB. Paraneoplastic syndromes (PNS) may occur with any tumor. Hyperthyroidism is occasionally associated with non-seminomatous germ-cell tumors with elevated HCG. We believe this is the first report of pediatric thyroid storm as a PNS in HB.

scholarly journals The Association of Thyroid Function With Bone Density During Childhood

2018 ◽  
Vol 103 (11) ◽  
pp. 4125-4134 ◽  
Author(s):  
Karlien Veldscholte ◽  
Mirjana Barjaktarovic ◽  
Katerina Trajanoska ◽  
Vincent W V Jaddoe ◽  
Theo J Visser ◽  
...  
Keyword(s):  
Bone Density ◽  
Bone Mass ◽  
Thyroid Function ◽  
Bone Mineral ◽  
Population Based ◽  
Inverse Association ◽  
Mineral Density ◽  
Free T4 ◽  
Total Body

Abstract Context Although the skeleton is a well-known thyroid hormone target organ, very little data are available on the association of thyroid function with bone outcomes during childhood. Objective To study the association of thyroid function with bone mass during childhood. Design, Setting, and Participants Population-based prospective cohort including 4204 children with TSH and free T4 (FT4) measured at the age of 6 years. Main Outcome Measures Bone density was assessed by a total body dual-energy X-ray absorptiometry scan at the median age of 6 years (95% range, 5.6 to 7.9) and at the age of 10 years (95% range, 9.0 to 10.9) in 4204 and 3404 participants, respectively. Results There was an inverse association of TSH with bone mineral density (BMD) at the age of 6 (β −0.028 ± 0.011, P = 0.009) and with follow-up measurements at the age of 10 (β −0.027 ± 0.011, P = 0.014), but not with bone mineral content (BMC) at the age of 6 (β −0.028 ± 0.015, P = 0.06) or for follow-up measurements of BMC at the age of 10 (β −0.011 ± 0.015, P = 0.47). There was an inverse association of FT4 with BMD (β −0.016 ± 0.006, P = 0.014) and BMC (β −0.023 ± 0.009, P = 0.009) cross-sectionally, and also at the age of 10 years (BMD: β −0.018 ± 0.007, P = 0.007; BMC: β −0.021 ± 0.009, P = 0.020). Conclusion A higher FT4 concentration is associated with lower bone mass at the age of 6 and at the age of 10 years. These data provide insights into the effects of thyroid function on bone physiology during childhood.

scholarly journals Thyroid Function and Cancer Risk: The Rotterdam Study

2016 ◽  
Vol 101 (12) ◽  
pp. 5030-5036 ◽  
Author(s):  
Samer R. Khan ◽  
Layal Chaker ◽  
Rikje Ruiter ◽  
Joachim G. J. V. Aerts ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Risk ◽  
Thyroid Function ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Solid Cancer ◽  
Free T4 ◽  
Increased Risk

Context: In vitro and in vivo experiments have assigned both oncosuppressive and oncogenic properties to thyroid hormones. Population-based studies have found inconclusive results. Objective: We aimed to prospectively assess the relation between thyroid function and incident cancer in a population-based setting. Design, Setting, and Participants: The current study is a prospective population-based cohort study including 10 318 participants for whom baseline measurements of free T4 (FT4) and/or TSH were available. Main Outcome Measures: Cox proportional hazards models were used to assess hazard ratios (HRs) of any solid non-skin cancer, as well as lung, breast, prostate, and gastrointestinal cancer specifically. Results: Higher FT4 levels were associated with a higher risk of any solid cancer (HR, 1.42; 95% confidence interval [CI], 1.12–1.79), lung cancer (HR, 2.33; 95% CI, 1.39–3.92) and breast (HR, 1.77; 95% CI, 1.10–2.84) cancer. The risk estimates were similar after exclusion of thyroid-altering medication, but the association lost significance for breast cancer. Compared with the lowest FT4 tertile, the highest tertile was associated with a 1.13-fold increased risk of any solid, 1.79-fold increased risk of lung, and 1.14-fold increased risk of breast cancer (P for trend <.05 for all). For TSH levels we found no associations with cancer risk. There was no differential effect of sex or age on the association between thyroid function and cancer risk. Conclusions: Higher FT4 levels are significantly associated with an increased risk of any solid, lung, and breast cancer. Further research should elucidate the underlying pathophysiological mechanisms.

scholarly journals HbA1c is inversely associated with thyroid cysts in a euthyroid population: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253841
Author(s):  
Yuji Shimizu ◽  
Shin-Ya Kawashiri ◽  
Yuko Noguchi ◽  
Yasuhiro Nagata ◽  
Takahiro Maeda ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Sectional Study ◽  
Normal Range ◽  
Free Triiodothyronine ◽  
Free T4 ◽  
Cross Sectional ◽  
Normal Thyroid Function

Anti-thyroid peroxidase antibody (TPO-Ab) is revealed to be inversely associated with thyroid cysts among euthyroid population. TPO-Ab causes autoimmune thyroiditis by bolstering thyroid inflammation. Therefore, at least partly, absence of thyroid cysts could indicate latent thyroid damage. Since participants with subclinical hypothyroidism are reported to have higher HbA1c than normal healthy controls, HbA1c could be inversely associated with thyroid cysts through a mechanism reflecting latent thyroid damage. To investigate the association between HbA1c and thyroid cysts among a euthyroid population, a cross-sectional study was conducted on 1,724 Japanese individuals who were within the normal range of thyroid function [i.e., normal range of free triiodothyronine (T3) and free thyroxine (T4)] and aged 40–74 years. Among this study population, 564 were diagnosed with thyroid cysts. Independently of thyroid related hormones [thyroid stimulating hormone (TSH), free T3, and free T4] and known cardiovascular risk factors, HbA1c was found to be significantly inversely associated with the presence of thyroid cysts. This association remained significant even after this analysis was limited to participants within a normal range of TSH. The fully adjusted odds ratios (ORs) of thyroid cysts for 1 standard deviation (SD) increment of HbA1c were 0.84 (0.74, 0.95) for total participants and 0.80 (0.70, 0.92) for participants within a normal range of TSH. Among participants with normal thyroid function, HbA1c was inversely associated with the presence of thyroid cysts. The absence of thyroid cysts and higher levels of HbA1c could indicate the latent functional damage of the thyroid.

scholarly journals Reference Ranges and Determinants of Thyroid Function During Early Pregnancy: The SELMA Study

2018 ◽  
Vol 103 (9) ◽  
pp. 3548-3556 ◽  
Author(s):  
Arash Derakhshan ◽  
Huan Shu ◽  
Maarten A C Broeren ◽  
Ralph A de Poortere ◽  
Sverre Wikström ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Population Based ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Free T4 ◽  
Serum Cotinine ◽  
Child Asthma ◽  
Mother And Child ◽  
Total Triiodothyronine ◽  
Main Determinants

Abstract Context Establishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for triiodothyronine measurements, and most studies do not take into account thyroid antibodies or human chorionic gonadotropin. Objective To determine reference ranges and to identify/quantify determinants of TSH, free T4 (FT4), free triiodothyronine (FT3), total T4 (TT4), and total triiodothyronine (TT3). Design, Setting, and Participants This study included 2314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5th to 97.5th percentiles after excluding thyroperoxidase antibody (TPOAb)–positive and/or thyroglobulin antibody (TgAb)–positive women. Intervention None. Main Outcome Measures TSH, FT4, FT3, TT4, and TT3 in prenatal serum. Results After exclusion of TPOAb-positive women, reference ranges were as follows: TSH, 0.11 to 3.48 mU/L; FT4, 11.6 to 19.4 pmol/L; FT3, 3.72 to 5.92 pg/mL; TT4, 82.4 to 166.2 pmol/L; and TT3, 1.28 to 2.92 nmol/L. Additional exclusion of TgAb-positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. Body mass index (BMI) and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4, and TT3. Conclusions We show that the exclusion of TgAb-positive women on top of excluding TPOAb-positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4, and TT3 that could reflect endocrine-disrupting effects and/or effects on thyroid hormone transport or deiodination.

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