Clinico-epidemiological spectrum of thyroid illness after salt iodination program in Nepal

2021 ◽  
Author(s):  
Arabinda Mohan Bhattarai ◽  
Dipendra Raj Pandeya ◽  
Sulochana Parajuli ◽  
Salina Pradhananga
Keyword(s):  
Learning Disabilities ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Free Triiodothyronine ◽  
Neonatal Hypothyroidism ◽  
Endocrine Disorder ◽  
Detailed History ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients

Abstract Background Thyroid disorder is an important endocrine disorder in Nepal which is mostly due to environmental deficiency of iodine. The earliest and potentially most damaging result of iodine deficiency is neonatal hypothyroidism and cretinism characterised by learning disabilities and poor motivation to achieve. Methods We selected one thousand known cases of thyroid disorders who visited biochemistry department of shree Birendra Hospital, chaunni for routine tests. A detailed history was obtained and free triiodothyronine (fT3), thyroxine (fT4) and thyroid stimulating hormone (TSH) estimation was done in Seimens CP Chemiluminiscence Immunoassay analyser. Result Puffiness of face, hoarseness of voice and weight gain were the presenting features in hypothyroid patients, whereas weight loss and restlessnes were predominant features in hyperthyroid patients. In our study the prevalence of hypothyroidism and hyperthyroidism was 27% and 12.5% respectively. Conclusion None of our patients had visible neck swellings or goiter which had subsided after salt iodination program in Nepal as environmental deficiency of iodine was the primary factor for development of goiter in Nepal.

scholarly journals Prevalence, Predictive Factors, and Characteristics of Osteoporosis in Hyperthyroid Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ayotunde O. Ale ◽  
Anthonia O. Ogbera ◽  
Henry O. Ebili ◽  
Olusola L. Adeyemo ◽  
Taiwo O. Afe
Keyword(s):  
Predictive Factors ◽  
Positive Association ◽  
Thyroid Stimulating Hormone ◽  
Sub Saharan Africa ◽  
Thyroid Disorder ◽  
Mineral Density ◽  
Biochemical Tests ◽  
Free Triiodothyronine ◽  
Sub Saharan ◽  
Hyperthyroid Patients

Objective. The osteoporosis in thyroid disorder has the lowest report especially in sub-Saharan Africa. This study aims to determine the prevalence, predictive factors, and characteristics of osteoporosis in hyperthyroid patients. Method. Forty (40) hyperthyroid patients and healthy controls ages 21–50 years were recruited in this study. Questionnaires were administered to capture bio- and clinical data. Biochemical tests included blood, thyroid functions, intact parathyroid hormone, corrected calcium, and 25-hydroxyvitamin D tests. Bone mineral density (BMD) was also evaluated. Data were analyzed using the SPSS 21. A p value < 0.05 was regarded as significant. Results. Osteoporosis was observed in 18 (45%) of study subjects, 13 (72.2%) females and 5 (27.8%) males, respectively. The BMD of the hyperthyroid patients had a negative correlation with free triiodothyronine, FT3 (r=−0.49, p=0.005), FT4 (r=−0.33, p=0.009), corrected calcium (r=−0.31, p=0.039), alkaline phosphatase (r=−0.53, p<0.001), and osteocalcin (r=−0.61, p<0.001). Conversely, a positive association with thyroid-stimulating hormone (TSH) (r=0.54, p<0.001) was observed. Multiple regression showed osteocalcin (p<0.001) and TSH (p=0.015) as independent predictors of osteoporosis. Conclusion. Thyrotoxicosis is a risk factor for osteoporosis occurrence, and we recommend routine screening for this bone disease in persons over 20 years old with this disorder.

scholarly journals Outcome of Fixed Dose of Radioiodine Therapy in Hyperthyroid Patients at NINMAS

2018 ◽  
Vol 20 (1) ◽  
pp. 37
Author(s):  
Sharmin Quddus ◽  
Fatima Begum ◽  
Nasreen Sultana ◽  
Rahima Perveen ◽  
Tapati Mandal ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Single Dose ◽  
Thyroid Function ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Thyroid Stimulating Hormone ◽  
Fixed Dose ◽  
Free Triiodothyronine ◽  
Toxic Goiter ◽  
Hyperthyroid Patients

<p><strong>Objective:</strong> The modified fixed doses of radioactive iodine (RAI) in different types of hyperthyroidism had been practiced at National Institute of Nuclear Medicine &amp; Allied Science (NINMAS) according to Society of Nuclear Medicine Bangladesh (SNMB) protocol since 2002 which was upgraded in 2015. The objective of the study was to observe the treatment outcome in modified fixed dose on previous protocol. Patients and Methods: In the present study the outcome of radioiodine therapy of hyperthyroid patients was retrospectively evaluated in 1349 consecutive primary hyperthyroid patients treated from January 2010 to December 2014 at NINMAS. Diagnosis of hyperthyroidism was done by thyroid function test; thyroid stimulating hormone (TSH), free triiodothyronine (FT3)   &amp; free thyroxine (FT4), 99m Technetium scan, thyroid radioiodine uptake and ultrasound imaging of thyroid gland. All patients received a fixed dose (8-29 m Ci) of radioactive iodine (RAI) depending on types of hyperthyroidism, visual assessment of gland size and severity of disease at diagnosis. They were followed up at 2 months of therapy, then every three months intervals for first year and thereafter 6 monthly up to 5 years or as needed during fluctuation of thyroid function.</p><p><strong>Results:</strong> Among the study population, 832 patients had diffuse toxic goiter (Graves’ disease), 369 patients were diagnosed as toxic multinodular goiter and 148 patients with single toxic nodule. At one year follow-up, permanent hypothyroidism occurred in 61.62% of patients and the cumulative incidence of hypothyroidism progressively increased up to 79.25% after 5 years. Cure or success of RAI therapy was considered as attainment of euthyroid state or hypothyroid state. About 11.26 % patients received more than single dose.</p><p><strong>Conclusion:</strong> Fixed dose RAI therapy is very much cost effective mode of treatment for primary hyperthyroidism with ~89% success by giving single dose.</p><p>Bangladesh J. Nuclear Med. 20(1): 37-40, January 2017</p>

scholarly journals A prospective descriptive study of evaluation of menstrual disorders in thyroid dysfunction

2021 ◽  
Vol 10 (7) ◽  
pp. 2759
Author(s):  
Durgavathi Kothapalli ◽  
Kamesari Kolluru
Keyword(s):  
Subclinical Hypothyroidism ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Endometrial Biopsy ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Menstrual Disorders ◽  
Menstrual Irregularities ◽  
Hypothyroid Patients ◽  
Common Manifestation

Background: Menstrual irregularities are common with thyroid disorders. It has been reported that hyperthyroidism the most common manifestation is simple oligomenorrhea and hypothyroidism usually is associated with polymenorrhea. Present study has been designed to evaluate the menstrual and endometrial patterns in women with thyroid disorders in costal Andhra Pradesh.Methods: During the study period of two years and ten months we have enrolled 110 patients with clinical presentation of thyroid disorder with menstrual irregularities as per our study criteria. Based on report patients were divided in to three groups, hyperthyroid, hypothyroid and subclinical hypothyroidism. Based on abnormal menstrual pattern patients were divided in to menorrhagia, oligomenorrhea, polymenorrhea, and amenorrhea groups. Endometrial biopsy was taken from women in perimenopausal age group and histopathological examination was done to know the pattern of endometrium.Results: Subclinical hypothyroidism was present in 24 (21.81%) patients, hypothyroidism was present in 52 (47.27%) patients and hyperthyroidism was present in 34 (30.90%) patients. amenorrhea was present in 26 (23.63%) patients, oligomenorrhea was present in 12 (10.90%) patients, Intermenstrual bleeding was present in 2 (1.81%) patients, Menorrhagia was present in 44 (40%) patients which was most common type of menstrual disorder and Polymenorrhagia was present in 26 (23.63%) patients.Conclusions: Hypothyroidism is most common thyroid disorder followed by hyperthyroidism and subclinical hypothyroidism is least common. We have found that menstrual irregularities are more common in hypothyroid patients than hyperthyroid. Menorrhagia and Polymenorrhagia is more common than amenorrhoea and oligomenorrhea in hypothyroid patients. 

scholarly journals Systematic review and meta-analysis for the value of thyroid disorder screening in men with ejaculatory dysfunction

2021 ◽  
Author(s):  
Ahmet Cihan ◽  
Ahmet Adil Esen
Keyword(s):  
Clinical Studies ◽  
Meta Analysis ◽  
Thyroid Stimulating Hormone ◽  
Synthesis Methods ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Eligibility Criteria ◽  
Delayed Ejaculation ◽  
Ejaculatory Dysfunction ◽  
Serum Tsh

Abstract Objective: To demonstrate evidence from available clinical studies to clarify the scientific points that have been achieved in relation to thyroid disorders and ejaculatory dysfunction. Data sources: Clinical trial articles published in English on Medline. Eligibility criteria: Clinical studies that investigated the association of thyroid disorders with the ejaculatory function of subjects and the trials evaluating the effect of thyroid dysfunction treatment on the ejaculatory function of the subjects were eligible. Synthesis methods: We searched Medline with “ejaculation” and different combinations of “thyroid,” “serum TSH,” “serum T3,” “serum T4” keywords in PubMed. Results: Standardized mean serum thyroid-stimulating hormone (TSH) levels in premature ejaculation (PE) sufferers differed from non-PE control subjects (p=.05). Hyperthyroidism was associated with increased odds among PE subjects (OR=2.0, p=.03). Delayed ejaculation was seen with increased odds in hypothyroid patients compared with hyperthyroidism patients (OR=57, p=.0001). Serum TSH and mean intra-vaginal ejaculation latency time (IELT) of the subjects showed a correlation both before and after treatment for thyroid disorder. Treatment of thyroid disorders improved the mean IELT measures of the subjects. The overall estimate of the effect of hyperthyroidism treatment on mean IELT was .64 (p=.0001) in the random-effects model. Limitations: The low quality and quantity of evidence from available studies limited the interpretation of our study findings. Conclusions: The causal relationship between ejaculatory dysfunction and thyroid disorders remains to be clarified. Sufferers of delayed ejaculation acquired PE subjects, and PE sufferers who have accompanying erectile dysfunction and/or anxiety may benefit from thyroid disorder investigation.

scholarly journals The Independent Association of TSH and Free Triiodothyronine Levels With Lymphocyte Counts Among COVID-19 Patients

2022 ◽  
Vol 12 ◽  
Author(s):  
David Tak Wai Lui ◽  
Chi Ho Lee ◽  
Wing Sun Chow ◽  
Alan Chun Hong Lee ◽  
Anthony Raymond Tam ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Linear Regression Analysis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Free Triiodothyronine ◽  
Protein Levels ◽  
Pituitary Thyroid Axis ◽  
Independent Association ◽  
Positive Correlations

BackgroundBoth lymphopenia and thyroid dysfunction are commonly observed among COVID-19 patients. Whether thyroid function independently correlates with lymphocyte counts (LYM) remains to be elucidated.MethodsWe included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to April 2021 who had thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3) and LYM measured on admission.ResultsA total of 541 patients were included. Median LYM was 1.22 x 109/L, with 36.0% of the cohort lymphopenic. 83 patients (15.4%) had abnormal thyroid function tests (TFTs), mostly non-thyroidal illness syndrome (NTIS). Patients with lymphopenia had lower TSH, fT4 and fT3 levels than those without. Multivariable stepwise linear regression analysis revealed that both TSH (standardized beta 0.160, p&lt;0.001) and fT3 (standardized beta 0.094, p=0.023), but not fT4, remained independently correlated with LYM, in addition to age, SARS-CoV-2 viral load, C-reactive protein levels, coagulation profile, sodium levels and more severe clinical presentations. Among the 40 patients who had reassessment of TFTs and LYM after discharge, at a median of 9 days from admission, there were significant increases in TSH (p=0.031), fT3 (p&lt;0.001) and LYM (p&lt;0.001). Furthermore, patients who had both lymphopenia and NTIS were more likely to deteriorate compared to those who only had either one alone, and those without lymphopenia or NTIS (p for trend &lt;0.001).ConclusionTSH and fT3 levels showed independent positive correlations with LYM among COVID-19 patients, supporting the interaction between the hypothalamic-pituitary-thyroid axis and immune system in COVID-19.

scholarly journals Analysis of Lag Behind Thyrotropin State After Radioiodine Therapy in Hyperthyroid Patients

2016 ◽  
Vol 17 (2) ◽  
pp. 103-107
Author(s):  
Mohshi Um Mokaddema ◽  
Fatima Begum ◽  
Simoon Salekin ◽  
Tanzina Naushin ◽  
Sharmin Quddus ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Free Triiodothyronine ◽  
Short Period ◽  
Delayed Recovery ◽  
One Year ◽  
Therapeutic Decision Making ◽  
Hyperthyroid Patients

Introduction: A good number of hyperthyroid patients may show delayed recovery of Thyroid Stimulating Hormone (TSH) level in clinically evident euthyroid condition after radioiodine therapy. This group of patients need to be addressed in therapeutic decision making. The purpose of the study was to evaluate the duration and pattern of lag in TSH recovery after I - 131 therapy and the relationship between clinical parameters with stable thyroid function status.Materials and Methods: Total 192 hyperthyroid patients treated with I-131 were included in this study. These patients were followed up clinically and biochemically at three month, six month and one year after radioiodine therapy. Patients having suppressed TSH with normal Free Triiodothyronine (FT3) / Free Thyroxin (FT4) level and clinically euthyroid condition were followed-up for one year without giving antithyroid drug.Results: At three months follow-up 42/192 (22%) had suppressed TSH with normal FT3/FT4 level. Duration of lagging behind state of TSH was three months for 42 patients (22 %), six months for 13 patients (7%) and One year in three patients (2 %). Twelve patients were lost from follow-up. Among 30 patients with lag behind TSH level, 16 (53%) became hypothyroid, 8 (27%) became euthyroid and 6 (20%) became hyperthyroid at one year follow-up. Lagging behind patient with high serum FT4 level at diagnosis and high Radio Active Iodine Uptake (RAIU) showed increased rate of relapse of hyperthyroidism.Conclusion: Lagging state of TSH may be unexpectedly prolonged in some hyperthyroid patients treated with I-131. These patients should be followed up with both TSH and thyroid hormone levels. Most of them do not require further therapy with short period of time.Bangladesh J. Nuclear Med. 17(2): 103-107, July 2014

Chemiluminescent third-generation assay (Amerlite TSH-30) of thyroid-stimulating hormone in serum or plasma assessed

1993 ◽  
Vol 39 (10) ◽  
pp. 2167-2173 ◽  
Author(s):  
E Wilkinson ◽  
P W Rae ◽  
K J Thomson ◽  
A D Toft ◽  
C A Spencer ◽  
...  
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Third Generation ◽  
Serum Samples ◽  
Nonthyroidal Illness ◽  
Ambulatory Patients ◽  
Stimulation Tests ◽  
Reference Preparation ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients ◽  
Stimulating Hormone

Abstract We assessed the laboratory performance and clinical utility of a new commercial third-generation assay of thyroid-stimulating hormone (TSH), Amerlite TSH-30. The interassay CV was 6% at TSH concentrations of approximately 0.08 mIU/L, and the analytical and functional detection limits of the assay were 0.005 and 0.0125 mIU/L, respectively. Although the assay recovered approximately 96% of TSH International Reference Preparation (TSH-IRP) 80/558 added to serum samples, the endogenous TSH concentrations in basal samples were significantly lower than those found by using two other TSH assays; bias data obtained from thyroliberin stimulation tests suggested that the negative bias found with TSH-30 may be due to the heterogeneity of TSH in basal samples. TSH-30 completely discriminated hyperthyroid and hypothyroid patients from euthyroid ambulatory patients but also detected TSH (&gt; 0.0125 mIU/L) in 3 of 46 untreated hyperthyroid patients. Compared with two second-generation assays, TSH-30 better discriminated between patients with subnormal TSH due to hyperthyroidism, thyroxine overreplacement, and nonthyroidal illness but there was still significant overlap between results for these groups.

scholarly journals The study of maternal and fetal outcome in pregnant women with thyroid disorders

2017 ◽  
Vol 6 (8) ◽  
pp. 3507 ◽  
Author(s):  
Sreelatha S. ◽  
Seema Nadagoudar ◽  
Asha Devi L.
Keyword(s):  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.

scholarly journals Effects of a Single Venous Dose of Zinc on Thyroid Status in Healthy Individuals and Patients With Graves' Disease

2000 ◽  
Vol 7 (3) ◽  
pp. 151-155 ◽  
Author(s):  
Lubna Farooqi ◽  
Gláucia M. F. S. Mazeto ◽  
Tadao Shuhama ◽  
José Brandão-Neto
Keyword(s):  
Thyroid Function ◽  
Plasma Levels ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Zinc Metabolism ◽  
Healthy Individuals ◽  
Free Triiodothyronine ◽  
Hormone Synthesis ◽  
Hyperthyroid Patients ◽  
Tsh Levels

Zinc metabolism may regulate thyroid function acting at TRH (thyrotropin-releasing hormone) synthesis, peripheral deiodination of T4 (tetraiodothyronine), and binding of thyroid hormones to nuclear receptors. The aim of this study was to investigate the effect of acute zinc administration on TSH (thyroid-stimulating hormone), FT3 (free triiodothyronine), and FT4 (free tetraiodothyronine) in 10 healthy individuals and 12 hyperthyroid patients with Graves' disease. All these individuals were studied following 25 mg Zn++ administered intravenously, at 7:00 a.m. after 12 h fast. Blood samples collected at 0, 3, 30, 60, 90, and 120 min after zinc administration showed no significant alteration in the plasma levels of TSH, FT3, and FT4 in hyperthyroid patients. There were no changes in the plasma levels of FT3 and FT4 in the control subjects, but TSH levels were acutely depressed by zinc administration. This study suggests that zinc given acutely and in pharmacological doses does not affect thyroid function in hyperthyroid subjects, but affect plasma TSH levels in healthy individuals.

scholarly journals Pattern of Thyroid Dysfunction in Women with Menstrual Disorders

2016 ◽  
Vol 2 (1) ◽  
pp. 3-6
Author(s):  
Saroj Khatiwada ◽  
Sharad Gautam ◽  
Rajendra KC ◽  
Shruti Singh ◽  
Shrijana Shrestha ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
Thyroid Disorder ◽  
Menstrual Disorders ◽  
Free Triiodothyronine ◽  
Menstrual Disorder

BACKGROUNDThyroid disorders are among the commonest endocrine disorders worldwide. Thyroid dysfunction can interfere in multiple metabolic and physiological processes including menstrual cycle. This study was conducted to find pattern of thyroid dysfunction among women with menstrual disorders.METHODSTwo hundred thirty three females with menstrual disorders were screened for thyroid dysfunction. Thyroid function was assessed by measuring serum free triiodothyronine (T3), free thyroxine (T4) and thyroid stimulating hormone (TSH) levels.RESULTSThe mean age of study patients was 25.7±6.8 years. The most common menstrual disorder observed was irregular cycle (72.5%, n=169) followed by amenorrhea (21.9%, n=51) and menorrhagia (5.6%, n=13). Most of the patients were in the age group 15-24 years (51.1%, n=119), followed by 25-34 years (36.1%, n=84) and 35-45 years (12.9%, n=30). Mean level of free T3 and T4 was 2.91±1.05 pg/ml, 1.42±0.57 ng/dl respectively. Median TSH was 2.0 mIU/L (IQR, 1.0-4.0). Thyroid dysfunction was seen in 25.8% (n=60) women. Most common thyroid dysfunction was subclinical hypothyroidism (14.2%, n=33) followed by subclinical hyperthyroidism (6.9%, n=16), overt hyperthyroidism (3%, n=7) and overt hypothyroidism (1.7%, n=4).CONCLUSIONSThe study finds thyroid dysfunction especially subclinical hypothyroidism to be common among women with menstrual disorders. Thus, it may be beneficial to screen menstrual disorder patients for thyroid function especially to rule out thyroid disorder as potential etiological agent for menstrual disturbance.

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