THYROID HORMONE THERAPY AND TREATMENT FOR WOMEN’S ABOVE 30 YEAR OLD WITH HYPOTHYROIDISM

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
N Rawat ◽  
S Saxena
Keyword(s):  
Immune System ◽  
Thyroid Hormone ◽  
Side Effects ◽  
Thyroid Hormones ◽  
Hormone Therapy ◽  
Free Thyroxine ◽  
Substitution Treatment ◽  
Free Triiodothyronine ◽  
Typical Condition ◽  
Serum Tsh

Thyroid hormones impact every single significant organ/frameworks and sufficient levels are significant for ideal capacity. Thyroid brokenness is a typical condition that effects somewhere in the range of 3 and 21% of the populace with predominance being increasingly regular in ladies and in more established people. Hypothyroidism is characterized by the expansion in thyroid-animating hormone (TSH) values, joined by diminished coursing free triiodothyronine (FT3) and free thyroxine (FT4). TSH is the most solid marker of sufficiency of substitution treatment, and an incentive inside the reference run (0.4–4.0 mIU/L) ought to be viewed as the helpful objective" have serum TSH esteems somewhere in the range of 0.4 and 2.5 mU/L. It is thusly contended that TSH esteems > 2.5 mU/L reflect hidden immune system thyroid ailment and add to the slanted TSH dissemination bend, a view additionally bolstered by the way that such people have a higher danger of movement to ensuing hypothyroidism. In this way, side effects of hypothyroidism are inadequate and vague in more established individuals. This prompts thyroid capacity tests being as often as possible mentioned. Then again, high thyroid capacity, as confirm by a low TSH level needs cautious observing and treatment considered if there is proof of end-organ harm, (for example, osteoporosis or AF), or if serum TSH is stifled. Keywords: TSH, Thyroid hormones, Hypothyroidism, FT4.

scholarly journals Correlations of Free Thyroid Hormones Measured by Tandem Mass Spectrometry and Immunoassay with Thyroid-Stimulating Hormone across 4 Patient Populations

2009 ◽  
Vol 55 (7) ◽  
pp. 1380-1388 ◽  
Author(s):  
Jacqueline Jonklaas ◽  
Natasa Kahric-Janicic ◽  
Offie P Soldin ◽  
Steven J Soldin
Keyword(s):  
Mass Spectrometry ◽  
Thyroid Hormone ◽  
Tandem Mass Spectrometry ◽  
Thyroid Hormones ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Tandem Mass ◽  
Free Triiodothyronine ◽  
Free Thyroid Hormones ◽  
Free Thyroid Hormone

Abstract Background: Accurate measurement of free thyroid hormones is important for managing thyroid disorders. Ultrafiltration liquid chromatography tandem mass spectrometry (LC-MS/MS) can reliably measure the concentrations of small molecules, including thyroid hormones. Our study was designed to compare free thyroid hormone measurements performed with immunoassay and LC-MS/MS. Methods: We studied the performance of LC-MS/MS in 4 different populations comprising pediatric patients, euthyroid adults, and healthy nonpregnant and pregnant women. The samples obtained from each population numbered 38, 200, 28, and 128, respectively. Free thyroxine, free triiodothyronine, and thyroid-stimulating hormone (TSH) concentrations were documented. Results: LC-MS/MS measurement of free thyroid hormones provided better correlation with log-transformed serum TSH in each population and also the populations combined. The correlations between free thyroxine measured by LC-MS/MS and log TSH in the pediatric outpatients and healthy adults were −0.90 and −0.77, respectively. The correlations for immunoassay were −0.82 and −0.48. The correlations between free triiodothyronine measured by LC-MS/MS and TSH for both pediatric and healthy adult populations were −0.72 and −0.68, respectively. Conclusions: Free thyroid hormone concentrations measured by LC-MS/MS correlate to a greater degree with log TSH values compared to concentrations measured by immunoassay. This correlation was maintained across the patient populations we studied and may reflect the accuracy and specificity of LC-MS/MS. The superior ability of LC-MS/MS to enable documentation of the well-known thyroid hormone–TSH relationship supports the use of this measurement technique in a variety of clinical situations.

scholarly journals Thyroid Hormone levels in Highlanders- A Comparison Between Residents of Two Altitudes in Nepal

2014 ◽  
Vol 11 (1) ◽  
pp. 18-21 ◽  
Author(s):  
O Nepal ◽  
BR Pokharel ◽  
K Khanal ◽  
P Gyawali ◽  
SL Malik ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
High Altitude ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
High Altitudes ◽  
Free Triiodothyronine ◽  
Sea Bed ◽  
High Altitude Natives ◽  
Stimulating Hormone

Background The endocrine changes related to altitude adaptation in human have attracted physiologists around the globe for long. A number of high altitude studies to detect the physiological changes have been performed now and then. But, the study to see the hormonal changes to compare populations residing at different high altitudes is a scarce. Hence, we have performed a study in native populations of different high altitude comparing changes in thyroid hormones in western Nepal. The Jharkot population included in this study is at altitude of 3760m and Jomsom population at 2800m height from sea bed. Objective The study is to compare changes in thyroid hormones at two different high altitude natives. Methods To compare thyroid status between high altitude natives at two different altitudes a cross sectional study is performed by random sampling method. The blood sample was collected in a vacutainer from fifty eight individuals after obtaining the informed consent of participants. The blood collected from antecubital vein was centrifuged in an hour and the serum obtained was used for biochemical analysis of free triiodothyronine, free thyroxine and thyroid stimulating hormone. Results Mean free thyroxine (fT4) of Jharkot population is significantly larger (p = 0.001) than Jomsom population. Mean thyroid stimulating hormone (TSH) with p = 0.597, does not indicate the difference between this two population. There is no significant difference between mean free triiodothyronine (fT3) of Jharkot and Jomsom population (p = 0.345). Conclusion The rise in free thyroid hormone at high altitude is not dependent on the thyroid stimulating hormone released from anterior pituitary. The rise in free thyroxine is found at higher altitude and no difference in fT3 level is detected in population studied at high altitudes. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11017 Kathmandu University Medical Journal Vol.11(1) 2013: 18-21

Establishment of Early Pregnancy Related Thyroid Hormone Models and Reference Intervals for Pregnant Women in China Based on Real World Data

2021 ◽  
Vol 53 (04) ◽  
pp. 272-279
Author(s):  
Chaochao Ma ◽  
Xiaoqi Li ◽  
Lixin Liu ◽  
Xinqi Cheng ◽  
Fang Xue ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Dynamic Change ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Stimulating Hormone

AbstractThyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.

scholarly journals Ablation of Thyroid Residues with 30 mCi 131I: A Comparison in Thyroid Cancer Patients Prepared with Recombinant Human TSH or Thyroid Hormone Withdrawal

2002 ◽  
Vol 87 (9) ◽  
pp. 4063-4068 ◽  
Author(s):  
Furio Pacini ◽  
Eleonora Molinaro ◽  
Maria Grazia Castagna ◽  
Francesco Lippi ◽  
Claudia Ceccarelli ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Dose Rate ◽  
Initial Dose ◽  
Standard Dose ◽  
Basal Serum ◽  
Recombinant Human Tsh ◽  
Thyroid Ablation ◽  
Serum Tsh ◽  
The Eu

The aim of the study was to assess whether stimulation by recombinant human TSH (rhTSH) may be used in patients with differentiated thyroid carcinoma for postsurgical ablation of thyroid remnants using a 30-mCi standard dose of 131I during thyroid hormone therapy. The rate of ablation was prospectively compared in three groups of patients consecutively assigned to one of three treatment arms: in the first arm, patients (n = 50) were treated while hypothyroid (HYPO); in the second arm, patients (n = 42) were treated while HYPO and stimulated in addition with rhTSH (HYPO + rhTSH); in the third arm, patients (n = 70) were treated while euthyroid (EU) on thyroid hormone therapy and stimulated with rhTSH (EU + rhTSH). The outcome of thyroid ablation was assessed by conventional HYPO 131I scan performed in HYPO state 6–10 months after ablation. Basal serum TSH was elevated in the HYPO and HYPO + rhTSH groups. In the EU + rhTSH group, basal serum TSH was 1.3 ± 2.5 μU/ml (range, &lt;0.005–11.9 μU/ml). After rhTSH, serum TSH significantly increased in the HYPO + rhTSH group and the EU + rhTSH group. Basal 24-h radioiodine thyroid bed uptake was 5.8 ± 5.7% (range, 0.2–21%) and 5.4 ± 5.7% (range, 0.2–26%) in the HYPO and HYPO + rhTSH groups, respectively. In the HYPO + rhTSH group, mean 24-h thyroid bed uptake rose to 9.4 ± 9.5% (range, 0.2–46%) after rhTSH (P &lt; 0.0001). The 24-h uptake after rhTSH in the EU + rhTSH group was 2.5 ± 4.3% (range, 0.1–32%), significantly lower (P &lt; 0.0001) than that found in the HYPO and HYPO + rhTSH groups. The rate of successful ablation was similar in the HYPO and HYPO + rhTSH groups (84% and 78.5%, respectively). A significantly lower rate of ablation (54%) was achieved in the EU + rhTSH group. Mean initial dose rate (the radiation dose delivered during the first hour after treatment) was significantly lower in the EU + rhTSH group (10.7 ± 12.6 Gy/h) compared with the HYPO + rhTSH group (48.5 ± 43 Gy/h) and the HYPO group (27.1 ± 42.5 Gy/h). In conclusion, our study indicates that by using stimulation with rhTSH, a 30-mCi standard dose of radioiodine is not sufficient for a satisfactory thyroid ablation rate. Possible reasons for this failure may be the low 24-h radioiodine uptake, the low initial dose rate delivered to the residues, and the accelerated iodine clearance observed in EU patients. Possible alternatives for obtaining a satisfactory rate of thyroid ablation with rhTSH may consist of increasing the dose of radioiodine or using different protocols of rhTSH administration producing more prolonged thyroid cells stimulation.

LINGUAL AND SUBLINGUAL THYROID GLANDS IN EUTHYROID CHILDREN

PEDIATRICS ◽  
1966 ◽  
Vol 38 (4) ◽  
pp. 647-651
Author(s):  
Wellington Hung ◽  
Judson G. Randolph ◽  
Domenic Sabatini ◽  
Theodore Winship
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Physical Examination ◽  
Thyroid Hormones ◽  
Hormone Therapy ◽  
Surgical Intervention ◽  
Ectopic Thyroid ◽  
Lingual Thyroid ◽  
Thyroid Glands ◽  
Careful Physical Examination

Five clinically euthyroid children with lingual or sublingual thyroid glands were seen during a 12-month period. Certain recommendations have been formulated based upon our experience with these patients. A careful physical examination should be performed to demonstrate the presence of a normally located thyroid gland in all children presenting with midline masses in the lingual or sublingual areas. When the thyroid gland cannot be palpated with certainty in these children, a scintiscan with I-131 should be carried out to determine if the mass is an ectopic thyroid gland and if a normally located thyroid gland is present. All children with lingual on sublingual thyroid glands should have a trial of full replacement thyroid hormone therapy before excision is contemplated. Thyroid therapy will prevent further hypertrophy and hyperplasia. Surgical intervention should be reserved for those children in whom there is dysphagia, dysphonia, ulceration, or hemorrhage due to a lingual thyroid gland or if the ectopic thyroid gland fails to decrease in size following a course of treatment with thyroid hormones.

Iodide Metabolism and Effects

2020 ◽  
pp. 25-33
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Dietary Supplement ◽  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Hormone Synthesis ◽  
Serum Tsh ◽  
Tsh Stimulation ◽  
Sensitive Marker

Iodine (I2) is essential in the synthesis of thyroid hormones T4 and T3 and functioning of the thyroid gland. Both T3 and T4 are metabolically active, but T3 is four times more potent than T4. Our body contains 20-30 mg of I2, which is mainly stored in the thyroid gland. Iodine is naturally present in some foods, added to others, and available as a dietary supplement. Serum thyroid stimulating hormone (TSH) level is a sensitive marker of thyroid function. Serum TSH is increased in hypothyroidism as in Hashimoto's thyroiditis. In addition to regulation of thyroid function, TSH promotes thyroid growth. If thyroid hormone synthesis is chronically impaired, TSH stimulation eventually may lead to the development of a goiter. This chapter explores the iodide metabolism and effects of Hashimoto's disease.

Subclinical hypothyroidism

2011 ◽  
pp. 543-547
Author(s):  
Jayne A. Franklyn
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Expert Panel ◽  
Elevated Serum ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Free Triiodothyronine ◽  
Function Tests ◽  
Serum Tsh

Subclinical hypothyroidism is defined biochemically as the association of a raised serum thyroid-stimulating hormone (TSH) concentration with normal circulating concentrations of free thyroxine (T4) and free triiodothyronine (T3). The term subclinical hypothyroidism implies that patients should be asymptomatic, although symptoms are difficult to assess, especially in patients in whom thyroid function tests have been checked because of nonspecific complaints such as tiredness. An expert panel has recently classified individuals with subclinical hypothyroidism into two groups (1): (1) those with mildly elevated serum TSH (typically TSH in the range 4.5–10.0 mU/l) and (2) those with more marked TSH elevation (serum TSH >10.0 mU/l).

scholarly journals Misleading results from immunoassays of serum free thyroxine in the presence of rheumatoid factor

1997 ◽  
Vol 43 (6) ◽  
pp. 957-962 ◽  
Author(s):  
Anthony G W Norden ◽  
Rodwin A Jackson ◽  
Lorraine E Norden ◽  
A Jane Griffin ◽  
Margaret A Barnes ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Rheumatoid Factor ◽  
Equilibrium Dialysis ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Free Thyroxine ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Serum Free Thyroxine ◽  
Stimulating Hormone

Abstract A novel interference with measurements of serum free thyroxine (FT4) caused by rheumatoid factor (RhF) is described. We found misleading, sometimes gross, increases of FT4 results in 5 clinically euthyroid elderly female patients with high RhF concentrations. All 5 patients had high FT4 on Abbott AxSYM® or IMx® analyzers. “NETRIA” immunoassays gave misleading results in 4 of the 5 patients; Amerlex-MAB® in 2 of 4 patients; AutoDELFIA®in 2 of the 5; and Corning ACS-180® and Bayer Diagnostics Immuno 1® in 1 of the 5. BM-ES700® system results for FT4 in these women remained within the reference range. Results for serum T4, thyroid-stimulating hormone, free triiodothyronine, thyroid-hormone-binding globulin, and FT4 measured by equilibrium dialysis were normal in all 5 patients. Drugs, albumin-binding variants, and anti-thyroid-hormone antibodies were excluded as interferences. Addition to normal serum of the RhF isolated from each of the 5 patients increased the apparent FT4 (Abbott AxSYM). Screening of 83 unselected patients demonstrated a highly significant positive correlation between FT4 (Abbott AxSYM) and RhF concentrations. Discrepant, apparently increased FT4 with a normal result for thyroid-stimulating hormone should lead to measurement of the patient’s RhF concentration.

scholarly journals The pituitary-thyroid axis in healthy men living under subarctic climatological conditions

2001 ◽  
Vol 169 (1) ◽  
pp. 195-203 ◽  
Author(s):  
J Hassi ◽  
K Sikkila ◽  
A Ruokonen ◽  
J Leppaluoto
Keyword(s):  
Thyroid Hormones ◽  
Climatic Factors ◽  
Feedback Mechanism ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Healthy Men ◽  
Non Invasive ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Serum Tsh

In order to evaluate the effects of climatic factors on the secretion of thyroid hormones and TSH in a high latitude population, we have taken serum and urine samples from 20 healthy men from northern Finland (67 degrees -68 degrees N) every 2 months for a period of 14 months. Serum free triiodothyronine (T(3)) levels were lower in February than in August (3.9 vs 4.4 pmol/l, P<0.05) and TSH levels were higher in December than during other months (2.1 vs 1.5-1.7 mU/l, P<0.01). Serum total and free thyroxine (T(4)), total T(3) and reverse T(3) levels and urinary T(4) levels were unchanged. Urinary T(3) levels were significantly higher in winter than in summer. Serum free T(3) correlated highly significantly with the outdoor temperature integrated backwards weekly for 7-56 days (r=0.26 for 1-56 days) from the day when the blood samples were taken. Serum TSH did not show any significant correlation with the thyroid hormones or with the integrated temperature of the previous days, but it did show an inverse and significant correlation (r=-0.31) with the ambient luminosity integrated backwards for 7 days from the day when the blood sample was taken. The gradually increasing correlation between outdoor temperatures and serum free T(3) suggests that the disposal of thyroid hormones is accelerated in winter, leading to low serum free T(3) levels and a high urinary free T(3) excretion. Since there was no correlation between thyroid hormones and serum TSH, the feedback mechanism between TSH and thyroid hormones may not be the only contributing factor, and other factors such as ambient luminosity may at least partly determine serum TSH in these conditions. Also urinary free T(3) appears to be a novel and non-invasive indicator for thyroid physiology.

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