scholarly journals TSH enhancement of FT4 to FT3 conversion is age dependent

2016 ◽  
Vol 175 (1) ◽  
pp. 49-54 ◽  
Author(s):  
David Strich ◽  
Gilad Karavani ◽  
Shalom Edri ◽  
David Gillis

ObjectiveWe previously reported increasing free T3 (FT3) to free T4 (FT4) ratios as thyroid-stimulating hormone (TSH) increases within the normal range in children. It is not known if this phenomenon is age-related among humans, as previously reported in rats. This study examines the relationships between TSH and FT3/FT4 ratios in different ages.DesignRetrospective examination of thyroid tests from patients without thyroid disease from community clinics.MethodsFree T3, free T4, and TSH levels from 527 564 sera collected from patients aged 1 year or greater were studied. Exclusion criteria were the following: missing data, TSH greater than 7.5mIU/L, and medications that may interfere with thyroid hormone activity. A total of 27 940 samples remaining after exclusion were stratified by age. Samples with available anthropometric data were additionally stratified for body mass index (BMI). Correlations of TSH to FT4, FT3, and FT3/FT4 ratios by age group were examined.ResultsUp to age 40, for each increasing TSH quartile, FT3 and the FT3/FT4 ratio increased and FT4 decreased significantly (for both FT3, FT4 and FT3/FT4 ratio,P<0.05 for every TSH quartile when compared with the 1st quartile, except FT3 in the 30–40 age group). In older age groups, increasing TSH was not associated with increased FT3/FT4 ratio.ConclusionAs TSH levels increase, FT3/FT4 ratios increase until age 40, but this differential increase does not occur in older age groups. This may reflect a decrease in thyroxine (T4) to triiodothyronine (T3) conversion with age, which may be part of the aging process.

2021 ◽  
Vol 8 (2) ◽  
pp. 966-970
Author(s):  
Vedartham Ramesh ◽  

Background: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation, so we want to determine the prevalence of thyroid dysfunction in children at kurnool district. Materials and Methods: A hospital based prospective observational study performed in new born and children below 18 years fulfilling the inclusion criteria visiting the pediatric OPD and IPD in Viswabharathi medical college, Kurnool if they had clinical suspicion of thyroid dysfunction. If suspicion of hypothyroidism, Free T4, Total T4, TSH levels and if suspicion of hyperthyroidism Free T3 and TSH were done. Results: Out of 70 case 3 cases (4.3%) are hyperthyroidism and 67 cases (95.7%) are hypothyroidism in these 3 (4.3%) cases had family history of thyroid disorders, male to female ratio was 1.3:6 and prevalence rate was high in the age group of 10 - 12 years 32.9% (23 cases). 13 (18.6%) cases had thyroid enlargement and 48 (68.57%) cases had anaemia. Treatment was started according to standard guidelines. Conclusion: The higher prevalence rate of thyroid disorders in childhood that to in female children and age group of 10 - 12 years in and around kurnool. Hence, screening of all new-borns and children should be mandatory as early diagnosis and treatment helps in prevention of complications of thyroid disorders. KEY WORDS: Free T3, Free T4, Goiter, Hyperthyroidism, Hypothyroidism, and Thyroid stimulating hormone.


2020 ◽  
Vol 33 (02) ◽  
pp. 120-125
Author(s):  
Pulakendu Bhattacharya ◽  
Shashi Giri ◽  
Baishakhi Ghosh ◽  
Abhiram Banerjee

AbstractSubclinical hypothyroidism (SCH) is a condition where serum thyroid-stimulating hormone (TSH) level is high, but the T3 and T4 are within normal level. SCH carries a risk of cardiovascular diseases or progression to overt hypothyroidism. Treatment becomes more necessary in case of older age groups and in females. Two cases of SCH treated with individualised homoeopathic medicine are presented and the improvement was significant showing reduction in the TSH levels with overall improvement in health.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1929-1929
Author(s):  
Olufunmilayo A Bamigbola ◽  
Lorna E Warwick

Abstract Background Lymphomas can occur in all age groups but most commonly occur in older adults. Despite the shift towards patient- centered care, very little has been done to explore the information needs of patients with lymphoma by age. It is important for information to accessible to patients of all ages, as informed patients are consistently associated with better outcomes and healthcare experiences. In this study, Lymphoma Coalition (LC) describes the age-related differences in the information needs of patients with lymphoma using the 2020 LC Global Patient Survey (GPS). The objectives of this study were to identify: 1) how patients felt about the amount of information they received at diagnosis 2) the content of the information received at diagnosis and the level of understanding, and 3) their informational needs. Methods Globally, 11,878 respondents including 9,179 patients and 2,699 caregivers took part in the 2020 LC GPS. There were 9,078 patients included in this analysis who self-identified their age. These patients were grouped into five age groups for analysis: 18-29 (n=638), 30-39 (n=1,196), 40-59 (n=3,261), 60-69 (n=2,216), and 70+ (n=1,767). Demographics of the five age groups were examined, and descriptive analyses for all questions relating to information needs were performed in IBM SPSS v27. Results The five age groups differed significantly (p&lt; 0.001) in all the demographic categories examined. These categories included lymphoma subtype, sex, area of residence, education level, employment status, and household status. Patients were asked how they felt about the amount of information given to them at diagnosis. The oldest age group (70+) reported the highest prevalence (70%) of having received the right amount of information (Table 1). The younger age groups (18-29; 30-39; and 40-59) reported the highest prevalence of not receiving enough information (38%, 42%, and 41% respectively). Although not many patients reported being given too much information, of those who did, the younger age groups (18-29; 30-39; and 40-59) were the most prevalent (10%; 7%; and 5% respectively) (Table 1). Patients were asked about the type of information given to them at diagnosis, and how well they understood it. Compared to the younger age groups, the older age groups (60-69 and 70+) more frequently reported that they received and understood information given to them on different medical treatment options, the process and stages of their care, and how to manage side effects of treatment (Table 1). Patients were also asked what they needed more information about (Table 1). The top three areas that all patients needed more information about (regardless of age group) were treatment options, side effects from treatment, and their diagnosis and what it means. There was significant difference in the prevalence of how these information needs were reported between the age groups (Table 1). There was also significant difference in the prevalence of reporting a need for more information on support for self care, psychological support/counselling, and fertility across the age categories (Table 1). The lowest prevalence for needing more information in any of these areas was observed in the older age groups (60-69 and 70+), while the highest prevalence was observed in the youngest age groups (18-29 and 30-39) (Table 1). Although few patients reported not needing more information in any of these areas, its reporting was most prevalent in the older age groups (60-69 and 70+) (12% and 19%, respectively) (Table 1). Summary/Conclusions This analysis revealed that patients with lymphoma/CLL experience medical information differently across age groups. Compared to the mid and oldest patient groups, younger patients with lymphoma or CLL reported experiencing medical information differently than older patients do and reported less understanding of the medical information given to them. The younger patients also reported higher informational needs about their disease and treatment that may also be related to their age (e.g. information on fertility and family support). Clinicians should note these differences in age-group experiences and information needs, with the understanding that younger patients with lymphoma or CLL may require additional information, attention, and support. In the future, LC would like to explore how demographic differences may have confounded results. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


1970 ◽  
Vol 8 (2) ◽  
pp. 231-237
Author(s):  
V Rohil ◽  
AK Mishra ◽  
MK Shrewastwa ◽  
KD Mehta ◽  
M Lamsal ◽  
...  

Background: Subclinical hypothyroidism itself is associated with serious complications and also there is a known risk of subclinical hypothyroidism patients getting converted into overt disease. Objectives: The objective of the present study was to find out the prevalence of subclinical hypothyroidism in the suspected cases i.e. amongst the cases attending the thyroid laboratory at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Materials and methods: It was a retrospective cross sectional study. Data of the free T3, free T4 and TSH estimations of the year 2007 of the Thyroid lab at BPKIHS, Dharan, Nepal was analyzed. ELISA based free T3, free T4 and TSH tests in the serum had been performed in all the cases. Results: Total cases were 1714 including 24.446% males and 75.554% females. Cases with raised TSH levels were 26.021%, cases with normal TSH levels were 54.66% and cases with low TSH levels were 19.316%. Total 350 cases (20.42 %) had subclinical hypothyroid dysfunction which includes 84 (4.901 %) males and 266 (15.519%) females. And the maximum percentage of cases in either gender was between the age groups 20 -59 years. Conclusion: The prevalence of subclinical thyroid hypothyroidism amongst the suspected cases was 20.42% which is much higher compared to the other parts of the world. The highest percentage was found in the female age group 20 - 59 years. The routine screening of the whole population is not cost effective and on the basis of the present study it is suggested that there may be routine screening of the selected populations, especially women between 20 to 59 years of age in Nepal region. The preferred screening method advised is a sensitive ELISA based TSH test. Key words: Subclinical hypothyroidism DOI: 10.3126/kumj.v8i2.3565 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 231-237


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261532
Author(s):  
Meg Fluharty ◽  
Elise Paul ◽  
Jessica Bone ◽  
Feifei Bu ◽  
Jill Sonke ◽  
...  

Introduction Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Methods Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50–59, 60–69, ≥70] for the frequency of arts participation outcome and [50–69 vs ≥70] all other outcomes. Results Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50–69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Conclusions Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Yasemin Ucal ◽  
Muhittin Serdar ◽  
Cansu Akın-Levi ◽  
Zeynep Zulfiye Yıldırım-Keles ◽  
Cem Turam ◽  
...  

AbstractObjectivesTrace elements are essential in thyroid functioning as they incorporate into biologically important enzymes as cofactors. The placenta can either activate or inhibit the transfer of maternal trace elements to the unborn. An imbalance of maternal trace elements in pregnancy may affect both maternal and newborn thyroid function.MethodsBlood samples from 315 lactating mothers were collected in the first 48 h after delivery and evaluated for selenium (Se), copper (Cu), manganese (Mn), and zinc (Zn) using flame atomic absorption spectroscopy (FAAS) and quadrupole inductively coupled plasma-mass spectrometer (ICP-MS). Thyroid hormones and auto-antibodies (thyroid-stimulating hormone (TSH), free T3 (fT3), free T3 (fT4), anti–thyroid peroxidase (anti-TPO), and antithyroglobulin (anti-TG)) were analyzed in maternal blood using an electro-chemiluminescence immunoassay (ECLIA). Between 48 and 72 postpartum hours, spot blood samples were used for newborn screening-TSH measurement. Correlation and multivariate analyses were performed to evaluate the effect of maternal trace element levels on newborn screening-TSH levels.ResultsThe medians (min-max) of maternal Se (45.16 µg/L (21.28–79.04)), Cu (210.10 µg/dL (117.04–390.64)), Mn (2.11 µg/L (0.20–3.46)), and Zn (0.43 mg/L (0.24–0.66)) were determined. A positive correlation was detected between Zn and maternal TSH levels (r=0.12, p < 0.05). Newborn screening-TSH was significantly correlated with maternal Cu (r=0.14, p < 0.01). Similarly, Cu exhibited weak associations in clustering analysis while others shared common clusters with newborn-screening TSH.ConclusionsThere was no significant association between most of the maternal serum trace elements and maternal thyroid hormone parameters, with an only exception between maternal Zn and maternal serum TSH. Finally, the association between maternal serum Cu levels and newborn screening-TSH levels may highlight the importance of maternal Cu levels on the newborn thyroid health.


2001 ◽  
Vol 8 (3) ◽  
pp. 556-559 ◽  
Author(s):  
Jaime Inostroza ◽  
Ana Maria Vinet ◽  
Gloria Retamal ◽  
Pedro Lorca ◽  
Gonzalo Ossa ◽  
...  

ABSTRACT All clinical S. pneumoniae specimens isolated from patients with invasive or sterile-site infections admitted to one regional general hospital in southern Chile were collected during a 5-year period (February 1994 to September 1999). A total of 247 strains belonging to 50 serotypes were isolated in this survey: 69 in patients under 5 years of age, 129 in patients 5 to 64 years old, and 49 from patients 65 years and older. Eight serotypes were identified in all age groups, while all other serotypes were found exclusively in one age group or in patients over 4 years of age. Serotype 3 was never found in patients under 5 years old, and serotype 14 was not found in patients >64 years of age. There was no difference in the serotypes causing infection in each one of the 5 years of the survey. Our results suggest that both bacterial virulence factors and host factors play an important role in the selection of S. pneumoniae serotypes causing invasive infection. Possible host factors include age-related differences in the immune response. Comparative studies with other areas of the world may help to further understanding of our observations in southern Chile.


1996 ◽  
Vol 85 (3) ◽  
pp. 410-418 ◽  
Author(s):  
Giuseppe Lanzino ◽  
Neal F. Kassell ◽  
Teresa P. Germanson ◽  
Gail L. Kongable ◽  
Laura L. Truskowski ◽  
...  

✓ Advanced age is a recognized prognostic indicator of poor outcome after subarachnoid hemorrhage (SAH). The relationship of age to other prognostic factors and outcome was evaluated using data from the multicenter randomized trial of nicardipine in SAH conducted in 21 neurosurgical centers in North America. Among the 906 patients who were studied, five different age groups were considered: 40 years or less, 41 to 50, 51 to 60, 61 to 70, and more than 71 years. Twenty-three percent of the individuals enrolled were older than 60 years of age. Women outnumbered men in all age groups. Level of consciousness (p = 0.0002) and World Federation of Neurological Surgeons grade (p = 0.0001) at admission worsened with advancing age. Age was also related to the presence of a thick subarachnoid clot (p = 0.0001), intraventricular hemorrhage (p = 0.0003), and hydrocephalus (p = 0.0001) on an admission computerized tomography scan. The rebleeding rate increased from 4.5% in the youngest age group to 16.4% in patients more than 70 years of age (p = 0.002). As expected, preexisting medical conditions, such as diabetes (p = 0.028), hypertension (p = 0.0001), and pulmonary (p = 0.0084), myocardial (p = 0.0001), and cerebrovascular diseases (p = 0.0001), were positively associated with age. There were no age-related differences in the day of admission following SAH, timing of the surgery and/or location, and size (small vs. large) of the ruptured aneurysm. During the treatment period, the incidence of severe complications (that is, those complications considered life threatening by the reporting investigator) increased with advancing age, occurring in 28%, 33%, 36%, 40%, and 46% of the patients in each advancing age group, respectively (p = 0.0002). No differences were observed in the reported frequency of surgical complications. No age-related differences were found in the overall incidence of angiographic vasospasm; however, symptomatic vasospasm was more frequently reported in the older age groups (p = 0.01). Overall outcome, assessed using the Glasgow Outcome Scale at 3 months post-SAH, was poorer with advancing age (p < 0.001). Multivariate analysis of overall outcome, adjusting for the different prognostic factors, did not remove the age effect, which suggests that the aging brain has a less optimal response to the initial bleeding. Age as a risk factor is a continuum; however, there seems to be a significant increased risk of poor outcome after the age of 60 years.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sarah Smith-Simpson ◽  
Lisa Fries ◽  
Carolyn Ross

Abstract Objectives The objective was to identify the age at which parents expose their children to different food textures and how challenging the textures were for their child to eat. It was hypothesized that older children would be exposed to a wider variety of food textures and that parents would consider a larger proportion of these textures to be easy to eat. Methods Parents (n = 365) in Grand Rapids, MI, USA with a child aged 6–36 months completed an online survey. The survey had 37 questions, including 15 unique food texture categories with food examples (Table 1). Parents were asked how difficult each texture category was for their child to eat using a 5-point scale ranging from “Very Easy” to “Very Difficult”, plus an option for “My child hasn't tried this yet”. Children were divided into 5 age groups (6-8 months, 9–12 months, 13–18 months, 19–24 months, 25–36 months) for analysis. Across texture category and age group, data were analyzed using analysis of variance, with mean separation accomplished using Fisher's LSD (P < 0.05). Results A majority of children in the youngest age group (6-8 months) had only eaten foods described as creamy, dissolvable, or pureed. All of the texture categories had been served to a majority of 9–12 month-old children, except for “hard” and “tough meat”. By 18 months of age, a majority of children had tried all food texture categories except “hard”. Across all age groups, creamy, dissolvable, and puree were rated as easy and “tough meat” was rated as difficult. The other textures showed age-related differences, with parents of older children reporting the textures as easier to eat than those of younger children. Food textures were compared within the 9–12 and 13–18 month age groups, when most new food textures are introduced, and similar trends were observed. The easiest textures were creamy, dissolvable, puree and soft, followed by lumpy and juicy, then slippery, chewy, rubbery, and sticky. The most difficult textures were leafy, with skin, hard, tough meat and combination of textures. Conclusions When considering textures of the foods that comprise a well-balanced, healthy diet, many foods are difficult for children to eat. Preparing foods such as green vegetables specifically to have age-appropriate textures could improve consumption. Funding Sources Washington State Univ College of Agricultural, Human and Natural Resource Emerging Research Issues Grant.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Okuyan Ertugrul ◽  
Uslu Ahmet ◽  
Enhos Asim ◽  
Hepgul E. Gulcin ◽  
Ayca Burak ◽  
...  

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds.


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