scholarly journals Serum TSH and serum thyroid peroxidase antibody fluctuate in parallel and high urinary iodine excretion predicts subsequent thyroid failure in a 1-year study of patients with untreated subclinical hypothyroidism

2008 ◽  
Vol 158 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Jesper Karmisholt ◽  
Peter Laurberg
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Urinary Iodine ◽  
Time Shift ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Iodine Excretion ◽  
Symptoms And Signs ◽  
Serum Tsh

ObjectiveTo explore the possibility of predicting decline or improvement in thyroid function over 1 year, and to investigate the correlations of serum TSH (s-TSH) with hypothyroidism-related symptoms and signs, serum thyroid peroxidase antibody (s-TPO-Ab) and urinary iodine excretion in individual patients with untreated subclinical hypothyroidism (SH).DesignMonthly repeated measurement study without intervention.MethodsTwenty-one patients without former thyroid disease who had been identified with s-TSH between 5 and 12 mU/l and normal serum thyroxine (s-T4) at two occasions were enrolled. Subsequently, 13 monthly measurements of s-TSH, hypothyroidism-related symptoms and signs, serum free T4, s-TPO-Ab and urinary iodine excretion were performed.ResultsOver the study year, s-TSH increased significantly in 5 patients, 16 had unchanged s-TSH, whereas none improved. From clinical and biochemical inclusion data, it was not possible to predict who would later increase in s-TSH. In individual patients, a highly significant correlation between s-TSH and s-TPO-Ab was found (r=0.37, P<0.0001) and also between s-TSH and urinary iodine excretion (r=0.14, P=0.034). No correlation between s-TSH and clinical symptoms and signs was observed. Time shift showed best correlation between s-TSH and s-TPO-Ab measured at the same time point, whereas urinary iodine excretion correlated best to s-TSH and s-TPO-Ab obtained 1 month later.ConclusionAt the time of inclusion, it was not possible to identify the 24% of SH patients who would show deterioration in thyroid function over the following year. Impairment in thyroid function varied in parallel with thyroid autoimmunity, whereas high urinary iodine excretion predicted high s-TSH and s-TPO-Ab 1 month later.

Earliest prevention of endemic goiter by iodine supplementation during pregnancy

1996 ◽  
Vol 134 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Klaus Peter Liesenkötter ◽  
Wolfgang Göpel ◽  
Ulrich Bogner ◽  
Barbara Stach ◽  
Annette Grüters
Keyword(s):  
Thyroid Function ◽  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Urinary Iodine ◽  
Thyroid Volume ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Iodine Supplementation ◽  
Iodine Excretion ◽  
Maternal Thyroid

Liesenkötter KP, Göpel W, Bogner U, Stach B, Grüters A. Earliest prevention of endemic goiter by iodine supplementation during pregnancy. Eur J Endocrinol 1996;134:443–8. ISSN 0804–4643 During pregnancy complex changes of maternal thyroid function occur and they are influenced by the maternal iodine supply. It has been demonstrated that with decreasing iodine supply maternal goiter and hypothyroxinemia as well as fetal and neonatal hypothyroidism become more prevalent. Therefore iodine supplementation during pregnancy is now strongly recommended also in areas of moderate iodine deficiency. To monitor the success of iodine supplementation and its theoretical risk of increasing the frequency of thyroid autoantibodies, we have investigated the thyroid volume, thyroid function, urinary iodine excretion and antibodies to thyroid peroxidase at 10–12 weeks of gestation and postpartum in 38 mothers receiving 300 μg potassium iodide/day and in 70 mothers without iodine supplementation. In all of their newborns thyroid volume was determined by ultrasound. The thyrotropin (TSH) levels and antibodies to thyroid peroxidase (TPO-ab) in the neonates were measured in dried blood spots on filter paper from their newborn screening. Urinary iodine excretion was increased significantly after iodine supplementation in mothers (p < 0.001) and their newborns (<0.05). No hypo- or hyperthyroidism was observed in the mothers or newborns. Interestingly, no difference of maternal thyroid volumes was observed between the two groups after pregnancy, but the volumes of the thyroid glands in newborns of mothers who received iodine were significantly (p < 0.004) lower (0.7 ± 0.4 ml) than in the control group (1.5 ± 1.1 ml). There was no change in the frequency of TPO-ab in either group after pregnancy. In four mothers transplacental passage of these antibodies was documented by positive measurement in the blood sample of the newborn. This study documents that iodine supplementation during pregnancy in an area of moderate iodine deficiency results in a lower size of neonatal thyroid volume and that this supplementation was not accompanied by an increase in the frequency of TPO-ab. Klaus Peter Liesenkötter, Kinderklinik Kaiserin Auguste Victoria Haus (KAVH), Virchow-Klinikum der Medizinische Fakultät der Humboldt-Universität zu Berlin, Heubnerweg 6, 14059 Berlin, Germany

scholarly journals Urinary Iodine Excretion and Serum Thyroid Function in Adults After Iodinated Contrast Administration

Thyroid ◽  
2015 ◽  
Vol 25 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Sun Y. Lee ◽  
Donny L.F. Chang ◽  
Xuemei He ◽  
Elizabeth N. Pearce ◽  
Lewis E. Braverman ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Urinary Iodine ◽  
Urinary Iodine Excretion ◽  
Contrast Administration ◽  
Iodinated Contrast ◽  
Iodine Excretion

scholarly journals Chronic iodine excess does not increase the incidence of hyperthyroidism: a prospective community-based epidemiological survey in China

2007 ◽  
Vol 156 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Fan Yang ◽  
Zhongyan Shan ◽  
Xiaochun Teng ◽  
Yushu Li ◽  
Haixia Guan ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Thyroid Peroxidase ◽  
Community Based ◽  
Iodine Excess ◽  
Iodine Supplementation ◽  
Excessive Iodine ◽  
Iodine Excretion ◽  
Excessive Iodine Intake

Objective: An increasing incidence of hyperthyroidism has been observed when iodine supplementation has been introduced to an iodine-deficient population. Moreover, the influence of chronic more than adequate or excessive iodine intake on the epidemiological features of hyperthyroidism has not been widely and thoroughly described. To investigate the influences of different iodine intake levels on the incidence of hyperthyroidism, we conducted a prospective community-based survey in three communities with mild-deficient, more than adequate (previously mild deficient iodine intake), and excessive iodine intake. Subjects and methods: In three rural Chinese communities, a total of 3761 unselected inhabitants aged above 13 years participated in the original investigation and 3018 of them received identical examinations after 5 years. Thyroid function, levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody and urinary iodine excretion were measured and thyroid ultrasound examination was also performed. Results: In three communities, median urinary iodine excretion was 88, 214, and 634 μg/l (P<0.05) respectively. The cumulative incidence of hyperthyroidism was 1.4, 0.9, and 0.8% (P>0.05) respectively. Autoimmune hyperthyroidism was predominant in thyroid hyperfunction in all the three cohorts. Either positive TPOAb (>50 U/ml) or goiter in original healthy participants was associated with the occurrence of unsuspected hyperthyroidism in 5 years (logistic regression, OR=4.2 (95% CI 1.7–8.8) for positive TPOAb, OR=3.1 (95% CI 1.4–6.8) for goiter). Conclusion: Iodine supplementation may not induce an increase in hyperthyroidism in a previously mildly iodine-deficient population. Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism, suggesting that excessive iodine intake may not be an environmental factor involved in the occurrence of autoimmune hyperthyroidism.

scholarly journals Variation in thyroid function in subclinical hypothyroidism: importance of clinical follow-up and therapy

2011 ◽  
Vol 164 (3) ◽  
pp. 317-323 ◽  
Author(s):  
Jesper Karmisholt ◽  
Stig Andersen ◽  
Peter Laurberg
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Repeated Measurements ◽  
Thyroid Peroxidase ◽  
Biochemical Tests ◽  
Free Triiodothyronine ◽  
Significant Difference ◽  
Hypothyroid Patients ◽  
Symptoms And Signs

Subclinical hypothyroidism (SCH) is a common condition that is often observed without therapy. However, no evidence-based recommendation exists with regards to how patients with untreated SCH should be monitored.Monitoring involves regular assessment of symptoms and signs of hypothyroidism (HYPO) and biochemical tests of thyroid function. An important question when repeated tests of thyroid function are performed is how large a difference in test results is needed to be confident that the change is real and not just due to chance variation.Recent data show that the least significant difference between two tests in SCH is 40% for TSH and 15% for free thyroxine and free triiodothyronine, with 90% confidence. Furthermore, monitoring has to be based on biochemical function testing because serial evaluation of symptoms and signs related to HYPO is rather insensitive in detecting worsening of thyroid insufficiency.When the presence of thyroid peroxidase auto-antibodies (TPO-Ab) in serum has been demonstrated, repeated measurements do not add much useful information in the monitoring of individual subclinical hypothyroid patients, as levels of TPO-Ab vary in parallel with TSH in these patients.Lastly, we discuss how differences in the monitoring procedure influence the diagnostic outcome, and we suggest a follow-up approach for untreated subclinical hypothyroid patients.

THE RELATIONSHIP BETWEEN SERUM PROTEIN-BOUND IODINE LEVELS AND URINARY IODINE EXCRETION AND SERUM THYROTROPHIN CONCENTRATIONS IN SUBJECTS FROM AN ENDEMIC GOITRE AREA IN CENTRAL JAVA

1978 ◽  
Vol 88 (3) ◽  
pp. 474-481 ◽  
Author(s):  
G. Hennemann ◽  
R. Djokomoeljanto ◽  
R. Docter ◽  
B. M. Goslings ◽  
C. van Hardeveld ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Serum Levels ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Central Java ◽  
Iodine Excretion ◽  
The Relationship ◽  
Serum Tsh

ABSTRACT Urinary 127I excretion, 24 h thyroid 131I uptake and serum values of thyrotrophin (TSH), triiodothyronine (T3) and protein-bound iodine (PBI) were measured in subjects from an area with severe (Segni) and moderate (Londjong) iodine deficiency. In Segni, 90 non-cretinous subjects and 40 cretins were studied. In both sub-groups from Segni non-compensated iodine deficiency was found. Although iodine excretion in these sub-groups was the same (mean: ± sd, 127I μg per g creatinine; non-cretins 16.9 ± 10.1 and cretins 15.2 ± 8.0) thyroid hormone serum levels were less in the cretins probably due to additional primary thyroid failure. In the subjects (non-cretins plus cretins) from Segni a positive relationship (r=0.39, P < 0.001) was found between urinary 127I excretion and serum PBI. Moreover in the same subjects a negative correlation was found between serum PBI and TSH (r=0.43; P < 0.001) while serum T3 did not correlate with TSH. In the Londjong area (mean ± sd 127I urinary excretion: 41.6 ± 18.6 μg per g creatinine) iodine deficiency appeared to be compensated in 52 subjects studied since mean serum levels of TSH, PBI and T3 were within normal range. No correlation between PBI and serum TSH was found. PBI too did not correlate with iodine excretion despite the fact that 37 subjects excreted less than 48 μg 127I per g creatinine below which value iodine excretion varied in all but one of the studied subjects from Segni. It is suggested on the basis of a difference in the average iodine intake between the groups from Segni and Londjong, that lack of "iodine buffer capacity" of the thyroid gland in the Segni subjects leads to a situation where changes in iodine intake are readily reflected in T4 production resulting in the correlation found between PBI and urinary excretion in this group.

scholarly journals Urinary iodine excretion and thyroid function status in school age children of hilly and plain regions of Eastern Nepal

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Prem Raj Shakya ◽  
Basanta Gelal ◽  
Binod Kumar Lal Das ◽  
Madhab Lamsal ◽  
Paras Kumar Pokharel ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Urinary Iodine ◽  
School Age Children ◽  
Urinary Iodine Excretion ◽  
School Age ◽  
Iodine Excretion

scholarly journals Urinary Iodine Level in Healthy Pregnant Women and its Correlation with Serum TSH & FT4

2017 ◽  
Vol 8 (1) ◽  
pp. 21-26
Author(s):  
PR Saha ◽  
R Maleque ◽  
S Biswas ◽  
R Haque ◽  
F Khondker ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urinary Iodine ◽  
First Trimester ◽  
Urinary Iodine Excretion ◽  
Urinary Iodine Concentration ◽  
Iodine Level ◽  
Significant Difference ◽  
Iodine Excretion ◽  
Serum Tsh ◽  
In Pregnancy

Pregnancy is accompanied by profound alteration of thyroid economy and relative iodine deficiency. Sub-optimal thyroid function in pregnancy is associated with impaired neuro intellectual development. Urinary iodine concentration is increased during pregnancy. The aims of this study were to evaluate urinary iodine level in pregnant women and also to elucidate its correlation with thyroid parameters (TSH&FT4) in pregnancy. This was a case control study carried out in the Department of Biochemistry, jointly with the Antenatal and Thyroid Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2003 to June 2004. Urinary iodine excretion was measured in 100 subjects of age range 20-35 years. Among them 60 were pregnant at first trimester and primi gravid. Rest 40 were non-pregnant women who were taken as control. Urinary iodine was measured by Wet digestion based on Sandell-Kolthoff principle. Thyroid Stimulating hormone (TSH) and free thyroxin (FT4) were measured by the AxSYM (Abbott -USA) by applying Micro particle Enzyme Immune Assay (MEIA) principle. The data was reported as Mean± SE; the mean age of the pregnant and nonpregnant women were 25.03±0.48 yrs and 25.20±0.60 yrs respectively. No significant difference was found regarding age. The median urinary iodine of pregnant women was 438.13µg/l (range240.50-490.0) and that non pregnant women was 412.50µg/l (range 240.0-473.75µgl). Mean serum TSH were 1.29±0.15 and 1.97±0.18 mIU/L and mean serum FT4 were 14.51±0.41 and 16.30 ±0.41pmol/L in pregnant and non pregnant women respectively. Urinary iodine level was significantly increased in pregnant women compared to that of the non pregnant group (p<0.05). A significant negative correlation was found between urinary iodine and serum TSH (p<0.01) whereas a positive correlation between urinary iodine and serum FT4 level is p<0.05 in pregnant and p<0.01 in non pregnant group. Urinary iodine excretion is increased in pregnancy than that in non pregnant women. Clinically and biochemically all the subjects were euthyroid and excretion rate of iodine in all subjects were above the normal range.Bangladesh J Med Biochem 2015; 8(1): 21-26

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