scholarly journals Persistence of hyperprolactinemia after treatment of primary hypothyroidism and withdrawal of long term use of estrogen: are the tuberoinfundibular dopaminergic neurons permanently lesioned?

2005 ◽  
Vol 49 (3) ◽  
pp. 468-472 ◽  
Author(s):  
Luiz Augusto Casulari ◽  
Fábio Celotti ◽  
Luciana A. Naves ◽  
Lucília Domingues ◽  
Carla Papadia
Keyword(s):  
Dopaminergic Neurons ◽  
Hormone Replacement ◽  
Hormonal Contraceptive ◽  
Primary Hypothyroidism ◽  
Trh Test ◽  
Pituitary Mass ◽  
Thyroid Hormone Replacement ◽  
Before And After ◽  
High Doses

Long term use of high doses of estrogen and the presence of chronic hyperprolactinemia may, at least in the rat, provoke lesions in the tuberoinfundibular dopaminergic (TIDA) neurons responsible for the control of prolactin (Prl) secretion. This occurrence, which is not yet well documented in humans, may have taken place in a patient on chronic oral hormonal contraceptive (OC) treatment who was seen for primary hypothyroidism, hyperprolactinemia and a pituitary mass. After thyroid hormone replacement, OC withdrawn and bromocriptine treatment, this patient could not maintain normal Prl levels, unless continuously treated with a dopaminergic agonist even when MRI was indicative of a normal situation. Function of TIDA neurons was investigated by TRH test (200µg IV) performed before and after treatment with 25mg carbidopa plus 250mg L-dopa every 4 hours for one day. Basal TSH was normal (3.9µU/mL) whereas basal Prl was high (67.5 ng/mL); both TSH and Prl levels appropriately increased after TRH: peaks 31.8µU/mL and 157.8 ng/mL, respectively. After treatment with carbidopa/L-dopa, basal TSH (1.6µU/mL) and Prl (34ng/mL) decreased and the response to TRH was partially blocked (10.3µU/mL and 61ng/mL, respectively). In spite of a normal response, we discuss the possibility that the persistence of hyperprolactinemia is due to lesion of the TIDA neurons produced by the long term use of high doses of estrogens and by the presence of chronic hyperprolactinemia.

The Relationship Between Brain Fog and Medication Adherence for Individuals With Hypothyroidism

2021 ◽  
pp. 105477382110381
Author(s):  
Kelly Haskard-Zolnierek ◽  
Courtney Wilson ◽  
Julia Pruin ◽  
Rebecca Deason ◽  
Krista Howard
Keyword(s):  
Memory Impairment ◽  
Hormone Replacement ◽  
Long Term Memory ◽  
Adherence Level ◽  
Thyroid Hormone Replacement ◽  
Memory Impairments ◽  
Cognitive Failures ◽  
Short And Long Term ◽  
The Relationship

Individuals with hypothyroidism suffer from symptoms including impairments to cognition (i.e., “brain fog”). Medication can help reduce symptoms of hypothyroidism; however, brain fog may hinder adherence. The aim of this study was to determine if memory impairment and cognitive failures are related to treatment nonadherence in 441 individuals with hypothyroidism. Participants with a diagnosis of hypothyroidism and currently prescribed a thyroid hormone replacement medication were placed in two groups according to adherence level and compared on validated scales assessing impairments to memory and cognition. Results indicated a significant association between treatment nonadherence and self-reported brain fog, represented by greater cognitive and memory impairments. Nonadherent individuals indicated impairments with prospective, retrospective, and short- and long-term memory; and more cognitive failures, compared to adherent individuals. Findings suggest the importance of interventions to enhance adherence for individuals with brain fog, such as encouraging the use of reminders.

Lithium treatment and thyroid dysfunction – data from an inpatient psychiatric department

2016 ◽  
Vol 33 (S1) ◽  
pp. S545-S545
Author(s):  
M. Lázaro ◽  
A. Mota ◽  
A. Moreira ◽  
R. Alves ◽  
M.A. Nobre
Keyword(s):  
Thyroid Dysfunction ◽  
Lithium Treatment ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
High Prevalence ◽  
Thyroid Hormone Replacement Therapy ◽  
Competing Interest ◽  
Psychiatric Department ◽  
Term Monitoring

IntroductionLithium is among the most effective therapies for bipolar disorder. Lithium treatment may cause hypothyroidism, goiter or to a lesser extent hyperthyroidism, since it can affect several aspects of thyroid functioning. The prevalence of lithium-associated hypothyroidism varies extensively between studies, reaching up to 47%, and affecting more females than males (5:1).ObjectiveDetermine the prevalence of thyroid dysfunction in an acute inpatient psychiatric department dedicated to affective disorders and its association with lithium therapy.AimsTo review the relation between lithium treatment and thyroid dysfunction.MethodsObservational, descriptive and retrospective study with clinical and laboratorial data concerning all inpatient episodes of 2015 in our Psychiatric Department. A non-systematic literature search was performed in PubMed.ResultsThe present study documented a high prevalence of thyroid dysfunction, particularly in women. Most cases were due to either hypothyroidism or subclinical hypothyroidism. Patients treated with lithium were more often under thyroid hormone replacement therapy (levothyroxine).ConclusionsThe evidence that lithium treatment is associated with hypothyroidism is well established and this condition is easily treatable with levothyroxine. This study highlights the importance of baseline screening of thyroid function and regular long-term monitoring in patients treated with lithium.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Hypothyroidism with Ascites

1970 ◽  
Vol 10 (2) ◽  
pp. 121-123
Author(s):  
Md Titu Miah ◽  
Raihan Rotap Khan ◽  
Zannatun Nur ◽  
Syed Mohammad Ali Romel ◽  
Md Kamal Hossain Patwary ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Complete Resolution ◽  
Hormone Replacement ◽  
Primary Hypothyroidism ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Replacement Therapy ◽  
Unnecessary Procedures ◽  
Liver Biopsies ◽  
High Index Of Suspicion ◽  
Key Words Ascites

Primary hypothyroidism is a common clinical condition. Ascites caused by hypothyroidism is rare. So its diagnosis is often delayed and patients frequently receive unnecessary procedures such as liver biopsies and exploratory laparotomies. We report a male person of 58 years with hypothyroidism with ascites who responded well with thyroid hormone replacement therapy with complete resolution of ascites. Analyses of ascites from patients in this condition usually shows exudative ascites with high protein (>2.5 g/dL) and SAAG < 1.1 gm/dl. High index of suspicion is required to reach at such diagnosis. Though it is a rare but prognosis is excellent with replacement therapy. Key words: Ascites, Hypothyroidism.   doi: 10.3329/jom.v10i2.2828   J MEDICINE 2009; 10 : 121-123

scholarly journals Effect of Adequate Thyroid Hormone Replacement on the Hypothalamo-Pituitary-Gonadal Axis in Premenopausal Women with Primary Hypothyroidism

2019 ◽  
Vol 8 (3) ◽  
pp. 152-158
Author(s):  
Bharath Bachimanchi ◽  
Suresh Vaikkakara ◽  
Alok Sachan ◽  
Ganji Praveen Kumar ◽  
Ashok Venkatanarasu ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Premenopausal Women ◽  
Primary Hypothyroidism ◽  
Thyroid Hormone Replacement

SERUM PROLACTIN IN PATIENTS WITH "FUNCTIONLESS" CHROMOPHOBE ADENOMAS BEFORE AND AFTER THERAPY

1977 ◽  
Vol 84 (3) ◽  
pp. 449-460 ◽  
Author(s):  
N. A. Samaan ◽  
M. E. Leavens ◽  
J. H. Jesse
Keyword(s):  
Hormone Replacement ◽  
Pituitary Surgery ◽  
Pituitary Tumour ◽  
Pituitary Hormones ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Primary Hypothyroidism ◽  
Pituitary Function ◽  
Serum Prolactin ◽  
Before And After

ABSTRACT The immunoreactive serum human prolactin (PRL) level was measured before and after intravenous administration of 500 μg of thyrotrophinreleasing hormone (TRH) in 11 patients with "functionless" chromophobe adenomas before and after surgery and after radiotherapy in 6 of these patients. The results were compared to other pituitary function tests. Two of the patients studied had recurrent disease after previous pituitary surgery and radiotherapy. Five patients had pituitary surgery through the transfrontal route, while 6 had adenoma removal via the transnasal transsphenoidal route. Before surgery, the serum PRL concentration was abnormally high in 4 patients, before and after TRH administration. It was normal in 6 and subnormal in 1 patient who had had previous therapy. Two of the patients studied showed high serum thyroid-stimulating hormone (TSH) levels in the presence of low serum T3 and T4 suggesting primary hypothyroidism with a secondary TSH-producing pituitary tumour. After surgery all patients showed a significant decrease of the serum PRL level. This contrasts with more variable results in the measurements of other pituitary hormones. Post-operative radiotherapy produced no significant additional change in serum PRL levels in 5 of the 6 patients measured 6 months to 4 years after radiotherapy. Five of the 6 patients who had adenoma removed via the transsphenoidal route required no cortisol replacement and 4 remained euthyroid, whereas all 5 patients after transfrontal surgery required both cortisol and thyroid hormone replacement. These results indicate: (1) that measurement of serum PRL levels at basal and after TRH administration in patients with "functionless" chromophobe adenomas before and after treatment may be the best index for evaluating the effect of therapy; (2) that adenoma removal may be followed by preservation of normal pituitary function, but this is more likely to occur if the transsphenoidal approach is used; and (3) that primary thyroid insufficiency may be associated with a pituitary adenoma.

scholarly journals Recurrence of carcinoma showing thymus-like differentiation (CASTLE) involving the thyroid gland

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
N. V. Dang ◽  
L. X. Son ◽  
N. T. T. Hong ◽  
N. T. T. Nhung ◽  
N. T. Tung ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Rare Disease ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Survival Rates ◽  
Thyroid Tumor ◽  
Term Survival ◽  
Case Presentation ◽  
Thyroid Hormone Replacement

Abstract Background Carcinoma showing thymus-like differentiation (CASTLE) in the thyroid gland is a rare disease with generally a favorable prognosis. Treatment with surgery and adjuvant radiotherapy has been shown to improve local control and long-term survival rates. In this report, we present a case of a recurrent thyroid gland CASTLE and review the literature on the diagnosis and treatment of this disease. Case presentation A 60-year-old woman, who was diagnosed with a CASTLE thyroid tumor in 2015, had a total thyroidectomy and was maintained on thyroid hormone replacement (levothyroxine). After 5 years, the patient had a recurrence, in an advanced stage unsuitable for surgery. As the patient declined to undergo radiotherapy, she was followed up without intervention and is currently stable after 15 months. Conclusions CASTLE is a rare disease, diagnosed based on postoperative pathology and immunohistochemistry analysis, especially upon CD5 marker. In case of relapse, treatment options include surgery and radiotherapy; however conservative management without intervention is an acceptable alternative in some cases.

Inherited primary hypothyroidism with thyrotrophin resistance in Japanese cats

1991 ◽  
Vol 129 (2) ◽  
pp. 245-NP ◽  
Author(s):  
H. Tanase ◽  
K. Kudo ◽  
H. Horikoshi ◽  
H. Mizushima ◽  
T. Okazaki ◽  
...  
Keyword(s):  
Autosomal Recessive ◽  
Hormone Replacement ◽  
Primary Hypothyroidism ◽  
Serum Concentrations ◽  
Laboratory Studies ◽  
Thyroid Hormone Replacement ◽  
Threefold Increase ◽  
Thyroid Glands ◽  
Mild Anaemia ◽  
Autosomal Recessive Manner

ABSTRACT Mutant cats were developed with non-goitrous primary hypothyroidism. They were clinically characterized by severely retarded growth, mild anaemia and high mortality in the young. They responded markedly to thyroid hormone replacement. Thyroid glands in the mutants were normal in position but slightly reduced in size. Laboratory studies revealed low serum concentrations of thyroxine (T4) and tri-iodothyronine (T3), and increased serum concentrations of TSH. Administration of TRH induced no further increase in TSH. Administration of exogenous TSH after suppression of endogenous TSH by T3 did not increase the serum concentration of T4 in the mutants, in sharp contrast with the threefold increase in serum T4 observed in the normal litter-mates. These findings suggest that the underlying pathogenesis of this disorder is unresponsive to TSH. Moreover, we found that the mutants were transmitted in an autosomal recessive manner. Journal of Endocrinology (1991) 129, 245–251

EFFECT OF PROLONGED ORAL ADMINISTRATION OF TRH ON PLASMA LEVELS OF THYROTROPHIN AND PROLACTIN IN NORMAL INDIVIDUALS AND IN PATIENTS WITH PRIMARY HYPOTHYROIDISM

1977 ◽  
Vol 85 (4) ◽  
pp. 744-752 ◽  
Author(s):  
Harald M. M. Frey ◽  
Egil Haug
Keyword(s):  
Elevated Serum ◽  
Primary Hypothyroidism ◽  
Trh Test ◽  
Normal Individuals ◽  
Term Administration ◽  
Maximal Rise ◽  
Trh Receptor ◽  
Serum Tsh ◽  
Tsh Levels

ABSTRACT Forty mg TRH/day was given orally for 3 weeks to 10 euthyroid women and 10 women with primary hypothyroidism on low replacement doses of thyroxine. Once weekly oral TRH was replaced by an iv TRH-test (0.4 mg) with measurement of serum concentration of TSH, prolactin (PRL), thyroxine (T4), triiodothyronine (T3) and cholesterol. In the normal group, mean serum T4 concentration increased after one week and remained elevated. Serum TSH concentration showed a slight tendency to decline. Maximal rise in TSH concentration after iv TRH (ΔTSH) fell from a mean of 4.0 ng/ml to 1.4 ng/ml within one week and stayed low. T3, cholesterol, PRL and ΔPRL were normal and unchanged throughout. In the hypothyroid group T4, T3, cholesterol, PRL and ΔPRL were not influenced by the TRH administration. In 2 patients (with the highest serum T4 concentrations) serum TSH concentration was normal and resistant to iv TRH. Of the 8 patients with elevated TSH, basal level and ΔTSH did not change in 2 (with subnormal T4 levels and the highest TSH levels). In the other 6 (with intermediate T4 levels) basal TSH fell from a mean of 10.1 ng/ml to 4.2 ng/ml, and ΔTSH from 10.0 ng/ml to 3.3 ng/ml after three weeks. It is concluded that in addition to feed-back effect of thyroid hormones, the pituitary response to long-term administration of TRH is determined by other factors. Among these may be reduced pituitary TRH receptor capacity and the activity of the TSH producing cells.

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