scholarly journals FT4 Should Replace TSH in Diagnosing Abnormal Thyroid Function

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Kristen Marie Yaun ◽  
Ashley Kennedy
Keyword(s):  
Thyroid Function ◽  
Cost Effective ◽  
Thyroid Stimulating Hormone ◽  
Serum Thyroxine ◽  
Testing Approach ◽  
Free Serum ◽  
Stimulating Hormone

In this paper, I argue that the method for diagnosing abnormal thyroid function should be the free serum thyroxine (FT4) test. The current and most widely used method for diagnosis is the thyroid stimulating hormone (TSH) test. The FT4-first testing approach is more accurate and more cost-effective and should replace the TSH test.

scholarly journals Thyroid-stimulating hormone decreases the risk of osteoporosis by regulating osteoblast proliferation and differentiation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuo Deng ◽  
Wenwen Zhang ◽  
Yanling Zhang ◽  
Mengqi Zhang ◽  
Zhikun Huan ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Mrna Levels ◽  
Dependent Manner ◽  
Osteoblast Proliferation ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Gene And Protein Expression ◽  
Proliferation And Differentiation ◽  
Stimulating Hormone

Abstract Background As the incidence of secretory osteoporosis has increased, bone loss, osteoporosis and their relationships with thyroid-stimulating hormone (TSH) have received increased attention. In this study, the role of TSH in bone metabolism and its possible underlying mechanisms were investigated. Methods We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and TSH and the bone mineral density (BMD) levels of 114 men with normal thyroid function. In addition, osteoblasts from rat calvarial samples were treated with different doses of TSH for different lengths of time. The related gene and protein expression levels were investigated. Results A comparison of the BMD between the high-level and low-level serum TSH groups showed that the TSH serum concentration was positively correlated with BMD. TSH at concentrations of 10 mU/mL and 100 mU/mL significantly increased the mRNA levels of ALP, COI1 and Runx2 compared with those of the control (P < 0.05, P < 0.01). Bone morphogenetic protein (BMP)2 activity was enhanced with both increased TSH concentration and increased time. The protein levels of Runx2 and osterix were increased in a dose-dependent manner. Conclusions The circulating concentrations of TSH and BMD were positively correlated with normal thyroid function in males. TSH promoted osteoblast proliferation and differentiation in rat primary osteoblasts.

scholarly journals Management of thyroid disease in pregnancy – Room for improvement in the first trimester

2016 ◽  
Vol 9 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Helen Robinson ◽  
Philip Robinson ◽  
Michael D’Emden ◽  
Kassam Mahomed
Keyword(s):  
General Practitioner ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
In Pregnancy ◽  
Stimulating Hormone

Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.

scholarly journals Association of altered thyroid function and prolactin level in polycystic ovarian syndrome

2016 ◽  
Vol 45 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Marufa Mustari ◽  
MA Hasanat ◽  
Qamrul Hasan ◽  
Sadiqa Tuqan ◽  
Md Shah Emran ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Prolactin Level ◽  
Polycystic Ovarian Syndrome ◽  
Density Lipoprotein ◽  
Serum Testosterone ◽  
Thyroid Stimulating Hormone ◽  
Primary Infertility ◽  
Altered Thyroid ◽  
Ovarian Syndrome ◽  
Stimulating Hormone

Polycystic ovarian syndrome (PCOS) is a common disorder for female with fertile age. Along with other clinical and biochemical manifestations, thyroid function and prolactin level may be altered in patients with PCOS. This study aimed to evaluate the clinical and biochemical status, as well as alteration of thyroid stimulating hormone (TSH), prolactin (PRL) level in patients with PCOS. Present study comprised of 100 diagnosed PCOS patients according to revised Rotterdem Consensus criteria. All patients were studied for serum testosterone, LH (lutenizing hormone), FSH (follicle stimulating hormone), blood glucose, lipid profile as well as TSH, FT4 (free thyroxin) and prolactin level. Out of 100 PCOS patients 97 had hirsutism, 64 had acanthosis nigricans, where menstrual irregularities were in 94 patients. Diastolic blood pressure (74±1.1 vs. 77±0.9, mmHg; p=0.017), total cholesterol (163±5.3 vs. 193±6.2 mg/dl; p<0.001), low density lipoprotein (LDL, 104±3.7 vs. 124±4.9 mg/dl; p=0.002) and frequency of acanthosis (25% vs. 75%; p<0.001) were significantly higher among the patients having BMI>25 Kg/m2 than those of have ? 25 Kg/m2. Among the fertile women (n=53), 47% had primary and 41.5% had secondary infertility; whereas of the total patients, 21% had altered thyroid function and 6.1% had raised prolactin (PRL, ng/ml) level. Differences of TSH (4.1±3.6 vs. 3.5±6.8, mIU/L; p=0.725) was not significant; whereas level of PRL (13.87±6.9vs. 9.4±5.2 ng/ml; p=0.018) was significantly higher in the group of primary infertility. Hirsutism, menstrual disturbance and acanthosis were very common in PCOS. Both primary and secondary sterility were also commonly observed and PRL was higher in primary infertility. About one fifth of PCOS had altered thyroid function.Bangladesh Med J. 2016 Jan; 45 (1): 1-5

Thyroid Function and Release of Thyroid-stimulating Hormone and Prolactin from the Pituitary in Human Obesity

1991 ◽  
Vol 19 (5) ◽  
pp. 389-394 ◽  
Author(s):  
R. Scaglione ◽  
M.R. Averna ◽  
M.A. Dichiara ◽  
C.M. Barbagallo ◽  
G. Mazzola ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Human Obesity ◽  
Stimulating Hormone

Original Paper: Assays for thyroid-stimulating hormone using dried blood spotted filter paper specimens to screen for hypothyroidism in older children and adults

2003 ◽  
Vol 10 (1) ◽  
pp. 5-10 ◽  
Author(s):  
L F Hofman ◽  
T P Foley ◽  
J J Henry ◽  
E W Naylor
Keyword(s):  
Nursing Homes ◽  
Filter Paper ◽  
Cost Effective ◽  
Dried Blood Spots ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Thyroid Peroxidase ◽  
Older Children ◽  
Finger Stick ◽  
Stimulating Hormone

Objective: Symptoms of hypothyroidism in adults can be mistaken for medical and psychiatric diseases, as well as for general signs of ageing such as weakness, lethargy and fatigue. The incidence of hypothyroidism is many-fold higher in adults than in newborn children. The latter have been routinely screened for the condition using filter paper dried blood spots (DBS) for nearly three decades but this cost-effective screening technique has only recently been applied to adults. This study was undertaken to show that DBS testing in adults and older children is an accurate way to screen for hypothyroidism. Methods: Serum and DBS specimens were collected from adults and children. Assays were run on both specimens and the results correlated. In addition 972 specimens were collected from adults at community centres and nursing homes. Follow-up studies were performed on patients with positive results. Results: The correlation coefficient for 118 matched serum and DBS specimens was 0.99. Thyroid-stimulating hormone (TSH) values were elevated in 50 of the 972 adults from nursing homes and community centres. Thirteen of these individuals were on thyroid medication and 28 had either high serum TSH or high thyroglobulin (TgAb) or thyroid peroxidase (TPOAb) antibody levels. Conclusions: Individuals can be screened for hypothyroidism by collecting finger stick DBS specimens at community centres, nursing homes and other locations which can be mailed by regular postal service to a central laboratory for accurate and inexpensive testing.

scholarly journals Menstrual disorders associated with thyroid dysfunction

2017 ◽  
Vol 6 (11) ◽  
pp. 5113
Author(s):  
Ramya M. R. ◽  
. Parvathavarthini ◽  
Darshan Savery ◽  
R. Sankareswari
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Cost Effective ◽  
Thyroid Stimulating Hormone ◽  
Reproductive Age ◽  
Function Evaluation ◽  
Medical College ◽  
Normal Thyroid Function ◽  
High Prevalence ◽  
Menstrual Patterns

Background: Present study was done to evaluate the thyroid function in patients presenting with varying menstrual patterns of reproductive age group from 15 to 45 years of age.Methods: This prospective study was carried out in obstetrics and gynecology Department of Sri Venkateshwaraa Medical College, Pondicherry, India on 155 women, clinically given the provisional diagnosis of dysfunctional uterine bleeding (DUB). All these patients were investigated for T3, T4, TSH (Thyroid stimulating hormone) levels and grouped according to that.Results: Among the 155 women (58.7%) were normal thyroid function, (41.3%) had hypothyroid and (1.3%) had subclinical hypothyroidism.Conclusions: There is a high prevalence of thyroid disorders in cases which are clinically diagnosed as DUB. Evaluating for thyroid and treating it medically which was most accurate and cost effective and unnecessary surgery was avoided. Hence the thyroid function evaluation should be mandatory in cases of DUB to detect thyroid dysfunction and these cases should be referred to physician for further medical treatment.

scholarly journals Thyroid function in preterm infants and neurodevelopment at 2 years

2020 ◽  
Vol 105 (5) ◽  
pp. 504-509 ◽  
Author(s):  
Fiona L R Williams ◽  
Alice Lindgren ◽  
Jennifer Watson ◽  
Anita Boelen ◽  
Timothy Cheetham
Keyword(s):  
Preterm Infants ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Cohort Analysis ◽  
Dried Blood Spots ◽  
Thyroid Stimulating Hormone ◽  
Composite Score ◽  
Fine Motor ◽  
The Relationship ◽  
Stimulating Hormone

ObjectivesPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment.DesignCohort analysis.Patients1275 infants born under 31 weeks’ gestation; there were no exclusion criteria.SettingThe infants were part of a UK daily iodine supplementation trial.Main outcomesThyroid-stimulating hormone, thyroid-binding globulin and total thyroxine levels were measured in dried blood spots on postnatal days 7, 14, 28 and the equivalent of 34 weeks’ gestation. Neurodevelopment was measured using the Bayley-III Scales of infant development at 2 years of age.ResultsNo infant was identified as hypothyroid through routine screening. The 3% of infants consistently in the top decile of gestationally age-adjusted thyroid-stimulating hormone levels had a reduction in cognitive score of 7 Bayley units when compared with those not in the top decile (95% CI –13 to –1). A reduction in motor composite score of 6 units (95% CI −12 to <−0.1) and fine motor score of 1 unit (95% CI –2 to –0.1) was also identified. The 0.7% of infants consistently in the bottom decile of age-adjusted thyroxine levels had a reduction in motor composite score of 14 units (95% CI –25 to –2) and its two subset scores, fine and gross motor, of 2 units (95% CI respectively −4.5 to <−0.1 and –4.3 to –0.3).ConclusionsPreterm infants with consistent ‘mild’ thyroid dysfunction score less on neurodevelopmental tests at 2 years of age. Many of these infants will not be detected by current clinical protocols or screening programmes.

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