scholarly journals Normal Reference Range for Serum TSH, Free T4, Total T4, and Total T3 on Roche® Platforms in Basrah, Iraq

Author(s):  
Nassar Taha Alibrahim ◽  
Samih Abed Odhaib ◽  
Ali Hussain Alhamza ◽  
Ammar Mohammed Saeed Almomin ◽  
Ibrahim Abbood Zaboon ◽  
...  

Background: Thyroid function tests are mandatory in clinical practice because symptoms and signs are not reliable to discriminate between various types of thyroid disease. Aim: The aim of this study was to determine assay-specific reference range for serum free T4, total T4, total T3 and TSH among healthy non-pregnant adult cohort for Roche® platforms in Basrah (Southern Iraq) from single laboratory in a tertiary center using indirect approach of the available data. Methods: A Cross sectional study for non-pregnant adults 19 years and above. Sera were analyzed by using cobs e411 for thyroid functions tests. Results: Total enrolled persons were 10,078. The 95% reference intervals for TSH were 0.20-6.50 μIU/mL, which increased with age though not linear, for free T4 were 0.8-1.70 ng/dL, for total T4 were 3.78-15.33 μg/dL, and for total T3 were 0.80-2.50 ng/mL. Colcusion: Cobs e411(Roche® analytical platform) analyzer reference range for thyroid function  cannot be applied for Iraqi population .

Author(s):  
Farahnaz Farzaneh ◽  
Farzaneh Khastehfekr

Background: Thyroid dysfunction is associated with negative pregnancy outcomes. There is a lack of reliable information on thyroid hormones in Iranian pregnant women, especially in Yazd. Objective: To determine the safe thyroid hormone levels in women of Yazd and also the first trimester-specific reference ranges for serum thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3). Materials and Methods: In this cross-sectional study, the serum of 1,148 women in the first trimester of pregnancy was analyzed. Thyroid function tests (TSH, T4, T3) were measured through radioimmunoassay (RIA) [immunoradiometric (IRMA) for TSH]. The study was conducted in Yazd, from September 2018 to November 2019. Reference intervals were defined as the 5th, 50th, and 95th percentiles. Results: The mean age of the participants was 28.78 (± 5.86 yr) (range: 15-45 yr). The thyroid hormones reference intervals in the first trimester were TSH (0.2-3.8 mIU/l), T4 (7.45-12.75, μg/dl), and T3 (100-217 ng/dl). Conclusion: The results of the present study determined a local thyroid function measurement in the first trimester of pregnancy at a center of Yazd, Iran. This could facilitate the decision-making of maternal TSH level during the first trimester of pregnancy. Key words: First pregnancy trimester, Thyrotropin, Thyroxine, Triiodothyronine.


2021 ◽  
Author(s):  
Stine Linding Andersen ◽  
Louise Knøsgaard ◽  
Aase Handberg ◽  
Peter Vestergaard ◽  
Stig Andersen

Objective: A high activity of the deiodinase type 2 has been proposed in overweight, obese, and smoking pregnant women as reflected by a high triiodothyronine (T3)/thyroxine (T4)-ratio. We speculated how maternal adiposity and smoking would associate with different thyroid function tests in the early pregnancy. Design: Cross-sectional study within the North Denmark Region Pregnancy Cohort. Methods: Maternal thyroid-stimulating hormone (TSH), total T4 (TT4), total T3 (TT3), free T4 (fT4), and free T3 (fT3) were measured in stored blood samples (median gestational week 10) by an automatic immunoassay. Results were linked to nationwide registers and live-birth pregnancies were included. The associations between maternal adiposity (overweight or obese), smoking, and log-transformed TSH, fT3/fT4-ratio, and TT3/TT4-ratio were assessed using multivariate linear regression and reported as adjusted exponentiated β (aβ) with 95% confidence interval (CI). The adjusted model included maternal age, parity, origin, week of blood sampling, and diabetes. Results: Altogether 5,529 pregnant women were included, and 40% were classified with adiposity, whereas 10% were smoking. Maternal adiposity associated with higher TSH (aβ 1.13 (95% CI 1.08-1.20)), whereas maternal smoking was associated with lower TSH in the early pregnancy (0.875 (0.806-0.950)). Considering the T3/T4-ratio, both maternal adiposity (fT3/fT4-ratio: 1.06 (1.05-1.07); TT3/TT4-ratio: 1.07 (1.06-1.08)) and smoking (fT3/fT4-ratio: 1.07 (1.06-1.09); TT3/TT4-ratio: 1.10 (1.09-1.12)) associated with a higher ratio. Conclusions: In a large cohort of Danish pregnant women, adiposity and smoking showed opposite associations with maternal TSH. On the other hand, both conditions associated with a higher T3/T4-ratio in early pregnancy, which may reflect altered deiodinase activity.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  

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.


2018 ◽  
Vol 31 (10) ◽  
pp. 1113-1116 ◽  
Author(s):  
Michelle S. Jayasuriya ◽  
Kay W. Choy ◽  
Lit K. Chin ◽  
James Doery ◽  
Alice Stewart ◽  
...  

Abstract Background: Prompt intervention can prevent permanent adverse neurological effects caused by neonatal hypothyroidism. Thyroid function changes rapidly in the first few days of life but well-defined age-specific reference intervals (RIs) for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free tri-iodothyronine (FT3) are not available to aid interpretation. We developed hour-based RIs using data mining. Methods: All TSH, FT4 and FT3 results with date and time of collection from neonates aged <7 days during 2005–2015 were extracted from the Monash Pathology database. Neonates with more than one episode of testing or with known primary hypothyroidism, identified by treating physicians or from medical records, were excluded from the analysis. The date and time of birth were obtained from the medical records. Results: Of the 728 neonates qualifying for the study, 569 had time of birth available. All 569 had TSH, 415 had FT4 and 146 had FT3 results. For age ≤24 h, 25–48 h, 49–72 h, 73–96 h, 97–120 h, 121–144 h and 145–168 h of life, the TSH RIs (2.5th–97.5th) (mIU/L) were 4.1–40.2, 3.2–29.6, 2.6–17.3, 2.2–14.7, 1.8–14.2, 1.4–12.7 and 1.0–8.3, respectively; the FT4 RIs (mean ± 2 standard deviation [SD]) (pmol/L) were 15.3–43.6, 14.7–53.2, 16.5–45.5, 17.8–39.4, 15.3–32.1, 14.5–32.6 and 13.9–30.9, respectively; the FT3 RIs (mean±2 SD) (pmol/L) were 5.0–9.4, 4.1–9.1, 2.8–7.8, 2.9–7.8, 3.5–7.2, 3.4–8.0 and 3.8–7.9, respectively. Conclusions: TSH and FT4 were substantially high in the first 24 h after birth followed by a rapid decline over the subsequent 168 h. Use of hour-based RIs in newborns allows for more accurate identification of neonates who are at risk of hypothyroidism.


Author(s):  
Süleyman Akarsu ◽  
Filiz Akbiyik ◽  
Eda Karaismailoglu ◽  
Zeliha Gunnur Dikmen

AbstractThyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.


2007 ◽  
Vol 157 (4) ◽  
pp. 509-514 ◽  
Author(s):  
Rt Stricker ◽  
M Echenard ◽  
R Eberhart ◽  
M-C Chevailler ◽  
V Perez ◽  
...  

Background: Maternal thyroid dysfunction has been associated with a variety of adverse pregnancy outcomes. Laboratory measurement of thyroid function plays an important role in the assessment of maternal thyroid health. However, occult thyroid disease and physiologic changes associated with pregnancy can complicate interpretation of maternal thyroid function tests (TFTs). Objective and methods: To 1) establish the prevalence of laboratory evidence for autoimmune thyroid disease (AITD) in pregnant women; 2) establish gestational age-specific reference intervals for TFTs in women without AITD; and 3) examine the influence of reference intervals on the interpretation of TFT in pregnant women. Serum samples were collected from 2272 pregnant women, and TFT performed. Gestational age-specific reference intervals were determined in women without AITD, and then compared with the non-pregnant assay-specific reference intervals for interpretation of testing results. Results: Thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (Tg-Ab) were positive in 10.4 and 15.7% of women respectively. TPO-Ab level was related to maternal age, but TPO-Ab status, Tg-Ab status, and Tg-Ab level were not. Women with TSH > 3.0 mIU/l were significantly more likely to be TPO-Ab positive. Gestational age-specific reference intervals for TFT were significantly different from non-pregnant normal reference intervals. Interpretation of TFT in pregnant women using non-pregnant reference intervals could potentially result in misclassification of a significant percentage of results (range: 5.6–18.3%). Conclusion: Laboratory evidence for thyroid dysfunction was common in this population of pregnant women. Accurate classification of TFT in pregnant women requires the use of gestational age-specific reference intervals.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A870-A870
Author(s):  
Bay Quang Nguyen

Abstract Background: Incidental thyroid nodules has become more prevalent in recent years due to applying diagnostic imaging tests. Many studies show that the rate of thyroid cancer in this group of patients is relatively high. Objective: To assess patients with incidentally detected thyroid nodules, including those who were diagnosed with thyroid cancer. Materials and Methods: A cross-sectional study, which involved 208 patients with 389 thyroid nodules detected by thyroid ultrasound. All patients have thyroid function tests. 272 nodules were performed fine-needle aspiration. Patients with thyroid cancer were assessed histopathology after removal. Results: The participants’ mean age was 47.22 ± 12.02. The female / male ratio is 6.7/1. No patients had history of head and neck irradiation or living in epidemiological areas with high prevalence of goiter. TSH level: 96.2% normal, 2.4% low, 1.4% high. In thyroid cancer group: 100% of patients had normal thyroid function. Nodule characteristics on ultrasound: Majority of thyroid nodules had diameters less than 1.5 cm (85.6%), multi-nodularity(52.9%). The largest carcinoma nodule was 2.35 cm, 22.2% of patients with thyroid cancer had ≥ 3 nodules. The malignancy rate of TIRADS 5 was 70.6%. FNA results of 272 thyroid nodules: the majority were Bethesda II (74,2%); the incidence of carcinoma (Bethesda V, VI) is 17.4%. 36 patients account for 17,3%, with 42 nodules were performed surgery, the results of histopathology were 100% of papillary thyroid carcinoma, which was consistent with cytological results. Conclusion: Thyroid nodules are common in women patients at the age of 31-60 with normal thyroid function. Most of them are &lt;1.5 cm in size. There are 17.3% of patients were thyroid carcinoma.


2016 ◽  
Vol 6 (2) ◽  
pp. 156
Author(s):  
K. G. Kibria ◽  
M. R. Alam ◽  
H. K. Paul ◽  
M. Fariduddin ◽  
M. A. Hasanat

<p><strong>Background:</strong> An association between thyroid dysfunction and dyslipidemia prevails. Levels of total cholesterol, low density lipoprotein cholesterol, triglycerides tend to increase as thyroid function declines.</p><p><strong>Objective:</strong> To find out the pattern of dyslipidemia in hypothyroid patients. <strong></strong></p><p><strong>Methods:</strong> Sixty cases were selected as a sample of convenience in this cross sectional study from in-patienl depa1tment of Medicine and Endocrinology, BSMMU. Meticulous history taking and thorough clinical examinations were done. Report of lipid profile and thyroid function tests were recorded from patients file. All the information's were recorded in a pre-designed sttuctured questionnaire. Collected data were classi­fied, edited, coded and entered into the computer for statistical analysis by using SPSS. <strong></strong></p><p><strong>Results:</strong> Among the 60 cases, 43 (72%) were female; 17(28%) were male. Age range was 24-59 years with a mean age of 38.80 (± I 0.35) years. Majority 38(65%) were housewife, followed by service holder 11(18.33%), 08(13.3%) were business men and 02(3.3%) had other occupations. Majority 42(70%) patients were taking thyroxin. Mean Total cholesterol (TC), LDL cholesterol, Triglycer­ide (TG) and HDL were 222.20(±42.25); 138.63(±31.51); 243.36(±83.13) and 37.30(±5.12) respectably. <strong></strong></p><p><strong>Conclusion:</strong> All hypothyroid subjects had dyslipidemia. The present study indicated that hypothyroidism was associated with an abnormal lipid profile, especially with respect to the levels of total cholesterol and triglyceride.</p>


2021 ◽  
Vol 19 (1) ◽  
pp. 9-13
Author(s):  
Bibush Amatya ◽  
Smita Joshi

Introduction: Hair loss is one of the most frequent complaints for which patients see a dermatologist. The three most common causes of hair loss in women are telogen effluvium, alopecia areata and female pattern hair loss.   Objectives The aim of this study was to investigate haemoglobin, iron profile and thyroid function tests in women with telogen effluvium, alopecia areata and female pattern hair loss.   Materials and Methods: This was a hospital based cross sectional study conducted at the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH). We recruited female patients with telogen effluvium, alopecia areata or female pattern hair loss who presented to our outpatient department between June 2019 and July 2020. Clinical and demographic data were collected and haemoglobin, serum iron profile and thyroid function investigated.   Results: A total of 80 patients were recruited in the study period.  The most common diagnosis was telogen effluvium (49, 61.25%) followed by alopecia areata (18, 22.5%) and female pattern hair loss (13, 16.25%). Although mean haemoglobin levels were within normal limits, inadequate ferritin levels for normal hair cycle were found in 77.55% of patients with telogen effluvium, 88.89% with alopecia areata and 84.61% with female pattern hair loss. Thyroid abnormalities were less commonly observed with more than 75% of the patients being euthyroid.   Conclusion: Haemoglobin levels are not representative of true iron status in females with acquired alopecia. We therefore recommend investigating iron profile in all females with telogen effluvium, alopecia areata or female pattern hair loss.


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