Occurrence of Arrhythmias in Women with Thyroid Cancer Receiving Suppressive Doses of Levothyroxine

Aim of the study: To assess the occurrence of cardiac arrhythmias caused by high doses of levothyroxine in patients with thyroid cancer with subclinical hyperthyroidism. Materials and Methods: This prospective study included 98 women divided into three groups according to plasma thyroid stimulating hormone (TSH) concentration: <0.1 µU/mL, 0.1–0.39 µU/mL, or 0.4–4.0 µU/mL (control group). All participants underwent laboratory tests and an electrocardiography (ECG) Holter test to assess their heart rate and the occurrence of arrhythmias. Statistical analysis assessed differences between groups in all clinical parameters and factors influencing the occurrence of arrhythmias. Results: There were no differences between groups in the maximum, average, or minimum heart rate or in the incidence of the studied cardiac arrhythmias. Heart rate in women with a TSH concentration of <0.1 µU/mL depended on age and the presence of arterial hypertension, and heart rate in women with a TSH concentration of 0.4–4.0 µU/mL depended on free triiodothyronine concentration and the presence of arterial hypertension; no relationship was identified for women with a TSH concentration of 0.1–0.39 µU/mL. One-way logistic regression analysis did not identify any factors influencing the occurrence of arrhythmias. Conclusions: While maintaining normal free triiodothyronine levels, the use of suppressive doses of levothyroxine after thyroidectomy for differentiated thyroid cancer does not induce clinically significant arrhythmias or affect average heart rate. None of the studied clinical parameters influenced the risk of arrhythmia.

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Use of Ethylmethylhydroxypyridine in Patients Presenting with Myocardial Infarction: Antiischemic, Antidepressant, Anxiolytic Effects

Family Medicine ◽

10.30841/2307-5112.4.2016.248524 ◽

2016 ◽

pp. 67-74

Author(s):

Maryna Dolzhenko ◽

Olena Popovich ◽

Oksana Shershnyova ◽

Oleksandr Nudchenko ◽

Kardo Faradzh ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Rate ◽

Heart Rate Variability ◽

Mental State ◽

Cardiac Arrhythmias ◽

Average Score ◽

Control Group ◽

Basic Therapy ◽

Coronary Syndrome ◽

St Segment

The objective: to evaluate the efficiency of ethylmethylhydroxypyridine (Mexiprim, STADA Arzneimittel AG, Germany) in patients presenting with myocardial infarction at hospital and outpatient stage. Patients and methods. The study included 59 patients with coronary artery disease, acute coronary syndrome with ST1segment elevation in the first day of admission to the ICU, AH, 3-stage, 2 degrees, HF. To all patients basic therapy according to current ESH/ESC guidelines was prescribed. To 39 patients additionally intravenous infusion of 200 mg of mexiprim o.d. for 10 days, followed by 125 mg per os three times a day for next 60 days was administered. Another 20 patients presented control group and received only basic therapy. The study design included: 24-hour Holter monitoring to estimate the dynamics of changes in the ST segment, cardiac arrhythmias and heart rate variability, evaluation by the scale of Beck, Hamilton scale for the assessment of anxiety (HARS) and depression (HDRS), the common blood and urine tests, biochemical blood analysis, evaluation of therapeutic tolerability conducted before treatment and 60 days after treatment. Surveys on a scale SAN, assessment of cognitive impairment on the MMSE scale were performed on the 60th day of treatment. Efficiency criteria were: a 50% reduction of cardiac arrhythmias, a decrease in ischemia, a decrease by 50% or more from baseline average score by HARS, HDRS scales, dynamics of the mental state questionnaire and less than 9 points on a scale of depression, reducing in SAN scale score. Results. In pаtients of mexiprim group significant reduction of depression scores by 62% were observed. According to the dynamics of the mental state questionnaire patients of mexiprim group reported feeling better, that is, reduction of score by 45% . According to the Hamilton scale for the assessment of anxiety (HARS), in particular mental anxiety – decrease in the total score of 65%, somatic anxiety – by 35.5%, and a total of 50% were revealed. In the group of patients receiving additionally intravenous Mexiprim for 10 days significantly reduced the number of single and group PACs, as well as single and multiple PVCs, not only in comparison with these parameters before the treatment, but also in comparison with the control group. In patients treated with Mexiprim no evidence of residual ischaemia were noted, but in the control group statistically significant segment depression ST remained. Heart rate variability was not significantly changed in the control group, but increased in patients who received Mexiprim. Conclusion. Use of Mexiprim in patients with myocardial infarction reduces ST segment depression, amount of ventricular and supraventricular arrhythmias, improved heart rate variability, and the state of anxiety and depression.

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Effect of Recombinant Human Erythropoietin (R-Huepo) Therapy on Plasma Ft3, FT4, TSH, FSH, LH, free Testosterone and Prolactin Levels in Hemodialysis Patients

The International Journal of Artificial Organs ◽

10.1177/039139889201501003 ◽

1992 ◽

Vol 15 (10) ◽

pp. 585-589 ◽

Cited By ~ 9

Author(s):

M. Yeksan ◽

N. Tamer ◽

M. Cirit ◽

S. Türk ◽

G. Akhan ◽

...

Keyword(s):

Free Testosterone ◽

Hemodialysis Patients ◽

Thyroid Stimulating Hormone ◽

Sexual Disorders ◽

Serum Prolactin ◽

Control Group ◽

Dialysis Session ◽

Free Triiodothyronine ◽

Human Erythropoietin ◽

Stimulating Hormone

The aim of this study was to evaluate the effect of r-HuEPO treatment on free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), free testosterone and prolactin levels in uremic hemodialysis patients. Twenty-four uremic hemodialysis patients were given r-HuEPO with a dose 60 U/kg as intravenous bolus injection at the end of each dialysis session. Once the hematocrit value of the patient had reached a range of 30-35%, the dose was adjusted so as to keep the hematocrit levels constant. Twenty uremic dialysis patients were taken as control group. The above-mentioned hormone levels of patients and control group were determined before and 4 months after r-HuEPO treatment. After the treatment, serum prolactin levels significantly decreased in both sexes (36.8 ± 7.8 vs 22.9 ± 6.3 ng/ml and 78.3 ±13.3 vs 37.4 ± 10.4 ng/ml male and female, respectively). FT3 and FT4 significantly increased (1.17 vs 1.67 pg/ml, p<0.05, and 0.64 vs 0.084 ng/dl, p<0.05, respectively). TSH levels increased but those changes were not significant. There was no change in the level of any hormone in the control group. Also, the sexual functions of eight male patients treated with r-HuEPO improved and menstruation started again in four female patients. We concluded that r-HuEPO treatment especially decreases prolactin level in uremic hemodialysis patients. It is conceivable that correction of elevated prolactin levels could improve sexual disorders in these patients.

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Associations of Thyroid Hormones and Resting Heart Rate in Patients Referred to Coronary Angiography

Hormone and Metabolic Research ◽

10.1055/a-1232-7292 ◽

2020 ◽

Vol 52 (12) ◽

pp. 850-855

Author(s):

Eva Steinberger ◽

Stefan Pilz ◽

Christian Trummer ◽

Verena Theiler-Schwetz ◽

Markus Reichhartinger ◽

...

Keyword(s):

Heart Rate ◽

Coronary Angiography ◽

Thyroid Hormones ◽

Thyroid Stimulating Hormone ◽

Resting Heart Rate ◽

Free Triiodothyronine ◽

Free Thyroid Hormones ◽

Cardiovascular Morbidity And Mortality ◽

Increased Risk ◽

Significant Difference

AbstractResting heart rate (RHR) is associated with increased risk of cardiovascular morbidity and mortality. Thyroid hormones exert several effects on the cardiovascular system, but the relation between thyroid function and RHR remains to be further established. We evaluated whether measures of thyroid hormone status are associated with RHR in patients referred to coronary angiography. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxin (FT4), and RHR were determined in 2795 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Median (25th to 75th percentile) serum concentrations were 1.25 (0.76–1.92) mU/l for TSH, 4.8 (4.2–5.3) pmol/l for FT3 and 17.1 (15.4-19.0) pmol/l for FT4, and mean (±standard deviation) RHR was 68.8 (±11.7) beats/min. Comparing the highest versus the lowest quartile, RHR (beats/min) was significantly higher in the fourth FT4 quartile [3.48, 95% confidence interval (CI): 2.23–4.73; p <0.001] and in the fourth FT3 quartile (2.30, 95% CI: 1.06–3.55; p <0.001), but there was no significant difference for TSH quartiles. In multiple linear regression analyses adjusting for various potential confounders, FT3 and FT4 were significant predictors of RHR (p <0.001 for both). In subgroups restricted to TSH, FT3, and FT4 values within the reference range, both FT3 and FT4 remained significant predictors of RHR (p <0.001 for all). In conclusion, in patients referred to coronary angiography, FT3 and FT4 but not TSH were positively associated with RHR. The relationship between free thyroid hormones and RHR warrants further investigations regarding its diagnostic and therapeutic implications.

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Interval Hypoxic Training in Rehabilitation Program for Adolescents with Overweight / Obesity and Comorbid Arterial Hypertension: Open-Label Randomized Study

Вопросы современной педиатрии ◽

10.15690/vsp.v20i1.2236 ◽

2021 ◽

Vol 20 (1) ◽

pp. 51-61

Author(s):

Alexandra V. Mashanskaya ◽

Anna V. Pogodina ◽

Alina V. Atalyan ◽

Lyubov V. Rychkova ◽

Olga V. Bugun ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Arterial Hypertension ◽

Aerobic Training ◽

Rehabilitation Program ◽

Control Group ◽

Hypoxic Training ◽

Psychoemotional State ◽

Experimental Group ◽

Age And Sex

Background. Searching for new strategies for the rehabilitation of adolescents with obesity and comorbid arterial hypertension (AHT) before significant pathological changes development in the cardiovascular system remains the urgent challenge. Objective. The aim of the study was to examine the effect of interval hypoxic training (IHT) on blood pressure (BP) levels in adolescents with overweight / obesity and comorbid AHT. Methods. Adolescents aged 14-17 years with body mass index SDS ≥ 1 and grade I AHT (mean level of systolic and/or diastolic BP ≥ 95th percentile for population of corresponding age, sex and height) have been randomized to the group «aerobic training» (treadmill walking) and “aerobic training + IHT” (usage of hypoxicator in intermittent operation cycles). All patients were on subcaloric diet (10% reduction in caloric intake for given age). Primary outcome measure was the difference between groups on systolic/diastolic BP levels according to 24-hour BP monitoring after completion of training program (10 classes each). The effects of IHT on body composition (bioelectrical impedance analysis), heart rate variability and psychoemotional state (Spielberger scale, assessment of health, activity and mood) were further estimated. Results. 43 patients were assigned to the index group, and 42 — to the control group. 67 patients have completed the research program. 5 patients (12%) from the IHT group and 13 patients (31%; p = 0.029) from the control group prematurely discontinued participation in the trial due to poor exercise tolerance. The groups were comparable in baseline systolic and diastolic BP. Decrease in BP occurred in both groups after 10 workouts. There were no differences in decrease value: mean difference for SBP was 2.4 mm Hg (95% CI -6.6 ... 1.8), for DBP — 0.2 mm Hg (-3.6 ... 4.0). However, the incidence of reaching the targeted SBP (< 95th percentile for the corresponding age and sex) after completion of the treatment was recorded in 66% patients in the experimental group and in 42% patients in the control group (p = 0,047). Positive dynamics in several indicators of heart rate variability and psychoemotional state were mentioned in the IHT group. Conclusion. The IHT implementation in the complex of rehabilitation program for adolescents with overweight / obesity and AHT has no additional positive effect on BP levels. However, the incidence of reaching the targeted SBP (< 95th percentile for the corresponding age and sex) after completion of the treatment was recorded in 66% patients in the experimental group and in 42% patients in the control group (p = 0,054).

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Antioxidant Potential of Parsley Leaf (Petroselinum crispum) Essential Oil on Hypothyroidism and Testicular Injury in Mice Intoxicated by Carbon Tetrachloride

BioMed Research International ◽

10.1155/2021/9989174 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Gehan M. Badr ◽

Abdulmohsen I. Algefare ◽

Manal A. Alfwuaires

Keyword(s):

Oxidative Stress ◽

Carbon Tetrachloride ◽

Thyroid Gland ◽

Essential Oil ◽

Thyroid Stimulating Hormone ◽

Seminiferous Tubules ◽

Control Group ◽

Petroselinum Crispum ◽

Free Triiodothyronine ◽

Stimulating Hormone

The aim of the present study was to investigate the ameliorative potential of parsley (Petroselinum crispum) leaf essential oil (PO) against the detrimental effects of carbon tetrachloride (CCl4) on the thyroid gland and testes of mice. Twenty-four adult male mice were divided into four groups and treated for 4 weeks. The 1st control group received 3 mL/kg olive oil intraperitoneally, twice a week followed by 0.5 mL/kg saline intragastrically daily. The 2nd CCl4 group received CCl4 (3 mL/kg intraperitoneally, twice a week). The 3rd PO group received PO (0.5 mL/kg intragastrically daily), while the 4th CCl4+PO group received CCl4 coadministrated with PO at the aforementioned doses. CCl4 group recorded significant ( p < 0.05 ) reduction in the activities of antioxidant enzyme catalase (CAT) and superoxide dismutase (SOD) and significant ( p < 0.05 ) increase in the lipid peroxidation end product’s level malondialdehyde (MDA) in the testes and thyroid glands. Meanwhile, serum levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid hormones (thyroid-stimulating hormone (TSH), total triiodothyronine (T3), free triiodothyronine (fT3), total thyroxine (T4), and free thyroxine (fT4)) significantly decreased. Also, histopathologically, the testicular tissue showed hypospermatogenesis within irregular-shaped seminiferous tubules with prominent edema in the interstitial spaces confirming the aforementioned biochemical alterations. Treatment with PO significantly reduced the testicular and thyroid oxidative stress ( p < 0.05 ) and elevated the testosterone (73.47%), FSH (92.11%), LH (33.33%), T3 (23.47%), fT3 (39.13%), T4 (27.91%), and fT4 (75%) as compared to that of CCl4-treated group corresponding values. The PO GC/MS analysis indicated bioactive monoterpenes (major component is 1,3,8-mentha triene 34.48%) and phenylpropenes (major component is myristicin 21.04%). Results suggested the ameliorative effect of PO against CCl4-induced hypogonadism in mice by suppressing oxidative stress and maintaining thyroid gland function.

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Study of thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) in subjects with dental fluorosis

European Journal of Dentistry ◽

10.1055/s-0039-1698949 ◽

2012 ◽

Vol 06 (02) ◽

pp. 184-190 ◽

Cited By ~ 10

Author(s):

Mahadevi B Hosur ◽

S R Puranik ◽

Shrinivas Vanaki ◽

Surekha R Puranik

Keyword(s):

Thyroid Hormones ◽

Dental Fluorosis ◽

Statistical Significance ◽

Serum Levels ◽

Iodine Intake ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Endemic Fluorosis ◽

Free Triiodothyronine ◽

Thyroid Gland Function

ABSTRACTObjective: Apart from its well-known deleterious dental and skeletal effects, fluoride excess can have toxic effects on many other tissues. Fluoride, when in excess, is known to interfere with thyroid gland function. Fluoride-induced thyroid disturbances similar to those observed in iodine deficiency state in spite of adequate iodine intake have been documented. Similar thyroid disturbances in individuals with dental fluorosis have not been well studied in populations with endemic fluorosis. This work was undertaken to study the effects of fluoride-induced thyroid disturbances in individuals with dental fluorosis.Methods: The study group included 65 subjects with dental fluorosis from endemic fluorosis populations. An additional control group was comprised of 10 subjects without dental fluorosis. The drinking water fluoride levels of the study populations were analyzed. Serum free FT3, FT4, and TSH levels of both groups were assessed.Results: All subjects with dental fluorosis had serum levels of thyroid hormones (FT3, FT4, and TSH) within the normal range, with the exception of 1 individual, who had elevated levels of TSH. Statistical significance was found when FT3 and TSH values were compared with different Dean’s index groups by a 1-way ANOVA test: FT3 (F = 3.4572; P=.0377) and TSH (F = 3.2649 and P=.0449).Conclusions: Findings of this study did not show any significant alterations in the levels of the thyroid hormones FT3, FT4, and TSH in subjects with dental fluorosis. Our observations suggest that thyroid hormone levels were not altered in subjects with dental fluorosis. Hence, future studies of this kind, along with more detailed investigations are needed. (Eur J Dent 2012;6:184-190)

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Massive levothyroxine ingestion in a pediatric patient: case report and discussion

CJEM ◽

10.2310/8000.2011.110361 ◽

2011 ◽

Vol 13 (03) ◽

pp. 165-168 ◽

Cited By ~ 11

Author(s):

Josephine Ho ◽

Renee Jackson ◽

David Johnson

Keyword(s):

Blood Pressure ◽

Emergency Department ◽

Heart Rate ◽

Case Report ◽

Hair Loss ◽

Treatment Options ◽

Thyroid Stimulating Hormone ◽

Patient Case ◽

Free Triiodothyronine ◽

Benign Course

ABSTRACTWe describe the course of a toddler who ingested a massive amount of levothyroxine and review treatment options for such overdoses. A 2½-year-old boy presented shortly after an ingestion of up to 7.6 mg of levothyroxine (potentially as much as 700 µg/kg). He was initially asymptomatic, treated with oral charcoal 1 g/kg, and discharged home from the emergency department after a few hours. He returned approximately 24 hours later with a temperature of 38.5°C, heart rate of 163 beats per minute, respiratory rate of 30 breaths per minute, and blood pressure of 136/70 mm Hg. He had a slightly decreased appetite and no signs or symptoms of infection. He was admitted to hospital and treated with oral acetaminophen. The initial free thyroxine (T4) was > 100 pmol/L and free triiodothyronine (T3) was 35.3 pmol/L. The patient had desquamation of the palms and soles, hair loss, and irritability during the month following the ingestion. Resolution of the elevated free T4occurred by 12 days post-ingestion and normalization of the thyroid-stimulating hormone by 7 weeks post-ingestion. There were no longterm sequelae. Levothyroxine overdose can result in significant complications, including seizures and arrhythmias, both of which should be monitored for. However, as our case illustrates, massive ingestion of levothyroxine in children typically follows a benign course.

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The Prevalence of Thyroid Autoimmunity in Children with Developmental Dyslexia

BioMed Research International ◽

10.1155/2021/7656843 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Roberta Degrandi ◽

Flavia Prodam ◽

Giulia Genoni ◽

Giorgio Bellomo ◽

Gianni Bona ◽

...

Keyword(s):

Developmental Dyslexia ◽

Thyroid Autoimmunity ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Thyroid Ultrasonography ◽

Free Triiodothyronine ◽

Significant Difference ◽

High Prevalence ◽

Systematic Determination

Background and Objectives. An association between developmental dyslexia and autoimmune disorders has been postulated. We aimed to evaluate the prevalence of thyroid autoimmunity in pediatric subjects with developmental dyslexia. Methods. We enrolled pediatric subjects with developmental dyslexia and, as a control group, healthy age- and sex-matched subjects without developmental dyslexia. Thyroid function was evaluated in subjects with developmental dyslexia measuring serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4). Thyroid autoimmunity was evaluated in all subjects measuring antithyroid peroxidase (TPO-Ab) and antithyroglobulin (TG-Ab) antibodies. In subjects with developmental dyslexia, thyroid ultrasonography (US) was also performed. Results. We enrolled 51 subjects with developmental dyslexia ( M : F = 39 : 12 , mean age 12.4 ± 9 years) and 34 controls ( M : F = 24 : 10 , mean age 10.8 ± 4 years). TPO-Ab positivity was significantly higher in subjects with developmental dyslexia compared to controls (60.8% vs. 2.9%, p < 0.001 ), while no significant difference was found in TG-Ab positivity (16% vs. 5.8%). Thyroid US performed in 49 subjects with developmental dyslexia revealed a thyroiditis pattern in 60%. Conclusions. We found an extremely high prevalence of thyroid autoimmunity in children with developmental dyslexia. Further studies are needed to confirm our observations, but our findings may change the approach to this disorder and eventually lead to a systematic determination of thyroid autoimmunity in children with developmental dyslexia.

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Cardiac arrhythmias and predictors in patients of young age with marfanoid habitus

Pediatrician (St Petersburg) ◽

10.17816/ped10237-46 ◽

2019 ◽

Vol 10 (2) ◽

pp. 37-46

Author(s):

Eugene V. Timofeev ◽

Eduard V. Zemtsovsky ◽

Svetlana V. Reeva

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Cardiac Arrhythmias ◽

Qt Interval ◽

Qt Dispersion ◽

Young Age ◽

Control Group ◽

Heart Rate Turbulence ◽

Ventricular Extrasystoles ◽

Prolonged Qt Interval

Cardiac arrhythmias are frequent manifestations of hereditary connective tissue disorders (HCTD). Such HCTD as Marfan syndrome (MS), the primary mitral valve prolapse are characterized by frequent supraventricular and ventricular extrasystoles, prolonged PQ and QT interval, reduced heart rate variability and frequent findings of other predictors of heart arrhythmias. Cardiac arrhythmias as well as their predictors in patients of young age with marfanoid habitus (MH) were not previously evaluated. Materials and methods. A total number of 238 patients of young age were examined. All patients received phenotypic and anthropometric screening and Holter ECG. Cardiac arrhythmias, duration of QT interval (QTc), QT dispersion (QTd), heart rate variability and heart rate turbulence were estimated. Results for young people with MH as compared with the control group are characterized by frequent detection of paired (42.6% vs 9.7%, p= 0.00001), group (17.0% vs 4.2%, p = 0.01) supraventricular extrasystoles, ventricular extrasystoles in pathological quantity (10.6% vs 1.4%, p = 0.02). Pathological value of heart rate turbulence is detected significantly more frequently in individuals with MH. During evaluation of variability a significant decrease in all spectral (HF, LF, VLF), as well as most statistical (SDNN, pNN50) indicators was revealed. Patients with MH are characterized by prolonged QT interval (QTc threshold in 480 ms overcomes 21% of boys with MH, p = 0.00001) and increase the variance of the QT interval (threshold of 50 ms overcomes 37.5% of girls with MH, p = 0.0004).

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Thyroxine Supplementation in Pregnant Women After Thyroidectomy for Thyroid Cancer and Neonatal Birth Weight

Frontiers in Endocrinology ◽

10.3389/fendo.2021.728199 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zheng Ding ◽

Fei Guo ◽

Yulai Zhou ◽

Xiaoyi Huang ◽

Zhiwei Liu ◽

...

Keyword(s):

Thyroid Cancer ◽

Birth Weight ◽

Pregnant Women ◽

Early Pregnancy ◽

Late Pregnancy ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Inverse Association ◽

Neonatal Birth Weight ◽

Maternal Thyroid

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P < 0.001) and late pregnancy (P < 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.

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