scholarly journals Macro-TSH in patients with primary hypothyroidism due to autoimmune thyroiditis

2021 ◽  
Vol 17 (4) ◽  
pp. 17-20
Author(s):  
A. G. Saribekian ◽  
D. A. Petrenko ◽  
D. A. Trukhina ◽  
A. G. Kuzmin ◽  
L. K. Dzeranova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Thyroid Gland ◽  
Autoimmune Thyroiditis ◽  
Thyroid Dysfunction ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Common Phenomenon ◽  
Functional Disorders ◽  
Key Indicators

Thyroid stimulating hormone (TSH) is one of the key indicators in the diagnosis of the thyroid gland functional disorders. Minor changes in TSH concentration make it possible to suspect thyroid dysfunction even before clinical manifestations, which increases the value of correct and timely measurement of it. In the clinical practice, an endocrinologist often encounter the well-known phenomenon of macroprolactinemia; a much less common phenomenon is macrotyrotropinemia (macro-TSH). The presence of macro-TSH complexes can be suspected when the serum detects atypically high TSH values with reference values of FT4 without any signs of hypothyroidism. Since the phenomenon is based on an autoimmune mechanism, macro-TSH can often be detected in patients with autoimmune thyroiditis (AIT). This article presents clinical cases of patients with a combination of the macro-TSH phenomenon and primary hypothyroidism due to AIT.

The Thyroid Gland: Physiology and Pathophysiology

2000 ◽  
Vol 19 (8) ◽  
pp. 11-26 ◽  
Author(s):  
Denise Kirsten
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Laboratory Tests ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
Premature Delivery ◽  
Follicular Cells ◽  
Metabolic Hormones ◽  
Radiologic Findings

The thyroid gland contains many follicular cells that store the thyroid hormones within the thyroglobulin molecule until they are needed by the body. The thyroid hormones, often referred to as the major metabolic hormones, affect virtually every cell in the body. Synthesis and secretion of the thyroid hormones depend on the presence of iodine and tyrosine as well as maturation of the hypothalamic-pituitary-thyroid system. Interruption of this development, as occurs with premature delivery, results in inadequate production of thyroid-stimulating hormone and thyroxine, leading to a variety of physiologic conditions. Pathologic conditions occur in the presence of insufficient thyroid production or a defect in the thyroid gland. Laboratory tests are important in diagnosing conditions of the thyroid gland. A thorough history in combination with clinical manifestations and radiologic findings are also useful in diagnosing specific thyroid conditions. Nurses play an important role in identifying and managing thyroid disorders and in providing supportive care to infants and their families.

Abnormal Uterine Bleeding (AUB) and Thyroid Function in Chhattisgarh

2017 ◽  
Vol 7 (2) ◽  
pp. 29-41
Author(s):  
Mukund Tiwari ◽  
Dr. Sarita Agrawal ◽  
Subarna Mitra
Keyword(s):  
Clinical Practice ◽  
Menstrual Cycle ◽  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Thyroid Disorder ◽  
Study Participants

Abnormal function of thyroid gland is associated with a disturbance in the menstrual cycle. However, in clinical practice, thyroid dysfunction is frequently overlooked as a possible etiology and therefore, the importance to investigate thyroid function in asymptomatic cases is under- recognized in India. Treating thyroid dysfunction in such cases can reverse the menstrual abnormality, thus avoiding unnecessary hormonal therapy or in long term, hysterectomy. This article is intended to determine the prevalence of overt and subclinical forms of hypothyroidism/hyperthyroidism among women with abnormal uterine bleeding (AUB) in a known iodine-deficient state of India, Chhattisgarh. Moreover, the aims included to characterize the types of menstrual abnormality with thyroid dysfunction in study participants. The present study found a prevalence of thyroid dysfunction in one out of five cases of menstrual abnormality, most common dysfunction being hypothyroidism. An appreciable proportion of thyroid disorder was found in patients with menorrhagia, oligomenorrhea, polymenorrhea and amenorrhea.

scholarly journals A study of serum thyroid stimulating hormone levels, and its correlation with clinical features and delayed diagnosis of hypothyroidism in central India

2019 ◽  
Vol 7 (1) ◽  
pp. 176
Author(s):  
Dharmendra Jhavar ◽  
Umesh Kumar Chandra ◽  
Shivshankar Badole ◽  
Anurag Rahekar ◽  
Sumit Vishwakarma
Keyword(s):  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Central India ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Delay In Diagnosis ◽  
High Level ◽  
High Index Of Suspicion

Background: The clinical manifestations of hypothyroidism are variable, depending upon its cause, duration and severity. The spectrum extends from subclinical to overt hypothyroidism to myxedema coma. A high degree of suspicion is thus required in order to appreciate the clinical manifestation of the disorder to reach a diagnosis. Purpose of this study was to correlate serum TSH level with severity of clinical manifestations and evaluate possible cause of delay in the diagnosis.Methods: A cross section observational and descriptive study for the assessment of severity of primary hypothyroidism at presentation and evaluation of the causes of delay in diagnosis in 86 patients was done from December 2012 to November 2013 in the Department of Medicine, MGM Medical College, Indore, MP, India.Results: Illiterate patients had significantly (p value 0.002) higher TSH values at presentation. 34.8% of patients presented as severe hypothyroidism with TSH value >100 mIU/L. Delay of as much as 7 years was noted. Majority of patients had a delay of around 1 to 3 years in diagnosis. Only 4.6% patients were diagnosed without any delay due to high level of suspicion at presentation.Conclusions: Due to non-specific symptomatology of hypothyroidism diagnosis is often delayed. Therefore, high index of suspicion is required at the physician’s level and test of thyroid function is available at subsided cost therefore it should be offered to all such patients.

scholarly journals Hypothyroidism: current state of the problem

2020 ◽  
pp. 96-107
Author(s):  
E. V. Biryukova ◽  
D. V. Kileynikov ◽  
I. V. Solovyeva
Keyword(s):  
Kinase Inhibitors ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Pathological Process ◽  
Primary Hypothyroidism ◽  
The Body ◽  
Hormone Deficiency ◽  
Side Reactions ◽  
Secondary Hypothyroidism

The article presents the issues of epidemiology, classification, and clinic of hypothyroidism. The frequency of hypothyroidism increases significantly with age. The most common form is primary hypothyroidism, caused by a pathological process in the thyroid gland itself. Secondary hypothyroidism or tertiary hypothyroidism is caused by insufficient secretion of thyroid- stimulating hormone (TSH), or thyrotropin-releasing hormone. The article deals with the main causes of primary and secondary hypothyroidism. The most common cause of primary hypothyroidism is autoimmune thyroiditis, which can develop both separately and simultaneously with other autoimmune diseases, as part of polyglandular syndrome. Special attention should be paid to the change of thyroid status as a result of adverse side reactions when using a range of drugs. The questions about the mechanisms of thyroid insufficiency development as a result of unfavorable side reactions when using a number of drugs (lithium preparations, iodine-containing compounds, tyrosine kinase inhibitors, etc.) have been raised. Undiagnosed hypothyroidism is a risk factor for the progression of already existing cardiovascular diseases. The severity of clinical manifestations is determined by the severity of thyroid hormone deficiency. There are no significant clinical differences between the pronounced forms of primary and secondary hypothyroidism. Depending on the degree of lesion, secondary hypothyroidism may be complicated by other manifestations of hypothalamic-pituitary disorders, as well as the latter may include a decrease in the secretion of antidiuretic hormone at a certain stage of their development. Diagnostic difficulties are discussed, as hypothyroidism disrupts the functioning of most organs and systems of the body (musculoskeletal, cardiovascular, urinary, gastrointestinal, central and peripheral nervous systems) and can be masked by various diseases. The final diagnosis of hypothyroidism is clarified by a number of laboratory and instrumental studies. Substitution therapy with levothyroxine is used to treat hypothyroidism of any etiology.

scholarly journals “Vitamin D Deficiency Is More Common in Women with Autoimmune Thyroiditis: A Retrospective Study”

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Nino Turashvili ◽  
Lali Javashvili ◽  
Elene Giorgadze
Keyword(s):  
Vitamin D ◽  
Retrospective Study ◽  
Vitamin D Deficiency ◽  
Autoimmune Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Thyroid Autoantibody ◽  
Chronic Autoimmune Thyroiditis ◽  
Antithyroglobulin Antibodies ◽  
Stimulating Hormone

Background. Vitamin D is a hormone that is mainly produced in the skin upon ultraviolet B radiation exposure and has important influence on various organs. In recent years, data have been collected that vitamin D deficiency plays an important role in the development of various nonskeletal diseases, including autoimmune diseases. Chronic autoimmune thyroiditis (Hashimoto’s thyroiditis) is one of the most common organ-specific autoimmune endocrine diseases. It is characterized by increased level of antithyroid peroxidase and/or antithyroglobulin antibodies in blood, which often leads to thyroid dysfunction and structural changes of the gland. There is an opinion that vitamin D deficiency may be considered as an important risk factor for development of chronic autoimmune thyroiditis, but data of various small studies are controversial. Despite the fact that Georgia is a sunny country, vitamin D deficiency is a widespread problem here. Thyroid diseases, including the chronic autoimmune thyroiditis, are also very common in Georgia. The aim of our research was to compare the level of vitamin D between the patients with chronic autoimmune thyroiditis and the healthy subjects. Methods. This retrospective study enrolled subjects, who were 18–70 years old and visited the clinics “Cortex” and “National Institute of Endocrinology” in 2018 or in 2019 from mid-spring to mid-summer. Data of thyroid-stimulating hormone, free thyroxine, antithyroid peroxidase antibodies, antithyroglobulin antibodies, thyroid ultrasonography, and 25(OH) vitamin D were retrospectively analysed based on medical history. In total, data of 1295 patients were collected. The statistical processing of data was performed through the SPSS 20 program. Results. The negative association between thyroid-stimulating hormone, antithyroid peroxidase antibodies, antithyroglobulin antibodies, heterogeneous parenchyma of thyroid gland, and vitamin D was found in women. Statistically significant association was not detected in men. Conclusions. Serum vitamin D is lower in women with autoimmune thyroiditis and primary hypothyroidism. Further studies are needed to evaluate the influence of vitamin D supplementation on thyroid autoantibody positivity or primary hypothyroidism.

Causes and laboratory investigation of hypothyroidism

2011 ◽  
pp. 530-537 ◽  
Author(s):  
Ferruccio Santini ◽  
Aldo Pinchera
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Thyroid Hormone Receptor ◽  
Hormone Secretion ◽  
Thyroid Tissue ◽  
Clinical Manifestations ◽  
Primary Hypothyroidism ◽  
Central Hypothyroidism ◽  
Resistance To Thyroid Hormones

Hypothyroidism is the clinical state that develops as a result of the lack of action of thyroid hormones on target tissues (1). Hypothyroidism is usually due to impaired hormone secretion by the thyroid, resulting in reduced concentrations of serum thyroxine (T4) and triiodothyronine (T3). The term primary hypothyroidism is applied to define the thyroid failure deriving from inherited or acquired causes that act directly on the thyroid gland by reducing the amount of functioning thyroid tissue or by inhibiting thyroid hormone production. The term central hypothyroidism is used when pituitary or hypothalamic abnormalities result in an insufficient stimulation of an otherwise normal thyroid gland. Both primary and central hypothyroidism may be transient, depending on the nature and the extent of the causal agent. Hypothyroidism following a minor loss of thyroid tissue can be recovered by compensatory hyperplasia of the residual gland. Similarly, hypothyroidism subsides when an exogenous inhibitor of thyroid function is removed. Peripheral hypothyroidism may also arise as a consequence of tissue resistance to thyroid hormones due to a mutation in the thyroid hormone receptor. Resistance to thyroid hormones is a heterogeneous clinical entity with most patients appearing to be clinically euthyroid while some of them have symptoms of thyrotoxicosis and others display selected signs of hypothyroidism. The common feature is represented by pituitary resistance to thyroid hormones, leading to increased secretion of thyrotropin that in turn stimulates thyroid growth and function. The variability in clinical manifestations depends on the severity of the hormonal resistance, the relative degree of tissue hyposensitivity, and the coexistence of associated genetic defects (see Chapter 3.4.8).

Irisin and thyroid dysfunction – news in endocrinology

2019 ◽  
Vol 6 ◽  
pp. 51-56
Author(s):  
Adrianna Zybek-Kocik ◽  
Marek Ruchała
Keyword(s):  
Physical Activity ◽  
Clinical Practice ◽  
Field Data ◽  
Thyroid Dysfunction ◽  
Doctoral Dissertation ◽  
Functional Disorders ◽  
Optimal Care ◽  
Functional States ◽  
Time Changes ◽  
The Relationship

Irisina, also known as irisine, is a newly discovered adipomiokine secreted under the influence of physical activity, having a significant impact on metabolism body. Under its influence comes the so-called „Browning” white adipose tissue and increase thermogenesis. In last time changes in irisin concentration in thyroid dysfunction are described. The aim of the work is to present the assumptions of the doctoral dissertation describing changes in irisine concentration in various functional states thyroid, consisting of three thematically related publications, discussion of the results obtained and their discussion in context the latest reports in this field. Data published so far on the relationship between functional disorders thyroid and irisine levels indicate a significant effect of overt hyperactivity and hypothyroidism on the concentration of irisin. The described changes probably due to the significant impact of the disorder thyroid function on the metabolism of muscle tissue. What’s more, they give she hopes to use these phenomena in clinical practice, the goal providing more optimal care for affected patients thyroid dysfunction. However, the available data is not fully compatible and there are still randomized, prospective studies that can fully explain phenomena described so far. They require further analysis and an in-depth assessment of pathomechanisms behind them, for implementation them to clinical practice.

scholarly journals Severe primary hypothyroidism in an apparently asymptomatic 19-year-old woman: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rania Dannan ◽  
Sulaiman Hajji ◽  
Khaled Aljenaee
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Conflicting Evidence ◽  
Thyroid Function Testing ◽  
History Of ◽  
Asymptomatic Individuals ◽  
High Index Of Suspicion

Abstract Background Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. Case presentation We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient’s insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. Conclusion There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.

scholarly journals VARIANTS OF THYROID GLAND PATHOLOGY IN CHRONIC HEPATITIS C PATIENTS

2017 ◽  
Vol 22 (4) ◽  
pp. 172-177
Author(s):  
Marina A. Nikonorova ◽  
N. S Lubskaya ◽  
E. V Volchkova ◽  
E. A Nemilostiva ◽  
O. I Matros
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Thyroid Gland ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Autoimmune Thyroiditis ◽  
Thyroid Dysfunction ◽  
Thyroid Status ◽  
History Of ◽  
The Relationship

Introduction. HCV is the cause not only of cirrhosis, hepatocellular carcinoma, but also extrahepatic manifestations. Currently, HCV is considered as an independent risk factor for thyroid pathology. In recent years, the level of pathology of the thyroid gland in the Altai Territory has increased by 16.4 times, which determined the purpose of this study: to study the features of the thyroid status in patients with chronic hepatitis C (CHC) in the Altai Territory. Materials and methods. There was executed a prospective, dynamic clinical, laboratory and instrumental examination of 240 CHC patients (47,5% of men and 52,5% of women aged of from 18 to 50 years), 120 of whom had HCV (49,1% of men and 50,9% of women, aged of from 18 to 50 years, mean age: 41,1±9,91 years) who did not receive antiviral therapy (HTV), the pathology of the thyroid gland in them was established for the first time. The study included the assessment of the level of TSH, total and free T3, T4, antibodies to thyreperoxidase (APPO), ultrasound examination of the thyroid gland. The diagnosis of CHC is based on HCV RNA, anti-HCV (core, NS3-5), blood biochemistry, fibrosis level score according to Metavir (elastometry, PBP). Results of the study. In HCV patients there were revealed autoimmune thyroiditis (AIT) (5%), AIT with hypothyroidism (10%), AIT with latent hypothyroidism (8,3%), latent hypothyroidism (10%), hypothyroidism (16,6%), euthyroidism (49,1%) and thyrotoxicosis in only 1 patient. Variants of thyroid dysfunction were presented in the form of euthyroidism (60%), hypothyroidism (20%), hyperthyroidism (10%) and autoimmune thyroiditis (10%). The relationship between the development of the thyroid dysfunction (TD) and the history of the history of HCV infection has been established. Discussion and conclusions. CHC patients were more likely to have a history of euthyroidism and hypothyroidism. The relationship between TD and the duration of HCV infection can be regarded as its extrahepatic manifestation, and not as comorbid conditions. Thorough examination of the thyroid status it makes possible to identify TD people, which can be reflected in the choice of antiviral therapy and will determine the prognosis of the development of side effects.

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