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 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

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 Radioiodine (131i) Therapy for Thyrotoxicosis Patients and their Outcome: Experience at Center for Nuclear Medicine & Ultrasound, Barisal

1970 ◽  
Vol 26 (2) ◽  
pp. 73-78
Author(s):  
Shankar Kumar Biswas ◽  
Nafisa Jahan ◽  
KBM Abdur Rahman
Keyword(s):  
Nuclear Medicine ◽  
Single Dose ◽  
Multinodular Goiter ◽  
Radioiodine Therapy ◽  
Effective Means ◽  
Fixed Dose ◽  
Thyroid Cells ◽  
Dose Method ◽  
Higher Doses ◽  
Key Words Thyrotoxicosis

Radioiodine therapy appears to be an effective means in controlling thyrotoxicosis and it acts either by destroying functioning thyroid cells or by inhibiting their ability to replicate. The variable radiosensitivity of the gland means that the choice of dose is empirical. Unfortunately all attempts at dosimetry have thus far failed to reliably deliver a dose that avoids recurrence and does not ultimately lead to hypothyroidism. Ninety five patients (female 66 and male 29) with thyrotoxicosis treated with radioiodine at the Center for Nuclear Medicine & Ultrasound, Barisal and their outcome were analyzed from January 2000 to December 2004. Before radioiodine administration clinical features of the patients, palpation of the thyroid gland and ultrasonogram were performed. 131<sub>I</sub> was given as fixed dose method and the dose ranged from 8-12 mCi. Higher doses were administered for larger goiter, multinodular goiter and in relapse cases. Hyperthyroid state was controlled in 85 (89%) patients after receiving single dose of radioiodine and 13 (13.6%) patients developed hypothyroidism within 3 months of therapy. Radioiodine therapy has proved to be cheap and effective method of treatment for thyrotoxicosis. Key words: Thyrotoxicosis, Radioiodine therapy, Hypothyroidism. DOI: 10.3329/jbcps.v26i2.4184 J Bangladesh Coll Phys Surg 2008; 26: 73-78

THYROID FUNCTION TESTS: A REVIEW

2021 ◽  
pp. 73-76
Author(s):  
Vasudev Sankhla ◽  
Aman Deep
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Radioactive Iodine ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Tsh Secretion ◽  
Line Test ◽  
Radioactive Iodine Uptake

Thyroid function tests are one of the most common endocrine panels in general practice because a good understanding of when to order them, indications for treatment are important for the optimal treatment of thyroid dysfunction. Thyroid-stimulating hormone (TSH) should be the rst test to be performed on any patient with suspected thyroid dysfunction and in follow-up of individuals on treatment. It is useful as a rst-line test because even small changes in thyroid function are sufcient to cause a signicant increase in TSH secretion. Thyroxine levels may be assessed in a patient with hyperthyroidism, to determine the severity of hyperthyroxinemia. Antithyroid peroxidase measurements should be considered while evaluating patients with subclinical hypothyroidism and can facilitate the identication of autoimmune thyroiditis during the evaluation of nodular thyroid disease. The measurement of TSH receptor antibody must be considered when conrmation of Graves’ disease is needed and radioactive iodine uptake cannot be done.

scholarly journals Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

scholarly journals Thyroid Function Changes and Pubertal Progress in Females: A Longitudinal Study in Iodine-Sufficient Areas of East China

2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Wang ◽  
Dandan He ◽  
Chaowei Fu ◽  
Xiaolian Dong ◽  
Feng Jiang ◽  
...  
Keyword(s):  
Linear Regression ◽  
Multiple Linear Regression ◽  
Thyroid Function ◽  
Pubertal Development ◽  
Thyroid Stimulating Hormone ◽  
East China ◽  
Regression Analyses ◽  
Free Triiodothyronine ◽  
Serum Tsh

BackgroundThe onset of puberty is influenced by thyroid function, and thyroid hormones (THs) fluctuate substantially during the period of pubertal development. However, it needs to be further clarified how THs change at specific puberty stages and how it influences pubertal development in girls. So far, longitudinal data from China are scarce.MethodsA cohort study was conducted among girls during puberty in iodine-sufficient regions of East China between 2017 to 2019. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs), including the ratio of FT4 to FT3 (FT4/FT3), Jostel’s TSH index (TSHI), and thyroid feedback quantile-based index (TFQI), were calculated. Puberty category scores (PCS), calculated based on the Puberty Development Scale (PDS), was used to assess the stage of puberty. Girls were grouped into three categories according to PCS changes (△PCS) and six categories according puberty stage (BPFP: pre-pubertal at both baseline and follow-up; BPFL: pre-pubertal at baseline and late-pubertal at follow-up, respectively; BPFT: pre-pubertal at baseline and post-pubertal at follow-up, respectively; BLFL: late-pubertal at both baseline and follow-up; BLFT: late-pubertal at baseline and post-pubertal at follow-up, respectively; BTFT: post-pubertal at both baseline and follow-up). Multiple linear regression analyses were used to evaluate the associations of THs changes with pubertal progress.ResultsThe levels of serum TSH and FT3 decreased while serum FT4 increased during the study period (P&lt;0.001). In multiple linear regression analyses, after adjustment for covariables, FT3 decreased by an additional 0.24 pmol/L (95% CI: -0.47 to -0.01) in the higher △PCS group than the lower △PCS group. Compared with the BLFL group, the BPFT group showed an additional decline in FT3 (β= -0.39 pmol/L, 95%CI: -0.73 to -0.04), the BTFT group showed a lower decline in TSH (β=0.50 mU/L, 95% CI: 0.21 to 0.80) and a lower decline in TSHI (β=0.24, 95%CI: 0.06 to 0.41), respectively. There was no association of △FT4 or △TFQI with △PCS or the puberty pattern.ConclusionsSerum TSH and FT3 decreased while serum FT4 increased among girls during puberty. Both the initial stage and the velocity of pubertal development were related to thyroid hormone fluctuations.

scholarly journals Obese patients with higher TSH levels had an obvious metabolic improvement after bariatric surgery

2021 ◽  
Vol 10 (10) ◽  
pp. 1326-1336
Author(s):  
Nannan Bian ◽  
Xiaomeng Sun ◽  
Biao Zhou ◽  
Lin Zhang ◽  
Qiu Wang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Thyroid Function ◽  
Fasting Blood Glucose ◽  
Thyroid Stimulating Hormone ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Free Triiodothyronine ◽  
The Relationship ◽  
Tsh Levels

Objective Bariatric surgery has become the most effective treatment for morbid obesity. Increasing evidence showed that bariatric surgery can alleviate insulin resistance and influence thyroid function. This study aimed to investigate the relationship between changes in thyroid function and adipose tissue insulin resistance (adipo-IR) after bariatric surgery. Methods A total of 287 non-diabetic participants with regular thyroid function were recruited and divided into the lean, overweight and obese groups. Among them, 50 morbidly obese patients submitted to bariatric surgery. Results The obese group had a higher level of adipo-IR, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), FT3/free thyroxine (FT4) and metabolism disorders than the lean and overweight groups. BMI was correlated with TSH, FT3, FT3/FT4 and adipo-IR (r = 0.309, 0.315, 0.322 and 0.651, respectively, all P < 0.001). Adipo-IR was significantly correlated with TSH (r = 0.402, P < 0.001), FT3 (r = 0.309, P < 0.001), and FT3/FT4 (r = 0.228, P < 0.05). Bariatric surgery resulted in a sharp decline in BMI, adipo-IR, TSH, FT3 and FT3/FT4 levels, meanwhile, metabolic disorders improved. The decrease in BMI after bariatric surgery was significantly correlated with reductions in adipo-IR (r = 0.577, P < 0.001) and TSH (r = 0.401, P = 0.005). Interestingly, the fasting blood glucose, fasting insulin, adipo-IR and TSH in the higher TSH group decreased more remarkably than in the lower TSH group. Conclusion Obese individuals with higher TSH levels had an obvious metabolic improvement after bariatric surgery.

scholarly journals The Relationship between Thyroid Function and Depressive Symptoms—the FIN-D2D Population-Based Study

2015 ◽  
Vol 8 ◽  
pp. CMED.S24111 ◽  
Author(s):  
Juha Saltevo ◽  
Hannu Kautiainen ◽  
Pekka Mäntyselkä ◽  
Antti Jula ◽  
Sirkka Keinänen-Kiukaanniemi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Depressive Symptoms ◽  
Thyroid Function ◽  
Participation Rate ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Population Based Study ◽  
The Mean ◽  
The Relationship

The association between thyroid function and depression is controversial. Both conditions express many similar symptoms, but the studies done give conflicting results. This study draws on a random, population-based sample of 4500 subjects aged 45–75 years old from Finland. The basic clinical study was done in 2007 for 1396 men and 1500 women (64% participation rate). Thyroid stimulating hormone (TSH), free thyroxine (F-T4), and free triiodothyronine (F-T3) were measured in 2013 from frozen samples. The 21-item Beck Depression Inventory (BDI-21) was applied to assess depressive symptoms (score ≥10 points). The prevalence of depressive symptoms was 17.5% in women and 12.5% in men. In women, the mean levels of TSH, F-T4, and F-T3 without depressive symptoms vs. with the presence of depressive symptoms were 1.92/1.97 mU/L, 13.1/13.1 pmol/L, and 3.91/3.87 pmol/L (NS), respectively. In men, the levels were 1.87/1.94 mU/L, 13.5/13.7 pmol/L, and 4.18/4.12 pmol/L (NS), respectively. In multiple regression analysis, TSH had no relationship to BDI-21 total score. We found no association between depressive symptoms and thyroid values.

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 Effect of Single Dose of Radioiodine Therapy on Volume Reduction of Thyroid Gland in Hyperthyroidism

2019 ◽  
Vol 21 (2) ◽  
pp. 87-91
Author(s):  
Shamrukh Khan ◽  
Faridul Alam ◽  
Fatima Begum ◽  
Sadia Sultana ◽  
Zeenat Jabin ◽  
...  
Keyword(s):  
Single Dose ◽  
Thyroid Gland ◽  
Radioactive Iodine ◽  
Volume Reduction ◽  
Radioactive Iodine Therapy ◽  
Short Term ◽  
Hormone Levels ◽  
Toxic Goiter ◽  
Primary Hyperthyroidism ◽  
Hormone Assay

Introduction: Radioactive iodine therapy (RAIT) in patients with hyperthyroidism (HT) causes apoptosis of thyrocytes to bring about restoration of thyroid function. The aim of the study was to find the short term extent of reduction of thyroid gland volume (TGV) by non-invasive quantitative assessment using ultrasound imaging (USG). Patients and Methods: This prospective study was conducted on a group of patients who had received RAIT due to  primary hyperthyroidism at National Institute of Nuclear Medicine & Allied Sciences (NINMAS). Pre-therapy work up included hormone assay and baseline measurement of TGV by US before administration of  appropriate fixed dose RAIT. Short term follow-up with hormone assay and serial measurements of TGV on two occasions were done at three and six months following the RAIT. Observed temporal changes of parameters were analyzed using appropriate statistics. Results: Total 117 patients with primary hyperthyroidism had received RAIT with diagnosis of diffuse toxic goiter in 86 patients, toxic multinodular goiter in 21 cases and single toxic nodular goiter in 10 cases. There was a decline of mean TGV from the baseline level of 24 ml to 14 ml at three months followed by a further decline to 9.1 ml at six months. Thus the volume reduction of thyroid gland was calculated to be 42% at three months and 62% at six months. The volume reduction was observed to be in a correlative trend with the normalization of hormone levels. The proportion of patients who showed persistent hyperthyroidism till the study end point was 23%. Conclusion: Single dose of radioactive iodine therapy resulted in reduction of TGV up to 62% till six months after RAIT while 23% patients showed persistent hyperthyroidism. The correlative trend of volume reduction with normalization of hormone levels indicates potentiality of TGV to emerge as an adjunct to conventional assessment of treatment efficacy following RAIT.   Bangladesh J. Nuclear Med. 21(2): 87-91, July 2018

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