Low basal thyrotropin with normal thyroid function in primary hyperparathyroidism

1989 ◽  
Vol 121 (5) ◽  
pp. 638-642 ◽  
Author(s):  
Clementine Gillet ◽  
Pierre Bergmann ◽  
Dominique Francois ◽  
Jean-Jacques Body ◽  
Jacques Corvilain
Keyword(s):  
Primary Hyperparathyroidism ◽  
Thyroid Function ◽  
Serum Calcium ◽  
Normal Subjects ◽  
Serum Levels ◽  
Normal Thyroid Function ◽  
Basal Serum ◽  
Highly Correlated ◽  
Serum Tsh ◽  
Age And Sex

Abstract. TSH serum levels and thyroid function in 32 patients with primary hyperparathyroidism and hypercalcemia were compared to those of 30 age and sex-matched normal subjects. Serum T3 and T4 concentrations in hyperparathyroidism were not different from normal. However, basal serum TSH concentrations measured with an ultrasensitive immunoradiometric assay were significantly lower than normal (1.09 ± 0.49 vs 2.06 ± 0.85 mU/l, p < 0.001). In hyperparathyroidism, TSH, but not T4 or T3, was negatively correlated with serum calcium, not with iPTH. The increase in TSH (Δ TSH) 30 min after the iv injection of TRH was also significantly blunted in patients with primary hyperparathyroidism; Δ TSH was highly correlated with basal TSH in hypercalcemic patients. The basal TSH concentration was higher and no longer different from normal (1.70 ± 1.2 mU/l) 2 to 12 months after removal of the parathyroid adenoma, when serum calcium was normalized, whereas T3 and T4 did not change. A low basal TSH with normal T4 and low T3 was found in 13 patients with hypercalcemia of malignancy. In these patients, TSH increased after treatment of hypercalcemia with 3-amino-1,hydroxypropylidene-1,1-bisphosphonate, whereas T4 did not change. The results suggest that the set point of pituitary thyroid feedback control could be decreased in chronic hypercalcemia and that hypercalcemia could render the thyroid more sensitive to TSH.

scholarly journals Screening of Thyroid Function in the First Half of Pregnancy

2016 ◽  
Vol 29 (1) ◽  
pp. 26-31
Author(s):  
Shaila Naznine Tania ◽  
Ferdousi Islam
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Thyroid Disorder ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
One Year ◽  
Serum Tsh

Objective: The study was conducted to find out any alterations in thyroid function status in first half of pregnancy (up to 20 weeks), with ultimate aim of deciding the usefulness of routine screening of thyroid function in pregnancy.Material and methods: A cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College and Hospital, Dhaka, Bangladesh, over a period of one year from July 2011 to June 2012 on pregnant women in their 1st half of pregnancy to screen for the thyroid function. Based on predefined eligibility criteria, a total of 230 pregnant women were purposively included in the study. Thyroid function status was assessed by measuring serum levels of TSH, free thyroxine (FT4), and free tri-iodothyronine (FT3). Women with thyroid disorders were excluded.Results: The mean age of the patients being 24 years. Over 90% of the women were housewife and majority (88.7%) was educated. Over one-quarter of women was overweight with mean body mass index being 22.1 ± 4.4 kg/m2. The women were predominantly multigravida with 56% in 1st trimester 44% in the 1st half of 2nd trimester of pregnancy (13-20 weeks). Based on trimester’s specific range of serum TSH in the 1st and 1st half of 2nd trimester (13-20 weeks) of pregnancy,13% of the patients were hypothyroid and 3% were hyperthyroid thus yielding a total of 37(16%) pregnant women with abnormal thyroid function status.Conclusion: The study concluded that one in every six women may have thyroid disorder in the first half of pregnancy and subclinical hypothyroidism is four times more common than the subclinical hyperthyroidism.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 26-31

Basal and TRH stimulated serum levels of TSH in patients with hyperprolactinaemia and in subjects on oestrogen treatment

1983 ◽  
Vol 102 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Eva M. Erfurth ◽  
Pavo Hedner ◽  
Anders Nilsson
Keyword(s):  
Serum Level ◽  
Serum Levels ◽  
Plasma Prolactin ◽  
Thyroid Antibodies ◽  
Elevated Plasma ◽  
Oestrogen Treatment ◽  
Pituitary Dysfunction ◽  
Basal Serum ◽  
The Mean ◽  
Serum Tsh

Abstract. In 21 hyperprolactinaemic patients without other signs of pituitary dysfunction the mean basal serum level of TSH was 4.4 ± 0.47 μU/ml that was significantly (P < 0.001) higher than controls (2.5 ± 0.16 μU/ml and oestrogen treated individuals (2.4 ± 0.29 μU/ml). The TSH increase was more pronounced (P < 0.05) in hyperprolactinaemic patients without sellar enlargement and with moderately elevated plasma prolactin levels (155 ± 42 μg/ml) than in patients with sellar enlargement and higher plasma prolactin levels (857 ± 306 μg/ml). The serum levels of thyroxine and triiodothyronine in the hyperprolactinaemic patients did not differ significantly from controls. Patients with thyroid antibodies were excluded. The increased basal serum level of TSH in hyperprolactinaemia is compatible with the concept of a reduced dopaminergic tonus as the mechanism for both changes. In patients with advanced hyperprolactinaemia and sellar enlargement the high prolactin level may induce some inhibition of TSH release and explain their lower basal serum level of TSH that was probably not due to pituitary compression as they responded normally to TRH. The TSH response to TRH was significantly (P < 0.05) correlated to the basal serum TSH in all groups. The regression lines were very similar for hyperprolactinaemic patients and controls suggesting that in hyperprolactinaemia the thyrotroph has not changed its mode of response to TRH. In contrast, oestrogen treated subjects in addition to dependence on basal serum TSH levels showed a genuinely augmented response to TRH (164.6 ± 20.3%, P < 0.01) compared to controls.

RELATION BETWEEN THYROID FUNCTION AND SERUM LEVELS OF LONG-ACTING THYROID STIMULATOR

1975 ◽  
Vol 79 (3) ◽  
pp. 451-458 ◽  
Author(s):  
J. C. Davis ◽  
L. J. Hipkin ◽  
V. K. Summers ◽  
T. M. D. Gimlette
Keyword(s):  
Thyroid Function ◽  
Normal Level ◽  
Normal Subjects ◽  
Serum Levels ◽  
The Other ◽  
Causative Role ◽  
Normal Range ◽  
The Mean ◽  
Long Acting ◽  
Normal Controls

ABSTRACT Bioassays of long-acting thyroid stimulator (LATS) were performed in three groups of subjects: in normal controls, in thyrotoxic patients before and serially after 131I treatment, and in patients with hypopituitarism. Of the untreated thyrotoxic patients, 27.7 % had raised serum LATS levels initially. There was no correlation between the relapse rate after 131I therapy and the initial or subsequent LATS titres: in particular, thyrotoxicosis sometimes recurred after an initially high LATS titre had fallen into the normal range. The distribution of the results of LATS assays in the hypopituitary patients was significantly different from that in the normal subjects; 4 out of 27 hypopituitary patients had LATS levels above the normal range, although they had no thyroxicosis. On the other hand, the majority of the patients with hypopituitarism, 19 out of 27, had LATS titres below the mean normal level, possibly due to deficiency of a substance we have termed pseudo LATS. These results raise doubts about a direct causative role for LATS in most cases of thyrotoxicosis.

scholarly journals A Case of Euthyroid Graves’ Ophthalmopathy in a Patient Sero-Negative for TSH Receptor Autoantibody

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Asami Hotta ◽  
Tomohiro Tanaka ◽  
Haruka Kato ◽  
Shota Kakoi ◽  
Yuki Shimizu ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Pulse Therapy ◽  
Tsh Receptor ◽  
Thyroid Autoantibodies ◽  
Thyroid Function Tests ◽  
Normal Thyroid Function ◽  
Function Tests ◽  
Graves Ophthalmopathy ◽  
History Of ◽  
Serum Tsh

We report of a case of Graves’ ophthalmopathy presented solely with symptoms of the eyes with normal thyroid function tests and negative immunoreactive TSH receptor autoantibody. 40-year-old male was referred to our hospital due to 2-month history of ocular focusing deficit without any signs or symptoms of hyper- or hypothyroidism. Serum thyroid function tests and 99mTc uptake were both within the normal range. Anti-thyroid autoantibodies were all negative except for the cell-based assay for serum TSH receptor stimulating activity. Since orbital CT scan and MRI gave typical results compatible with Graves’ ophthalmopathy, we treated the patients with corticosteroid pulse therapy and orbital radiation therapy, leading to a partial improvement of the symptoms. This case gives insights into the potential pathophysiologic mechanism underlying Graves’ ophthalmopathy and casts light upon the difficulties of establishing the diagnosis in a euthyroid case with minimal positive results for anti-thyroid autoantibodies.

EFFECT OF THYROTROPHIN-RELEASING HORMONE ON SERUM LEVELS OF PITUITARY HORMONES IN MEN AND WOMEN

1973 ◽  
Vol 73 (3) ◽  
pp. 455-464 ◽  
Author(s):  
P. A. Torjesen ◽  
E. Haug ◽  
T. Sand
Keyword(s):  
Normal Subjects ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Serum Growth Hormone ◽  
Maximal Increase ◽  
Thyrotrophin Releasing Hormone ◽  
Releasing Hormone ◽  
Baseline Levels ◽  
Serum Tsh

ABSTRACT The rapid iv administration of 0.5 mg of synthetic thyrotrophin-releasing hormone (TRH) increased the serum thyroid-stimulating hormone (TSH) concentration in 20 normal subjects from baseline levels of 2.0 ± 0.5 ng/ml (sem) to peak values of 6.0 ± 0.7 ng/ml (sem) in women and 4.5 ± 0.5 ng/ml (sem) in men. The maximal increase occurred 30 min after TRH. The serum growth hormone (HGH) concentrations increased from baseline levels of 2.6± 1.0 ng/ml (sem) to peak values of 7.8± 1.3 ng/ml (sem) in women. In men there was no rise in the serum HGH concentrations. The serum levels of luteinizing hormone (LH) and folliclestimulating hormone (FSH) did not change significantly. In patients with hyperthyroidism the serum TSH concentrations did not change following TRH. Patients with primary hypothyroidism showed an exaggerated and prolonged increase in serum TSH concentrations after TRH administration. A routine TRH-stimulation test is proposed.

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.

Evaluation of thyroid function in neonatal and adult rats: The neglected endocrine mode of action

2003 ◽  
Vol 75 (11-12) ◽  
pp. 2055-2068 ◽  
Author(s):  
M. S. Christian ◽  
N. A. Trenton
Keyword(s):  
Metabolic Rate ◽  
Thyroid Function ◽  
Critical Period ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Female Rats ◽  
Male Rats ◽  
Adult Rats ◽  
Male And Female Rats ◽  
Serum Tsh

Although known to regulate growth and development, cellular metabolism, the use of oxygen, and basal metabolic rate, thyroid hormones have been only minimally evaluated in neonatal rodents at critical times of development. Despite some modulation of metabolic rate by other hormones, such as testosterone, growth hormone, and norepinephrine, 3,5,3'-triiodothyronine (T3) and 3,5,3',5'-tetraiodothyronine (T4) are the most important metabolic rate modulators. Endpoints used for thyroid function assessment in neonatal and adult rats include thyroid-stimulating hormone (TSH), T3, and T4 levels and histopathology. In rodents, decreased serum levels of T3 and T4 and increased serum TSH levels, with sustained release of TSH and resultant follicular cell hypertrophy/hyperplasia, are typical hormonal and histopathological findings attributable to compounds altering thyroid function. Hypothyroidism early in the neonatal period can affect reproductive endpoints in both male and female rats, with the critical period of exposure being the first two weeks postnatal. Hypothyroidism has been shown to reduce gonadotrophin levels and delay pubertal spermatogenesis in male rats and to block gonadotropin-induced first ovulation in immature female rats by decreasing FSH and luteinizing hormone (LH) serum concentrations. Inclusion of evaluations of TSH, T3, and T4 assays in multigeneration and developmental neurotoxicity protocols may assist in risk assessments.

Changes in pituitary and thyroid function with increasing age in young male rats.

1979 ◽  
Vol 237 (3) ◽  
pp. E224 ◽  
Author(s):  
F Azizi
Keyword(s):  
Thyroid Function ◽  
Subcutaneous Administration ◽  
Young Male ◽  
Thyroid Stimulating Hormone ◽  
Male Rats ◽  
Progressive Decline ◽  
Basal Serum ◽  
Serum T4 ◽  
Serum Tsh ◽  
Bovine Tsh

As the age of young adult male rats increased from 30 to 150 days, the serum thyroxine (T4) decreased by 50% and the serum thyroid-stimulating hormone (TSH) increased by 250%. There was no change in the serum triiodothyronine (T3). The increment in serum TSH after injection of thyrotropin-releasing hormone (TRH) was not significantly different at any of the ages studied, but the old animals had significantly lower increments in serum T4 and T3 after subcutaneous administration of bovine TSH. Despite a higher basal serum TSH, the older rats had a lesser increase in serum TSH after thyroidectomy or propylthiouracil. Thus, 1) there is a progressive decline in intrinsic thyroid function between 30 and 150 days of age in male rats, and 2) pituitary TSH response to fall in serum concentration of thyroid hormones is also decreased with age.

PITUITARY-THYROID FUNCTION IN SPIRONOLACTONE TREATED HYPERTENSIVE WOMEN

1979 ◽  
Vol 90 (3) ◽  
pp. 577-584 ◽  
Author(s):  
A. G. H. Smals ◽  
P. W. C. Kloppenborg ◽  
W. H. L. Hoefnagels ◽  
J. I. M. Drayer
Keyword(s):  
Thyroid Function ◽  
Bolus Injection ◽  
Serum Testosterone ◽  
High Dose ◽  
Enhancing Effect ◽  
Basal Serum ◽  
The Mean ◽  
17 Hydroxyprogesterone ◽  
Lh Rh ◽  
Serum Tsh

ABSTRACT Four weeks high dose spironolactone treatment (Aldactone® Searle, 100 mg q. i. d.) significantly enhanced the TSH (Δ max. 8.5 ± 4.1 vs. 4.6 ± 3.1 μU/ml, P < 0.05) and T3 (Δ max. 32±27 vs. 11 ± 16 ng/100 ml, P < 0.05) responses to an intravenous TRH/LH-RH bolus injection in 6 eumenorrhoeic euthyroid hypertensive women, without affecting basal serum TSH, T3 or T4 levels or the basal and stimulated LH, FSH and prolactin values (P > 0.10). The mean serum testosterone, 17-hydroxyprogesterone and oestradiol levels were also similar before and during therapy. Spironolactone, possibly by virtue of its antiandrogenic action, may exert its enhancing effect on pituitary-thyroid function by modulating the levels of receptors for TRH in the thyrotrophs or by altering the T3 receptor in the pituitary permitting a greater response to TRH.

Thyroid Stimulating Hormone Measurement by an Ultrasensitive Assay during Thyroxine Replacement: Comparison with other Tests of Thyroid Function

1987 ◽  
Vol 24 (6) ◽  
pp. 614-619 ◽  
Author(s):  
T Wheatley ◽  
P M S Clark ◽  
J D A Clark ◽  
P R Raggatt ◽  
O M Edwards
Keyword(s):  
Replacement Therapy ◽  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Biochemical Tests ◽  
Basal Serum ◽  
Total Thyroxine ◽  
Thyroxine Replacement ◽  
Thyroxine Replacement Therapy ◽  
Serum Tsh ◽  
Stimulating Hormone

Serum thyroid stimulating hormone (TSH) was measured using a highly sensitive enzyme-amplified immunoassay in 37 clinically euthyroid patients receiving thyroxine replacement therapy and compared with other biochemical tests of thyroid function. A highly significant correlation ( P<0·001) was found between the basal serum TSH and the increase in serum TSH concentration 20 min after the administration of thyrotropin releasing hormone (TRH). The basal serum TSH was negatively correlated with the serum total thyroxine ( P=0·05). When patients results were classified as abnormal or normal many discrepancies were noted between the various thyroid tests. A suppressed serum TSH was found in 65% of patients with a normal serum total thyroxine. However, in patients on thyroxine replacement therapy a basal TSH measured by enzyme-amplified immunoassay provides the same information as a TRH test.

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