scholarly journals HYPOTHYROIDISM AND GOITER IN A YOUNG MALE WITH SUSPECTED DIETARY IODINE DEFICIENCY FOLLOWED BY THYROTOXICOSIS AFTER IODINE SUPPLEMENTATION

2020 ◽  
Vol 6 (1) ◽  
pp. e19-e22
Author(s):  
Itivrita Goyal ◽  
Manu Raj Pandey ◽  
Rajeev Sharma
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Young Male ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Normal Range ◽  
Iodine Supplementation ◽  
Function Tests

Objective: Iodine deficiency disorders (IDDs) remain a major public health concern in most parts of the world but are extremely rare in North America. We describe a case of goiter in a young male with dietary history and findings suggestive of IDD. Methods: Laboratory and imaging procedures including thyroid function tests, autoantibodies, urine iodine, thyroid ultrasound, and radioactive iodine (RAI) uptake scan were performed. Results: On initial presentation, thyroid-stimulating hormone (TSH) was 24.4 mIU/L (normal range is 0.4 to 5.0 mIU/L), free thyroxine was <0.4 ng/dL (normal range is 0.8 to 1.8 ng/dL), and thyroid peroxidase antibody was positive at 43 IU/mL (normal range is <35 IU/mL). He reported consuming strawberries and peanut butter sandwiches with no intake of dairy or seafood due to gastrointestinal issues (abdominal pain, bloating, and nausea). Physical exam revealed a diffusely enlarged, palpable thyroid gland (grade II goiter). Ultrasound of the neck showed an enlarged thyroid gland with no nodules. RAI uptake scan showed diffuse increased uptake (91%). Given his poor diet, a 24-hour urinary iodine excretion test was ordered which was suggestive of very low iodine intake. He was started on multivitamins with 150 μg of iodine daily. On follow up, clinical exam showed grade I goiter and TSH had normalized to 0.7 mIU/L and free thyroxine was 1.2 ng/dL. He continued on iodine supplementation and tolerated iodine-rich foods. Six months later, thyroid function tests showed hyperthyroidism with TSH of <0.002 ng/dL and free thyroxine was elevated to 2.8 ng/dL. Iodine supplements were stopped. Conclusion: Hypothyroidism and goiter due to IDD should be suspected in the setting of poor dietary intake. IDDs can be rapidly diagnosed in a patient on a restricted diet with multiple urinary iodine determinations and RAI study. Regular thyroid labs should be done to monitor for hyperthyroidism that can develop after iodine supplementation.

scholarly journals Sonographic Echo-pattern of the Thyroid Gland among the Non-nodular Goitrous Patients Having Abnormal thyrotropin Level at their First Diagnosis

2018 ◽  
Vol 18 (2) ◽  
pp. 152-155
Author(s):  
Nasrin Begum ◽  
Kabiruzzaman Shah ◽  
Parvez Ahmed ◽  
Mosharruf Hossain ◽  
Shariful Islam Chowdhury ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Nodular Goiter ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Thyroid Function Tests ◽  
Normal Range ◽  
Management Algorithm ◽  
Function Tests ◽  
Thyrotropin Level

Objective: This study was done to observe the high resolution sonographic echo-pattern of the thyroid gland among the non-nodular goitrous patients having abnormal thyrotropin (TSH) level at their first diagnosis.Method: This study was conducted at the Institute of Nuclear medicine and Allied Sciences, Rajshahi, Bangladesh during the period between 1st January, 2014 and 31st March, 2015. The goitrous patients are referred at this Institute by the clinicians for radionuclide thyroid scan, HRUS of thyroid gland and thyroid function tests. Under the basis of convenient sampling technique, 62 patients are included as sample. Their age, gender, HRUS echo-patterns of goiter and thyrotropin levels are recorded and analyzed with statistical software IBM SPSS v. 16.Results: Among the total enrolled patients (n=62), 57 (91.9 %) were female and five (8.1 %) were male. Mean (± SD) age was 28 ± 11.85 years (range=8 to 69 years). Regarding thyrotropin level among the sample patients (n=62), 53 (85.5 %) had above normal range and 9 (14.5 %) had below normal range. In relation to sonographic echo-pattern of the non-nodular goitrous patients (n=62), 43 (69.4 %) had hypoechoic feature, 15 (24.2 %) had non-homogenous feature and four (6.5 %) had both hypoechoic and non-homogenous feature. Among the 43 goitrous patients with hypoechoic feature, 38 had thyrotropin above normal range and five had below normal range; among the 15 goitrous patients with non-homogenous feature, 12 had thyrotropin above normal range and three had below normal range and among the four goitrous patients with both hypoechoic and non-homogenous feature, three had thyrotropin above normal range and one had below normal range.Conclusion: The results of this study will be helpful in the relevant prospective studies which will be concerned with developing non-nodular goiter management algorithm, in addition to the role of other parameters like thyroid function tests especially thyrotropin level, circulating thyroid autoantibodies detection and fine needle aspiration biopsy (FNAB) cytology findings.Bangladesh J. Nuclear Med. 18(2): 152-155, July 2015

The Association Between Blood Pressure and Normal Range Thyroid Function Tests in a Population Based Tehran Thyroid Study

2015 ◽  
Vol 48 (03) ◽  
pp. 151-156 ◽  
Author(s):  
A. Amouzegar ◽  
M. Heidari ◽  
S. Gharibzadeh ◽  
L. Mehran ◽  
M. Tohidi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Thyroid Function ◽  
Population Based ◽  
Thyroid Function Tests ◽  
Normal Range ◽  
Function Tests

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).

Assessment of normal range of thyroid function tests in healthy Egyptian pregnant women

2018 ◽  
Vol 15 (2) ◽  
pp. 70
Author(s):  
NagwaRoshdy Mohamed ◽  
NerminAhmed Sheriba ◽  
NesmaAli Ibrahim ◽  
AhmedMagdy Hegab
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Function Tests ◽  
Normal Range ◽  
Function Tests

Pictorial reporting of multiple thyroid function results.

1976 ◽  
Vol 22 (10) ◽  
pp. 1562-1566
Author(s):  
R W Pain ◽  
B M Duncan
Keyword(s):  
Thyroid Function ◽  
Reporting System ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Testing Procedures ◽  
Function Tests ◽  
Free Thyroxine Index ◽  
Total Thyroxine ◽  
Experience Difficulty

Abstract Clinicians experience difficulty in correctly interpreting the results of in vitro thyroid function tests in the presence of abnormalities of thyrobinding proteins or when results are borderline. This difficulty has been largely resolved in our laboratory by three innovations. First, the borderline areas for each of three routine tests of thyroid function (total thyroxine, thyrobinding index, and free thyroxine index) were accurately determined. Second, the results from this routine profile of three tests were displayed pictorially so as to produce patterns characteristic of various diagnostic situations, including euthyroidism in the presence of abnormalities of thyrobinding proteins. Third, interpretive comments and, in the case of borderline patterns, suggested further testing procedures were added to the report. Clinicians find the reporting system helpful and respond when additional tests are suggested. The system, operated manually at first, was later computerized.

scholarly journals Moderate Iodine Deficiency Is Common in Pregnancy but Does Not Alter Maternal and Neonatal Thyroid Function Tests

2020 ◽  
Vol 11 ◽  
Author(s):  
Tal Schiller ◽  
Arnon Agmon ◽  
Viviana Ostrovsky ◽  
Gabi Shefer ◽  
Hilla Knobler ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Iodine Content ◽  
First Trimester ◽  
Thyroid Function Tests ◽  
Neonatal Thyroid Function ◽  
Iodine Deficiency In Pregnancy ◽  
In Pregnancy

IntroductionAn Israeli national survey found that 85% of pregnant women had urinary iodine content (UIC) levels below the adequacy range (&lt;150 µg/L). Widespread desalinated water usage and no national fortification plan are possible causes. Studies assessing relationships between iodine status and maternal and neonatal thyroid function provided varying results. Our aims were to determine whether iodine deficiency was associated with altered maternal or neonatal thyroid function and the factors leading to iodine deficiency.MethodsA cross-sectional study including 100 healthy women without prior thyroid disease, in their first trimester of a singleton pregnancy were recruited from an HMO clinic in central Israel. The women were followed from their first trimester. All women completed a 24-h dietary recall and life habits questionnaires. We tested for UIC, maternal and neonatal thyroid function, maternal autoantibodies, and neonatal outcomes.ResultsMedian UIC in our cohort was 49 µg/L [25%–75% interquartile range (IQR) 16-91.5 µg/L], with 84% below adequacy range. No correlation was found between iodine deficiency and maternal or neonatal thyroid function which remained within normal ranges. Antibody status did not differ, but thyroglobulin levels were significantly higher in iodine insufficient subjects. UIC was higher in women consuming an iodine containing supplement. There was no association between UIC and dietary iodine content or water source.ConclusionsModerate iodine deficiency is common in our healthy pregnant women population. Our data imply that moderate iodine deficiency in pregnancy seem sufficient to maintain normal maternal and neonatal thyroid function.

scholarly journals Enlarged Thyroid Gland with Normal Thyroid Function Tests

2008 ◽  
Vol 21 (2) ◽  
pp. 179-182
Author(s):  
Carol F. Adair ◽  
John T. Preskitt ◽  
Kristin L. Joyner ◽  
Robin W. Dobson
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Function Tests ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Function Tests

scholarly journals Report of the IFCC Working Group for Standardization of Thyroid Function Tests; Part 2: Free Thyroxine and Free Triiodothyronine

2010 ◽  
Vol 56 (6) ◽  
pp. 912-920 ◽  
Author(s):  
L. M. Thienpont ◽  
K. Van Uytfanghe ◽  
G. Beastall ◽  
J. D. Faix ◽  
T. Ieiri ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Working Group ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Free Triiodothyronine ◽  
Function Tests

scholarly journals Thyroid Abscess Initially Presenting as Destructive Thyroiditis With Subsequent Hypothyroidism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A961-A961
Author(s):  
Ahl Jeffrey Caseja ◽  
Richard L Wang ◽  
Samer Nakhle
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Fluid Collection ◽  
Neck Mass ◽  
Vascular Supply ◽  
Thyroid Function Tests ◽  
Ct Guided ◽  
Hormone Synthesis ◽  
Function Tests ◽  
Thyroid Abscess

Abstract Introduction: Due to its rich vascular supply and high iodine content infection of the thyroid gland is rare and is uncommonly associated with hyperthyroidism. We report a case of a thyroid abscess presenting with hyperthyroidism with subsequent hypothyroidism in an immunocompetent patient. Clinical Case: A 34-year old female with no past medical history presented with an enlarging neck mass associated with worsening, non-radiating throat pain of three-week duration associated with dysphagia. She reports 15-lb weight loss and palpitations. On presentation vital signs were within normal range. Physical examination revealed a diffusely tender anterior neck mass. Her thyroid function tests revealed TSH 0.01 uIU/mL (0.358-3.74), FT4 2.4 ng/dL (0.76-1.46), TSI &lt;0.10 IU/L (0.00-0.55), TPO 12 IU/mL (0-34). Laboratory workup was also significant for leukocytosis, thrombocytosis, and hyponatremia. Thyroid ultrasound revealed a large, irregularly shaped, multiloculated fluid collection involving both lobes measuring 6.4 x 4.8 x 2.0 cm. She was started on Vancomycin and Ampicillin/Sulbactam, Metoprolol, and Methimazole. Needle aspiration of 30 cc of purulent material was performed with culture showing a heavy growth of streptococcus constellatus sensitive to penicillin. After a 4-day inpatient stay, she was discharged with Amoxicillin/Clauvanate as well as Methimazole 10mg BID. Ten days after being discharged, the patient again presented to the emergency department with complaint that the neck mass had increased in size. CT neck showed a 5.1 x 2.8 x 0.8 cm lobulated fluid collection. CT-guided drainage was performed, cytology and wound culture were found to be unremarkable. Thyroid function tests revealed she was hypothyroid with TSH 31.157 uIU/mL and FT4 of 0.72 ng/dL. Upon discharge, Methimazole was discontinued and she was started on Levothyroxine 75 mcg daily. Due to failure of prior antibiotics, she received a 14-day course of IV Ceftriaxone. Outpatient follow-up eight weeks later showed she was euthyroid on Levothyroxine 75 mcg with ultrasound revealing small thyroid gland with resolution of the abscess. Conclusion: Hyperthyroidism in the setting thyroid abscess is secondary to destructive thyroiditis. As there is no increase in thyroid hormone synthesis, there is no role for treatment with antithyroid medication. Symptomatic control with beta-blocker, surgical drainage, and IV antibiotics are recommended for cases of thyroid abscesses. If infection persists or extensive necrosis develops, thyroidectomy may be indicated. Hypothyroidism can be a consequence of destructive thyroiditis as was seen in this patient.

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