Serum T3 and T4 Levels in Sick Children

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 776-776
Author(s):  
J. N. Carter ◽  
J. M. Corcoran ◽  
C. J. Eastman ◽  
L. Lazarus ◽  
M. O'Halloran

We have reported that most adults with severe, chronic, nonthyroidal illnesses (i.e., sick euthyroid patients) have significantly decreased circulating levels of triiodothyronine (T3) and thyroxine (T4), whilst the thyrotropin (TSH) levels are not elevated.1 The T3 levels are usually reduced into the hypothyroid range, whilst the T4 levels generally remain within the normal range. The patients in that study were aged from 21 to 84 years. We have recently concluded a study of circulating thyroid hormone levels in children of various ages and have found that the mean levels of both T3 and T4 are higher than in adults.

2007 ◽  
Vol 157 (2) ◽  
pp. 221-223 ◽  
Author(s):  
Anastasios Papadimitriou ◽  
Dimitrios T Papadimitriou ◽  
Anna Papadopoulou ◽  
Polyxeni Nicolaidou ◽  
Andreas Fretzayas

Introduction: A recent study on TSH receptor (TSHR) null mice suggested that skeletal loss occurring in hyperthyroidism is caused by the low TSH rather than high thyroid hormone levels. The aim of this study was to examine whether low TSH results in osteoporosis in the human. Subjects and methods: We determined bone mineral density (BMD) and markers of bone metabolism in two male siblings aged 9.8 and 6.8 years with isolated TSH deficiency, due to a mutation of the TSH β-subunit gene. BMD was measured in the lumbar spine (L1–L4) by dual-energy X-ray absorptiometry. Laboratory investigation included the determination of serum calcium, phosphate, 25-hydroxy-vitamin D, parathyroid hormone concentrations, and urine calcium (Ca)/creatinine (Cr) ratio. Osteoblast activity was measured by serum bone alkaline phosphatase and osteocalcin levels, and osteoclast activity by urine cross-linked amino-terminal, carboxy-terminal telopeptides of type I collagen and deoxypyridinoline concentrations. Results: BMD of both patients was within the normal range for age and sex; z-scores were −0.55 and −0.23 for patients 1 and 2 respectively. Serum calcium, phosphate, urine Ca/Cr ratio, and specific markers of bone metabolism were also within normal range. Conclusion: In childhood, chronic extremely low TSH levels, in the face of normal thyroid hormone levels, are not related to bone loss.


Author(s):  
J H Parr

Serum concentration of free T3 and, in female patients, FT4, were found to be lower in 20 asymptomatic, moderately-poor or well controlled, diabetics treated with insulin than in a group of non-diabetic subjects. Over a mean 3-month period of the study a significant fall occurred in HbA1 concentration in both groups of diabetics without change in free thyroid hormone levels. The mean capillary blood glucose, fasting free insulin and fasting lipid concentrations, other than high density lipoprotein (HDL) cholesterol, did not change. No correlations were found between the changes in HbA1 and free thyroid hormone concentrations. Improvement in long term metabolic control did not influence free thyroid hormone levels in well controlled and moderately-poor controlled diabetics, taking insulin.


2007 ◽  
Vol 92 (1) ◽  
pp. 208-211 ◽  
Author(s):  
Giorgos S. Metsios ◽  
Andreas D. Flouris ◽  
Athanasios Z. Jamurtas ◽  
Andres E. Carrillo ◽  
Demetrios Kouretas ◽  
...  

Abstract Context: Active smoking influences normal metabolic status and thyroid function. Objective: The objective was to assess experimentally the effects of 1 h of moderate passive smoking in a controlled simulated bar/restaurant environment on the metabolism and thyroid hormone levels in healthy nonsmokers. Participants: Eighteen (nine females, nine males) healthy individuals (mean ± sd: age, 25.3 ± 3.1 yr; height, 174.0 ± 10.1 cm; weight, 65.2 ± 13.7 kg) participated in the study. Design: In repeated-measures randomized blocks, participants visited the laboratory on 2 consecutive days. In the experimental condition, they were exposed to 1 h of moderate passive smoking at a carbon monoxide concentration of 23 ± 1 ppm in an environmental chamber, whereas in the control condition participants remained in the same chamber for 1 h breathing normal atmospheric air. Main Outcome Measures: In both conditions, cotinine serum and urine levels, resting energy expenditure (REE), as well as concentration of T3, free T4, and TSH were assessed before participants entered the chamber and immediately after their exit. Heart rate and blood pressure were tested in 10-min intervals during all REE assessments. Results: The mean ± sd difference of serum and urine cotinine levels (−0.27 ± 3.94 vs. 14.01 ± 6.54 and 0.05 ± 2.07 vs. 7.23 ± 3.75, respectively), REE (6.73 ± 98.06 vs. 80.58 ± 120.91) as well as T3 and free T4 (0.05 ± 0.11 vs. 0.13 ± 0.12 and 0.02 ± 0.15 vs. 0.22 ± 0.20) were increased in the experimental compared with the control condition at baseline and follow-up (P < 0.05). No statistically significant variation was observed in the mean difference of the remaining parameters (P > 0.05). Serum and urine cotinine values were linearly associated with REE (P < 0.05). Conclusion: One hour of passive smoking at bar/restaurant levels is accompanied by significant increases in metabolism and thyroid hormone levels.


KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 787-790
Author(s):  
Tanvir Iqbal ◽  
M Obaidulla Ibne Ali ◽  
Nur E Atia ◽  
Tahorul Islam

Background: Screening for thyroid hormones in the newborn baby is extremely important to detect the newborns who are borned with hypofunctional state of thyroid gland. This screening program in first few weeks of life is essential to prevent serious complications of hypothyroidism in future such as mental retardation.Objective: To assess the thyroid hormone levels in normal newborn and preterm, low birth weight babies and comparison of thyroid dysfunction between these two groups.Method: This cross - sectional analytical type of study was conducted in the department of physiology and paediatrics of Rajshahi Medical College & Hospital (RMCH) from July 2015 to June 2016. A total of 70 newborn baby were enrolled by systematic sampling of which 40 were normal healthy newborn and 30 were preterm, low birth weight babies. Data was collected from the parents and they were filled out standard questionnaire. Then venous blood was collected from each and every neonate and blood was sent to laboratory for estimation of thyroid hormone levels. FT4 and TSH values were estimated as these two are the most important parameters for determination of thyroid function.Result: In this study, the mean (±SD) serum FT4 level in term and preterm neonates were 14.17±2.14 and 12.25±3.16 (pg/ml) respectively. This FT4 value is significantly higher in term neonates than preterm neonates (P<0.05). The mean (±SD) serum TSH level in term and preterm neonates were 3.37±2.12 and 4.23±3.23 (?IU/ml) respectively. Statistically there was no significant difference in TSH values between these two groups (P 0.05).Conclusion: From this study it was evident that preterm, low birth weight babies are more likely to develop hypofunctional state of thyroid gland than normal term babies. The newborns who were found hypothyroid, were informed to their parents for consultation with the concerned physicians. The physicians then took necessary steps to correct the hypofunctional state of thyroid gland.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 787-790


2005 ◽  
Vol 90 (12) ◽  
pp. 6498-6507 ◽  
Author(s):  
Robin P. Peeters ◽  
Serge van der Geyten ◽  
Pieter J. Wouters ◽  
Veerle M. Darras ◽  
Hans van Toor ◽  
...  

Context: Pronounced alterations in serum thyroid hormone levels occur during critical illness. T3 decreases and rT3 increases, the magnitudes of which are related to the severity of disease. It is unclear whether these changes are associated with decreased tissue T3 concentrations and, thus, reduced thyroid hormone bioactivity. Patients and Study Questions: We therefore investigated, in 79 patients who died after intensive care and who did or did not receive thyroid hormone treatment, whether total serum thyroid hormone levels correspond to tissue levels in liver and muscle. Furthermore, we investigated the relationship between tissue thyroid hormone levels, deiodinase activities, and monocarboxylate transporter 8 expression. Results: Tissue iodothyronine levels were positively correlated with serum levels, indicating that the decrease in serum T3 during illness is associated with decreased levels of tissue T3. Higher serum T3 levels in patients who received thyroid hormone treatment were accompanied by higher levels of liver and muscle T3, with evidence for tissue-specific regulation. Tissue rT3 and the T3/rT3 ratio were correlated with tissue deiodinase activities. Monocarboxylate transporter 8 expression was not related to the ratio of the serum over tissue concentration of the different iodothyronines. Conclusion: Our results suggest that, in addition to changes in the hypothalamus-pituitary-thyroid axis, tissue-specific mechanisms are involved in the reduced supply of bioactive thyroid hormone in critical illness.


1998 ◽  
Vol 76 (12) ◽  
pp. 1120-1131 ◽  
Author(s):  
William N Henley ◽  
Linda L Bellush ◽  
Marc Tressler

A three-part study explored the basis for an interaction between changes in thyroid status and bulbospinal serotonin (5HT) metabolism. In experiment 1, three well-characterized models of primary hypothyroidism were all accompanied by significant increases in 5HT metabolism. In experiment 2, circulating thyroid hormone levels were experimentally varied from very low methimazole (Meth) treatment to very high (T3 implants: 2.5, 5.0, or 7.5 mg triiodothyronine). As in experiment 1, Meth led to elevated 5HT. Hyperthyroidism was accompanied by significant reductions in 5HT, while urinary norepinephrine excretion paralleled 5HT. In experiment 3, rats were subjected to Meth either 2 weeks before or after induction of diabetes with streptozotocin (Stz). Meth prevented Stz-associated reductions in 5HT and attenuated development of hyperphagia. Meth could not reverse established Stz-associated reduction in 5HT or hyperphagia, although both were slightly attenuated. Thus, although the first two experiments argue for a simple inverse relationship between circulating thyroid hormone levels and 5HT in the brain, experiment 3 demonstrated that Stz-associated decrements in 5HT could not be reversed by subsequent lowering of circulating thyroid hormone. Nor did accompanying measurements indicate that glycemic status or circulating levels of leptin were important predictors of 5HT. Thus the interaction between thyroid hormones and 5HT is both more subtle and more complex than previously thought.Key words: hypothyroidism, hyperthyroidism, serotonin, diabetes mellitus.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A849-A849
Author(s):  
Ricardo H Costa e Sousa ◽  
Rodrigo Rorato ◽  
Anthony Neil Hollenberg ◽  
Kristen R Vella

Abstract Thyroid hormone (TH) is a major regulator of development and metabolism. An important mechanism controlling TH production is the negative feedback at the hypothalamic and pituitary level and it has been suggested that thyroid hormone receptor β (TRβ) is the main mediator of TH actions in the hypothalamic paraventricular nucleus (PVN). Nevertheless, the direct actions of TH and TRβ in the negative regulation of TRH have yet to be demonstrated in vivo. Here we used two approaches to investigate the TRH neuron. First, we used a chemogenetic tool to directly investigate the role of TRH neurons on the regulation of thyroid hormone levels. Mice expressing Cre-recombinase in TRH neurons received bilateral injections of the activating designer receptors exclusively activated by designer drugs (DREADD) directly into the PVN. Activation of TRH neurons produced a rapid and sustained increase in circulating TSH levels in both males and females. TSH levels increased approximately 10-fold from baseline within 15 minutes of injection of CNO, returning to baseline within 2.5 hours. TH levels were increased approximately 2-fold in males and females. Therefore, using a chemogenetic approach, we were able to directly evaluated the role of PVN TRH neurons on the control of thyroid activity, for the first time. Next, we generated mice deficient in TRβ specifically in neurons expressing melanocortin 4 receptor (MC4R), which overlaps with TRH expression in the PVN. Knockout mice (KO) developed normally and showed no change in TH and TSH levels. TRH mRNA levels in the PVN of KO mice were similar to control mice. To investigate if the deletion of TRβ in the PVN changes the sensitivity of the HPT axis to T3, mice were rendered hypothyroid and given increasing doses of T3 for 2 weeks. Results show no difference in TRH mRNA or serum TSH between controls and KO. Surprisingly, despite the presence of detectable genomic recombination on the TRβ gene in the PVN, there was no difference in TRβ mRNA expression between control and KO mice, suggesting that either MC4R-positive neurons do not express TRβ or they represent a very small population of TRβ-positive cells in the PVN. Present data show that TRH neuron activation rapidly stimulates TSH release and increases TH levels, demonstrating a major role of these neurons in the regulation of the hypothalamic-pituitary-thyroid (HPT) axis. Nevertheless, deletion of TRβ from MC4R neurons had no major effect on either TRH or TH levels in in mice. Additionally, TRβ in MC4R-positive TRH neurons in the PVN is not necessary for TH-induced suppression of TRH mRNA. Although further studies are necessary, these data suggest that there are distinct populations of hypophysiotropic TRH neurons in the PVN, some of which are not regulated by thyroid hormone and TRβ.


1988 ◽  
Vol 118 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Gen Komaki ◽  
Hajime Tamai ◽  
Takahiro Mori ◽  
Tetsuya Nakagawa ◽  
Shu Mori

Abstract. We investigated changes in the serum angiotensin-converting enzyme, as an index of thyroid hormone action, before, during and after fasting in 15 non-obese, hospitalized patients. Serum angiotensinconverting enzyme decreased significantly from 14.6 ± 1.1 U/l before fasting to 13.2 ± 1.1 U/l on the 5th day (P < 0.05, N = 15) during fasting, and to 10.6 ± 1.0 U/l on the 10th day (P < 0.05, N = 8). The serum TSH and T3 levels decreased significantly to below the normal range, and the serum T4 level decreased gradually during fasting, whereas free T4 (Amerlex) changed slightly, but within normal range. Although re-feeding did not lead to any reduction in the serum TSH, T3, or T4 level, the serum angiotensin-converting enzyme further decreased to 8.7 ± 0.9 U/l on the 5th day of re-feeding compared with that on the 10th day of fasting (P < 0.01, N = 8). There was a delay in the re-elevation of serum angiotensin-converting enzyme following a rise in serum T3. No correlations were found between serum angiotensin-converting enzyme levels and thyroid hormone levels throughout the study period. It is concluded that a significant reduction in the serum angiotensin-converting enzyme level occurs under a 'low T3' state during acute starvation, although there is no clear association between serum angiotensinconverting enzyme and thyroid hormone levels.


1989 ◽  
Vol 67 (8) ◽  
pp. 1851-1855 ◽  
Author(s):  
A. F. Youngson ◽  
H. A. McLay

Circulating levels of thyroid and steroid hormones in salmon (Salmo salar) that had spent one winter in seawater have been determined in fish at rest and after a 4-h exposure to increased water velocity. The responses of fish of both sexes to this challenge were examined in April and June, while the fish were in seawater; sexually maturing males only were examined in freshwater in August and November. Mean thyroxine levels in resting controls ranged from 8.8 to 15.2 ng/mL. Mean thyroxine levels in challenged fish were significantly greater on each occasion. In male fish, 11-oxotestosterone levels were reduced after challenge, while androstenedione levels in females remained unchanged. In April, thyroxine levels after challenge were correlated with 11-oxotestosterone levels in males and with androstenedione levels in females.


Endocrine ◽  
2021 ◽  
Vol 74 (2) ◽  
pp. 285-289
Author(s):  
Stephen P. Fitzgerald ◽  
Nigel G. Bean ◽  
James V. Hennessey ◽  
Henrik Falhammar

Abstract Purpose Recently published papers have demonstrated that particularly in untreated individuals, clinical parameters more often associate with thyroid hormone, particularly free thyroxine (FT4), levels than with thyrotropin (TSH) levels. Clinical and research assessments of the thyroid state of peripheral tissues would therefore be more precise if they were based on FT4 levels rather than on TSH levels. In this paper we describe implications of, and opportunities provided by, this discovery. Conclusions The FT4 level may be the best single test of thyroid function. The addition of free triiodothyronine (FT3) and TSH levels would further enhance test sensitivity and distinguish primary from secondary thyroid dysfunction respectively. There are opportunities to reconsider testing algorithms. Additional potential thyroidology research subjects include the peripheral differences between circulating FT4 and FT3 action, and outcomes in patients on thyroid replacement therapy in terms of thyroid hormone levels. Previously performed negative studies of therapy for subclinical thyroid dysfunction could be repeated using thyroid hormone levels rather than TSH levels for subject selection and the monitoring of treatment. Studies of outcomes in older individuals with treatment of high normal FT4 levels, and pregnant women with borderline high or low FT4 levels would appear to be the most likely to show positive results. There are fresh indications to critically re-analyse the physiological rationale for the current preference for TSH levels in the assessment of the thyroid state of the peripheral tissues. There may be opportunities to apply these research principles to analogous parameters in other endocrine systems.


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