Increased thyroidal T4 to T3 conversion in autonomously functioning thyroid adenoma: from euthyroidism to thyrotoxicosis.

LENUS (Irish Health Repository)

Solter, M

2012-01-31

AIM: The aim was to investigate whether the intrathyroid conversion of T4 to T3 in autonomously functioning thyroid adenoma (AFTA) tissue could influence serum T3 levels and suppression of TSH, especially in patients with borderline thyroid function. PATIENTS AND METHODS: In ten patients with AFTA, thyroidal conversion of T4 to T3 was investigated in nodular and paranodular, TSH-suppressed tissue. All patients had normal serum T4 and suppressed TSH. Serum T3 was normal in six, and borderline or slightly increased in four. AFTA and paranodular tissues were surgically removed and frozen at -70 degrees C, then homogenized in a glass homogenizer, centrifuged at 100,000xg, and particulate fraction collected as a pellet. Analysis mixture consisted of thyroid enzyme suspension in 50 mumol\\/L TRIS buffer with 5 mumol DTT and 200 muL 1.3 mumol T4. Incubation was performed at 37 degrees C and the generation of T3 measured after 5, 10, 20 and 40 minutes respectively. RESULTS: T3 production (pmol\\/mg protein) was significantly higher in AFTA than in paranodular tissues (8.8 1.2\\/Mean +\\/- SE\\/vs. 1.8 +\\/- 0.2; p<0.01), and excessively high (9.8, 14.1, 14.2 and 15.0) in four patients with borderline or slightly supranormal serum T3. A significant correlation was found between serum T3 concentrations and T3 generation (T4 conversion) in AFTA tissues. CONCLUSION: Results suggest that increased thyroidal T4 to T3 conversion in AFTA tissue could be involved in an increased delivery of T3, increased serum T3 and suppressed serum TSH, particularly in patients with the disease evolving from euthyroid to an early hyperthyroid phase.

Long-term follow-up in toxic solitary autonomous thyroid nodules treated with radioactive iodine

International Nuclear Information System (INIS)

Huysmans, D.A.; Corstens, F.H.; Kloppenborg, P.W.

1991-01-01

The long-term effects of radioiodine treatment on thyroid function in patients with a toxic solitary autonomous thyroid nodule were evaluated. Fifty-two patients received a therapeutic dose of 20 mCi of iodine-131 ( 131 I). Duration of follow-up was 10 +/- 4 yr. Follow-up data included a biochemical evaluation of thyroid function. The failure rate (recurrent hyperthyroidism) was 2%. The incidence of hypothyroidism was 6% and was not related to the dose per gram of nodular tissue. Oral administration of 20 mCi of radioiodine is a simple and highly effective method for the treatment of patients with a toxic autonomous thyroid nodule. The risk of development of hypothyroidism is low if extranodular uptake of 131 I is prevented. This can be achieved by not treating euthyroid patients, by no longer using injections of exogenous thyroid stimulating hormone in the diagnostic work-up of the patients and by always performing radioiodine imaging shortly before treatment

Cardiac autonomic regulation is disturbed in children with euthyroid Hashimoto thyroiditis.

Science.gov (United States)

Kilic, Ayhan; Gulgun, Mustafa; Tascilar, Mehmet Emre; Sari, Erkan; Yokusoglu, Mehmet

2012-03-01

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common form of thyroiditis in childhood. Previous studies have found autonomic dysfunction of varying magnitude in patients with autoimmune diseases, which is considered a cardiovascular risk factor. We aimed to evaluate the heart rate variability (HRV), a measure of cardiac autonomic modulation, in children with euthyroid Hashimoto thyroiditis (eHT). The study included 32 patients with eHT (27 girls and 5 boys; mean age 11 ± 4.1 years, range 8-16; body mass index 0.47 ± 0.69 kg/m(2)), as judged by normal or minimally elevated serum TSH levels (normal range: 0.34-5.6 mIU/l) and normal levels of free thyroid hormones (FT4 and FT3) and 38 euthyroid age-matched controls. Patients with eHT and control subjects underwent physical examination and 24-hour ambulatory ECG monitoring. Time-domain parameters of HRV were evaluated for cardiac autonomic functions. Children with eHT displayed significantly lower values of time-domain parameters of SDANN (standard deviation of the averages of NN intervals), RMSSD (square root of the mean of the sum of the squares of differences between adjacent NN intervals), NN50 counts (number of pairs of adjacent NN intervals differing by more than 50 ms) and PNN50 (NN50 count divided by the total number of all NN intervals) for each 5-min interval, compared to healthy controls (p < 0.05 for each), indicating the decreased beat-to-beat variation of heart rate. In conclusion, eHT is associated with disturbed autonomic regulation of heart rate. Hence, the children with eHT are at higher risk for developing cardiovascular diseases.

Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule.

Science.gov (United States)

Treglia, Giorgio; Trimboli, Pierpaolo; Verburg, Frederik A; Luster, Markus; Giovanella, Luca

2015-07-01

International guidelines significantly diverge on the effectiveness of thyroid scintigraphy (TS) in the initial work-up of thyroid nodules. In particular, the role of TS to detect or exclude the presence of autonomously functioning thyroid nodules (AFTN) in patients with normal serum thyrotropin (TSH) is still a matter to debate. Here, we aimed to review the literature on the prevalence of normal TSH value among patients with AFTN and meta-analyse data of the retrieved eligible papers. A comprehensive literature search of studies published from January 2000 to December 2014 on AFTN detected by TS was performed. Records reporting serum TSH values in AFTN were selected. Pooled prevalence of AFTN with normal TSH values was calculated on a per-patient analysis including 95% confidence intervals (95% CI). Eight records including 2761 AFTN were selected for the meta-analysis. Pooled prevalence of AFTN with normal TSH detected by TS was 50% (95% CI: 32-68%). Selection bias in the included studies and heterogeneity among studies were potential limitations of the meta-analysis. Present meta-analysis shows that about one in two patients with AFTN demonstrated by TS has a TSH value within normal references. As a consequence, TSH measurement may not be considered as effective as a single tool to detect or exclude AFTN, and TS remains mandatory. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Radioiodine therapy of functional autonomy using the functional autonomous volume

International Nuclear Information System (INIS)

Seeger, T.; Emrich, D.; Sandrock, D.

1995-01-01

In order to determine the effective radiation dose to be delivered by 131 I in functional autonomy we have used the functional autonomous volume calculated from the global 99m Tc thyroid uptake under exogenous or endogenous suppression before and 3 to 7 months after treatment. The radiation dose to the autonomous volume was calculated retrospectively in 131 patients with unifocal, multifocal and disseminated autonomy (75 hyperthyroid, 56 euthyroid) who received 131 I treatment of 200-300 Gy to the total volume of the gland. It could be shown that at least 350 Gy to the autonomous volume are required to reach the desired effect of treatment which was dependent only on the radiation dose delivered to the functional autonomous volume. (orig.) [de

Percutaneous ethanol injection therapy of autonomous (toxic) thyroid nodules

International Nuclear Information System (INIS)

Dieter Erich Apitzsch, M. D.; Staedtische Paracelsusklinik

2005-01-01

In Europe, 9-10% of hyperfunctioning thyroid glands have toxic, autonomous thyroid nodules (ATN). Since 1994, in the Municipal hospital of Marl, Germany, 186 patients have performed percutaneous ethanol ablation of toxic thyroid nodules with very good or at least sufficient results. In this article, the ablation technique is described in detail and the costs of therapy of ATN are given.(authors)

Autonomous nodule of the thyroid: correlation of patient age, nodule size, and functional status

International Nuclear Information System (INIS)

Blum, M.; Shenkman, L.; Hollander, C.S.

1975-01-01

In light of new techniques for measuring circulating thyroid hormones and for studying the thyroid gland, we present our experience with 35 patients with solitary autonomous nodules of the thyroid to define more precisely the clinical course of patients with this disorder. The patients ranged in age from 19 to 80 years and 31 of the 35 were female. Younger patients were generally euthyroid and sought attention because of a thyroid mass; virtually all older patients were hyperthyroid. Eighteen had obvious clinical features of hyperthyroidism and 5 over age 70 had apathetic hyperthyroidism; all 5 of the elderly and 13 of the 18 under age 70 had elevated thyroxine (T 4 ) and triiodothyronine (T 3 ) levels. Isolated elevation of T 3 and elevated basal metabolic rate were observed in 5 previously untreated clinically hyperthyroid young patients. In each of these, thyroid uptake of 131 I was not suppressible with exogenous T 3 and BMR was elevated in those tested. Two elderly patients, who had previously been treated for conventional hyperthyroidism with radioactive iodine, had T 3 toxicosis when hyperthyroidism recurred. There was a strong positive correlation between the age of the patient, the size of the nodule and the thyroid functional state. The mean area of the nodules projected on 131 I rectilinear scan for euthyroid patients was 5.1 cm 2 . The mean area of the nodules in hyperthyroid subjects was significantly higher, 13.4 cm 2 in patients with T 3 toxicosis and 19.3 cm 2 in subjects with conventional hyperthyroidism. Progression from a euthyroid state to hyperthyroidism was observed in four patients. One of these became thyrotoxic within days after an injection of iodinated contrast medium. Spontaneous resolution of nodules occurred in two patients

[Treatment of autonomous and cystic thyroid nodules with intranodular ethanol injection].

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Braga-Basaria, Milena; Trippia, Marcus Adriano; Stolf, Anderson Ravy; Mesa, Cléo; Graf, Hans

2002-01-01

Intranodular ethanol injection has been used for the past 10 years as an efficient modality for treating patients with thyroid nodules. Several studies have reported the success of this therapy in autonomous and cystic nodules and, more recently, in cold benign nodules. To evaluate the efficacy of this therapeutic modality on the treatment of autonomous and cystic thyroid nodules. 42 patients (26 with cystic and 16 with autonomous nodules) were treated with ultrasound guided intranodular 99% ethanol injection and followed for 6 months. No major complications were observed during or after treatment, however, most of the patients reported slight to moderate pain and/or discomfort after the injection. Most of the nodules showed reduction after the treatment. Autonomous nodules had a mean reduction of 50.3% and cystic nodules of 69.3%. No significant differences in pretreatment serum total T3, total T4 or TSH were observed among the patients in the cystic group. Patients in the autonomous group with hyperfunctioning nodules showed a decrease in serum total T3, total T4 and an increase in serum TSH levels, hence, proving the effectiveness of this therapy. Intranodular ethanol injection is a safe and efficient treatment for autonomous and cystic nodules of the thyroid.

Results of 131I-therapy of autonomous adenomas of the thyroid

International Nuclear Information System (INIS)

Swoboda, G.

1978-01-01

185 adenoma patients were re-examined after 131 I therapy. The examinations comprised an anamnesis, physical examinations, and scintiscanning. Further, the volume of the former adenoma was determined by planimetry and its weight calculated. For a diagnosis of the thyroid function, T 4 and T 3 levels were determined, the T 3 /T 4 ratio was calculated, a T 3 -in-vitro test was carried out, and the fT 4 index was calculated. TRH functional tests were carried out including radioimmunological TSH determination. Therapeutic success was judged on the basis of hot node disappearance in the scintigraphic picture and TSH level normalisation after TRH administration. Retrospective calculations were carried out in order to determine the dose received by the adenoma if its weight had been determined by planimetry. The problem of how to remove the surplus thyroid hormone formed before therapy could be solved by this functional diagnosis. Further, the author studied the correlation between the disappearance of the autonomous adenoma from the scintigraphic picture on the one hand and the restitution of the normal thyroid shape and a measurable TSH increase on the other. Special attention was paid to a relative or absolute shortage of thyroid hormone and to changes in the T 4 /T 3 ratio. Finally, the thyroid function after 131 I therapy was compared with that of normal subjects and struma patients. (orig./MG) [de

Iodine and thyroid function

Directory of Open Access Journals (Sweden)

Hye Rim Chung

2014-03-01

Full Text Available Severe iodine deficiency causes hypothyroidism that results in impaired somatic growth and motor development in children. Mild and moderate iodine deficiencies cause multifocal autonomous growth of thyroid, which results in thyrotoxicosis. On the other hand, iodine excess is associated with the development of hypothyroidism and thyroid autoimmunity. In areas of iodine deficiency, a sudden increase in iodine intake is associated with transient hyperthyroidism. Recent studies demonstrated that long-term thyroid function of subjects who experienced both iodine deficiency and iodine excess during childhood tended to be abnormal despite optimization of their current iodine intake. Iodine status in the Korean Peninsula is very unique because people in the Republic of Korea have been shown to have predominantly excessive iodine levels, whereas the Democratic People's Republic of Korea is known to be an iodine-deficient area. Further research is warranted to verify the optimal ranges of iodine intake and to clarify the effects of iodine intake on thyroid disorders in the Korean Peninsula.

Possibilities of nontoxic autonomous thyroid nodules treatment by percutaneous ethanol injection

Directory of Open Access Journals (Sweden)

Anđelković Zoran

2011-01-01

Full Text Available Background/Aim. According to the current principles, autonomous functional thyroid nodules are treated by surgery or by radioiodin therapy. Ultrasound guided percutaneous ethanol injection into solid tumors of the soft tissues was a starting point in attempts to treat the thyroid nodules by the same method. The aim of the study was to assess the efficiency of percutaneous injection in treating solitary, nontoxic, autonomous thyroid nodules of up to 15 mL volume. Methods. In 25 patients with solitary nontoxic autonomous thyroid nodules diagnosed by tehnetium-99m scanning as an intensive area having a complete supremacy in the paranodal tissue, an ultrasound guided percutaneous ethanol injection was applied. The procedure was carried out repeatedly once a week until the reduction in nodule size to 50% of the initial size was achieved. Results. An average size of the nodule before curing was 9.68 ± 5.01 mL. An average quantity of the injected ethanol was 9.52 ± 5.08 mL, ie 1.06 ± 0.48 mL/mg of the tissue. The regression of the nodule size in the successfully (Δvol% u = - 57.09 ± 13.75%, p < 0.001 and partly successfully cured (Δvol du = -48.45 ± 14.35%, p < 0.05 was statistically significant compared to the size before the treatment. After ceasing ethanol injection, 18 months later, a further size regression (Δvol% = -79.20 ± 9.89% compared to the initial one (p < 0.001 was noticed. Soon, after the procedure was finished, a statistically significant concentration increase of Thyroid Stimulating Hormone (TSH was noticed compared to the initial values (0.18 ± 0.16 vs 0.34 ± 0.31 mU/L, p < 0.01. According to the given criteria, in two female patients satisfactory results were not achieved, but, a year later, in one of them the nodule was not seen by repeated scintigram. The number and frequency of side effects were insignificant. Conclusion. Repeated percutaneous ethanol injections into nontoxic solitary autonomous thyroid nodules result in

Therapeutic options in the management of autonomously functioning thyroid adenomas

International Nuclear Information System (INIS)

Barrenechea, E.A.; Ong, A.

2005-01-01

Full text: Autonomously functioning thyroid nodules or adenomas (AFTN or AFTA) was established as a clinical entity in 1918 by Goetsch correlating cellular mitochondrial content with nodular function and showing the inverse correlation between AFTN function and extra nodular tissue function. They are almost always benign and degeneration, which is common in AFTN, can result in the development of hyperthyroidism. It is therefore important to know the function of these nodules by requesting for the thyroid function tests namely T3, T4, and TSH. They are diagnosed by thyroid scans using I-131 or Tc 99m as a hot solitary nodule in one lobe with the other lobe not appearing on scan or suppressed. The frequency of AFTA worldwide is quite variable depending on geography. It ranges from 1% in North America to 10 % in some areas in Europe and Asia or in areas of iodine deficiency. The traditional methods of treatment of these nodules have been surgery and radioactive iodine ablation. Surgical treatment as a rule is indicated in young patients with nodules larger than 3 cm and those with local compressive symptoms. RAI is used in elderly patients and those who are poor surgical risks. The usual dose ranges from 20 to 30 mCi and is definitely larger that when treating Graves' disease. Others have resorted to PEI or percutaneous ethanol injection with reported success. There has been no definite management of these AFTA due to the variable natural history and some would only recommend observation for asymptomatic small adenomas, which are euthyroid. Therefore this paper studied the results of treatment using RAI ablation, surgery or plain observation for AFTA. Percutaneous ethanol injection is not being done in our center. In the local setting, where thyroid disease is still endemic, the incidence of AFTA is not so high. Graves' disease is still the predominating cause of hyperthyroidism followed by multinodular goiter. Toxic AFTA occurs in 3% of the total hyperthyroid

A rare cause of hyperthyroidism: functioning thyroid metastases.

Science.gov (United States)

Gardner, Daphne; Ho, Su Chin

2014-10-09

Hyperthyroidism is a common medical problem that is readily treated with antithyroid medications. However, attributing the correct aetiology of hyperthyroidism alters management and outcome. We present a case of a 66-year-old woman with a seemingly common problem of hyperthyroidism associated with a goitre, which was initially attributed to a toxic nodule. However, Tc-99m pertechnetate uptake scan and thyroid-stimulating hormone receptor antibody were negative, inconsistent with a toxic nodule or Grave's disease. Her thyroid function tests proved difficult to control over the next few months. She eventually proceeded to a total thyroidectomy and histology revealed follicular variant papillary thyroid carcinoma. She was started on levothyroxine postoperatively but developed severe hyperthyroidism, revealing the cause of hyperthyroidism to be autonomously functioning thyroid metastases. Although functioning thyroid metastases are very rare, they need to be considered among the differential diagnoses of hyperthyroidism, as there are nuances in management that could alter the eventual outcome. 2014 BMJ Publishing Group Ltd.

Therapy of benign thyroid diseases (hyperthyroidism, autonomic adenomas, euthyreotic struma)

International Nuclear Information System (INIS)

Glanzmann, C.; Horst, W.

1976-01-01

The study deals with methods of treatment of benign thyroid affections: diffuse hyperthyroidism, autonomous adenoma, euthyreotic struma. 70% of the patients examined require resective therapy for diffuse hyperthyroidism. In the majority of the cases radio-iodine resection is the method to be chosen. The risk of an eventual X-ray cancer is smaller than the operation mortality. As far as children and adolescents are concerned, 131-iodine therapy is generally not advisable because of the carcinogenic risk which might be heightened. The autonomous adenoma can be eliminated without any problems by using 131-iodine. In case of a large adenoma with considerable regressive changes operation should be preferred. The therapeutic measures in the case of a struma mainly depend on the question if there are any clinical symptoms or any signs indicating an increased risk of malignancy. In case of mechanical complaints caused by a struma nodosa without important regressive changes parenchyma can be reduced by administering 131-iodine once or several times. The reduction of the thyroid function to the middle or lower limit of the normal range in case of euthyreosis is carried out by 131-iodine administration. (GSE) [de

F-18 FDG PET finding in autonomous thyroid nodules

International Nuclear Information System (INIS)

Park, Chan H.; Lee, Myoung Hoon; Yoon, Seek Nam; Hwang, Kyung Hoon

2001-01-01

F-18 FDG PET has become an important diagnostic imaging modality of various malignancies including thyroid cancer. Focal hypermetabolic lesion in the thyroid gland is usually considered malignant (Fig.1), although some benign lesions are also hypermetabolic. The aim of our poster presentation is to demonstrate F-18- FDG PET finding in autonomous thyroid nodules (ATN) and to avoid confusion in the interpretation of F-18-FDG PET performed for the evaluation of thyroid malignancy. Two patients with ATN (one with toxic and the other with nontoxic) underwent F-18-PET. ATN was proven by Tc-99m pertechnate thyroid scan (TS) and thyroid function tests (TFTs) were performed. First patient with ATN was asymptomatic and had a long history of thyroid nodule. Second patient was suffering from acute myelogenous leukemia (AML) and he was mildly thyrotoxic clinically and chemically. Gamma camera based F-18 FDG PET was performed utilizing Elscints Varicam (Haifa, Israel) one hour after IV administration of 111 MBq (3mCi) F-18 FDG. Patients were fasting more than 6 hours prior ot FDG injection. First patients was scanned the neck and second patient had scan of the whole trunk including neck for the evaluation of AML. Both nontoxic and toxic ATNs were hypermetabolic and it was impossible to differentiate benign from malignancy. Biopsy of nodule of the first patient and surgical removal of the nodule in the second patient was benign. Benign nontoxic and toxic ATNs are F-18 FDG avid. The reason for this is that ATN has increased glycolysis and iodide metabolism. Therefore, focal increased FDG uptake within the thyroid gland should be interpreted with TS and TFTs for an accurate diagnosis when F-18 FDG PET is used in the evaluation of thyroid malignancy

Radioiodine therapy of benign thyroid disorders: functional thyroid autonomy

International Nuclear Information System (INIS)

Dunkelmann, S.

2005-01-01

In the last 15 years, several concepts have been developed to further improve the outcome of radioiodine therapy in functional thyroid autonomy. Results of radioiodine therapy in functional autonomy are considerably better than in Graves' disease. All of the currently-applied concepts offer healing rates of 75-100%, but they differ considerably in the hypothyreosis rates attained. The target volume can be precisely determined by sonography only in unifocal autonomy. In the case of multifocal and disseminated autonomy, the entire thyroid is taken as the target volume and the focal dose is reduced ('dosimetric compromise'). TcTUs-based dose concepts calculate the functionally autonomous volume from the TcTUs and replace the target volume by sonography, in the TcTUs-adapted dose concepts, sonographic target volume is left and the focal dose varied in dependence of the suppression uptake. The objective is to attain a high rate of success with a low rate of hypothyreosis. (orig.)

Thyroid Function Tests

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... Home » Thyroid Function Tests Leer en Español Thyroid Function Tests FUNCTION HOW DOES THE THYROID GLAND FUNCTION? ... Cancer Thyroid Nodules in Children and Adolescents Thyroid Function Tests Resources Thyroid Function Tests Brochure PDF En ...

The thyroid nodule. Thyrotropin and peripheral thyroid hormones

International Nuclear Information System (INIS)

Zimny, M.

2008-01-01

Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

Autonomous thyroid nodules in adolescents: clinical characteristics and results of TRH testing

International Nuclear Information System (INIS)

Osburne, R.C.; Goren, E.N.; Bybee, D.E.; Johnsonbaugh, R.E.

1982-01-01

Seven adolescents with autonomous thyroid nodules were evaluated over a three-year period. They had hyperfunctioning nodules on radionuclide scan which failed to suppress with exogenous administration of thyroid hormone. They were clinically euthyroid and had normal T4, free T4, and basal TSH values. However, as a group they had elevated total serum T3 concentrations, blunted TSH response to TRH, and accelerated closure of cranial sutures, all of which suggested subtle hyperthyroidism. These patients have been followed for one to five years. Four have undergone partial thyroidectomy because of persistent elevation in the serum T3 concentration or enlargement of the nodule. The clinical presentation and laboratory findings in this group are similar to those found in adults with autonomous nodules

Autonomous thyroid nodules in adolescents: clinical characteristics and results of TRH testing

Energy Technology Data Exchange (ETDEWEB)

Osburne, R.C.; Goren, E.N.; Bybee, D.E.; Johnsonbaugh, R.E.

1982-03-01

Seven adolescents with autonomous thyroid nodules were evaluated over a three-year period. They had hyperfunctioning nodules on radionuclide scan which failed to suppress with exogenous administration of thyroid hormone. They were clinically euthyroid and had normal T4, free T4, and basal TSH values. However, as a group they had elevated total serum T3 concentrations, blunted TSH response to TRH, and accelerated closure of cranial sutures, all of which suggested subtle hyperthyroidism. These patients have been followed for one to five years. Four have undergone partial thyroidectomy because of persistent elevation in the serum T3 concentration or enlargement of the nodule. The clinical presentation and laboratory findings in this group are similar to those found in adults with autonomous nodules.

Long-term follow-up of autonomous hyperfunctioning thyroid nodules treated with 131I

International Nuclear Information System (INIS)

Zhou Qian

1990-01-01

30 cases of hyperthyroidism caused by solitary autonomous functioning thyroid nodules (AFTN) and treated with 131 I 4 to 24 years earlier (mean, 14.13 years) were studied. In comparison, a control group of 15 cases with AFTN, trated surgically 4 to 22 years ago (mean, 8.66 years), was also examined. The results showed that: (1) Thyroid scintigraphy is not only the determinant criterion for the diagnosis of AFTN, but also the most reliable measure for evaluating the effect of treatment and prognosis. Disappearance of the hot nodule and restoration of the function of suppressed thyroid tissue indicate cure of the disease. (2) Solitary toxic thyroid nodules are frequently polyclonal and occur in nodular goiters with scattered small multifocal hot areas. Therefore, recurrence of the disease is unavoidable either after 131 I therapy or partial thyroidectomy. (3) After treatment of this disease, an absent or low response to TRH test dose not indicate ineffective cure, and an exaggerated response also dose not predict hypothyroidims. (4) Use 131 I and surgery are almost equally effective for the treatment of this disease. All the patients are clinically euthyroid. According to the scintigraphic pattern, all the surgically treated patients are cured, but there are 1 recurrent and 1 with persistent hot nodule in the 131 I therapy group. (5) The 131 I dose calculated individually is more reasonable than a standard does

F-18-FDG-PET in autonomous goiter

International Nuclear Information System (INIS)

Boerner, A.R.; Voth, E.; Schicha, H.

1999-01-01

Aim: Gain-of-function mutations of the thyrotropin receptor (TSHR) gene have been invoked as one of the major causes of toxic thyroid adenomas. This study evaluates F-18-FDG-PET in these patients. Methods: Twenty patients with focal autonomous nodules and ten with disseminated autonomy were investigated the day before radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG-Uptake was higher in patients than in controls. Focal autonomous nodules were associated with focally enhanced glucose metabolism. Disseminated autonomous goiters showed various patterns of focal or global hypermetabolism. Conclusion: Autonomous thyroid tissue caused by constitutive mutations of the TSH receptor is characterised by simultaneous increases in glucose and iodine metabolism which are correlated. (orig.) [de

Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions.

Science.gov (United States)

Mavai, Manisha; Singh, Yogendra Raj; Gupta, R C; Mathur, Sandeep K; Bhandari, Bharti

2018-04-01

Autonomic activity may be deranged in thyroid dysfunctions and may lead to cardiovascular morbidity and mortality. Myopathy is a common manifestation in thyroid disorders and may be associated with raised serum creatine kinase (CK). We hypothesized that cardiovascular abnormality in thyroid dysfunction may manifest as raised CK-MB. This study was designed to investigate the correlation of CK and its isoform CK-MB with thyroid profile and linear parameters of heart rate variability (HRV). The study was conducted on 35 hypothyroid and hyperthyroid patients each, and 25 age-matched healthy controls. Autonomic activity was assessed by simple short term 5-min HRV. Biochemical evaluation of serum thyroid profile, CK-NAC and CK-MB were estimated in all the subjects. Our results demonstrated low HRV in hypo- as well as hyperthyroid patients. We observed significantly higher serum CK levels in hypothyroid patients when compared to hyperthyroids and controls. However, no significant differences were observed in CK-MB levels in the three groups. Significant positive correlation of CK with TSH and negative correlation with some HRV parameters (LF power, HF power, total power, SDNN, RMSSD) was observed in hypothyroid patients. Whereas correlation of CK-MB with thyroid profile as well as HRV parameters was non-significant in all the groups. Based on the CK and CK-MB findings and their correlation, we conclude that the cardiovascular changes seen in thyroid dysfunctions may primarily be due to autonomic imbalance without apparent cardiac muscle involvement. Whereas, raised CK levels indicate predominantly skeletal muscle involvement in hypothyroid patients.

Features and Outcome of Autonomous Thyroid Nodules in Children: 31 Consecutive Patients Seen at a Single Center.

Science.gov (United States)

Ly, Samantha; Frates, Mary C; Benson, Carol B; Peters, Hope E; Grant, Frederick D; Drubach, Laura A; Voss, Stephan D; Feldman, Henry A; Smith, Jessica R; Barletta, Justine; Hollowell, Monica; Cibas, Edmund S; Moore, Francis D; Modi, Biren; Shamberger, Robert C; Huang, Stephen A

2016-10-01

Most thyroid nodules are benign and their accurate identification can avoid unnecessary procedures. In adult patients, documentation of nodule autonomy is accepted as reassurance of benign histology and as justification to forgo biopsy or thyroidectomy. In contrast, the negative predictive value of nodule autonomy in children is uncertain. Some recent publications recommend surgical resection as initial management, but few address the degree of TSH suppression or the specific scintigraphic criteria used to diagnose autonomy. The objective of the study was to study the presenting features and cancer risk of children with autonomous nodules. Medical records of all 31 children diagnosed with autonomous nodules at our center from 2003 to 2014 were retrospectively reviewed. All children met full diagnostic criteria for autonomous nodules, defined by both autonomous 123 I uptake into the nodule and the suppression of uptake in the normal thyroid parenchyma on scintigraphy performed during hypothyrotropinemia. The median age of presentation was 15 years (range 3-18 y) with a female to male ratio of 15:1. Fifty-eight percent of patients had solitary nodules and 42% had multiple nodules. The median size of each patient's largest autonomous nodule was 39 mm (range 18-67 mm). Most of the children in this series (68%) had diagnostic biopsies and/or operative pathology of their largest autonomous nodule, which showed benign cytology or histology in all cases. In this pediatric series, the cancer rate observed in biopsied or resected autonomous nodules was 0%. Whereas larger studies are needed to confirm our findings, these results agree with earlier reports suggesting that thyroid cancer is rare in rigorously defined autonomous nodules and support that conservative management may be offered to selected children who meet strict diagnostic criteria for autonomous nodules, deferring definitive therapies until adulthood when the risks of thyroidectomy and 131 I ablation are lower.

The thyroid nodule. Thyrotropin and peripheral thyroid hormones; Der Schilddruesenknoten. TSH und periphere Hormone

Energy Technology Data Exchange (ETDEWEB)

Zimny, M. [Klinikum Hanau (Germany). Inst. fuer Nuklearmedizin

2008-09-15

Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

Iodine intake as a determinant of thyroid disorders in populations

DEFF Research Database (Denmark)

Laurberg, Peter; Cerqueira, Charlotte; Ovesen, Lars

2010-01-01

Depending on the availability of iodine, the thyroid gland is able to enhance or limit the use of iodine for thyroid hormone production. When compensation fails, as in severely iodine-deficient populations, hypothyroidism and developmental brain damage will be the dominating disorders. This is, out...... of all comparison, the most serious association between disease and the level of iodine intake in a population. In less severe iodine deficiency, the normal thyroid gland is able to adapt and keep thyroid hormone production within the normal range. However, the prolonged thyroid hyperactivity associated...... with such adaptation leads to thyroid growth, and during follicular cell proliferation there is a tendency to mutations leading to multifocal autonomous growth and function. In populations with mild and moderate iodine deficiency, such multifocal autonomous thyroid function is a common cause of hyperthyroidism...

Association of parathyroid adenoma and autonomous nodule of the thyroid. Diagnostic efficacy of 201thallium-sup(99m)technetium scintigraphy

International Nuclear Information System (INIS)

Talbot, J.N.; Kiffel, T.; Duron, F.; Nordlinger, B.

1986-01-01

The thallium-technetium subtraction technique, proposed originally by Ferlin and co-workers, is now widely used to localize parathyroid adenoma. We report here the case of a hypercalcemic women, referred to our ward with the biologically assessed diagnosis of primary hyperparathyroidism. Thallium-technetium substraction scintigraphy not only successfully localized the parathyroid adenoma but alsorevealed the existence of an autonomous nodule of the thyroid, which was not suspected. It has previously been shown that this method can localize parathyroid adenoma in cases of cold thyroid nodule. This report shows that this is also true in the case of hot thyroid nodule. No observations of concomitant parathyroid adenoma and autonomous nodule of the thyroid have been reported (at least during the two past decades). Is this association casual or has it never been raticed. Further examinations can be performed with thallium when a hot thyroid is found in a hypercalcemic patient. (orig.)

Our experience with radioiodine therapy of thyroid functional autonomies

International Nuclear Information System (INIS)

Kraft, Otakar

2005-01-01

targeted radiation dose in autonomously functioning tissue. The radioiodine amount administered was based on the volume of thyroid or the nodule, 24-hours radioiodine accumulation, the effective half-life of radioiodine, the absorbed dose of 500 Gy per gram of the nodule (UFA) or 300 Gy per gram of the whole thyroid (in patients with MFA and DFA). Before radioiodine therapy an average serum levels of total thyroxine was 164.6 nmol/l, of free thyroxine 20.8 pmol/l and triiodothyronine 3.2 nmol/l, in all patients TSH was suppressed. Before therapy patient's complaints were cardiovascular in 88% of patients (tachycardia, irregular pulse, palpitation), neurological (nerves, agitation) in 72% of patients, hypermetabolic (loss of weight, intolerance of warm, perspiration) in 68% of patients and local (feeling of neck compression, swallow difficulties) in 30% of patients. After therapy the average serum levels of total thyroxine was 108.8 nmol/l, free thyroxine 12.5 pmol/l and triiodothyronine 2.0 nmol/l and improvement of symptoms in 91%, without improvement in 8.7% and worsening in 0.3% of patients. The suppression of TSH disappeared in 607 of treated patients (76%). A volume reduction of thyroid of 38% was achieved in any type of functional autonomy after radioiodine treatment. Side effects were minimal and in some patients presented as a transient neck pressure or pain and neck swelling as a manifestation of post radiation thyroiditis. Post radiation hypothyroidism was diagnosed in 36 patients (4.5%). The results of this study show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects. It is effective and for patients non-demanding. (author)

Thyroid function and obesity.

Science.gov (United States)

Laurberg, Peter; Knudsen, Nils; Andersen, Stig; Carlé, Allan; Pedersen, Inge Bülow; Karmisholt, Jesper

2012-10-01

Important interaction exists between thyroid function, weight control, and obesity. Several mechanisms seem to be involved, and in studies of groups of people the pattern of thyroid function tests depends on the balance of obesity and underlying thyroid disease in the cohort studied. Obese people with a normal thyroid gland tend to have activation of the hypothalamic-pituitary-thyroid axis with higher serum TSH and thyroid hormones in serum. On the other hand, small differences in thyroid function are associated with up to 5 kg difference in body weight. The weight loss after therapy of overt hypothyroidism is caused by excretion of water bound in tissues (myxoedema). Many patients treated for hyperthyroidism experience a gain of more weight than they lost during the active phase of the disease. The mechanism for this excessive weight gain has not been fully elucidated. New studies on the relation between L-T3 therapy and weight control are discussed. The interaction between weight control and therapy of thyroid disease is important to many patients and it should be studied in more detail.

Early recognition of autonomous thyroid tissue by a combination of quantitative thyroid pertechnetate scintigraphy with the free T4 equivalent

International Nuclear Information System (INIS)

Joseph, K.; Mahlstedt, J.; Welcke, U.

1980-01-01

A suspicion of AFTT can be raised in 80% of still euthyroid patients by a combined evaluation of an equivalent to the free T 4 (FTE) and an equavilant to the clearance using a quantitative evaluation of the thyroid technetium scan (TcTU). The suppression test not only confirms the autonomy in a qualitative manner but also provides an estimate of the volume of autonomous tissue because The TcTU after suppression strictly correlates linearly with the volume of the AFTT. Since after iodine administration FTE increases proportionally to the volume of AFTT, the procedure can be of some prognostic value: those with autonomous tissue in excess of a critical volume will almost certainly develop hyperthyroidism following a certain minimum rate of iodine administration. A prospective study of patients under age 50 whose thyroids contained various amounts of AFTT has shown that prophylactic dietary iodine supplementation will not cause hyperthyroidism to develop provided the additional iodine intake does not exceed 100 μg per day. (orig./MG) [de

Marine-Lenhart syndrome with papillary thyroid carcinoma

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Hulusi Atmaca

2015-01-01

Full Text Available Graves′ disease with accompanying functioning nodules is known as Marine-Lenhart syndrome. Autonomously functioning thyroid nodules (AFTNs also within Graves′ thyroid tissue are almost always bening in nature. A 45-year-old man developed hyperthyroidism due to the coexistence of Graves′ disease and AFTN. Total thyroidectomy was performed. The hyperfunctioning nodule with centrally hypoactive foci detected by technetium-99m thyroid scanning was histologically diagnosed as papillary thyroid carcinoma that was 2.5 cm in diameter. We report the presence of papillary thyroid carcinoma within AFTN in patients with Marine-Lenhart syndrome, which has not been reported so far.

Marine-Lenhart syndrome with papillary thyroid carcinoma.

Science.gov (United States)

Atmaca, Hulusi; Çolak, Ramis; Yazici, Zihni Acar; Kefeli, Mehmet; Tosun, Fevziye Canbaz

2015-04-01

Graves' disease with accompanying functioning nodules is known as Marine-Lenhart syndrome. Autonomously functioning thyroid nodules (AFTNs) also within Graves' thyroid tissue are almost always bening in nature. A 45-year-old man developed hyperthyroidism due to the coexistence of Graves' disease and AFTN. Total thyroidectomy was performed. The hyperfunctioning nodule with centrally hypoactive foci detected by technetium-99m thyroid scanning was histologically diagnosed as papillary thyroid carcinoma that was 2.5 cm in diameter. We report the presence of papillary thyroid carcinoma within AFTN in patients with Marine-Lenhart syndrome, which has not been reported so far.

The role of thyroid scanning in hyperthyroidism

International Nuclear Information System (INIS)

Fogelman, I.; Cooke, S.G.; Maisey, M.N.

1986-01-01

Radionuclide thyroid imaging was performed in 872 consecutive patients with hyperthyroidism. Of these, 84% were found to have diffuse toxic hyperplasia (Graves' disease), while 12% had autonomously functioning nodules (Plummer's disease), 3% had Graves' disease developing in a multinodular gland, and in the remaining 1%, either a clear diagnosis could not be established or the hyperthyroidism was due to thyroiditis or the Jod-Basedow phenomenon. It was found that a thyroid scan seldom provides additional diagnostic information in patients with Graves' disease when a diffuse goitre is present. However, if patients are to be treated with radioiodine ( 131 I), thyroid imaging with tracer quantitation can replace a 24-h 131 I uptake measurement, this having the advantages that the patients are required to attend only once, and that the gland size can be measured. In addition, visual confirmation of tracer uptake by the thyroid is obtained and patients with thyroiditis will not receive inappropriate therapy. When single or multiple thyroid nodules are palpated, a thyroid scan is crucial in establishing an accurate diagnosis, as it is not otherwise possible to differentiate between Plummer's disease and Graves' disease developing in a multinodular gland. Indeed, in 20 of our 63 patients (32%) with single autonomously functioning nodules, the initial clinical assessment had been incorrect. (orig.)

Thyroid hormone and the central control of homeostasis.

Science.gov (United States)

Warner, Amy; Mittag, Jens

2012-08-01

It has long been known that thyroid hormone has profound direct effects on metabolism and cardiovascular function. More recently, it was shown that the hormone also modulates these systems by actions on the central autonomic control. Recent studies that either manipulated thyroid hormone signalling in anatomical areas of the brain or analysed seasonal models with an endogenous fluctuation in hypothalamic thyroid hormone levels revealed that the hormone controls energy turnover. However, most of these studies did not progress beyond the level of anatomical nuclei; thus, the neuronal substrates as well as the molecular mechanisms remain largely enigmatic. This review summarises the evidence for a role of thyroid hormone in the central autonomic control of peripheral homeostasis and advocates novel strategies to address thyroid hormone action in the brain on a cellular level.

Thyroid function study

International Nuclear Information System (INIS)

Rocha, A.F.G. da

1976-01-01

A short revision of thyroid physiology is done. The radioisotopes of common use in thyroid investigation and the choice of the most appropriated ones are discussed. A table showing radioisotopes frequently used in this study, with their main characteristics is presented. Among several isotopic assays in thyroid propaedeutics, those that refer to the function study, topographic studies and tests 'in vitro' are pointed out. Exploration methods 'in vivo' are treated, such as: thyroid uptake; urinary excretion; thyroid scintigraphy, with scintigraphic imagings; stimulation test by TSH; suppression test; pbi; clearance test with perchlorate; iodine deficiency test and thyroid study with technetium. 'In vitro' proofs like triiodothyronine (T 3 ) and thyroxine (T 4 ) assays, as well as free thyroxine index, are treated. At last, the therapeutics by Iodine 131 is commented and emphasis is given to its application on the treatment of hyperthyroidism and thyroid carcinoma [pt

Neonatal thyroid screening results are related to gestational maternal thyroid function

NARCIS (Netherlands)

Kuppens, S.M.I.; Kooistra, L.; Wijnen, H.A.; Vader, H.L.; Hasaart, T.H.M.; Oei, S.G.; Vulsma, T.; Pop, V.J.

2011-01-01

Objective To study the relationship between maternal thyroid function at each pregnancy trimester and neonatal screening results. Background Overt maternal thyroid dysfunction during gestation is associated with poor neonatal thyroid function. However, research on the relationship between suboptimal

Evaluation of thyroid function tests in non-thyroidal illness

International Nuclear Information System (INIS)

Schutte, D.P.

1988-01-01

Normal thyroid physiology and pathophysiology with reference to non-thyroidal illness (NTI) is reviewed including specific disease states and drugs and their effect on thyroid function tests. The diagnostic utility of two new highly sensitive thyrotrophin (TSH) assays as screening tests for thyroid dysfunction are evaluated and compared with conventional thyroid function assays. A group of 40 patients with NTI was studied. This group was compared to a group of normal controls and a group of thyrotoxic patients. Conventional thyroid function tests yielded many values outside the reference range in the NTI group. The general pattern that emerged was decreased total triiodothyronine levels in 70% of NTI patients, normal to low thyroxine values, increased mean free thyroxine values (dialysis), low mean values for the free thyroxine index and varying results for newer commercial assays for free thyroxine according to methodology. The TSH response to intravenous thyroliberin (TRH) was found to be blunted compared to controls. Basal TSH levels were measured with two ultasensitive TSH assays. The immunoradiometric assays yielded fewer values outside the reference range in the NTI group than conventional thyroid function tests. This assay yielded undetectable basal TSH levels in all thyrotoxic patients and could reliably separate thyrotoxic patients from the NTI group. Basal TSH levels with ultrasensitive TSH assays correlated well with the TSH response to TRH (TSH) and could obviate the need for TRH tests. Ultrasensitive TSH assays are promising first line screening tests in NTI. 120 refs., 13 figs., 7 tabs

Treatment of solitary, autonomously-functioning, non-toxic thyroid nodules with I131 Adenema tiroideo autónomo no tóxico tratamiento con I131

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Federico Uribe Londoño

1991-03-01

Full Text Available

Fifteen euthyroid patients (14 women and 1man with solitary autonomously functioning non-toxic thyroid nodules (AFTN were treated with high doses of I¹³¹ (mean 19.2 mCi. Diagnosis was made by I¹³¹ thyroid scan and triiodothyronine suppression test. The size of the nodule was determined by thyroid ecography both before and after treatment. Evaluation of thyroid function was performed clinically and by T3 T4 and TSH determinations before therapy and during follow.up. AII patients had complete suppression of the surrounding thyroid parenchyma. Two cases of hypothyroidism were found in the first two years of follow-up. We have no explanation for this fact since extranodular thyroid tissue was suppressed and the patients were receiving oral triiodothyronine during radioidine treatment. The nodules decreasedin size In 9 of 13 patients followed (average decrease 45% and disappeared in other 2. our findings suggest that solitary non-toxic AFTN should be treated with I¹³¹ particularly if complete suppression of the surrounding thyroid tissue is found. If complete disappearance of the nodule is considered desirable surgical removal must be performed.

Se trataron 14 mujeres y un hombre, con adenomas tiroideos solitarios funcionalmente autónomos, no tóxicos, con I¹³¹ a una dosis promedio de 19.2 mCi. La gamagrafía tiroidea demostró hipercaptación del nódulo con supresión total del resto de la glándula. El tamaño del nódulo se determinó por medio de ecografía tiroidea antes y después del tratamiento, y su autonomía por la prueba de supresión con triyodotironina. El estado tiroideo se puso de presente clínicamente y por la medición de T3, T 4 y TSH en el plasma, antes de la terapia con el radiofármaco y durante la evolución postratamiento. En dos

Ultrasound-guided laser thermal ablation in the treatment of autonomous hyperfunctioning thyroid nodules and compressive nontoxic nodular goiter.

Science.gov (United States)

Spiezia, Stefano; Vitale, Giovanni; Di Somma, Carolina; Pio Assanti, Angelo; Ciccarelli, Antonio; Lombardi, Gaetano; Colao, Annamaria

2003-10-01

Percutaneous laser thermal ablation (LTA) has been applied in several tumors. In this study we evaluated the safety and long-term efficacy of LTA in the treatment of benign thyroid nodules. Seven patients with autonomous hyperfunctioning thyroid nodule (group A) and five patients with compressive nodular goiter (group B) were treated with LTA. Up to three needles were positioned centrally in the thyroid nodule and laser fiber was placed in the lumen of the needle. Laser illumination was performed reaching a maximal energy deposition of 1800 J per fiber. Thyroid nodule volume, endocrinologic, and clinical evaluation were performed at baseline, 3, and 12 months after the treatment. Scintigraphy was performed at diagnosis and 12 months after the first session in group A. In group A, mean thyroid volume decreased from 3.15 +/- 1.26 mL to 0.83 +/- 0.49 mL (p thyroid volume decreased from 11.14 +/- 4.99 mL to 3.73 +/- 1.47 mL (p thyroid nodules.

Impact of alcohol use on thyroid function

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Yatan Pal Singh Balhara

2013-01-01

Full Text Available Alcohol is one of the commonest illicit psychoactive substances consumed globally and is the world′s third largest risk factor for disease and disability. It has been reported to have multiple effects on the hypothalamo-pituitary-thyroid axis and the functioning of the thyroid gland. It has been reported to cause direct suppression of thyroid function by cellular toxicity, and indirect suppression by blunting thyrotropin-releasing hormone response. It causes a decrease of peripheral thyroid hormones during chronic use and in withdrawal. Alcohol use may also confer some protective effect against thyroid nodularity, goiter, and thyroid cancer. This article presents a review of the clinically relevant effects of alcohol on the functioning of the thyroid gland and also discusses the effect of medication used in treatment of alcohol dependence on thyroid function.

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

DEFF Research Database (Denmark)

Biondi, Bernadette; Bartalena, Luigi; Cooper, David S

2015-01-01

Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective...

Pemphigus Vulgaris with Solitary Toxic Thyroid Nodule

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Mostafa Alfishawy

2014-01-01

Full Text Available Background. Pemphigus vulgaris is an autoimmune vesiculobullous disease, affecting the skin and mucous membranes. It is reported to be associated with other autoimmune diseases including autoimmune thyroid diseases. However we report herein a case of pemphigus vulgaris associated with autonomous toxic nodule. Case Presentation. A 51-year-old woman was evaluated for blisters and erosions that develop on her trunk, face, and extremities, with a five-year history of progressively enlarging neck mass, and a past medical history of pemphigus vulgaris seven years ago. The condition was associated with palpitation, dyspnea, and heat intolerance. Thyroid function tests and thyroid scan were compatible with the diagnosis of thyrotoxicosis due to autonomous toxic nodule. Exacerbation of pemphigus vulgaris was proved by skin biopsy from the patient which revealed histologic picture of pemphigus vulgaris. Conclusion. Autoimmune thyroid diseases are reported to associate pemphigus vulgaris. To our knowledge, this case is the first in the English literature to report association between pemphigus vulgaris and autonomous toxic nodule and highlights the possibility of occurrence of pemphigus vulgaris with a nonautoimmune thyroid disease raising the question: is it just a coincidence or is there an explanation for the occurrence of both conditions together?

Ultrasonographic evaluation of Hashimoto's thyroiditis: Comparison of size and echo change with thyroid function

International Nuclear Information System (INIS)

Lee, Kang Rae; Cho, Jae Hyun; Kim, Yun Jeong; Kim, Hyun Man; Park, Rae Woong; Suh, Jung Ho; Kang, Byung Chul

1999-01-01

To demonstrate sonographic features of Hashimoto's thyroiditis according to the thyroid function. We reviewed 54 thyroid ultrasonographic examinations of untreated Hashimoto's thyroiditis. We reviewed thyroid ultrasonographic examinations and focused on the presence of ill-defined low echoic lesions and glandular enlargement. We performed another thyroid ultrasonographic examination of 14 healthy volunteers, in order to obtain normal size of thyroid gland. Comparison was made between these morphologic characteristics and functional stage of the disease. The mean diameter of thyroid gland was 2.16 ± 0.43 cm in patients with Hashimoto's thyroiditis, and 1.41 ± 0.42 cm in normal control group of the thyroid gland. There was no statistically significant relationship between thyroid function and size. There was morphologic abnormalities in 46 patients (85%). Among them, 7 patients revealed diffuse low echogenicity in the entire thyroid gland, 32 patients showed peripherally located, ill-defined focal hypoechoic lesion, and 7 patients showed solitary or multiple. well-defined nodular lesions. Decreased echogenicity of the thyroid gland was related to hypothyroid status. Hashimoto's thyroiditis has specific morphologue characteristics in ultrasonographic features, which are well correlated with thyroid function.

Thyroid Function and Cognition during Aging

Directory of Open Access Journals (Sweden)

M. E. Bégin

2008-01-01

Full Text Available We summarize here the studies examining the association between thyroid function and cognitive performance from an aging perspective. The available data suggest that there may be a continuum in which cognitive dysfunction can result from increased or decreased concentrations of thyroid hormones. Clinical and subclinical hypothyroidism as well as hyperthyroidism in middle-aged and elderly adults are both associated with decreased cognitive functioning, especially memory, visuospatial organization, attention, and reaction time. Mild variations of thyroid function, even within normal limits, can have significant consequences for cognitive function in the elderly. Different cognitive deficits possibly related to thyroid failure do not necessarily follow a consistent pattern, and L-thyroxine treatment may not always completely restore normal functioning in patients with hypothyroidism. There is little or no consensus in the literature regarding how thyroid function is associated with cognitive performance in the elderly.

In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

Energy Technology Data Exchange (ETDEWEB)

Spesshardt, K. (Sankt-Vincentius-Krankenhaeuser, Karlsruhe (Germany, F.R.). Radiologische Abt. mit Strahlentherapie und Nuklearmedizin)

1980-10-15

In-vivo diagnoses of thyroid diseases can be carried out using /sup 123/I, /sup 131/I, and /sup 99/sup(m)Tc-pertechnetate. For the thyroid scintiscan, /sup 99/sup(m)Tc-pertechnetate or /sup 123/I are used. Some functional parameters can be determined using /sup 99/sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with /sup 123/I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using /sup 131/I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited.

In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

International Nuclear Information System (INIS)

Spesshardt, K.

1980-01-01

In-vivo diagnoses of thyroid diseases can be carried out using 123 I, 131 I, and 99 sup(m)Tc-pertechnetate. For the thyroid scintiscan, 99 sup(m)Tc-pertechnetate or 123 I are used. Some functional parameters can be determined using 99 sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with 123 I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using 131 I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited. (orig./MG) [de

Environmental chemicals and thyroid function

DEFF Research Database (Denmark)

Boas, Malene; Main, Katharina M; Feldt-Rasmussen, Ulla

2009-01-01

PURPOSE OF REVIEW: To overview the effects of endocrine disrupters on thyroid function. RECENT FINDINGS: Studies in recent years have revealed thyroid-disrupting properties of many environmentally abundant chemicals. Of special concern is the exposure of pregnant women and infants, as thyroid...

The clinician and the thyroid

Energy Technology Data Exchange (ETDEWEB)

Biersack, H.J.; Hotze, A. (Bonn Univ. (Germany, F.R.). Inst. fuer Klinische und Experimentelle Nuklearmedizin)

1991-09-01

The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a miner role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases. (orig.).

The clinician and the thyroid

International Nuclear Information System (INIS)

Biersack, H.J.; Hotze, A.

1991-01-01

The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a miner role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases. (orig.)

Thyroid disorders in mild iodine deficiency

DEFF Research Database (Denmark)

Laurberg, P; Nøhr, S B; Pedersen, K M

2000-01-01

in elderly subjects, especially women, with risk of cardiac arrhythmias, osteoporosis, and muscle wasting. The hyperthyroidism is caused by autonomous nodular growth and function of the thyroid gland and it is accompanied by a high frequency of goiter. Pregnant women and small children are not immediately...... endangered but the consequences of severe iodine deficiency for brain development are grave and a considerable safety margin is advisable. Moreover, a shift toward less malignant types of thyroid cancer and a lower radiation dose to the thyroid in case of nuclear fallout support that mild-to-moderate iodine...

Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

OpenAIRE

Luca Giovanella; Fabrizio Fasolini; Sergio Suriano; Luca Mazzucchelli

2010-01-01

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the 9 9 m T c -pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissu...

Thyroid nodules, thyroid function and dietary iodine in the Marshall islands.

Science.gov (United States)

Takahashi, T; Fujimori, K; Simon, S L; Bechtner, G; Edwards, R; Trott, K R

1999-08-01

Thyroid nodules have been found to be common in the population of the Marshall Islands. This has been attributed to potential exposure of radioiodines from the nuclear weapons tests on Bikini and Eniwetok between 1946 and 1958. In order to get a full picture of thyroid pathology in the Marshallese population potentially exposed to radioactive fallout we performed a large thyroid screening programme using palpation, high resolution ultrasound and fine needle biopsies of palpable nodules. In addition, various parameters of thyroid function (free T3, free T4, thyroid stimulating hormone [TSH]) and anti-thyroid antibodies were examined in large proportions of the total population at risk. Since dietary iodine deficiency is an established risk factor for thyroid nodules, iodine concentration in urine samples of 362 adults and 119 children was measured as well as the iodine content of selected staple food products. The expected high prevalence of thyroid nodules was confirmed. There was no indication of an increased rate of impaired thyroid function in the Marshallese population. A moderate degree of iodine deficiency was found which may be responsible for some of the increased prevalence of thyroid nodules in the Marshallese population. Studies on the relationship between exposure to radioiodines and thyroid nodules need to take dietary iodine deficiency into account in the interpretation of findings.

[Thyroid nodule].

Science.gov (United States)

Clerc, Jérôme

2005-01-31

The thyroid nodule is a frequent, most often benign, chronic, multifocal and slowly progressive disease. The first line strategy is to diagnose cancerous nodules (thyroid nodules is controversial since the prognosis of thyroid cancer is excellent for lesions measuring less than 20 mm. Though imaging accuracy is quite limited in assessing the diagnosis of thyroid cancer, both ultrasounds (US) and thyroid scan are helpful to enhance nodular identification (>30%), to sort the nodules relevant for cytological sampling and to optimize the follow-up, the major source of health costs. Suspicious and non contributive FNAs must have a control FNA within 6 months. Nodules with a non suspicious FNA (>85%) require long term follow-up. This follow-up is mainly morphological. New or evolutive nodules, as assessed by palpation or US, will require iterative FNAs or should be considered for surgery. In patients with hyperfunctioning nodules on the scan (10 to 20%), a yearly evaluation of the TSH level is sufficient. These nodules account either for autonomously functioning ones, which slowly develop towards thyrotoxicosis, or for hyperplastic nodules frequently disclosing a lymphocytic thyroiditis. Morbidity due to thyroid autonomy is still underestimated especially in aging patients with TSH levels thyroid nodule is suggested.

Congenital leptin deficiency and thyroid function

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Paz-Filho Gilberto

2009-11-01

Full Text Available Abstract Thyroid function is closely related to leptin's secretion by the adipose tissue. In states of leptin-deficiency, the circadian rhythm of TSH is altered, leading to central hypothyroidism in animal models. In humans, central hypothyroidism has also been described in rare cases of congenital leptin deficiency. However, the thyroid phenotype in these cases is heterogeneous, with the occurrence of central hypothyroidism in a minority of cases. Here we describe thyroid function in four leptin-deficient humans (2 males aged 5 and 27, and 2 females aged 35 and 40, before and during leptin replacement with recombinant human methionyl leptin (r-metHuLeptin. The child was evaluated for four years, and the adults, for eight years. In addition, the adults were submitted to a brief withdrawal of leptin during six weeks in the sixth year. Our results show that, regardless of leptin replacement, our leptin-deficient patients have normal thyroid function. In spite of having an important role in regulating the hypothalamic-pituitary-thyroidal axis, leptin is not required for normal thyroid function. Trial Registration ClinicalTrials.gov Identifiers: NCT00659828 and NCT00657605

Cardiovascular Disease and Thyroid Function

DEFF Research Database (Denmark)

Faber, Jens; Selmer, Christian

2014-01-01

Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...... at the cellular level. Subclinical hyperthyroidism is associated with increased left ventricular mass of the heart, which reverts after obtaining euthyroidism. Mortality and risk of major cardiovascular events are increased. Subclinical hypothyroidism is also associated with subtle changes in the heart, e.g. its...

Clinical evaluation of echography in diagnosis of thyroid disease

International Nuclear Information System (INIS)

Fritzsche, H.; Braendle, J.

1983-01-01

In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves' disease

International Nuclear Information System (INIS)

Dederichs, B.; Otte, R.; Klink, J.E.; Schicha, H.

1996-01-01

Aim: It is well known that radioiodine therapy (RITh) leads to a significant thyroid volume reduction (TVR). But until now only little data has been presented due to the course of time and the extent of TVR. Method: Therefore the data of 33 patients with Graves' disease (GD), 36 patients with multifocal (MAG) and 31 with solitary (SAG) autonomous goitre were analyzed retrospectively. Results: All the patients showed a highly significant (p [de

Ultrasonographic evaluation of Hashimoto's thyroiditis: Comparison of size and echo change with thyroid function

Energy Technology Data Exchange (ETDEWEB)

Lee, Kang Rae; Cho, Jae Hyun; Kim, Yun Jeong; Kim, Hyun Man; Park, Rae Woong; Suh, Jung Ho [Aju University School of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

1999-12-15

To demonstrate sonographic features of Hashimoto's thyroiditis according to the thyroid function. We reviewed 54 thyroid ultrasonographic examinations of untreated Hashimoto's thyroiditis. We reviewed thyroid ultrasonographic examinations and focused on the presence of ill-defined low echoic lesions and glandular enlargement. We performed another thyroid ultrasonographic examination of 14 healthy volunteers, in order to obtain normal size of thyroid gland. Comparison was made between these morphologic characteristics and functional stage of the disease. The mean diameter of thyroid gland was 2.16 {+-} 0.43 cm in patients with Hashimoto's thyroiditis, and 1.41 {+-} 0.42 cm in normal control group of the thyroid gland. There was no statistically significant relationship between thyroid function and size. There was morphologic abnormalities in 46 patients (85%). Among them, 7 patients revealed diffuse low echogenicity in the entire thyroid gland, 32 patients showed peripherally located, ill-defined focal hypoechoic lesion, and 7 patients showed solitary or multiple. well-defined nodular lesions. Decreased echogenicity of the thyroid gland was related to hypothyroid status. Hashimoto's thyroiditis has specific morphologue characteristics in ultrasonographic features, which are well correlated with thyroid function.

Challenges in interpretation of thyroid function tests in pregnant women with autoimmune thyroid disease

DEFF Research Database (Denmark)

Feldt-Rasmussen, Ulla; Bliddal, Sofie; Rasmussen, Åse Krogh

2011-01-01

Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable...... for thyroid dysfunction also in pregnancy. However, using serum TSH for control of treatment of maternal thyroid autoimmunity infers a risk for compromised foetal development. Peripheral thyroid hormone values are highly different among laboratories, and there is a need for laboratory-specific gestational age......-related reference ranges. Equally important, the intraindividual variability of the thyroid hormone measurements is much narrower than the interindividual variation (reflecting the reference interval). The best laboratory assessment of thyroid function is a free thyroid hormone estimate combined with TSH...

The Link between Thyroid Function and Depression

Directory of Open Access Journals (Sweden)

Mirella P. Hage

2012-01-01

Full Text Available The relation between thyroid function and depression has long been recognized. Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities. Traditionally, the most commonly documented abnormalities are elevated T4 levels, low T3, elevated rT3, a blunted TSH response to TRH, positive antithyroid antibodies, and elevated CSF TRH concentrations. In addition, thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressant drugs. However, the mechanisms underlying the interaction between thyroid function and depression remain to be further clarified. Recently, advances in biochemical, genetic, and neuroimaging fields have provided new insights into the thyroid-depression relationship.

The effect of excessive iodine diet on thyroid function

International Nuclear Information System (INIS)

Wang Yuhua; Li Yaming

2009-01-01

The modify of the thyroid cell structure can be induced by excessive iodine diet. Then the disordered thyroid function can result in a number of thyroid disease. The radionucline thyroid imaging play an important role in diagnoses of thyroid. Amplify on the effect of excessive diet on thyroid function will be worthy instructing what preparation should do before doing the thyroid nuclide imaging. (authors)

Post Partum Depression and Thyroid Function

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Farahnaz Keshavarzi MD

2011-09-01

Full Text Available Objective: Risk of depression is particularly high for women during the prenatal period. Various investigators have attempted to establish a link between thyroid function and post partum depression. This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.Methods: In this case-control study, subjects were selected from Obstetrics & Gynecology and Psychiatric clinics of Kermanshah University of Medical Sciences. Forty eight patients suffering from postpartum depression according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR, and 65 normal controls underwent diagnostic evaluation by one trained psychiatrist using Structured Clinical Interview for DSM-IV-TR. Then, the demographic questionnaire and the Persian version of Edinburgh Postnatal Depression Scale (EPDS were completed by the participants. Finally, their thyroid functions were assessed. Data analyses were done using the SPSS program 13.Results: No statistically significant differences were observed between thyroid function tests and postpartum depression. According to multiple regression analysis with stepwise method, subjects with lower serum TSH, T3RU, T3 levels, younger age and longer period after delivery tended to have higher EPDS scores (P-value=0.008. Conclusion:The present study reports that those women with postpartum depression had a no greater prevalence of thyroid dysfunction than the control subjects. It seems that thyroid dysfunction should be considered in women with postpartum depression individually, but the role of thyroid as an important cause of this condition is not yet established. This suggests that future studies should concentrate on this concept in postpartum depression.

Sonographic decreased echogenicity of thyroid parenchyma in asymptomatic population: Correction with thyroid function and thyroid autoimmune activity

Energy Technology Data Exchange (ETDEWEB)

Park, Ji Yeon; Park, Noh Hyuck; Park, Chan Sub; Lee, Ji Ye [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Chun, Kyung Ah [Dept. of Radiology, Catholic Kwandong University School of Medicine, Gangneung (Korea, Republic of); Yi, Seong Yoon [Div. of Hematology-Oncology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of); Park, Hee Jin [Dept. of of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

2016-09-15

The aim of the study was to evaluate the correlation between decreased echogenicity of thyroid and thyroid hormones or autoantibodies. From January 2009 to December 2011, 543 patients with decreased parenchymal echogenicity [M:F = 133:410, median age: 42 years (range: 9-82 years)], who did not have solid nodule, symptom or medication related to thyroid and underwent thyroid function test were retrospectively reviewed. Images were classified based on the degree of hypoechogenicity, heterogenicity or thyroid size. 1) Group A: mild decreased echogenicity, group B: marked decreased echogenicity, 2) group Ho: homogeneous echogenicity, group He: heterogeneous echogenicity, 3) group 1: decreased size, group 2: normal size, group 3: increased size. Differences in triiodiothyronyne (T3), free-thyroxine (fT4), thyrotropin (TSH), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and anti-TSH receptor antibody (TSH-rAb) were evaluated among groups. T3, fT4, and TSH levels differed between groups A and B (p < 0.001, p = 0.001, p < 0.001). TgAb and TPOAb of group B were higher than group A (p = 0.006, p < 0.001). TPOAb of group He was higher than group Ho (p < 0.001). TSH-rAb and TPOAb of group 3 were higher than group 2 (p = 0.017, p < 0.001). The patients with findings of markedly decreased, heterogeneous echogenicity or thyroid enlargement may have abnormal thyroid function and autoantibodies. These may facilitate the physicians' decision to order tests for thyroid function and autoimmune activity.

Grading of methods of thyroid diagnosis

Energy Technology Data Exchange (ETDEWEB)

Pfannenstiel, P [Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany, F.R.). Fachbereich Nuklearmedizin

1980-09-24

After anamnesis and physical examination, the first step in thyroid diagnosis is the determination of serum thyroxine, if necessary together with a parameter to determine the free thyroxine. If the findings are still unclear and if hypo- or hyperthyroidism are suspected, triiodothyronine determination, the TSH-TRH test, and in some cases also the two-phase radioiodine test are applied. The functional diagnosis is supplemented by thyroid scintiscanning, with the aid of short-lived radionuclides, e.g. /sup 99/sup(m)Tc-O/sub 4/ or /sup 123/I. If an autonomous transformation of part of the thyroid is suspected, scintiscanning is repeated after suppression of the thyroid by thyroid hormone. If scintiscanning has shown a cold area inside the thyroid, biopsy followed by a cytological evaluation of the aspirate is indicated. Depending on the suspected clinical diagnosis, the available tests should be used carefully and efficiently for the initial diagnosis as well as for course control of thyroid diseases.

Functional scintigraphy of the thyroid

International Nuclear Information System (INIS)

Baehre, M.; Emrich, D.

1983-01-01

In order to obtain more diagnostic information by thyroid scintigraphy we used a gamma camera with a high resolution collimator and a computer. This led to an improvement of thyroid scintigrams and their documentation. Additionally it allowed to obtain values for global and regional uptake of pertechnetate before and under suppression. The usefulness of this method was proven by investigation of 50 individuals with normal thyroid function and 32 euthyroid patients with pathological suppressibility in an area of iodine deficiency. In normals global thyroid uptake and its suppression correlated with the FT 4 I and Δ TSH after TRH in dependence of their iodine excretion. Three types of pathological reaction under suppression could be delineated: 1. pure focal autonomy, 2. generalized (disseminated) autonomy, 3. combined focal and disseminated autonomy. The means of Δ TSH decreased stepwise from group 1 to 3 indicating increasing autonomy. The method is predominantly helpful to detect autonomy in euthyroid goitre. It is superior to qualitative evaluation of scintigrams. Additionally it is useful for decisions in therapy, especially for functionally orientated operation. (orig.) [de

Kinetic studies of triiodothyronine (T3) in subjects with autonomous thyroid nodule using specific antiserum for the determination of labelled T3 in plasma

International Nuclear Information System (INIS)

Bianchi, R.; Zucchelli, G.C.; Giannessi, D.; Pilo, A.; Toni, M.G.; Carpi, A.

1976-01-01

The triiodothyronine (T 3 ) kinetics have been evaluated using a 125 I-T 3 and single injection technique; five patients with autonomously functioning thyroid nodule clinically euthyroid, one hypothyroid patient and three control subjects have been studied. Serum-labelled T 3 concentration has been measured by a new method based on extraction of the hormone on small Sephadex G-25 columns, followed by elution with specific antiserum. The analysis of experimental data has been performed using noncompartmental treatment (integral approach). Single compartment analysis of the same data has been also done and results presented for comparison. Average value of metabolic clearance rate was 26.0 1/day in control subjects while larger values (range 28.9 - 53.4 1/day) were found in patients with autonomous nodule and total inhibition of extranodular parenchyma

Thyroid function after mantle irradiation in Hodgkin's disease

International Nuclear Information System (INIS)

Smith, R.E. Jr.; Adler, R.A.; Clark, P.; Brinck-Johnsen, T.; Tulloh, M.E.; Colten, T.

1981-01-01

The thyroid function of 64 patients with Hodgkin's disease who received mantle irradiation during the period 1966 to 1976 was studied. More than two-thirds (44 to 64) had some thyroid dysfunction. Twenty had mild dysfunction manifested by an abnormal thyroid-stimulating hormone response to thyrotropin-releasing hormone. Twenty had what could be termed compensated hypothyroidism while four were overtly hypothyroid. The severity of dysfunction was not related to age, sex, or chemotherapy. We found, however, that decreased thyroid function was inversely proportional to the length of time between a diagnostic lymphangiogram and the radiation therapy. These results are consistent with the hypothesis that the iodine load of the lymphangiogram renders the thyroid gland more radiosensitive. Thyroxine suppression of the thyroid gland during the period from the lymphangiogram through the termination of radiation therapy is suggested as a means of avoiding thyroid injury

Thyroid Function after Subtotal Thyroidectomy in Patients with Graves' Hyperthyroidism

NARCIS (Netherlands)

Limonard, E. J.; Bisschop, P. H.; Fliers, E.; Nieveen van Dijkum, E. J.

2012-01-01

Background. Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy. Aim. To evaluate thyroid function after subtotal thyroidectomy for Graves'

Thyroid function testing in women who had a stillbirth

NARCIS (Netherlands)

Nijkamp, Janna W.; Korteweg, Fleurisca J.; Groen, Henk; Timmer, Albertus; Van den Berg, Gerrit; Bossuyt, Patrick M.; Mol, Ben Willem J.; Erwich, Jan Jaap H. M.

ContextThyroid dysfunction is thought to be associated with stillbirth. Therefore, thyroid function is often recommended in the diagnostic investigations for stillbirth. ObjectiveWe aimed to evaluate the added value of thyroid function testing in the diagnostic investigations for stillbirth. Design

Hyperfunctioning solid/trabecular follicular carcinoma of the thyroid gland.

Science.gov (United States)

Giovanella, Luca; Fasolini, Fabrizio; Suriano, Sergio; Mazzucchelli, Luca

2010-01-01

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the (99m)Tc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

Challenges in interpretation of thyroid function tests in pregnant women with autoimmune thyroid disease

DEFF Research Database (Denmark)

Feldt-Rasmussen, Ulla; Bliddal, Sofie; Rasmussen, Åse Krogh

2011-01-01

Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable....... Measurement of antithyroperoxidase and/or TSH receptor antibodies adds to the differential diagnosis of autoimmune and nonautoimmune thyroid diseases....... for thyroid dysfunction also in pregnancy. However, using serum TSH for control of treatment of maternal thyroid autoimmunity infers a risk for compromised foetal development. Peripheral thyroid hormone values are highly different among laboratories, and there is a need for laboratory-specific gestational age...

Is there still a role for thyroid scintigraphy in the workup of a thyroid nodule in the era of fine needle aspiration cytology and molecular testing? [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Rodrigo Moreno-Reyes

2016-04-01

Full Text Available Thyroid scintigraphy is now rarely used in the work-up of a thyroid nodule except in the presence of a low TSH value. Therefore, autonomously functioning thyroid nodules (AFTNs with a normal TSH value are diagnosed only in the rare medical centers that continue to use thyroid scan systematically in the presence of a thyroid nodule. In this review, we discuss the prevalence of AFTN with a normal TSH level and the possible consequences of performing fine needle aspiration cytology (FNAC in an undiagnosed AFTN. We also discuss the risk of malignant AFTN which may be higher than previously stated.

Role of Estrogen in Thyroid Function and Growth Regulation

Directory of Open Access Journals (Sweden)

Ana Paula Santin

2011-01-01

Full Text Available Thyroid diseases are more prevalent in women, particularly between puberty and menopause. It is wellknown that estrogen (E has indirect effects on the thyroid economy. Direct effects of this steroid hormone on thyroid cells have been described more recently; so, the aim of the present paper was to review the evidences of these effects on thyroid function and growth regulation, and its mechanisms. The expression and ratios of the two E receptors, α and β, that mediate the genomic effects of E on normal and abnormal thyroid tissue were also reviewed, as well as nongenomic, distinct molecular pathways. Several evidences support the hypothesis that E has a direct role in thyroid follicular cells; understanding its influence on the growth and function of the thyroid in normal and abnormal conditions can potentially provide new targets for the treatment of thyroid diseases.

Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

Directory of Open Access Journals (Sweden)

Luca Giovanella

2010-01-01

Full Text Available A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the 99mTc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

SELENIUM SUBSTITUTION – EFFECT ON THYROID FUNCTION

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Milica Pešić

2015-03-01

Full Text Available The understanding of the essential role of selenium (Se in thyroid hormone synthesis, metabolism and action, as well as normal thyroid function, increased during the past decades. The thyroid gland is among the human tissues with the highest Se content per mas unit, similar to other endocrine organs and brain. Biological actions of Se are mediated, in most cases, through the expression of at least 30 selenoproteins coded by 25 selenoprotein genes in the human. Via the selenoproteins, selenium can influence the cell function through antioxidant activites, modifying redox status and thyroid hormone synthesis and metabolism. Selenoproteins iodothyronine deiodinases are present in most tissues and have a role to increase the production of bioactive tri-iodothyronine. Futhermore, Se has been shown to be important in the regulation of immune function. Se deficiency is accompained by the loss of immune competence. The links between Se deficiency, altered immune function and inflamation have prompted studies in humans to examine if Se suplementation can modify auto-antibodies production in patients with chronic autoimmune thyroiditis. Until now, several randomised prospective clinical trials have been performed in patients with established chronic autoimmune thyrioditis. The clinical endpoint of each study was the decrease in TPO antibodies concentration after 3-12 months of treatment. Ussualy, the dosage of daily Se supplementation was 200µg. Selenium suplemetation had no significant effect on the concentration of TSH or thyroid hormone concentrations. These studies indicate that Se treatment result in reduced inflammatory activity, but it does not cure chronc autoimmune process.

Do thyroid-stimulating immunoglobulins cause non-toxic and toxic multinodular goitre

International Nuclear Information System (INIS)

Brown, R.S.; Jackson, I.M.D.; Pohl, S.L.; Reichlin, S.

1978-01-01

The prevalence of serum thyroid-stimulating immunoglobulins, (T.S.I.) in a variety of thyroid diseases was determined in 96 patients and 35 normal controls. Significantly elevated levels of T.S.I. were found not only in patients with Graves' disease and Hashimoto's thyroiditis but also in those with non-toxic and multinodular goitre, whereas patients with a single autonomously functioning thyroid nodule, with subacute thyroiditis, and with 'hyperthyroiditis' had levels which did not differ from those in the controls. it is postulated that non-toxic multinodular goitre, like Graves' disease, may result from increased circulating T.S.I. which in some cases may be present in sufficient concentration to cause thyrotoxicosis. (author)

Autonomous functioning of the goitre

International Nuclear Information System (INIS)

Emrich, D.

1994-01-01

The article summarizes the status of knowledge on functional autonomy of the thyroid gland from the standpoint of definition, pathogenesis, pathophysiology, epidemiology, diagnostics and treatment. (orig.) [de

Thyroid function and thyroid antibodies in recurrent miscarriage women

International Nuclear Information System (INIS)

Zahran, A. B. H.

2010-01-01

The aim of this study is to determine thyroid status in recurrent miscarriage Sudanese women and to determine the association between thyroid antibodies and miscarriage. The study included patients attending obstetrics and gynecology unit at Khartoum teaching hospital and Omdurman New hospital since June 2008 to Jan 2009, these patients were complaining of vaginal bleeding. Sixty, apparently healthy pregnant women with history of unexplained recurrent miscarriages during the first trimester, their ages ranged between 20 and 45 years were selected as target group. Forty healthy, normal pregnant women of the same gestational age and known to reach term and had healthy labor, patients with age ranged between 17 and 41 years were selected from (SAEC), referral clinic center at Khartoum Teaching and Omdurman New Hospitals as control group. The two groups were physically examined and their thyroid glands were seen by the physician. Questionnaires were completed for all the subjects. Patients with metabolic or endocrinologic disorders, genital organ anamoly, uterine myoma, mal nourishment or exposed to toxic substances were excluded from the study. Five ml of venous blood samples were collected from the target and control subjects. Thyroid function test and thyroid antibodies (TT 4 , TT 3 , FT 4 , FT 3 , TSH, TPO-Ab and Tg-Ab) were measured for the two groups (target and control ) using RIA technique. The results of this study showed that there was a significant decrease decrease in the concentrations of thyroid hormones (TT 4 and TT 3 ) in the target group (p-value = 0.0001 and 0.004 respectively) compared with the control group. Moreover, there was a significant elevation in the concentration of TSH in the target group (p- value = 0.0001). The free T-4 concentration was lower but not significant in the target group (p-value=0.075), FT 3 level was similar in both groups (p-value = 0.591). The presence of abnormal high concentrations of TT 4 in control and target groups

Two novel mutations in the sixth transmembrane segment of the thyrotropin receptor gene causing hyperfunctioning thyroid nodules.

Science.gov (United States)

Gozu, Hulya; Avsar, Melike; Bircan, Rifat; Claus, Maren; Sahin, Serap; Sezgin, Ozlem; Deyneli, Oguzhan; Paschke, Ralf; Cirakoglu, Beyazit; Akalin, Sema

2005-04-01

Autonomously functioning thyroid nodules (AFTNs) can present as hyperfunctioning adenomas or toxic multinodular goiters. In the last decade, a large number of activating mutations have been identified in the thyrotropin receptor (TSHR) gene in autonomously functioning thyroid nodules. Most have been situated close to, or within the sixth transmembrane segment and third intracellular loop of the TSHR where the receptor interacts with the Gs protein. In this study we describe two novel mutations in the sixth transmembrane segment of the TSHR causing hyperfunctioning thyroid nodules. Genomic DNAs were isolated from four hyperfunctioning thyroid nodules, normal tissues and peripheral leukocytes of two patients with toxic multinodular goiter. After amplifying the related regions, TSHR and G(s)alpha genes were analyzed by single-strand conformation polymorphism (SSCP) analysis. The precise localization of the mutations was identified by automatic DNA sequence analysis. Functional studies were done by site-directed mutagenesis and transfection of a mutant construct into COS-7 cells. We identified two novel TSHR mutations in two hyperfunctioning thyroid nodules: Phe631Val in the first patient and Iso630Met in the second patient. Both mutant receptors display an increase in constitutive stimulation of basal cyclic adenosine monophosphate (cAMP) levels compared to the wild-type receptor. This confirms that these mutant receptors cause hyperfunctioning thyroid nodules.

Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function

Directory of Open Access Journals (Sweden)

Jia Liu

2018-04-01

Full Text Available BackgroundHypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism.MethodsA total of 5,608 non-obese individuals including 1,402 AIT patient and 4,206 sex-, age-, and body mass index (BMI-matched healthy controls were recruited.ResultsThe AIT patients had significantly lower free T3 and free T4 levels, and higher TSH, antithyroid peroxidase antibodies (TPOAb and TgAb levels. The elevated levels of high sensitivity C reactive protein (hsCRP and homeostasis model assessment of insulin resistance (HOMA-IR were observed in the AIT patients than the controls [hsCRP: 0.65 (0.27–1.33 vs. 0.20 (0.03–0.74 mg/L; HOMA-IR: 2.78 ± 1.60 vs. 2.33 ± 1.49; all P < 0.05]. Thyroid function was not associated with metabolic parameters and inflammatory makers, while the TPOAb titer was positively associated with the HOMA-IR and hsCRP levels after adjustment for confounding factors (all P < 0.05. Multivariate regression analysis demonstrated that the TPOAb level was an independent influencing factor for the HOMA-IR and hsCRP levels (HOMA-IR: β = 0.058, P < 0.05; hsCRP: β = 0.108, P < 0.05.ConclusionThe TPOAb level is associated with HOMA-IR and hsCRP levels independently of thyroid function in non-obese individuals. Mild deviation of thyroid function within the normal range, chronic inflammation, and insulin resistance may be the links between AIT and atherosclerosis in the non-obese population.

Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

Science.gov (United States)

Garberoglio, Sara; Testori, Ornella

2016-01-01

A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue and displays the differential accumulation of radionuclides in the investigated cells, thus providing a functional map. Moreover, this technique is a fundamental tool in the clinical and surgical management of thyroid diseases, including: single thyroid nodules with a suppressed thyroid-stimulating hormone level, for which fine-needle aspiration biopsy (FNAB) is used to identify hot nodules; multinodular goiters, especially larger ones, to identify cold or indeterminate areas requiring FNAB and hot areas that do not need cytologic evaluation, and to evaluate mediastinal extension; the diagnosis of ectopic thyroid tissue; subclinical hyperthyroidism to identify occult hyperfunctioning tissue; follicular lesions to identify a functioning cellular adenoma that could be benign, although such nodules are mostly cold on scintigraphy; to distinguish low-uptake from high-uptake thyrotoxicosis, and to determine eligibility for radioiodine therapy. © 2016 S. Karger AG, Basel.

Thyroid peroxidase antibodies in pregnant women with type 1 diabetes: impact on thyroid function, metabolic control and pregnancy outcome

DEFF Research Database (Denmark)

Vestgaard, Marianne; Nielsen, Lene Ringholm; Rasmussen, Åse Krogh

2008-01-01

In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome.......In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome....

Preoperative thyroid function and weight loss after bariatric surgery.

Science.gov (United States)

Neves, João Sérgio; Souteiro, Pedro; Oliveira, Sofia Castro; Pedro, Jorge; Magalhães, Daniela; Guerreiro, Vanessa; Costa, Maria Manuel; Bettencourt-Silva, Rita; Santos, Ana Cristina; Queirós, Joana; Varela, Ana; Freitas, Paula; Carvalho, Davide

2018-05-16

Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Patients with a history of thyroid disease, treatment with thyroid hormone or antithyroid drugs and those with preoperative evaluation consistent with overt hypothyroidism or hyperthyroidism were excluded. The preoperative levels of TSH and FT4 were not associated with weight loss after bariatric surgery. The variation of FT3 within the reference range was also not associated with weight loss. In contrast, the subgroup with FT3 above the reference range (12.3% of patients) had a significantly higher excess weight loss than patients with normal FT3. This difference remained significant after adjustment for age, sex, BMI, type of surgery, TSH and FT4. In conclusion, we observed an association between high FT3 and a greater weight loss after bariatric surgery, highlighting a group of patients with an increased benefit from this intervention. Our results also suggest a novel hypothesis: the pharmacological modulation of thyroid function may be a potential therapeutic target in patients undergoing bariatric surgery.

Does selenium supplementation affect thyroid function?

DEFF Research Database (Denmark)

Winther, Kristian Hillert; Bonnema, Steen Joop; Cold, Frederik

2015-01-01

OBJECTIVE: Selenium is present in the active site of proteins important for thyroid hormone synthesis and metabolism. The objective of this study is to investigate the effect of selenium supplementation in different doses on thyroid function, under conditions of suboptimal dietary selenium intake....... DESIGN: The Danish PREvention of Cancer by Intervention with SElenium pilot study (DK-PRECISE) is a randomized, double-blinded, placebo-controlled trial. A total of 491 males and females aged 60-74 years were randomized to 100 μg (n=124), 200 μg (n=122), or 300 μg (n=119) selenium-enriched yeast......=0.015), respectively, per 100 μg/day increase, with insignificant differences between 6 months and 5 years. No significant effects were found for FT3 and FT3:FT4 ratio. CONCLUSIONS: In euthyroid subjects, selenium supplementation minutely and dose-dependently affects thyroid function, when compared...

Correlation of Thyroid Functions with Severity and Outcome of ...

African Journals Online (AJOL)

During normal pregnancy, changes in thyroid function are well documented; however, information regarding thyroid function in preeclampsia is scanty. Pregnancy is associated with increased total thyroxine (T4) and, in preeclampsia, biochemical hypothyroidism (raised thyroid‑stimulating hormone [TSH]) occurs.

Bioprinting of a functional vascularized mouse thyroid gland construct.

Science.gov (United States)

Bulanova, Elena A; Koudan, Elizaveta V; Degosserie, Jonathan; Heymans, Charlotte; Pereira, Frederico DAS; Parfenov, Vladislav A; Sun, Yi; Wang, Qi; Akhmedova, Suraya A; Sviridova, Irina K; Sergeeva, Natalia S; Frank, Georgy A; Khesuani, Yusef D; Pierreux, Christophe E; Mironov, Vladimir A

2017-08-18

Bioprinting can be defined as additive biofabrication of three-dimensional (3D) tissues and organ constructs using tissue spheroids, capable of self-assembly, as building blocks. The thyroid gland, a relatively simple endocrine organ, is suitable for testing the proposed bioprinting technology. Here we report the bioprinting of a functional vascularized mouse thyroid gland construct from embryonic tissue spheroids as a proof of concept. Based on the self-assembly principle, we generated thyroid tissue starting from thyroid spheroids (TS) and allantoic spheroids (AS) as a source of thyrocytes and endothelial cells (EC), respectively. Inspired by mathematical modeling of spheroid fusion, we used an original 3D bioprinter to print TS in close association with AS within a collagen hydrogel. During the culture, closely placed embryonic tissue spheroids fused into a single integral construct, EC from AS invaded and vascularized TS, and epithelial cells from the TS progressively formed follicles. In this experimental setting, we observed formation of a capillary network around follicular cells, as observed during in utero thyroid development when thyroid epithelium controls the recruitment, invasion and expansion of EC around follicles. To prove that EC from AS are responsible for vascularization of the thyroid gland construct, we depleted endogenous EC from TS before bioprinting. EC from AS completely revascularized depleted thyroid tissue. The cultured bioprinted construct was functional as it could normalize blood thyroxine levels and body temperature after grafting under the kidney capsule of hypothyroid mice. Bioprinting of functional vascularized mouse thyroid gland construct represents a further advance in bioprinting technology, exploring the self-assembling properties of tissue spheroids.

Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of 99mTc-pertechnetate: applicability to unifocal thyroid autonomy?

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Joe, Alexius Y.; Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer; Wissmeyer, Michael; Juengling, Freimut D.; Krause, Thomas M.

2006-01-01

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on 99m Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1±10.3 years) with unifocal thyroid autonomy were treated at three different centres with 131 I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU s (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36±19% and 38±20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28±16%; p s can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

Thyroid function in neonatal hypothyroidism.

Science.gov (United States)

Dussault, J H; Letarte, J; Guyda, H; Laberge, C

1976-10-01

Various aspects of the thyroid function have been measured in 28 cases of neonatal hypothyroidism detected by means of the Quebec Screening Program for Metabolic Diseases. In all instances the T4 value in the blood of filter paper spot was below 2 SD of the mean of the day, averaging 0.39 +/- 0.04 ng/40 mul (mean +/- SEM) of eluted blood. The T4 value of a second similar sample averaged 0.22 +/- 0.04 ng/mul of eluted blood; this value was significantly lower than the first one. The serum T4 concentration was decreased in all the infants, whereas three of them had a normal serum TSH concentration. At least three groups of patients could be identified: (1) patients with primary thyroid failure, (2) those with secondary or tertiary hypothyrodism, and (3) those with abnormal synthesis of thyroid hormone.

Thyroid function and some related biochemical parameters in bilharzial liver disease

International Nuclear Information System (INIS)

Ibrahim, W. Abdel Massih

1983-01-01

Bilharziasis in its different forms is estimated to affect at least 200 million people in the world (W.H.O., 1973). In egypt, it affects 60 - 70% of the rural population (WcMullen, 1963). Bilharzial ova reaches the liver with the portal blood stream causing a fibro - cellular reaction in and around the portal tract resulting in hepatic periportal fibrosis with various clinical stages (Abdalla et al., 1978 b). The effect of liver disease on thyroid function is still a subject of controversy and contradiction. While some reports are published on the effect of non-bilharzial liver disease on thyroid function, there is scanty studies as regards to bilharzial liver diseases . Most of the studies carried out to evaluate thyroid function in bilharzial liver disease, were focused on the estimation of one or two parameters of thyroid function e.g., T 3 and TSH. The available review of literature was focused on some parameters of thyroid function ignoring the others thyroid function tests and not considering the hormone carrier proteins. Thus resulting inconsistent and contradictory results (Ghareeb, 1962; El Haieg and Ibrahim, 1977)

Interconnection between thyroid hormone signalling pathways and parvovirus cytotoxic functions.

OpenAIRE

Vanacker, J M; Laudet, V; Adelmant, G; Stéhelin, D; Rommelaere, J

1993-01-01

Nonstructural (NS) proteins of autonomous parvoviruses can repress expression driven by heterologous promoters, an activity which thus far has not been separated from their cytotoxic effects. It is shown here that, in transient transfection assays, the NS-1 protein of the parvovirus minute virus of mice (MVMp) activates the promoter of the human c-erbA1 gene, encoding the thyroid hormone (T3) receptor alpha. The endogenous c-erbA1 promoter is also a target for induction upon MVMp infection. M...

Pathophysiology of recent advances in current thyroid function testing

International Nuclear Information System (INIS)

Hesch, R.D.

1977-01-01

In the first chapter I have discussed thyroid function and thyroid status which is determined by thyroid gland function in secreting T4 and peripheral biotransformation of T4. The accuracy of a current in-vitro diagnostic strategy allows high reliability in clinical routine. More recent test procedures for iodothyronines and immunological phenomena need further evaluation. In another chapter the biotransformation of T4 to bioactive and regulatory iodothyronines with respect to possible clinical implications is discussed. Finally, the role of TBG for interpration of T4 and T3 concentrations is determined and more attention directed to its functional heterogeneity. (orig.) [de

Thyroid disease: thyroid function tests and interpretation

African Journals Online (AJOL)

Diseases of the thyroid are among the most prevalent of medical conditions, especially in women, but the symptoms can be relatively nonspecific or mild. For this reason, clinicians have been placing increased reliance on the laboratory for assistance in the diagnosis of thyroid disorders. In the 1950s, only one thyroid.

Thyroid function profile in cord blood and postnatal changes at 24 ...

African Journals Online (AJOL)

Background: Studying the acute postnatal changes of newborn thyroid function is essential for determining the best timing of screening for congenital hypothyroidism. There is paucity of literature on neonatal thyroid function and particularly the postnatal changes in Nigeria. Objectives: To describe the profile of thyroid ...

Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy

International Nuclear Information System (INIS)

Baehre, M.; Lindemann, C.; Emrich, D.; Hilgers, R.

1988-01-01

This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99m Tc pertechnetate uptake under suppression (TcU s ), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by highresolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. ΔTSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcU s . I these classes, free thyroxie index (FT 4 I) and total triiodothyronine (TT 3 ) icreased with increasing TcU s , whereas ΔTSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT 4 I, TT 3 and ΔTSH in each of the TcU s classes depended on the individual iodine supply. It is concluded that, in patients with thyroid autonomy, actual thyroid hormone concentrations and TSH stimulation are determined by two major factors: the extent of autonomy and the individual iodine supply. Therefore, in iodine deficiency, the TRH test may be normal

Functional Imaging of Autonomic Regulation: Methods and Key Findings

Directory of Open Access Journals (Sweden)

Paul M Macey

2016-01-01

Full Text Available Central nervous system processing of autonomic function involves a network of regions throughout the brain which can be visualized and measured with neuroimaging techniques, notably functional magnetic resonance imaging (fMRI. The development of fMRI procedures has both confirmed and extended earlier findings from animal models, and human stroke and lesion studies. Assessments with fMRI can elucidate interactions between different central sites in regulating normal autonomic patterning, and demonstrate how disturbed systems can interact to produce aberrant regulation during autonomic challenges. Understanding autonomic dysfunction in various illnesses reveals mechanisms that potentially lead to interventions in the impairments. The objectives here are to: 1 describe the fMRI neuroimaging methodology for assessment of autonomic neural control, 2 outline the widespread, lateralized distribution of function in autonomic sites in the normal brain which includes structures from the neocortex through the medulla and cerebellum, 3 illustrate the importance of the time course of neural changes when coordinating responses, and how those patterns are impacted in conditions of sleep-disordered breathing, and 4 highlight opportunities for future research studies with emerging methodologies. Methodological considerations specific to autonomic testing include timing of challenges relative to the underlying fMRI signal, spatial resolution sufficient to identify autonomic brainstem nuclei, blood pressure and blood oxygenation influences on the fMRI signal, and the sustained timing, often measured in minutes of challenge periods and recovery. Key findings include the lateralized nature of autonomic organization, which is reminiscent of asymmetric motor, sensory and language pathways. Testing brain function during autonomic challenges demonstrate closely-integrated timing of responses in connected brain areas during autonomic challenges, and the involvement with

[Features of the functioning of the thyroid gland in HIV-infected].

Science.gov (United States)

Timofeeva, E V; Liashchenko, O Ia

2013-01-01

In the article analyzed the current literature, devoted to the peculiarities of functioning of the thyroid gland in patients with HIV infection. Based on the analysis of literature data bases demonstrated the structure of thyroid function disorders in HIV-infected, as well as the mechanisms of the pathogenesis of these disorders. In the structure of thyroid function is dominated by hypothyroidism, euthyroid pathological syndrome, Graves' disease, for which the opportunistic infections are triggers immune activation. It should be noted that the step of acquired immunodeficiency syndrome is accompanied by the development of inflammatory and neoplastic processes in the thyroid gland. Convincingly demonstrated the negative impact of highly active antiretroviral therapy in HIV-positive for the development of thyroid dysfunction, in connection which the expediency of forming risk groups and the timely correction of the projected thyroid diseases.

Effects of hyperthyroidism, hypothyroidism, and thyroid autoimmunity on female sexual function.

Science.gov (United States)

Oppo, A; Franceschi, E; Atzeni, F; Taberlet, A; Mariotti, S

2011-06-01

Thyroid hormones affect male and female sexual functions, but data in hypo- and hyperthyroid women are scanty. To investigate sexual function in hypo- and hyperthyroid women before and immediately after restoration of euthyroidism and in women with euthyroid Hashimoto's thyroiditis (HT). Fifty-six women with thyroid diseases (age 19-50 yr; 22 with hyperthyroidism, 17 with hypothyroidism, and 17 with euthyroid HT) and 30 age-matched healthy women. Hypoactive sexual desire, disorders of sexual arousal, vaginal lubrication, orgasm, satisfaction, and sexual pain (SPD) were assessed by Female Sexual Function Index. Serum TSH, free T4 (FT4) and thyroid autoantibodies (anti-thyroglobulin, anti-thyroperoxidase, and TSH-receptor antibodies) were assessed at the diagnosis; FT4 and TSH were repeated after treatment to confirm normalization of thyroid function. All sexual domains scores were significantly reduced (p ranging hyperthyroid women. Correction of hypothyroidism was associated to normalization of desire, satisfaction, and pain, while arousal and orgasm remained unchanged. In hyperthyroid women therapy normalized sexual desire, arousal/lubrication, satisfaction, and pain, while orgasm remained significantly impaired. Interestingly, euthyroid HT women displayed a significant decrease in sexual desire (phyperthyroidism markedly impair female sexual function. A rapid improvement is observed with the restoration of euthyroidism, although a longer period of time may be needed for full normalization. Preliminary data suggest that thyroid autoimmunity may selectively impair sexual desire, independently from thyroid function.

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection

OpenAIRE

Larijani, Bagher; Pajouhi, Mohammad; Ghanaati, Hossein; Bastanhagh, Mohammad-Hassan; Abbasvandi, Fereshteh; Firooznia, Kazem; Shirzad, Mahmood; Amini, Mohammad-Reza; Sarai, Maryam; Abbasvandi, Nasreen; Baradar-Jalili, Reza

2002-01-01

Abstract Background Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. Methods 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH ...

Vascular and renal function in experimental thyroid disorders.

Science.gov (United States)

Vargas, Félix; Moreno, Juan Manuel; Rodríguez-Gómez, Isabel; Wangensteen, Rosemary; Osuna, Antonio; Alvarez-Guerra, Miriam; García-Estañ, Joaquín

2006-02-01

This review focuses on the effects of thyroid hormones in vascular and renal systems. Special emphasis is given to the mechanisms by which thyroid hormones affect the regulation of body fluids, vascular resistance and, ultimately, blood pressure. Vascular function is markedly affected by thyroid hormones that produce changes in vascular reactivity and endothelial function in hyper- and hypothyroidism. The hypothyroid state is accompanied by a marked decrease in sensitivity to vasoconstrictors, especially to sympathetic agonists, alteration that may play a role in the reduced blood pressure of hypothyroid rats, as well as in the preventive effects of hypothyroidism on experimental hypertension. Moreover, in hypothyroid rats, the endothelium-dependent and nitric oxide donors vasodilation is reduced. Conversely, the vessels from hyperthyroid rats showed an increased endothelium-dependent responsiveness that may be secondary to the shear-stress induced by the hyperdynamic circulation, and that may contribute to the reduced vascular resistance characteristic of this disease. Thyroid hormones also have important effects in the kidney, affecting renal growth, renal haemodynamics, and salt and water metabolism. In hyperthyroidism, there is a resetting of the pressure-natriuresis relationship related to hyperactivity of the renin-angiotensin system, which contributes to the arterial hypertension associated with this endocrine disease. Moreover, thyroid hormones affect the development and/or maintenance of various forms of arterial hypertension. This review also describes recent advances in our understanding of thyroid hormone action on nitric oxide and oxidative stress in the regulation of cardiovascular and renal function and in the long-term control of blood pressure.

Anti-thyroid antibodies and thyroid function in neuromyelitis optica spectrum disorders.

Science.gov (United States)

Wang, Xuan; Yi, Huan; Liu, Jia; Li, Min; Mao, Zhi-Feng; Xu, Li; Peng, Fu-Hua

2016-07-15

Neuromyelitis optica spectrum disorders (NMOSD) are complicated neuroautoimmune disorders which can coexist with other organ-specific autoimmune disorders. The most frequently specific organ is the thyroid. The aim of this study is to evaluate the thyroid function of NMOSD patients and detect the difference between anti-thyroid antibodies (ATAbs) seropositive and seronegative NMOSD patients. 88 patients diagnosed with NMOSD were enrolled and their thyroid functions were evaluated. They were divided into two groups by ATAbs abnormalities. In addition, demographic characteristics, clinical symptoms and MRI scan results of brain and spinal cord were assessed. Anti-thyroid peroxidase antibodies (TPOAbs) and anti-thyroglobulin antibodies (TGAbs) seropositivities were detected more frequently in patients with NMOSDs when compared with healthy controls (37.5% vs 14.9%, P=0.01, Diff22.6%, 95CI[9.0%, 34.9%]; 31.8% vs 16.2%, P=0.022, Diff15.6%, 95CI[2.27%, 27.9%]). In NMOSD patients, the Expanded disability status scale score (EDSS) score was significantly higher in ATAbs seropositive group than that in ATAbs seronegative group (median 6.5 vs 3.75, P=0.012). However, there is no significant difference for demographic characteristics and other clinical symptoms. Moreover, NMOSD patients with ATAbs abnormalities had more brain and cervical cord lesions when compared with ATAbs negative NMOSD patients (83.8% vs 61.4%, P=0.029, Diff22.4%, 95CI[0.9%, 40.9%]; 93.9% vs 59.6%, P=0.001, Diff34.3%, 95CI[13.6%, 50.4%]). NMOSD patients have a higher frequency of ATAbs abnormalities. ATAbs may be associated with disability status, brain abnormalities and cervical cord lesions. Copyright © 2016 Elsevier B.V. All rights reserved.

A population study of the association between thyroid autoantibodies in serum and abnormalities in thyroid function and structure

DEFF Research Database (Denmark)

Pedersen, I.B.; Laurberg, P.; Knudsen, N.

2005-01-01

autoantibodies in serum and abnormalities in thyroid function and structure, and to study the thyroid volume in subjects with subclinical autoimmune hypothyroidism. Design A population study including 4649 randomly selected subjects. Measurements Blood tests were used to analyse for thyroid peroxidase...

Whole-genome sequence-based analysis of thyroid function

DEFF Research Database (Denmark)

Taylor, Peter N.; Porcu, Eleonora; Chew, Shelby

2015-01-01

Normal thyroid function is essential for health, but its genetic architecture remains poorly understood. Here, for the heritable thyroid traits thyrotropin (TSH) and free thyroxine (FT4), we analyse whole-genome sequence data from the UK10K project (N = 2,287). Using additional whole-genome seque...

Iodine status and thyroid function of Boston-area vegetarians and vegans.

Science.gov (United States)

Leung, Angela M; Lamar, Andrew; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N

2011-08-01

Adequate dietary iodine is required for normal thyroid function. The iodine status and thyroid function of U.S. vegetarians and vegans have not been previously studied. Environmental perchlorate and thiocyanate (inhibitors of thyroid iodine uptake) exposures may adversely affect thyroid function. The objective of the study was to assess the iodine status and thyroid function of U.S. vegetarians (consume plant based products, eggs, milk; abstain from meat, poultry, fish, shellfish) and vegans (avoid all animal products) and whether these may be affected by environmental perchlorate and thiocyanate exposures. This was a cross-sectional assessment of urinary iodine, perchlorate, and thiocyanate concentrations and serum thyroid function in Boston-area vegetarians and vegans. One hundred forty-one subjects (78 vegetarians, 63 vegans) were recruited; one vegan was excluded. Median urinary iodine concentration of vegans (78.5 μg/liter; range 6.8-964.7 μg/liter) was lower than vegetarians (147.0 μg/liter; range 9.3-778.6 μg/liter) (P vegans (630 μg/liter; range 108-3085 μg/liter) was higher than vegetarians (341 μg/liter; range 31-1963 μg/liter) (P vegans may be at risk for low iodine intake, and vegan women of child-bearing age should supplement with 150 μg iodine daily. Environmental perchlorate and thiocyanate exposures are not associated with thyroid dysfunction in these groups.

Surgical intervention in chronic (Hashimoto's) thyroiditis

Energy Technology Data Exchange (ETDEWEB)

Thomas, C.G. Jr.; Rutledge, R.G.

1981-06-01

Experience with 260 thyroidectomies at the North Carolina Memorial Hospital performed between 1875 and 1980 for a dominant thyroid mass was reviewed to determine the reliability of criteria for diagnosis and the indications for surgical treatment. Using the criteria of clinical findings, complemented by laboratory studies. Four patients had Hashimoto's thyroiditis coincidental to another disease for which thyroidectomy was performed. In seven patients Hashimoto's thyroiditis alone constituted the indications for operation. The indications for operation in these patients were: autonomous function with mild hyperthyroidism (2 patients); associated cold nodule (2 patients); thyromegaly unresponsive to suppressive therapy (2 patients); and rapidly enlarging mass simulating a neoplasm (1 patient). Only one of 71 patients with well differentiated carcinoma had Hashimoto's thyroiditis. One patient with Hashimoto's thyroiditis had associated lymphoma. In most patients, Hashimoto's thyroiditis can be identified using appropriate clinical and laboratory criteria without resorting to thyroidectomy to differentiate between thyroiditis and a neoplasm. Operations are indicated in patients with suspected or established chronic thyroiditis for: 1) the presence of a dominant mass with incomplete regression on suppressive therapy. 2) Progression of thyromegaly despite suppressive therapy. 3) Historic or physical findings suggest a malignancy. 4) Indeterminant findings on cutting needle biopsy.

Intrathoracic toxic thyroid nodule causing hyperthyroidism with a multinodular normal functional cervical thyroid gland

International Nuclear Information System (INIS)

Serim, Burcu Dirlik; Korkmaz, Ulku; Can, Unal; Altun, Gulay Durmus

2016-01-01

Radionuclide scintigraphy with I-131 and Tc-99m pertechnetate ( 99 mTc0 4 ) has been widely used in detecting toxic nodules. Intrathoracic goiter usually presents as an anterior mediastinal mass. Mostly the connection between intrathoracic mass and the cervical thyroid gland is clearly and easily identified occurring as a result of inferior extension of thyroid tissue in the neck, which is called as secondary intrathoracic goiter. Completely separated, aberrant or in other words primary intrathoracic goiters arise as a result of abnormal embryologic migration of ectopic thyroid closely associated with aortic sac and descend into the mediastinum. Intrathoracic goiters are generally nontoxic nodules existing with mass effect without causing hyperthyroidism. However, mostly reported cases had enlarged thyroid glands in the neck. This report demonstrates the usefulness of I-131 and 99 mTc0 4 scintigraphy for detecting intrathoracic goiter causing hyperthyroidism with a normal functioned cervical thyroid gland

Lack of association between autonomously functioning thyroid nodules and germline polymorphisms of the thyrotropin receptor and Gαs genes in a mild to moderate iodine-deficient Caucasian population.

Science.gov (United States)

Vicchio, Teresa Manuela; Giovinazzo, Salvatore; Certo, Rosaria; Cucinotta, Mariapaola; Micali, Carmelo; Baldari, Sergio; Benvenga, Salvatore; Trimarchi, Francesco; Campennì, Alfredo; Ruggeri, Rosaria Maddalena

2014-07-01

Mutations of the thyrotropin receptor (TSHR) and/or Gαs gene have been found in a number of, but not all, autonomously functioning thyroid nodules (AFTNs). Recently, in a 15-year-old girl with a hyperfunctioning papillary thyroid carcinoma, we found two somatic and germline single nucleotide polymorphisms (SNPs): a SNP of the TSHR gene (exon 7, codon 187) and a SNP of Gαs gene (exon 8, codon 185). The same silent SNP of the TSHR gene had been reported in patients with AFTN or familial non-autoimmune hyperthyroidism. No further data about the prevalence of the two SNPs in AFTNs as well as in the general population are available in the literature. To clarify the possible role of these SNPs in predisposing to AFTN. Germline DNA was extracted from blood leukocytes of 115 patients with AFTNs (43 males and 72 females, aged 31-85 years, mean ± SD = 64 ± 13) and 100 sex-matched healthy individuals from the same geographic area, which is marginally iodine deficient. The genotype distribution of the two SNPs was investigated by restriction fragment length polymorphism-polymerase chain reaction. The prevalence of the two SNPs in our study population was low and not different to that found in healthy individuals: 8 % of patients vs. 9 % of controls were heterozygous for the TSHR SNP and 4 % patients vs. 6 % controls were heterozygous for the Gαs SNP. One patient harbored both SNPs. These results suggest that these two SNPs do not confer susceptibility for the development of AFTN.

Making sense of thyroid function tests | Gezawa | Nigerian Journal of ...

African Journals Online (AJOL)

Background: Thyroid disorders are second only to diabetes mellitus among endocrine problems encountered in practice. Many patients with thyroid disorders tend to present with nonspecific symptoms to clinicians in different specialties, who are often quick to request for a thyroid function test. Although interpretation of the ...

The function of the thyroid gland in patients with multi-drug resistant tuberculosis

Directory of Open Access Journals (Sweden)

S. L. Matveyeva

2017-08-01

Full Text Available Abstract Background Multidrug-resistant tuberculosis (MDRTB remains a health problem for many countries in the world. The share of MDRTB is 10–30% among newly diagnosed cases and 20–70% among relapses and treatment failure. The aim of the study is to define the side effects of second line drugs used in the treatment of MDRTB on thyroid function. Methods In 30 patients with multidrug resistant tuberculosis, echostructure of thyroid was studied by ultrasound imaging method. Indices of thyroid function: plasma levels of free thyroxin, thyroid stimulating hormone were studied before chemotherapy initiated, at the end of intensive phase and after the treatment finished. Results Decreasing of thyroid function under antituberculosis chemotherapy was approved. Monitoring and correction of thyroid function during antituberculosis chemotherapy was suggested. Conclusion Patients with MDRTB taking ethionamide and PAS are at increased risk for hypothyroidism and goiter, and therefore require monitoring of thyroid function at all stages of antituberculosis chemotherapy for its timely correction.

Relationship between serum TSH and the responsiveness of toxic solitary autonomous thyroid nodules to radioiodine therapy

DEFF Research Database (Denmark)

Pedersen-Bjergaard, U; Kirkegaard, B C

1998-01-01

hypothyroidism both had detectable serum TSH at the time of 131I treatment. No other clinical parameter seemed to influence the outcome. CONCLUSION: There is no clinically significant effect of circulating TSH on the response of toxic solitary autonomous thyroid nodules to 131I therapy. However, keeping...... the patients subclinically hyperthyroid when receiving 131I treatment may possibly result in a reduced frequency of hypothyroidism.......) were euthyroid, three (8%) had responded insufficiently and required further antithyroid therapy, and two (5%) had developed hypothyroidism. No significant difference in the response pattern between patients with suppressed or detectable serum TSH could be demonstrated. The two patients who developed...

Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of {sup 99m}Tc-pertechnetate: applicability to unifocal thyroid autonomy?

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J.; Joe, Alexius Y. [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Wissmeyer, Michael [Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland); Juengling, Freimut D.; Krause, Thomas M. [University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland)

2006-05-15

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on {sup 99m}Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1{+-}10.3 years) with unifocal thyroid autonomy were treated at three different centres with {sup 131}I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU{sub s} (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36{+-}19% and 38{+-}20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28{+-}16%; p<0.01). A dose strategy based on the TcTU{sub s} can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

A meta-analysis of thyroid-related traits reveals novel loci and gender-specific differences in the regulation of thyroid function.

Directory of Open Access Journals (Sweden)

Eleonora Porcu

Full Text Available Thyroid hormone is essential for normal metabolism and development, and overt abnormalities in thyroid function lead to common endocrine disorders affecting approximately 10% of individuals over their life span. In addition, even mild alterations in thyroid function are associated with weight changes, atrial fibrillation, osteoporosis, and psychiatric disorders. To identify novel variants underlying thyroid function, we performed a large meta-analysis of genome-wide association studies for serum levels of the highly heritable thyroid function markers TSH and FT4, in up to 26,420 and 17,520 euthyroid subjects, respectively. Here we report 26 independent associations, including several novel loci for TSH (PDE10A, VEGFA, IGFBP5, NFIA, SOX9, PRDM11, FGF7, INSR, ABO, MIR1179, NRG1, MBIP, ITPK1, SASH1, GLIS3 and FT4 (LHX3, FOXE1, AADAT, NETO1/FBXO15, LPCAT2/CAPNS2. Notably, only limited overlap was detected between TSH and FT4 associated signals, in spite of the feedback regulation of their circulating levels by the hypothalamic-pituitary-thyroid axis. Five of the reported loci (PDE8B, PDE10A, MAF/LOC440389, NETO1/FBXO15, and LPCAT2/CAPNS2 show strong gender-specific differences, which offer clues for the known sexual dimorphism in thyroid function and related pathologies. Importantly, the TSH-associated loci contribute not only to variation within the normal range, but also to TSH values outside the reference range, suggesting that they may be involved in thyroid dysfunction. Overall, our findings explain, respectively, 5.64% and 2.30% of total TSH and FT4 trait variance, and they improve the current knowledge of the regulation of hypothalamic-pituitary-thyroid axis function and the consequences of genetic variation for hypo- or hyperthyroidism.

A Meta-Analysis of Thyroid-Related Traits Reveals Novel Loci and Gender-Specific Differences in the Regulation of Thyroid Function

Science.gov (United States)

Volpato, Claudia B.; Wilson, Scott G.; Cappola, Anne R.; Bos, Steffan D.; Deelen, Joris; den Heijer, Martin; Freathy, Rachel M.; Lahti, Jari; Liu, Chunyu; Lopez, Lorna M.; Nolte, Ilja M.; O'Connell, Jeffrey R.; Tanaka, Toshiko; Trompet, Stella; Arnold, Alice; Bandinelli, Stefania; Beekman, Marian; Böhringer, Stefan; Brown, Suzanne J.; Buckley, Brendan M.; Camaschella, Clara; de Craen, Anton J. M.; Davies, Gail; de Visser, Marieke C. H.; Ford, Ian; Forsen, Tom; Frayling, Timothy M.; Fugazzola, Laura; Gögele, Martin; Hattersley, Andrew T.; Hermus, Ad R.; Hofman, Albert; Houwing-Duistermaat, Jeanine J.; Jensen, Richard A.; Kajantie, Eero; Kloppenburg, Margreet; Lim, Ee M.; Masciullo, Corrado; Mariotti, Stefano; Minelli, Cosetta; Mitchell, Braxton D.; Nagaraja, Ramaiah; Netea-Maier, Romana T.; Palotie, Aarno; Persani, Luca; Piras, Maria G.; Psaty, Bruce M.; Räikkönen, Katri; Richards, J. Brent; Rivadeneira, Fernando; Sala, Cinzia; Sabra, Mona M.; Sattar, Naveed; Shields, Beverley M.; Soranzo, Nicole; Starr, John M.; Stott, David J.; Sweep, Fred C. G. J.; Usala, Gianluca; van der Klauw, Melanie M.; van Heemst, Diana; van Mullem, Alies; H.Vermeulen, Sita; Visser, W. Edward; Walsh, John P.; Westendorp, Rudi G. J.; Widen, Elisabeth; Zhai, Guangju; Cucca, Francesco; Deary, Ian J.; Eriksson, Johan G.; Ferrucci, Luigi; Fox, Caroline S.; Jukema, J. Wouter; Kiemeney, Lambertus A.; Pramstaller, Peter P.; Schlessinger, David; Shuldiner, Alan R.; Slagboom, Eline P.; Uitterlinden, André G.; Vaidya, Bijay; Visser, Theo J.; Wolffenbuttel, Bruce H. R.; Meulenbelt, Ingrid; Rotter, Jerome I.; Spector, Tim D.; Hicks, Andrew A.; Toniolo, Daniela; Sanna, Serena; Peeters, Robin P.; Naitza, Silvia

2013-01-01

Thyroid hormone is essential for normal metabolism and development, and overt abnormalities in thyroid function lead to common endocrine disorders affecting approximately 10% of individuals over their life span. In addition, even mild alterations in thyroid function are associated with weight changes, atrial fibrillation, osteoporosis, and psychiatric disorders. To identify novel variants underlying thyroid function, we performed a large meta-analysis of genome-wide association studies for serum levels of the highly heritable thyroid function markers TSH and FT4, in up to 26,420 and 17,520 euthyroid subjects, respectively. Here we report 26 independent associations, including several novel loci for TSH (PDE10A, VEGFA, IGFBP5, NFIA, SOX9, PRDM11, FGF7, INSR, ABO, MIR1179, NRG1, MBIP, ITPK1, SASH1, GLIS3) and FT4 (LHX3, FOXE1, AADAT, NETO1/FBXO15, LPCAT2/CAPNS2). Notably, only limited overlap was detected between TSH and FT4 associated signals, in spite of the feedback regulation of their circulating levels by the hypothalamic-pituitary-thyroid axis. Five of the reported loci (PDE8B, PDE10A, MAF/LOC440389, NETO1/FBXO15, and LPCAT2/CAPNS2) show strong gender-specific differences, which offer clues for the known sexual dimorphism in thyroid function and related pathologies. Importantly, the TSH-associated loci contribute not only to variation within the normal range, but also to TSH values outside the reference range, suggesting that they may be involved in thyroid dysfunction. Overall, our findings explain, respectively, 5.64% and 2.30% of total TSH and FT4 trait variance, and they improve the current knowledge of the regulation of hypothalamic-pituitary-thyroid axis function and the consequences of genetic variation for hypo- or hyperthyroidism. PMID:23408906

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection.

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Larijani, Bagher; Pajouhi, Mohammad; Ghanaati, Hossein; Bastanhagh, Mohammad-Hassan; Abbasvandi, Fereshteh; Firooznia, Kazem; Shirzad, Mahmood; Amini, Mohammad-Reza; Sarai, Maryam; Abbasvandi, Nasreen; Baradar-Jalili, Reza

2002-12-06

BACKGROUND: Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. METHODS: 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (thyroid hormone levels. Ethanol injections were performed once every 1-4 weeks. Ethanol injections were stopped when serum T3, T4 and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection. RESULTS: Average pre-treatment nodule volume [18.2 PlusMinus; 12.7 ml] decreased to 5.7 PlusMinus; 4.6 ml at 6 months follow-up [P thyroid hormone levels at 3 and 6 months follow-up [P 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia. CONCLUSION: Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.

Management of hyper and hypo thyroid conditions

Energy Technology Data Exchange (ETDEWEB)

Locke, W.

1982-03-01

In hyperthyroidism, the primary objective of therapy is to reduce secretion of thyroid hormone, which can be accomplished in various ways. The stimulus to hypersecretion can be removed in some causes of hyperthyroidism; in others, hormone synthesis and release can be inhibited by drugs such as thioamides, adrenergic blocking agents, or possibly lithium or glucocorticoids. Radioactive iodine is indicated for primary therapy of uncomplicated hyperthyroidism due to Graves' disease in persons over 30 years of age (myxedema may be a complication) and for treatment of autonomous thyroid adenoma in patients who are not suitable candidates for surgery. Surgical ablation is preferred for some causes of hyperthyroidism but may induce postoperative hypothyroidism. Hypothyroidism due to thyroid failure usually presents few therapeutic difficulties and can be managed simply by long-term hormone replacement. Before hormone replacement is prescribed for secondary or tertiary hypothyroidism, the other pituitary functions should be assessed.

Management of hyper and hypo thyroid conditions

International Nuclear Information System (INIS)

Locke, W.

1982-01-01

In hyperthyroidism, the primary objective of therapy is to reduce secretion of thyroid hormone, which can be accomplished in various ways. The stimulus to hypersecretion can be removed in some causes of hyperthyroidism; in others, hormone synthesis and release can be inhibited by drugs such as thioamides, adrenergic blocking agents, or possibly lithium or glucocorticoids. Radioactive iodine is indicated for primary therapy of uncomplicated hyperthyroidism due to Graves' disease in persons over 30 years of age (myxedema may be a complication) and for treatment of autonomous thyroid adenoma in patients who are not suitable candidates for surgery. Surgical ablation is preferred for some causes of hyperthyroidism but may induce postoperative hypothyroidism. Hypothyroidism due to thyroid failure usually presents few therapeutic difficulties and can be managed simply by long-term hormone replacement. Before hormone replacement is prescribed for secondary or tertiary hypothyroidism, the other pituitary functions should be assessed

Follicular variant of papillary thyroid carcinoma presenting as toxic nodule in an adolescent: coexistent polymorphism of the TSHR and Gsα genes.

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Ruggeri, Rosaria Maddalena; Campennì, Alfredo; Giovinazzo, Salvatore; Saraceno, Giovanna; Vicchio, Teresa Manuela; Carlotta, Dario; Cucinotta, Maria Paola; Micali, Carmelo; Trimarchi, Francesco; Tuccari, Giovanni; Baldari, Sergio; Benvenga, Salvatore

2013-02-01

Autonomously functioning, "hot", thyroid nodules are not common in children and adolescents. Such nodules are not considered alarming because they are assumed to be benign adenomas. Herein, we present a 15-year-old girl with a papillary thyroid carcinoma of 3.5 cm in diameter, which was functionally autonomous and scintigraphically hot. The patient, initially referred to our Endocrine Unit because of a thyroid nodule, returned 6 months later for symptoms of hyperthyroidism. Hyperthyroidism was confirmed biochemically. Radioactive iodine ((131)I) thyroid scintigraphy was consistent with an autonomous thyroid nodule. As per guidelines, the patient underwent surgery and a pathological examination revealed papillary carcinoma, follicular variant. The excised nodule was examined for activating mutations of the thyrotropin receptor (TSHR), Gsα (GNAS1), H-RAS, N-RAS, K-RAS, and BRAF genes by direct sequencing. No mutations were found. Nevertheless, two combined nonfunctioning mutations were detected: a single-nucleotide polymorphism (SNP) of the TSHR gene, in exon 7, at codon 187 (AAT→AAC, both encoding asparagine), and a SNP within exon 8 of the Gsα gene at codon 185 (ATC→ATT, both encoding isoleucine). Both SNPs were also identified in the germline DNA of the patient. The same SNPs were sought in the parents and brother of our patient. Her father was heterozygous for the TSHR SNP, her mother heterozygous for the Gsα SNP, and her brother was wild type. This case demonstrates that the presence of hyperfunctioning thyroid nodule(s) does not rule out cancer and warrants careful evaluation, especially in childhood and adolescence to overlook malignancy.

The relationship between 24 h/4 h radioiodine-131 uptake ratio and outcome after radioiodine therapy in 1402 patients with solitary autonomously functioning thyroid nodules

International Nuclear Information System (INIS)

Filesi, M.; Travascio, L.; Montesano, T.

2009-01-01

The objective of this study was to evaluate the role of 24 h/4 h uptake ratio (UR) in response to radioiodine-131 ( 131 I) therapy in patients with autonomously functioning thyroid nodules (AFTN). A total of 1402 consecutive hyperthyroid patients were treated with 131 I, between 1958 and 2005. Therapeutic doses (D) were calculated according to the formula: D=weight of nodule x dose per gram of nodular tissue (q)/24 h 131 I uptake. The ratios of the 24 and 4 h uptake were retrospectively calculated and the patients were grouped according to outcome and q into three groups of UR (≤1.25; 1.26-1.68; ≥1.69) by means of terziles. Of the 1402 patients, 95 did not respond to 131 I treatment while 93/1307 developed hypothyroidism. Most non-responders (55.8%) had UR ≤1.25, while many hypothyroid patients (66.7%) had UR ≥1.69 (χ 2 : P 131 I treatment, increasing to 13.9% at 5 years and 26.2% at 10 years. The 131 I UR can predict the outcome of 131 I treatment in AFTN and may have utility in modifying treatment in some patients to limit post-radioiodine induced hypothyroidism and treatment failures in order to achieve euthyroidism. (author)

Association between thyroid function and gallstone disease

Institute of Scientific and Technical Information of China (English)

Henry V(o)lzke; Daniel M Robinson; Ulrich John

2005-01-01

AIM: To investigate those associations using data of the population-based Study of Health in Pomerania.METHODS: A study population of 3 749 residents aged 20-79 years without previously diagnosed thyroid disease was available for analyses. Serum TSH was used to assess thyroid function. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on ultrasound. Logistic regression was performed to analyze independent associations between thyroid function and cholelithiasis.RESULTS: There were 385 persons (10.3%) with low (＜0.3 mIU/L), 3 321 persons (88.6%) with normal and 43 persons (1.2%) with high serum TSH levels (＞3 mIU/L).The proportion of cholelithiasis among males and females was 14.4% and 25.3%, respectively. Among males, there was an independent relation between high serum TSH and cholelithiasis (OR 3.77; 95%-CI 1.06-13.41; ,P＜0.05). zAlso among males, there was a tendency towards an elevated risk of cholelithiasis in persons with low serum TSH (OR 1.40; 95%-CI 0.96-2.02; P = 0.07). In the female population, no such relation was identified.CONCLUSION: There is an association between thyroid and gallstone disease with a gender-specific relation between hypothyroidism and cholelithiasis.

Metal ions to affect thyroid functions

International Nuclear Information System (INIS)

Nishida, Mikio

1994-01-01

The mechanism of physiological action of the trace elements that exert effects to internal secretion organs has not much been specified. The reasons are presumed as the elements exert effects to many enzyme groups, change the structural constitution, or modify the permeability of matters. As the metallic elements that exert effects to thyroid, there are more than ten kinds including Li, Ca, Co, Br, I, Hg, Pb and Se. In this report, the knowledge that the authors observed about the effects of Mn, I and Li which are apt to accumulate on thyroid is introduced. Mn and I were quantitatively determined by activation analysis, and Li by atomic absorption spectrometry. There is the report that the excessive intake of Mn causes human thyroid tumor. By the shortage of Mn, the restriction of energy metabolism, growth delay, sterility, bone abnormality and motion disorder arise. The contents of Mn and I in the periphery of thyroid tumors were examined by activation analysis. When an antipsychotic Li is administered, the function of thyroid is often lowered. Those effects are explained. In the case of Mn excess and Mn shortage, the new problem that the hormone residue in globulin tended to increase arose. The similar phenomenon occurred also in the case of I. The reason is unknown at present. (K.I.)

/sup 99m/Tc pertechnetate uptake in the thyroid measured with a scintillation camera: a parameter of thyroid function. [/sup 131/I

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Sokole, E.B.; van der Schoot, J.B.; Alberts, C.

1975-01-01

A /sup 99m/Tc pertechnetate thyroid uptake procedure, using a scintillation camera and a data storage system, is described. After comparison of extrathyroidal activity in several regions below the thyroid, activity in the clavicular regions was preferred for correction of the thyroid uptake measurement. No pertechnetate uptake curve obtained over the initial 15 min after injection was found to be representative of a specific thyroid function, and regional thyroid uptake curves gave only quantitative differences. The 15-min pertechnetate thyroid uptake measurement, with correction for clavicular extrathyroidal activity, correlates well with /sup 131/I uptake and is a good parameter of thyroid function, especially in the distinction of euthyroidism and hyperthyroidism.

[Autonomy and malignancy of thyroid glad tumors. A critical analysis of the literature on the existence of hyperfunctioning follicular and papillary thyroid gland carcinomas].

Science.gov (United States)

Schröder, S; Marthaler, B

1996-09-01

Data in the literature communicated in 63 publications were evaluated in which scintigraphically warm or hot nodules were described as identical to a follicular or papillary carcinoma diagnosed based on histology of the resection specimen, thus suggesting autonomous hyperfunction of a malignant thyroid neoplasia. In the majority of cases, this assumption could not be accepted, or only within strict limits. In these patients, it appeared more likely that the carcinoma was located adjacent to or within a benign hyperfunctioning thyroid area or that large masses of a thyroid carcinoma had only simulated the picture of a hyperfunctioning nodule by suppression of endogenous TSH and thus of the residual parenchyma's function. In other cases, the diagnosis of a hyperfunctioning thyroid carcinoma had to be doubted or rejected owing to the lack of plausibility of the documented morphological findings. At the end of the literature survey, only 10 case descriptions unequivocally verified that, though very rarely, a papillary or follicular thyroid carcinoma may manifest itself as a solitary warm or hot thyroid nodule. Such a scintigraphical finding thus cannot be regarded as proof of benignancy of a given thyroid tumour.

Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy

International Nuclear Information System (INIS)

Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C.

1998-01-01

Aim: To examine all cases with Graves' disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves' disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves' disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves' disease; however no therapeutical consequences are recommended. (orig.) [de

Taurine ameliorated thyroid function in rats co-administered with chlorpyrifos and lead.

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Akande, Motunrayo Ganiyat; Shittu, Muftau; Uchendu, Chidiebere; Yaqub, Lukuman Surakat

2016-12-01

Chlorpyrifos is a widely used organophosphate insecticide for domestic, agricultural and industrial purposes. Lead is a toxic heavy metal and it is used for domestic and industrial purposes. Taurine is a semi essential amino acid with bioprotective properties. The aim of this study was to investigate the effects of taurine on thyroid function in Wistar rats co-administered with chlorpyrifos and lead. The rats were divided into 5 groups of 10 rats each. The first two groups were administered with distilled water and soya oil (1 ml/kg) respectively. The other groups received taurine (50 mg/kg), chlorpyrifos + lead [chlorpyrifos (4.25 mg/kg, 1/20 median lethal dose] and lead (233.25 mg/kg, 1/20 median lethal dose) and taurine + chlorpyrifos + lead respectively. The treatments were administered once daily by oral gavage for 16 weeks. The rats were euthanized after the completion of the study and the thyroid function and thyroid histoarchitecture were evaluated. The results revealed that co-administration of chlorpyrifos and lead to the rats induced perturbations in thyroid function and this was manifested by reductions in the concentrations of triiodothyronine and thyroxine, increased thyroid stimulating hormone concentration and degeneration of the follicular epithelia of the thyroid gland. Taurine alleviated the perturbations in thyroid function and improved thyroid gland histoarchitecture. The beneficial effects of taurine may be attributed to its ability to protect the body from toxicity and oxidative stress. Taurine may be useful for prophylaxis against disruptions in thyroid function in animals that are exposed to environmental chlorpyrifos and lead.

The Evolution of Thyroid Function after Presenting with Hashimoto Thyroiditis Is Different between Initially Euthyroid Girls with and Those without Turner Syndrome.

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Wasniewska, Malgorzata; Salerno, Mariacarolina; Corrias, Andrea; Mazzanti, Laura; Matarazzo, Patrizia; Corica, Domenico; Aversa, Tommaso; Messina, Maria Francesca; De Luca, Filippo; Valenzise, Mariella

2016-01-01

To prospectively investigate, during a 5-year follow-up, whether the prognosis of thyroid function with Hashimoto thyroiditis (HT) is different in euthyroid girls with Turner syndrome (TS) than in euthyroid girls without TS. In 66 TS girls and 132 non-TS girls with euthyroid HT and similar thyroid functional test results at HT diagnosis, we followed up the evolution of thyroid status over time. At the end of follow-up, the TS girls exhibited higher TSH levels, lower fT4 levels, and lower prevalence rates of both euthyroidism and subclinical hypothyroidism, but higher prevalence rates of both overt hypothyroidism and hyperthyroidism, irrespective of the karyotype. An association with TS is able to impair the long-term prognosis of thyroid function in girls with HT. Such an effect occurs irrespective of thyroid functional test results at HT diagnosis and is not necessarily linked with a specific karyotype. © 2016 S. Karger AG, Basel.

TTH biological effect and thyrocyte binding in functional states of the thyroid gland

International Nuclear Information System (INIS)

Petrova, G.A.

1979-01-01

It was established in experiments made in vitro on the thyroid glands of intact animals and also on hyperplastic, functionally atrophied and inflamed thyroid glands that tritiated TTH actively incorporated into thyroid gland cells of the control animals and raised the rate of thyroxin secretion. Under the conditions of experimental hyperplasia, atrophy and thyroiditis of the thyroid gland, the hormonogenic reaction of thyrocytes and the nature of TTH binding by them was greatly disturbed. The thyrocytes of the hyperplastic and inflamed thyroid tissue did not accept the labelled TTH and did not react to its administration by intensification of thyroxin secretion. The thyrocytes of the functionally atrophied thyroid gland tissue actively bound the tritiated TTH and enhanced thyroxin secretion

Radionuclide method for functional and structural examination of the thyroid gland

International Nuclear Information System (INIS)

Mladenov, K.

2009-01-01

Full text: The aim of this study is development and routine daily practice of the radionuclide method for tracking of the thyroid gland functional status and structure. 168 patients with various thyroid diseases were examined. Nuclear medicine examination is held by gamma camera (Siemens and ADAK). 74 MBq 99m Tc-pertechnetate is injected intravenous. The activity of full and empty syringe is measured. Static scintigrams of full and empty syringes and injection place and duration 10 seconds are carried out. On 20 th minute a static scintigraphy of the thyroid gland with a duration of 300 seconds in front position is held. The individual dose calibration factor is calculated. The functional status of thyroid gland as well as its structural changes is determined. In addition, the relationships between the accumulation of radiopharmaceutical in the salivary glands and thyroid are determined. 168 patients are studied, 97 of them are with euthyroidism, 71 with hyperthyroidism and 19 - with hypothyroidism. The nuclear medicine diagnostic method provides information about functional and structural condition of the thyroid gland. The study is determining for decision to conduct the metabolic brachytherapy of hyperthyroid conditions

Thyroid Function within the Reference Range and the Risk of Stroke

DEFF Research Database (Denmark)

Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J

2016-01-01

CONTEXT: The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously. DESIGN AND SETTING:...

Pregnancy outcomes are not altered by variation in thyroid function within the normal range in women free of thyroid disease.

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Veltri, Flora; Kleynen, Pierre; Grabczan, Lidia; Salajan, Alexandra; Rozenberg, Serge; Pepersack, Thierry; Poppe, Kris

2018-02-01

In the recently revised guidelines on the management of thyroid dysfunction during pregnancy, treatment with thyroid hormone (LT4) is not recommended in women without thyroid autoimmunity (TAI) and TSH levels in the range 2.5-4.0 mIU/L, and in a recent study in that particular group of pregnant women, more complications were observed when a treatment with LT4 was given. The objective of the study was therefore to investigate whether variation in thyroid function within the normal (non-pregnant) range in women free of thyroid disease was associated with altered pregnancy outcomes? Cross-sectional data analysis of 1321 pregnant women nested within an ongoing prospective collection of pregnant women's data in a single centre in Brussels, Belgium. Thyroid peroxidase antibodies (TPO-abs), thyroid-stimulating hormone (TSH), free T4 (FT4) and ferritin levels were measured and baseline characteristics were recorded. Women taking LT4, with TAI and thyroid function outside the normal non-pregnant range were excluded. Pregnancy outcomes and baseline characteristics were correlated with all TSH and FT4 levels within the normal range and compared between two groups (TSH cut-off 500 mL) was inversely associated with serum FT4 levels (OR: 0.35; CI 95%: 0.13-0.96); P  = 0.040. Also 10% of women free of thyroid disease had serum TSH levels ≥2.5 mIU/L. Variation in thyroid function during the first trimester within the normal (non-pregnant) range in women free of thyroid disease was not associated with altered pregnancy outcomes. These results add evidence to the recommendation against LT4 treatment in pregnant women with high normal TSH levels and without TPO antibodies. © 2018 European Society of Endocrinology.

Thyrocyte-specific Gq/G11 deficiency impairs thyroid function and prevents goiter development.

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Kero, Jukka; Ahmed, Kashan; Wettschureck, Nina; Tunaru, Sorin; Wintermantel, Tim; Greiner, Erich; Schütz, Günther; Offermanns, Stefan

2007-09-01

The function of the adult thyroid is regulated by thyroid-stimulating hormone (TSH), which acts through a G protein-coupled receptor. Overactivation of the TSH receptor results in hyperthyroidism and goiter. The Gs-mediated stimulation of adenylyl cyclase-dependent cAMP formation has been regarded as the principal intracellular signaling mechanism mediating the action of TSH. Here we show that the Gq/G11-mediated signaling pathway plays an unexpected and essential role in the regulation of thyroid function. Mice lacking the alpha subunits of Gq and G11 specifically in thyroid epithelial cells showed severely reduced iodine organification and thyroid hormone secretion in response to TSH, and many developed hypothyroidism within months after birth. In addition, thyrocyte-specific Galphaq/Galpha11-deficient mice lacked the normal proliferative thyroid response to TSH or goitrogenic diet, indicating an essential role of this pathway in the adaptive growth of the thyroid gland. Our data suggest that Gq/G11 and their downstream effectors are promising targets to interfere with increased thyroid function and growth.

Hypothalamus-pituitary-thyroid axis activity and function of cardiac muscle in energy deficit

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Katarzyna Lachowicz

2017-12-01

Full Text Available Frequently repeated statement that energy restriction is a factor that improves cardiovascular system function seems to be not fully truth. Low energy intake modifies the hypothalamus-pituitary-thyroid axis activity and thyroid hormone peripheral metabolism. Thyroid hormones, as modulators of the expression and activity of many cardiomyocyte proteins, control heart function. Decreased thyroid hormone levels and their disturbanced conversion and action result in alternation of cardiac remodeling, disorder of calcium homeostasis and diminish myocardial contractility. This review provides a summary of the current state of knowledge about the mechanisms of energy restriction effects on thyroidal axis activity, thyroid hormone peripheral metabolism and action in target tissues, especially in cardiac myocytes. We also showed the existence of energy restriction-thyroid-heart pathway.

Functional insulin receptors are overexpressed in thyroid tumors: is this an early event in thyroid tumorigenesis?

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Frittitta, L; Sciacca, L; Catalfamo, R; Ippolito, A; Gangemi, P; Pezzino, V; Filetti, S; Vigneri, R

1999-01-15

Insulin receptor (IR), a member of the receptor tyrosine kinase family, is expressed in normal thyroid cells and affects thyroid cell proliferation and differentiation. The authors measured IR content in benign and malignant thyroid tumors by three independent methods: a specific radioimmunoassay, 125I-insulin binding studies, and immunohistochemistry. The results obtained were compared with the IR content in paired, adjacent, normal thyroid tissue. To assess IR function in thyroid carcinoma cells, glucose uptake responsiveness to insulin was also studied in a human transformed thyroid cell line (B-CPAP) and in follicular carcinoma cells in primary culture. In 9 toxic adenomas, the average IR content was similar to that observed in the 9 paired normal thyroid tissue specimens from the same patients (2.2+/-0.3 vs. 2.1+/-0.3). In 13 benign nonfunctioning, or "cold," adenomas, the average IR content was significantly higher (P thyroid tissue (4.0+/-0.4 vs. 1.6+/-0.2 and 5.6+/-1.0 vs. 1.8+/-0.2, respectively). The finding of a higher IR content in benign "cold" adenomas and in thyroid carcinomas was confirmed by both binding and immunostaining studies. The current studies indicate that 1) IR content is elevated in most follicular and papillary differentiated thyroid carcinomas, and 2) IR content is also elevated in most benign follicular adenomas ("cold" nodules) but not in highly differentiated, hyperfunctioning follicular adenomas ("hot" nodules), which very rarely become malignant. This observation suggests that increased IR expression is not restricted to the thyroid malignant phenotype but is already present in the premalignant "cold" adenomas. It may contribute, therefore, to thyroid tumorigenesis and/or represent an early event that gives a selective growth advantage to transformed thyroid cells.

Clinical course of thyroid function and thyroid associated-ophthalmopathy in patients with euthyroid Graves’ disease

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Suzuki N

2018-04-01

Full Text Available Nami Suzuki,1 Jaeduk Yoshimura Noh,1 Toshiaki Kameda,1 Ai Yoshihara,1 Hidemi Ohye,1 Miho Suzuki,1 Masako Matsumoto,1 Yo Kunii,1 Kenji Iwaku,1 Natsuko Watanabe,1 Koji Mukasa,1 Ai Kozaki,2 Toshu Inoue,2 Kiminori Sugino,1 Koichi Ito1 1Department of Internal Medicine, Ito Hospital, Tokyo, Japan; 2Department of Ophthalmology, Olympia Eye Hospital, Tokyo, Japan Background: Euthyroid Graves’ disease (EGD is a rare condition defined as the presence of thyroid-associated ophthalmopathy (TAO in patients with normal thyroid function. Due to the rarity of this disease, only a limited number of studies and case reports are available for further evaluation of the characteristics of the disease. The aim of this study was to examine the changes in the thyroid function, thyrotropin receptor antibodies (TRAb and eye symptoms, and then determine whether TRAb is related to TAO in EGD patients. TRAb in this study was defined as including both thyrotropin-binding inhibitory immunoglobulin (TBII and thyroid-stimulating immunoglobulin (TSAb. Patients and methods: Medical records of patients diagnosed with EGD were reviewed. Ophthalmologists specializing in TAO examined the eyes of all subjects. Results: Of the 58 patients diagnosed with EGD, 24.1% developed hyperthyroidism, while 3.4% developed hypothyroidism. A total of 72.4% of the 58 patients remained euthyroid throughout the entire follow-up period. At the initial presentation, TBII and TSAb were positive in 74.5% and 70.5%, respectively. Ophthalmic treatments were administered to 30 (51.7% out of the 58 patients. A significant spontaneous improvement of the eye symptoms was found in 28 of the EGD patients who did not require eye treatments. EGD patients exhibited positive rates for both TBII and TSAb, with the number of the TRAb-positive patients gradually decreasing while the eye symptoms spontaneously improved over time. There were no correlations found between TRAb at initial presentation and the eye symptoms

Autonomic Function Impairment and Brain Perfusion Deficit in Parkinson’s Disease

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Wei-Che Lin

2017-06-01

Full Text Available IntroductionAutonomic disorders have been recognized as important Parkinson’s disease (PD components. Some vulnerable structures are related to the central autonomic network and have also been linked to autonomic function alterations. The aims of the study are to evaluate the severity of the autonomic dysfunction and the cortical hypoperfusion using arterial spin labeling (ASL MRI. And then, possible relationships of significant between-group differences in perfusion pattern to clinical variables and autonomic functions were examined to determine the pharmaceutical effects of dopaminergic treatment on cerebral blood flow (CBF in patients with PD.MethodsBrain ASL MRI was carried out in 20 patients with PD (6 men and 14 women, mean age: 63.3 ± 6.4 years and 22 sex- and age-matched healthy volunteers to assess whole-brain CBF and the effects of dopaminergic therapy on perfusion. All subjects underwent a standardized evaluation of cardiovagal and adrenergic function including a deep breathing, Valsalva maneuver, and 5-min head-up tilt test. Perfusion MRI data were acquired on a 3.0 T scanner with a pulsed continuous ASL technique. The CBF, autonomic parameters, and clinical data were analyzed after adjusting for age and sex.ResultsPatients exhibited a decline in autonomic function (rapid heart rate in response to deep breathing, low baroreflex sensitivity, high systolic and diastolic pressure, and altered tilting test response, widespread low CBF, and robust response to dopaminergic therapy. Lower perfusion in the middle frontal gyrus was associated with increased clinical disease severity (Unified Parkinson’s Disease Rating Scale I score, P < 0.001. Lower perfusion in autonomic control areas, such as the frontal lobe and insula, were significantly associated with autonomic impairment (P < 0.001.ConclusionsOur study indicates that PD is a progressive neurodegenerative disorder that changes the perfusion of central nervous system

Thyroid peroxidase antibodies in pregnant women with type 1 diabetes: impact on thyroid function, metabolic control and pregnancy outcome

DEFF Research Database (Denmark)

Vestgaard, Marianne; Nielsen, Lene Ringholm; Rasmussen, Åse Krogh

2008-01-01

In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti-TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome....

Thyroid function, reduced kidney function and incident chronic kidney disease in a community-based population: the Atherosclerosis Risk in Communities study.

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Schultheiss, Ulla T; Daya, Natalie; Grams, Morgan E; Seufert, Jochen; Steffes, Michael; Coresh, Josef; Selvin, Elizabeth; Köttgen, Anna

2017-11-01

Reduced kidney function is a common public health problem that increases risk for a wide variety of adverse outcomes, making the identification of potentially modifiable factors associated with the development of incident chronic kidney disease (CKD) important. Alterations in the hypothalamic-pituitary-thyroid axis have been linked to reduced kidney function, but the association of thyroid function with the development of incident CKD is largely uncharacterized. Concentrations of thyroid stimulating hormone (TSH), free thyroxine (FT4), triiodothyronine (T3) and thyroid peroxidase antibody (TPOAb) were quantified in 12 785 black and white participants of the ongoing community-based prospective Atherosclerosis Risk in Communities study. Thyroid markers and clinical categories of thyroid dysfunction (euthyroidism, combined subclinical and overt hypothyroidism, combined subclinical and overt hyperthyroidism) were also evaluated for their association with reduced kidney function (estimated glomerular filtration rate kidney function at study baseline. The clinical entities hypothyroidism and hyperthyroidism were also associated with higher odds of baseline reduced kidney function, but this was not significant. However, none of the markers of thyroid function nor different clinical categories of thyroid dysfunction (hypothyroidism, hyperthyroidism or TPOAb positivity) were associated with incident CKD in adjusted analyses. Elevated TSH, FT4 and reduced T3 concentrations were associated with reduced kidney function cross-sectionally. The lack of association with the development of incident CKD suggests that altered thyroid function in the general population is not causally related to CKD development, but screening for thyroidal status may be especially relevant in persons with reduced kidney function. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Variation of left heart function and thyroid hormone in cirrhosis

International Nuclear Information System (INIS)

Liu Junchi; Du Sujun; Mao Shaorong; Lu Jun; Tang Xiaoling

1996-01-01

The observation of 52 cases of cirrhosis left heart function indices traced with 113 In m in quiet and motion, and the combining determination of thyroid hormone serum levels with RIA are described. The cirrhosis to the function of liver damage increased, the indices of left heart function has great change. Moreover, the serum levels of T 3 , FT 3 in thyroid hormone are decreased obviously and the serum level of rT 3 is also increased significantly

Sex differences in autonomic function following maximal exercise.

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Kappus, Rebecca M; Ranadive, Sushant M; Yan, Huimin; Lane-Cordova, Abbi D; Cook, Marc D; Sun, Peng; Harvey, I Shevon; Wilund, Kenneth R; Woods, Jeffrey A; Fernhall, Bo

2015-01-01

Heart rate variability (HRV), blood pressure variability, (BPV) and heart rate recovery (HRR) are measures that provide insight regarding autonomic function. Maximal exercise can affect autonomic function, and it is unknown if there are sex differences in autonomic recovery following exercise. Therefore, the purpose of this study was to determine sex differences in several measures of autonomic function and the response following maximal exercise. Seventy-one (31 males and 40 females) healthy, nonsmoking, sedentary normotensive subjects between the ages of 18 and 35 underwent measurements of HRV and BPV at rest and following a maximal exercise bout. HRR was measured at minute one and two following maximal exercise. Males have significantly greater HRR following maximal exercise at both minute one and two; however, the significance between sexes was eliminated when controlling for VO2 peak. Males had significantly higher resting BPV-low-frequency (LF) values compared to females and did not significantly change following exercise, whereas females had significantly increased BPV-LF values following acute maximal exercise. Although males and females exhibited a significant decrease in both HRV-LF and HRV-high frequency (HF) with exercise, females had significantly higher HRV-HF values following exercise. Males had a significantly higher HRV-LF/HF ratio at rest; however, both males and females significantly increased their HRV-LF/HF ratio following exercise. Pre-menopausal females exhibit a cardioprotective autonomic profile compared to age-matched males due to lower resting sympathetic activity and faster vagal reactivation following maximal exercise. Acute maximal exercise is a sufficient autonomic stressor to demonstrate sex differences in the critical post-exercise recovery period.

Autonomic nervous system function in chronic exogenous subclinical thyrotoxicosis and the effect of restoring euthyroidism.

Science.gov (United States)

Eustatia-Rutten, Carmen F A; Corssmit, Eleonora P M; Heemstra, Karen A; Smit, Johannes W A; Schoemaker, Rik C; Romijn, Johannes A; Burggraaf, Jacobus

2008-07-01

Knowledge on the relationship between the autonomic nervous system and subclinical hyperthyroidism is mainly based upon cross-sectional studies in heterogeneous patient populations, and the effect of restoration to euthyroidism in subclinical hyperthyroidism has not been studied. We investigated the long-term effects of exogenous subclinical hyperthyroidism on the autonomic nervous system and the potential effects of restoration of euthyroidism. This was a prospective single-blinded, placebo-controlled, randomized trial. The study was performed at a university hospital. A total of 25 patients who were on more than 10-yr TSH suppressive therapy after thyroidectomy was examined. Patients were studied at baseline and subsequently randomized to a 6-month thyroid hormone substitution regimen to obtain either euthyroidism or maintenance of the subclinical hyperthyroid state. Urinary excretion of catecholamines and heart rate variability were measured. Baseline data of the subclinical hyperthyroidism patients were compared with data obtained in patients with hyperthyroidism and controls. Urinary excretion of norepinephrine and vanillylmandelic acid was higher in the subclinical hyperthyroidism patients compared with controls and lower compared with patients with overt hyperthyroidism. Heart rate variability was lower in patients with hyperthyroidism, intermediate in subclinical hyperthyroidism patients, and highest in the healthy controls. No differences were observed after restoration of euthyroidism. Long-term exogenous subclinical hyperthyroidism has effects on the autonomic nervous system measured by heart rate variability and urinary catecholamine excretion. No differences were observed after restoration to euthyroidism. This may indicate the occurrence of irreversible changes or adaptation during long-term exposure to excess thyroid hormone that is not remedied by 6-month euthyroidism.

Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease

DEFF Research Database (Denmark)

Åsvold, Bjørn O; Vatten, Lars J; Bjøro, Trine

2015-01-01

documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD). OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk. DESIGN...... known thyroid or cardiovascular disease at baseline. EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline. MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status....... This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit....

Modular Measuring System for Assesment of the Thyroid Gland Functional State

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Vladimir Rosik

2005-01-01

Full Text Available Distributed modular system BioLab for biophysical examinations enabling assessment of the thyroid gland functional state is presented in the paper. The BioLab system is based on a standard notebook or desktop PC connected to an Ethernet-based network of two smart sensors. These sensors are programmed and controlled from PC and enable measurement of selected biosignals of the human cardiovascular and neuromuscular system that are influenced by the production of thyroid gland hormones. Recorded biosignals are processed in a PC and peripheral indicators characterizing thyroid gland functional state are evaluated.

Thyroid carcinoma mimicking a toxic adenoma

International Nuclear Information System (INIS)

De Rosa, G.; Testa, A.; Satta, M.A.; Maurizi, M.; Aimoni, C.; Artuso, A.; Silvestri, E.; Rufini, V.; Troncone, L.

1990-01-01

A young woman with a thyroid papillary carcinoma behaving as an autonomously hyperfunctioning nodule is described. Only 17 similar patients have been seen in the past 25 years. It is emphasized that hyperthyroidism does not exclude malignant disease in hot nodules. This possibility suggests that all thyroid nodules, either cold or hot, require careful management. Therefore, in 'at risk' cases, surgery could be the most useful treatment. (orig.)

[Analysis on iodine nutritional status and thyroid function in pregnant women].

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Li, Hongbo; Wang, Yanling; Zheng, Jing; Wang, Yancai; Huang, Dahong; Liang, Liping; Ren, Xudong; Dou, Yugui; Zhu, Xiaonan

2012-07-01

To investigate the iodine nutritional status and thyroid function of pregnant women during different periods of pregnancy, to provide evidence for guiding iodine supplementation for them. A cross-sectional survey was performed in 90 pregnant women in Wuwei City from April 2009 to January 2010. The morning blood samples and random urine samples were collected, and the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroglobulin antibodies (TGAb), thyroid microsomal antibodies (TMAb) in blood samples and iodine in urine samples were detected. The medians of urinary iodine were 231.49, 158.25 and 328.35 microg/L for women in early, middle and late period of pregnancy, The ratio of urinary iodine below 150 microg/L were 39.29%, 45.16% and 25.81%, respectively. The FT3, FT4 levels in the first trimester were higher than those in the third trimester (P 0.05). The positive rate of TGAb and TMAb antibody of pregnant women in different period of time were not significantly different (P > 0.05). The incidence of thyroid function disorder was significantly different in different gestation periods. Generally, the iodine nutritional status of these pregnant women was appropriate, but there was a tendency towards hypothyroid in some women. Monitoring urinary iodine and thyroid function in pregnant women should be carried out regularly.

Hypothyroidism in a dog after surgery and radiation therapy for a functional thyroid adenocarcinoma

International Nuclear Information System (INIS)

Kramer, R.W.; Price, G.S.; Spodnick, G.J.

1994-01-01

Hypothyroidism was diagnosed in a dog which had undergone unilateral thyroid lobectomy and external beam irradiation (48 Gy in 3 Gy fractions) for a functional cystic thyroid adenocarcinoma. Hypothyroidism became biochemically apparent within 4 months of completion of radiation therapy, and clinically apparent within 7 months. Clinical signs resolved after thyroid hormone supplementation. The potential for alterations in thyroid function should be considered in any animal undergoing radiation therapy in which the thyroid gland is included in the radiation field. This potential may be greater if surgery and radiation are combined

Activating thyrotropin receptor mutations are present in nonadenomatous hyperfunctioning nodules of toxic or autonomous multinodular goiter.

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Tonacchera, M; Agretti, P; Chiovato, L; Rosellini, V; Ceccarini, G; Perri, A; Viacava, P; Naccarato, A G; Miccoli, P; Pinchera, A; Vitti, P

2000-06-01

Toxic multinodular goiter, a heterogeneous disease producing hyperthyroidism, is frequently found in iodine-deficient areas. The pathogenesis of this common clinical entity is still unclear. The aim of the present study was to search for activating TSH receptor (TSHr) or Gs alpha mutations in areas of toxic or functionally autonomous multinodular goiters that appeared hyperfunctioning at thyroid scintiscan but did not clearly correspond to definite nodules at physical or ultrasonographic examination. Surgical tissue specimens from nine patients were carefully dissected, matching thyroid scintiscan and thyroid ultrasonography, to isolate hyperfunctioning and nonfunctioning areas even if they did not correspond to well-defined nodules. TSHr and Gs alpha mutations were searched for by direct sequencing after PCR amplification of genomic DNA. Only 2 adenomas were identified at microscopic examination, whereas the remaining 18 hyperfunctioning areas corresponded to hyperplastic nodules containing multiple aggregates of micromacrofollicules not surrounded by a capsule. Activating TSHr mutations were detected in 14 of these 20 hyperfunctioning areas, whereas no mutation was identified in nonfunctioning nodules or areas contained in the same gland. No Gs alpha mutation was found. In conclusion, activating TSHr mutations are present in the majority of nonadenomatous hyperfunctioning nodules scattered throughout the gland in patients with toxic or functionally autonomous multinodular goiter.

Unstable Thyroid Function in Older Adults Is Caused by Alterations in Both Thyroid and Pituitary Physiology and Is Associated with Increased Mortality.

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Mammen, Jennifer S; McGready, John; Ladenson, Paul W; Simonsick, Eleanor M

2017-11-01

Average thyrotropin (TSH) levels are known to be higher in older adults when measured in cross-sectional populations. Possible etiologies include differential survival, neutral aging changes, or increased disease prevalence at older ages. This study aimed to elucidate the mechanisms underlying changing thyroid function during aging, and to determine the association of changes with survival, by analyzing the individual thyroid axis over time. Individual patterns of changing TSH and free thyroxine (fT4) were determined in 640 participants in the Baltimore Longitudinal Study of Aging who had at least three measures of serum TSH and fT4, not on medications, over an average of seven years of follow-up. Participants with changing phenotypes were identified based on quintiles for both slopes. Those with alterations in primary thyroid gland function demonstrated intact negative feedback (rising TSH with declining fT4 or declining TSH with rising fT4). Other participants had a parallel rise or fall of TSH and fT4 levels, consistent with pituitary dysfunction. Predictors of phenotype were analyzed by logistic regression. Differential survival between thyroid aging phenotypes was analyzed using multivariate Cox regression. While the majority of participants at all ages had stable thyroid function, changes were more common among older adults, with 32.3% of those aged >80 years but only 9.5% of those aged function changes in the highest and lowest quintiles. Regression to the mean accounts for some of the changes, for example increased baseline TSH was associated with a falling TSH pattern (odds ratio = 1.4 [confidence interval 1.1-1.7] per 1 mIU/L). Importantly, changing thyroid function in either the upper or lower quintiles of slope for TSH and fT4 was associated with increased risk of death compared to stable thyroid status (hazard ratio = 5.4 [confidence interval 3.1-9.5]). Changing thyroid hormone function is increasingly common at older ages and is associated

Environmental chemicals and thyroid function

DEFF Research Database (Denmark)

Boas, Malene; Feldt-Rasmussen, Ulla; Skakkebaek, Niels E

2006-01-01

. There is substantial evidence that polychlorinated biphenyls, dioxins and furans cause hypothyroidism in exposed animals and that environmentally occurring doses affect human thyroid homeostasis. Similarly, flame retardants reduce peripheral thyroid hormone (TH) levels in rodents, but human studies are scarce. Studies...... also indicate thyroid-disruptive properties of phthalates, but the effect of certain phthalates seems to be stimulative on TH production, contrary to most other groups of chemicals. Thyroid disruption may be caused by a variety of mechanisms, as different chemicals interfere with the hypothalamic...

Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part

International Nuclear Information System (INIS)

Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J.; Wengenmair, H.; Kopp, J.

2006-01-01

Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

Limits of clinical tests to screen autonomic function in diabetes type 1.

Science.gov (United States)

Ducher, M; Bertram, D; Sagnol, I; Cerutti, C; Thivolet, C; Fauvel, J P

2001-11-01

A precocious detection of cardiac autonomic dysfunction is of major clinical interest that could lead to a more intensive supervision of diabetic patients. However, classical clinical exploration of cardiac autonomic function is not easy to undertake in a reproducible way. Thus, respective interests of autonomic nervous parameters provided by both clinical tests and computerized analysis of resting blood pressure were checked in type 1 diabetic patients without orthostatic hypotension and microalbuminuria. Thirteen diabetic subjects matched for age and gender to thirteen healthy subjects volunteered to participate to the study. From clinical tests (standing up, deep breathing, Valsalva maneuver, handgrip test), autonomic function was scored according to Ewing's methodology. Analysis of resting beat to beat blood pressure provided autonomic indices of the cardiac function (spectral analysis or Z analysis). 5 of the 13 diabetic patients exhibited a pathological score (more than one pathological response) suggesting the presence of cardiovascular autonomic dysfunction. The most discriminative test was the deep breathing test. However, spectral indices of BP recordings and baro-reflex sensitivity (BRS) of these 5 subjects were similar to those of healthy subjects and of remaining diabetic subjects. Alteration in Ewing's score given by clinical tests may not reflect an alteration of cardiac autonomic function in asymptomatic type 1 diabetic patients, because spectral indices of sympathetic and parasympathetic (including BRS) function were within normal range. Our results strongly suggest to confront results provided by both methodologies before concluding to an autonomic cardiac impairment in asymptomatic diabetic patients.

Interconnection between thyroid hormone signalling pathways and parvovirus cytotoxic functions.

Science.gov (United States)

Vanacker, J M; Laudet, V; Adelmant, G; Stéhelin, D; Rommelaere, J

1993-01-01

Nonstructural (NS) proteins of autonomous parvoviruses can repress expression driven by heterologous promoters, an activity which thus far has not been separated from their cytotoxic effects. It is shown here that, in transient transfection assays, the NS-1 protein of the parvovirus minute virus of mice (MVMp) activates the promoter of the human c-erbA1 gene, encoding the thyroid hormone (T3) receptor alpha. The endogenous c-erbA1 promoter is also a target for induction upon MVMp infection. Moreover, T3 was found to up-modulate the level of cell sensitivity to parvovirus attack. These data suggest an interconnection between T3 signalling and NS cytotoxic pathways. Images PMID:8230488

Thyroid function in children and adolescents with Hashimoto’s thyroiditis after l-thyroxine discontinuation

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Giorgio Radetti

2017-04-01

Full Text Available Objective: Thyroid function may recover in patients with Hashimoto’s thyroiditis (HT. Design: To investigate thyroid function and the need to resume l-thyroxine treatment after its discontinuation. Setting: Nine Italian pediatric endocrinology centers. Patients: 148 children and adolescents (25 m and 123 f with HT on treatment with l-thyroxine for at least one year. Intervention and main outcome measure: Treatment was discontinued in all patients, and serum TSH and fT4 concentrations were measured at the time of treatment discontinuation and then after 2, 6, 12 and 24 months. Therapy with l-thyroxine was re-instituted when TSH rose >10 U/L and/or fT4 was below the normal range. The patients were followed up when TSH concentrations were between 5 and 10 U/L and fT4 was in the normal range. Results: At baseline, TSH was in the normal range in 139 patients, and was between 5 and 10 U/L in 9 patients. Treatment was re-instituted after 2 months in 37 (25.5% patients, after 6 months in 13 patients (6.99%, after 12 months in 12 patients (8.6%, and after 24 months in an additional 3 patients (3.1%. At 24 months, 34 patients (34.3% still required no treatment. TSH concentration >10 U/L at the time of diagnosis was the only predictive factor for the deterioration of thyroid function after l-thyroxine discontinuation. Conclusions: This study confirms that not all children with HT need life-long therapy with l-thyroxine, and the discontinuation of treatment in patients with a TSH level <10 U/L at the time of diagnosis should be considered.

Association of thyroid function with human serum ghrelin and leptin levels

International Nuclear Information System (INIS)

Wang Jinping; Xu Hao; Wu Qiulian

2008-01-01

Objective: To investigate the effect of different status of thyroid function (hypothyroidism and hyperthyroidism as well as euthyroid status) on serum ghrelin and leptin levels. Methods: The levels of serum ghrelin and leptin were determined by radio immunoassay in 46 untreated subjects with hyperthyroidism, 15 hyperthyroid patients achieved a euthyroid status after radioiodine 131 I therapy, 21 cases of hypothyroidism and 18 cases of normal controls, respectively. Meanwhile, the serum levels of free triiodothyronine (FT 3 ), free thyroxine (FT 4 ) and thyroid-stimulating hormone (TSH) were measured by chemiluminescence immune assay. Results: (1) The levels of serum ghrelin in untreated hyperthyroidism were significantly lower than those in hyperthyroid patients achieved a euthyroid status (t=3.21, P 3 (r=-0.29, P 4 (r=-0.26, P< 0.05), positively correlated with serum TSH (r=0.36, P<0.05); serum leptin levels did not correlate with thyroid hormone. Conclusion: The levels of serum ghrelin were differently under different thyroid functional status and correlated with thyroid hormone, while serum leptin were not. (authors)

Functioning and nonfunctioning thyroid adenomas involve different molecular pathogenetic mechanisms.

Science.gov (United States)

Tonacchera, M; Vitti, P; Agretti, P; Ceccarini, G; Perri, A; Cavaliere, R; Mazzi, B; Naccarato, A G; Viacava, P; Miccoli, P; Pinchera, A; Chiovato, L

1999-11-01

The molecular biology of follicular cell growth in thyroid nodules is still poorly understood. Because gain-of-function (activating) mutations of the thyroid-stimulating hormone receptor (TShR) and/or Gs alpha genes may confer TSh-independent growth advantage to neoplastic thyroid cells, we searched for somatic mutations of these genes in a series of hyperfunctioning and nonfunctioning follicular thyroid adenomas specifically selected for their homogeneous gross anatomy (single nodule in an otherwise normal thyroid gland). TShR gene mutations were identified by direct sequencing of exons 9 and 10 of the TShR gene in genomic DNA obtained from surgical specimens. Codons 201 and 227 of the Gs alpha gene were also analyzed. At histology, all hyperfunctioning nodules and 13 of 15 nonfunctioning nodules were diagnosed as follicular adenomas. Two nonfunctioning thyroid nodules, although showing a prevalent microfollicular pattern of growth, had histological features indicating malignant transformation (a minimally invasive follicular carcinoma and a focal papillary carcinoma). Activating mutations of the TShR gene were found in 12 of 15 hyperfunctioning follicular thyroid adenomas. In one hyperfunctioning adenoma, which was negative for TShR mutations, a mutation in codon 227 of the Gs alpha gene was identified. At variance with hyperfunctioning thyroid adenomas, no mutation of the TShR or Gs alpha genes was detected in nonfunctioning thyroid nodules. In conclusion, our findings clearly define a different molecular pathogenetic mechanism in hyperfunctioning and nonfunctioning follicular thyroid adenomas. Activation of the cAMP cascade, which leads to proliferation but maintains differentiation of follicular thyroid cells, typically occurs in hyperfunctioning thyroid adenomas. Oncogenes other than the TShR and Gs alpha genes are probably involved in nonfunctioning follicular adenomas.

Phthalates Are Metabolised by Primary Thyroid Cell Cultures but Have Limited Influence on Selected Thyroid Cell Functions In Vitro.

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Juliana Frohnert Hansen

Full Text Available Phthalates are plasticisers added to a wide variety of products, resulting in measurable exposure of humans. They are suspected to disrupt the thyroid axis as epidemiological studies suggest an influence on the peripheral thyroid hormone concentration. The mechanism is still unknown as only few in vitro studies within this area exist. The aim of the present study was to investigate the influence of three phthalate diesters (di-ethyl phthalate, di-n-butyl phthalate (DnBP, di-(2-ethylhexyl phthalate (DEHP and two monoesters (mono-n-butyl phthalate and mono-(2-ethylhexyl phthalate (MEHP on the differentiated function of primary human thyroid cell cultures. Also, the kinetics of phthalate metabolism were investigated. DEHP and its monoester, MEHP, both had an inhibitory influence on 3'-5'-cyclic adenosine monophosphate secretion from the cells, and MEHP also on thyroglobulin (Tg secretion from the cells. Results of the lactate dehydrogenase-measurements indicated that the MEHP-mediated influence was caused by cell death. No influence on gene expression of thyroid specific genes (Tg, thyroid peroxidase, sodium iodine symporter and thyroid stimulating hormone receptor by any of the investigated diesters could be demonstrated. All phthalate diesters were metabolised to the respective monoester, however with a fall in efficiency for high concentrations of the larger diesters DnBP and DEHP. In conclusion, human thyroid cells were able to metabolise phthalates but this phthalate-exposure did not appear to substantially influence selected functions of these cells.

Systemic evaluation of thyroid function in women and men according to the radioimmunoassay data

Energy Technology Data Exchange (ETDEWEB)

Morozov, S.L.; Trusov, V.V.; Lajzan, L.K. (Nauchno-Issledovatel' skij Inst. Rentgenologii i Radiologii, Moscow (USSR); Izhevskij Meditsinskij Inst. (USSR); Udmurtskij Gosudarstvennyj Univ., Izhevsk (USSR))

1984-08-01

A new variant of the integral quantitative systemic evaluation of thyroid function is presented. Its essence is as follows: the integral index of evaluation is based on the simultaneous registration of 3 thyroid indices TTH, T/sub 3/ and T/sub 4/. The proposed method makes it possible to unravel changes in thyroid function concealed by homeostasis in women depending on the menstruation phase and reflects in a summary form by means of one figure the entire activities of the hypophyseal-thyroid system.

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection

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Sarai Maryam

2002-12-01

Full Text Available Abstract Background Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. Methods 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (3, T4 and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection. Results Average pre-treatment nodule volume [18.2 ± 12.7 ml] decreased to 5.7 ± 4.6 ml at 6 months follow-up [P 4 and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia. Conclusion Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.

Percutaneous ethanol injection of large autonomous hyperfunctioning thyroid nodules.

Science.gov (United States)

Tarantino, L; Giorgio, A; Mariniello, N; de Stefano, G; Perrotta, A; Aloisio, V; Tamasi, S; Forestieri, M C; Esposito, F; Esposito, F; Finizia, L; Voza, A

2000-01-01

To verify the effectiveness of percutaneous ethanol injection (PEI) in the treatment of large (>30-mL) hyperfunctioning thyroid nodules. Twelve patients (eight women, four men; age range, 26-76 years) with a large hyperfunctioning thyroid nodule (volume range, 33-90 mL; mean, 46.08 mL) underwent PEI treatment under ultrasonographic (US) guidance. US was used to calculate the volume of the nodules and to assess the diffusion of the ethanol in the lesions during the procedure. When incomplete necrosis of the nodule was depicted at scintigraphy performed 3 months after treatment, additional PEI sessions were performed. Four to 11 PEI sessions (mean, seven) were performed in each patient, with an injection of 3-14 mL of 99.8% ethanol per session (total amount of ethanol per patient, 30-108 mL; mean, 48.5 mL). At scintigraphy after treatment in all patients, recovery of extranodular uptake, absence of uptake in the nodule, and normalization of thyroid-stimulating hormone (thyrotropin) levels were observed. In all patients, US showed volume reductions of 30%-50% after 3 months and 40%-80% after 6-9 months. Side effects were self-limiting in all patients. During the 6-48-month follow-up, no recurrence was observed. PEI is an effective and safe technique for the treatment of large hyperfunctioning thyroid nodules.

Characterization of thyroid function and antithyroid antibody tests among Saudis

Science.gov (United States)

Jammah, Anwar A.; Alshehri, Anwar S.; Alrakhis, Afaf A.; Alhedaithy, Asma S.; Almadhi, Asma M.; Alkwai, Hala M.; Alhamad, Maram M.; Alzahrani, Saad H.

2015-01-01

Objective: To determine the reference intervals for thyroid function tests and the prevalence of thyroid autoimmunity in the Saudi population. Methods: A cross-sectional prospective study was conducted in King Khalid University Hospital, Riyadh, Saudi Arabia from January to June 2013. History and physical examination were obtained. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were measured by Electro-chemiluminescence Immunoassay system-assay. Anti-thyroperoxidase, and anti-thyroglobulin antibodies were measured using enzyme-linked immunosorbent-assay. Subjects with previous or a family history of thyroid disorders, those taking medications affecting thyroid function, pregnant or lactating women, and those with goiter were excluded. Individuals with positive antibodies were excluded from the final analysis of the TSH reference range, but were used to determine the prevalence of thyroid autoimmunity. Results: Out of 337 Saudi subjects initially screened, 132 (aged 13-60 years) were candidates for reference calculation, the mean±standard deviation, and (2.5th-97.5th) percentile of TSH (mIU/L) was 1.96±0.9 (0.59-4.37), for FT4 (pmol/L) was 15.47±1.83 (12.04-19.13), and for FT3 (pmol/L) was 5.22±0.7 (4.07-6.76). The TSH was higher in the antibodies positive group (2.5±1.17 mIU/L) compared with the negative one (1.96±0.9 mIU/L) (pantithyroid antibodies. Conclusion: The TSH reference range was similar to laboratory references. Thyroid antibodies were prevalent in Saudis, necessitating further work in larger scale studies. PMID:25987111

The effect of chemoradiation therapy on pituitary-thyroid system function in children suffering Hodgkin's disease

International Nuclear Information System (INIS)

Konoplya, N.E.; Sachivko, N.V.; Zhavrid, Eh.A.

1997-01-01

The functional status of the thyroid gland was evaluated in 63 children with Hodgkin's disease, aged 4-15 years, before, in the course of and 5 years after chemoradiation therapy. Thyroxin (T4), triiodothyronine (T) and thyroid-stimulating hormone (TSH) in the blood were assayed. The disease was shown to disrupt the pituitary-thyroid system leading to hypothyroidism development which progressed as the disease advanced. While chemotherapy brought the balance between the peripheral thyroid hormone levels and TSH back to normal, thyroid function decrease again following radiotherapy of the neck. The most pronounced and persistent failure of the pituitary-thyroid system was registered with the total target dose of 30 Gy and higher. Irradiation in a dose of 20 Gy caused less disruption and the function was spontaneously restored within 12 months after the treatment

Thyroid function and cold acclimation in the hamster, Mesocricetus auratus

International Nuclear Information System (INIS)

Tomasi, T.E.; Horwitz, B.A.

1987-01-01

Basal metabolic rate (BMR), thyroxine utilization rate (T 4 U), and triiodothyronine utilization rate (T 3 U) were measured in cold-acclimated (CA) and room temperature-acclimated (RA) male golden hamsters, Mesocricetus auratus. Hormone utilization rates were calculated via the plasma disappearance technique using 125 I-labeled hormones and measuring serum hormone levels via radioimmunoassay. BMR showed a significant 28% increase with cold acclimation. The same cold exposure also produced a 32% increase in T 4 U, and a 204% increase in T 3 U. The much greater increase in T 3 U implies that previous assessments of the relationship between cold acclimation and thyroid function may have been underestimated and that cold exposure induces both quantitative and qualitative changes in thyroid function. It is concluded that in the cold-acclimated state, T 3 U more accurately reflects thyroid function than does T 4 U. A mechanism for the cold-induced change in BMR is proposed

Effect of abnormal thyroid function on the severity of Graves' ophthalmopathy

NARCIS (Netherlands)

Prummel, M. F.; Wiersinga, W. M.; Mourits, M. P.; Koornneef, L.; Berghout, A.; van der Gaag, R.

1990-01-01

Many clinicians have the impression that treatment of thyroid dysfunction ameliorates ophthalmopathy in Graves' disease. The aim of our study was to relate thyroid function to the severity of Graves' ophthalmopathy. We studied 90 patients with Graves' ophthalmopathy and Graves' hyperthyroidism in

Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

Science.gov (United States)

Walfish, P G; Strawbridge, H T; Rosen, I B

1985-12-01

To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

Thyroid function in mothers who gave birth to neonates with transient congenital hypothyroidism

International Nuclear Information System (INIS)

Karam, G.A.; Hakimi, H.; Rezaeian, M.; Gafarzadeh, A.; Rashidinejad, H.; Khaksari, M.

2009-01-01

Objective: To determine the thyroid status of mother's of newborns with primary congenital hypothyroidism. Methodology: Thyroid function tests were carried out on 80 mothers of hypothyroid newborns and 80 mothers of non-hypothyroid newborns as control. Results: The mean difference of the tests revealed that mothers of congenitally hypothyroid infants had a lower triiodothyronine resin uptake (T3RU) concentrations compared with the control population. The higher value of free thyroxin index (FTI) in case group showed a tendency to significance. The proportional frequency distribution showed; T3RU and triiodothyronine (T3) had a significant difference, and FTI showed a tendency to significance. There were no significant differences between; thyroid-stimulating hormone (TSH), thyroxine (T4) and anti-thyroid peroxidase antibodies (anti-TPO) in two groups. Conclusions: These results indicated that at least some cases of primary congenital hypothyroidism were attributable to the maternal thyroid disease. Therefore, we recommend that each pregnant woman should be assessed for thyroid function in region with a high prevalence of thyroid disease. (author)

The pharmacists' role in improving guideline compliance for thyroid function testing in patients with heart failure.

Science.gov (United States)

Ziman, Melanie E; Bui, Hien T; Smith, Craig S; Tsukiji, Lori A; Asmatey, Veda M; Chu, Steven B; Miano, John S

2012-04-01

This single-center retrospective pilot program's objective was to utilize outpatient pharmacists to improve laboratory test adherence in chronic heart failure (CHF) patients overdue for thyroid function testing, thereby demonstrating the value of the outpatient pharmacist and justifying possible clinical role expansion. Thyroid disorders may contribute to CHF development, progression, and exacerbation. Testing is the standard of care in CHF patients per American Heart Association's 2009 Guidelines. Delinquency was defined as labs not conducted within 1 year in patients with euthyroid history, within 6 months in patients with thyroid dysfunction, abnormal labs at any time without follow-up, or lab absence after thyroid medication initiation, adjustment, or discontinuation. Targeted 80 nonpregnant adult CHF patients with delinquent thyroid function tests were counseled to get thyroid labs at point of sale, via telephone, e-mail, or letter. In collaboration with physicians, pharmacists ordered thyroid-stimulating hormone (TSH) and free T4 (FT4) labs. For patients with abnormal laboratory results, pharmacists coordinated drug therapy and follow-up labs. Data were collected from November 1, 2009 to March 30, 2010. Seventy-two patients (90%) previously delinquent for thyroid function testing received relevant thyroid labs. Ten patients (12.5%) with abnormal thyroid function tests not on prior drug therapy received treatment.

Thyroid function in healthy and unhealthy preterm newborns

African Journals Online (AJOL)

2018-06-02

Jun 2, 2018 ... Thyroid function in healthy and unhealthy preterm newborns. Gökten Korkmaz1 ... disruptions of this system can cause permanent damage. Unrecognized early .... hypoglycemia, hypocalcemia and malnutrition. Some rare.

[Effects of maternal hyperthyroidism and antithyroid drug therapy on thyroid function of newborn infants].

Science.gov (United States)

Lian, Xiao-lan; Bai, Yao; Xun, Yun-hua; Dai, Wei-xin; Guo, Zhi-sheng

2005-12-01

To evaluate the relationship between the incidence of abnormal thyroid function of newborns and maternal hyperthyroidism with antithyroid drug therapy. The clinical data of 35 neonates born to mothers with hyperthyroidism from 1983 to 2003 in Peking Union Medical College Hospital were retrospectively analyzed. According to the maternal thyroid function and the antithyroid drugs taken during pregnancy, subjects were divided into different groups. The proportion of abnormal thyroid function in newborn was 48.6% (17/35). The prevalences of primary hypothyroidism, subclinical hypothyroidism, hypothyroxinemia, and central hypothyroidism were 29.4%, 29.4%, 35.3%, and 5.9%, respectively. The incidence of abnormal thyroid function of neonates whose mothers did not take the antithyroid drugs (ATDs) until the third trimester of pregnancy was significantly higher than those without and with ATDs during the first or second trimester (P hyperthyroid mothers did not take ATDs until the third trimester of pregnancy may be increased. Prompt diagnosis and appropriate treatment of hyperthyroidism in pregnant women are essential for the prevention of neonatal thyroid functional abnormality.

Assay of free thyroxine and free triiodothyronine in fine-needle aspiration of thyroid nodules: a useful and low-cost assessment.

Science.gov (United States)

Barbaro, Daniele; Macchia, Enrico; Orsini, Paola; Piazza, Francesca; Lapi, Paola; Pasquini, Cristina

2004-01-01

To evaluate whether analysis of thyroid hormones in fine-needle aspiration (FNA) of thyroid nodules can provide information about the functional status and the nature of the nodules. We studied 4 groups of patients: group 1, 17 patients with autonomous hyperfunctioning thyroid nodules; group 2, 52 patients with cold nonfunctioning thyroid nodules; group 3, 12 patients with malignant thyroid nodules; and group 4 (control group), 10 patients with nonthyroid nodular lesions (enlarged parathyroid glands or lymph nodes). The assay of thyroid hormones was performed in FNA after the washing of needles and, with patient consent, also in normal thyroid parenchyma. The free thyroxine (FT(4)) and free triiodothyronine (FT(3)) values were remarkably high in group 1 (mean, 5.5 +/- 0.53 ng/dL and 27.6 +/- 3.1 pg/mL, respectively; Pnodules. These results show that assay of FT(4) and FT(3) in FNA can yield information about the functional status of thyroid nodules and, indirectly, about the nature of nodules. In this era of sophisticated new molecular markers in FNA cytology, this low-cost diagnostic method can be readily performed in every laboratory.

CO-occurring exposure to perchlorate, nitrate and thiocyanate alters thyroid function in healthy pregnant women

International Nuclear Information System (INIS)

Horton, Megan K.; Blount, Benjamin C.; Valentin-Blasini, Liza; Wapner, Ronald; Whyatt, Robin; Gennings, Chris; Factor-Litvak, Pam

2015-01-01

Background: Adequate maternal thyroid function during pregnancy is necessary for normal fetal brain development, making pregnancy a critical window of vulnerability to thyroid disrupting insults. Sodium/iodide symporter (NIS) inhibitors, namely perchlorate, nitrate, and thiocyanate, have been shown individually to competitively inhibit uptake of iodine by the thyroid. Several epidemiologic studies examined the association between these individual exposures and thyroid function. Few studies have examined the effect of this chemical mixture on thyroid function during pregnancy Objectives: We examined the cross sectional association between urinary perchlorate, thiocyanate and nitrate concentrations and thyroid function among healthy pregnant women living in New York City using weighted quantile sum (WQS) regression. Methods: We measured thyroid stimulating hormone (TSH) and free thyroxine (FreeT4) in blood samples; perchlorate, thiocyanate, nitrate and iodide in urine samples collected from 284 pregnant women at 12 (±2.8) weeks gestation. We examined associations between urinary analyte concentrations and TSH or FreeT4 using linear regression or WQS adjusting for gestational age, urinary iodide and creatinine. Results: Individual analyte concentrations in urine were significantly correlated (Spearman's r 0.4–0.5, p<0.001). Linear regression analyses did not suggest associations between individual concentrations and thyroid function. The WQS revealed a significant positive association between the weighted sum of urinary concentrations of the three analytes and increased TSH. Perchlorate had the largest weight in the index, indicating the largest contribution to the WQS. Conclusions: Co-exposure to perchlorate, nitrate and thiocyanate may alter maternal thyroid function, specifically TSH, during pregnancy. - Highlights: • Perchlorate, nitrate, thiocyanate and iodide measured in maternal urine. • Thyroid function (TSH and Free T4) measured in maternal blood

CO-occurring exposure to perchlorate, nitrate and thiocyanate alters thyroid function in healthy pregnant women

Energy Technology Data Exchange (ETDEWEB)

Horton, Megan K., E-mail: megan.horton@mssm.edu [Department of Preventive Medicine, Icahn School of Medicine, New York, New York (United States); Blount, Benjamin C.; Valentin-Blasini, Liza [National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia (United States); Wapner, Ronald [Department of Obstetrics and Gynecology, Columbia University, New York, New York (United States); Whyatt, Robin [Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York (United States); Gennings, Chris [Department of Preventive Medicine, Icahn School of Medicine, New York, New York (United States); Factor-Litvak, Pam [Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York (United States)

2015-11-15

Background: Adequate maternal thyroid function during pregnancy is necessary for normal fetal brain development, making pregnancy a critical window of vulnerability to thyroid disrupting insults. Sodium/iodide symporter (NIS) inhibitors, namely perchlorate, nitrate, and thiocyanate, have been shown individually to competitively inhibit uptake of iodine by the thyroid. Several epidemiologic studies examined the association between these individual exposures and thyroid function. Few studies have examined the effect of this chemical mixture on thyroid function during pregnancy Objectives: We examined the cross sectional association between urinary perchlorate, thiocyanate and nitrate concentrations and thyroid function among healthy pregnant women living in New York City using weighted quantile sum (WQS) regression. Methods: We measured thyroid stimulating hormone (TSH) and free thyroxine (FreeT4) in blood samples; perchlorate, thiocyanate, nitrate and iodide in urine samples collected from 284 pregnant women at 12 (±2.8) weeks gestation. We examined associations between urinary analyte concentrations and TSH or FreeT4 using linear regression or WQS adjusting for gestational age, urinary iodide and creatinine. Results: Individual analyte concentrations in urine were significantly correlated (Spearman's r 0.4–0.5, p<0.001). Linear regression analyses did not suggest associations between individual concentrations and thyroid function. The WQS revealed a significant positive association between the weighted sum of urinary concentrations of the three analytes and increased TSH. Perchlorate had the largest weight in the index, indicating the largest contribution to the WQS. Conclusions: Co-exposure to perchlorate, nitrate and thiocyanate may alter maternal thyroid function, specifically TSH, during pregnancy. - Highlights: • Perchlorate, nitrate, thiocyanate and iodide measured in maternal urine. • Thyroid function (TSH and Free T4) measured in maternal blood

Thyroid function in girls with menstrual disturbances in iodine-deficiency region

Directory of Open Access Journals (Sweden)

O Konstantinova

2010-06-01

Full Text Available The estimate the functional state of the female adolescent thyroid with menstrual cycle disorder, living in the iodine deficiency regions, 130 female adolescents with irregular menstrual cycle were examined. Hypothyroidism incidence (in them was 16.9%. In addition we considered TSH range 2.5–4.0 mU/l (highly normal TSH level the extent of which was 12.3%. High extent of antibody carriage to the thyroid (31.3% in girls with irregular menses, having high blood TSH level. There were no statistical differences between the structure of menstrual dysfunction and menstrual duration depending on thyroid function (p = 0.2383, respectively, as well as the average values of estradiol levels depending on TSH level (p = 0.3213. Thus, the influence of highly normal TSH on menstrual function development in female adolescents.

Thyroid Function among Breastfed Children with Chronically Excessive Iodine Intakes

Directory of Open Access Journals (Sweden)

Inger Aakre

2016-06-01

Full Text Available Iodine excess may impair thyroid function and trigger adverse health consequences for children. This study aims to describe iodine status among breastfed infants with high iodine exposure in the Saharawi refugee camps Algeria, and further assess thyroid function and iodine status among the children three years later. In 2010, a cross-sectional study among 111 breastfed children aged 0–6 months was performed (baseline study. In 2013, a second cross-sectional study (follow-up study was conducted among 289 children; 213 newly selected and 76 children retrieved from baseline. Urinary iodine concentration (UIC and breast milk iodine concentration (BMIC were measured at baseline. UIC, thyroid hormones and serum thyroglobulin (Tg were measured at follow-up. At baseline and follow-up, 88% and 72% had excessive iodine intakes (UIC ≥ 300 µg/L, respectively. At follow-up, 24% had a thyroid hormone disturbance and/or elevated serum Tg, including 9% with subclinical hypothyroidism (SCH, 4% with elevated fT3 and 14% with elevated Tg. Children with SCH had poorer linear growth and were more likely to be underweight than the children without SCH. Excessive iodine intakes and thyroid disturbances were common among children below four years of age in our study. Further, SCH seemed to be associated with poor growth and weight.

Hyperthyroidism in patients with thyroid cancer.

Science.gov (United States)

Sharma, Sunil Dutt; Kumar, Gaurav; Guner, Karen; Kaddour, Hesham

2016-06-01

We present a retrospective case series of patients with hyperthyroidism and thyroid cancer. Our goal was to look at their clinical characteristics and outcomes to determine which patients would require further investigation. We reviewed the case notes of all patients with a histopathologic diagnosis of thyroid cancer and biochemical evidence of hyperthyroidism who had been treated at a thyroid cancer center from January 2006 through October 2013. During that time, 66 patients had been diagnosed with thyroid cancer. Of these, 8 patients (12%)-all women, aged 29 to 87 years (mean: 55.6; median: 50.5)-had biochemical evidence of hyperthyroidism. Among these 8 patients, 4 had an autonomously functioning toxic nodule (AFTN), 3 were diagnosed with Graves disease, and 1 had a toxic multinodular goiter. Five patients had suspicious features on preoperative ultrasonography. All 8 patients were diagnosed with the papillary type of thyroid carcinoma. The mean size of the tumor in the 4 patients with AFTN was significantly larger than it was in those with Graves disease (42.3 ± 23.8 mm vs. 3.8 ± 1.6; p = 0.04). The 3 patients with Graves disease all had incidentally found papillary microcarcinoma. Between these two groups, the patients with AFTN had a poorer prognosis; 2 of them had extracapsular invasion and lymph node metastasis, and another died of her disease. We found that the incidence of hyperthyroidism in thyroid cancer patients was relatively high (12%). In contrast to what has previously been reported in the literature, patients with AFTN seem to have more aggressive disease and poorer outcomes than do patients with Graves disease. Any suspicious nodule associated with hyperthyroidism should be evaluated carefully.

Few items in the thyroid-related quality of life instrument ThyPRO exhibited differential item functioning

DEFF Research Database (Denmark)

Watt, Torquil; Grønvold, Mogens; Hegedüs, Laszlo

2014-01-01

To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis.......To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis....

Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger; Joe, Alexius; Zimmerlin, Martina; Krause, Thomas M.

2002-01-01

The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ). The TcTU s value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70±9 years, and the mean thyroid volume was 54±26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU s : 150 Gy for a TcTU s of 1.5%-2.49%, 200 Gy for a TcTU s of 2.5%-3.49%, 250 Gy for a TcTU s of 3.5%-4.49% and 300 Gy for a TcTU s of ≥4.5%. Normalisation of TcTU s and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU s in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54±26 before treatment to 34±20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU s can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

The radioimmunoassay in revealing preclinical disorders of the pituitary-thyroid system functioning

International Nuclear Information System (INIS)

Piven', N.V.; Pilatova, N.L.; Lukhverchik, L.N.; Kuz'menkova, E.I.; Solovej, V.V.; Mokhort, T.V.

2001-01-01

The main purpose of this research was to study the value of radioimmunoassay (RIA) for assessing the pituitary - thyroid function in healthy persons (aged 18-45). Quantitative criteria have been worked put for estimation of thyroid gland function for the population of Belarus in accordance with regional ecological situation. On this basis, concentrations of thyrotropin, thyroxine, triiodothyronine, thyroglobulin, thyroxine binding globulin were determined by RIA in blood samples. The analysis of the data obtained revealed latent forms of hyperthyroidism (42%) and hypothyroidism (21%), regarded by the authors as late medical consequences of Chernobyl accident. Subclinical stages were diagnosed in most cases. Thus RIA has proved useful for studying the functional state of the regulatory 'pituitary-thyroid gland' system and revealing prenosological disorders in it

Comparative study of the parameters of thyroid function TSH, PB131J, T3, T4 in healthy persons and patients after thyroid surgery

International Nuclear Information System (INIS)

Rueffer, W.

1979-01-01

Goals of the investigation were: 1. Study of the parameters TSH, PB 131 I, T 4 , T 3 in strumectomized patients with different functional states of the thyroid after surgery, and comparison with a normal collective. 2. Study of the correlation between pituitary and thyroid behaviour of strumectomized patients by comparing PB 131 I and TSH, T 4 and TSH, and T 3 and TSH. 3. Comparison of in-vivo- and in-vitro tests (TRH, T 4 , T 3 ) in order to assess the thyroid function after strumectomy and for early detection of impending relapses. 466 patients have been grouped according to the functional state of their thyroids. The mean values obtained for each group were compared with those of a normal collective. (orig./MG) [de

Thyroid function testing in neonates born to women with hypothyroidism.

Science.gov (United States)

McGovern, Matthew; Reyani, Zahra; O'Connor, Pamela; White, Martin; Miletin, Jan

2016-12-01

Our aim was to assess the utility of serum thyroxine and thyroid stimulating hormone performed at 10-14 days of life in diagnosing congenital hypothyroidism (CH) in babies born to mothers with hypothyroidism. This was a retrospective study of all babies born in a tertiary referral centre for neonatology over a 12-month period. Infants who had thyroid function testing (TFT) checked at 10-14 days of life because of maternal hypothyroidism during the period of study were included. The results of the newborn bloodspot and day 10-14 TFT were recorded along with whether or not patients were subsequently treated. Of the 319 patients included in the study, only two patients were found to have CH and in both cases the newborn blood spot had been abnormal. No extra cases of CH were detected from the thyroid test at 10-14 days and this practice should be discontinued due to the robust nature of existing newborn screening programmes. What is Known: • Congenital hypothyroidism(CH) is the commonest preventable cause of childhood intellectual impairment. • Family history of hypothyroidism has been implicated as a risk factor for CH. • CH has formed part of newborn screening since the 1970s. What is New: • There is no research recommending thyroid function testing at 10-14 days of life to detect CH in neonates born to mothers with hypothyroidism. • Thyroid function testing at 10-14 days of life does not improve diagnostic yield for CH in babies born to mothers with hypothyroidism. • Newborn blood spot remains the mainstay for accurate and timely diagnosis of CH.

Thyroid Hormones and Thyroid Function status in each clinical phase of Korean Hemorrhagic Fever

International Nuclear Information System (INIS)

Shin, Young Tae; Jeon, Byung Sook; Yoon, Sung Yeul; Lee, Houn Young; Kim, Sam Yong; Ro, Heung Kyu

1983-01-01

Fifteen cases of Korean hemorrhagic fever who were admitted Chungnam National University Hospital from October 1981 to December 1981 were analysed on the evaluation of metabolic changes of the thyroid hormones, and thyroid function status in each clinical phase. 1) Serum T 3 , T 4 concentration, FT 4 I and T 4 /TBG ratio were significantly lower (p 4 , TSH and TBG concentration were within normal range in all phase of KHF. Thus in Korean hemorrhagic fever, euthyroidism is probably maintained by normal or elevated serum FT 4 . 2) T 4 /T 3 and rT 3 /T 3 ratio (p 4 to T 3 in oliguric and early diuretic phase.

Natural History of Thyroid Function in Adults with Down Syndrome--10-Year Follow-Up Study

Science.gov (United States)

Prasher, V.; Gomez, G.

2007-01-01

Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…

Influence of excessive iodine intake on the thyroid function and spectrum of thyroid abnormalities in population of Turinsk, Sverdlovsk Region, of Russia

Directory of Open Access Journals (Sweden)

Aleksey V. Kiyaev

2015-05-01

Full Text Available Background. Previous surveys showed chronic iodine excess - median urinary iodine concentration (UIC over 500 mcg/l — supposedly due to water contamination in population of Turinsk, a town in Sverdlovsk Region of Russia. Aim. Conduct an assessment of the effects of chronic iodine excess on thyroid function and spectrum of thyroid abnormalities in schoolchildren and adults. Materials and methods. Assessment was conducted in 100 schoolchildren and 100 adults residing in Turinsk and 97 schoolchildren and 100 adults in the control site (city of Pervouralsk with optimal UIC. Assessment included thyroid ultrasonogrpahy, urinary iodine and dry spot TSH in schoolchildren and TSH and TPO-ab in adults. Iodine was also measured in random water samples from 10 households in Turinsk. Results. Median UIC in schoolchildren in Turinsk (719 mcg/l was significantly higher (129 mcg/l than in Pervouralsk resulting in higher prevalence of thyroid enlargement and TSH level. In adults TSH level as well as prevalence of sub-clinical hypothyroidism and autoimmune thyroiditis were higher in residents of Turinsk compared to control group from Pervouralsk. Conclusions. Iodine excess alters thyroid function in schoolchildren and adults increasing prevalence of thyroid enlargement in children and autoimmune thyroidis in adults.

Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of {sup 99m}Tc-pertechnetate thyroid uptake

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger [Department of Nuclear Medicine, University Hospital Bonn (Germany); Joe, Alexius; Zimmerlin, Martina [Department of Nuclear Medicine, University Hospital Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

2002-04-01

The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}). The TcTU{sub s} value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70{+-}9 years, and the mean thyroid volume was 54{+-}26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU{sub s}: 150 Gy for a TcTU{sub s} of 1.5%-2.49%, 200 Gy for a TcTU{sub s} of 2.5%-3.49%, 250 Gy for a TcTU{sub s} of 3.5%-4.49% and 300 Gy for a TcTU{sub s} of {>=}4.5%. Normalisation of TcTU{sub s} and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU{sub s} in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54{+-}26 before treatment to 34{+-}20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU{sub s} can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

Maternal Thyroid Function in Early Pregnancy and Child Neurodevelopmental Disorders

DEFF Research Database (Denmark)

Andersen, Stine Linding; Andersen, Stig; Vestergaard, Peter

2018-01-01

of abnormal maternal thyroid function was 12.5% in the sub-cohort and significantly higher among cases of ASD (17.9%; aHR = 1.5 [CI 1.1-2.1]), but not among other types of neurodevelopmental disorders (febrile seizures: 12.7%; epilepsy: 13.1%; SDD: 12.6%; and ADHD: 14.0%). However, evaluation of subtypes......: The design was a case-cohort study within the Danish National Birth Cohort (1997-2003). From the eligible cohort of 71,706 women, a random 12% sub-cohort (n = 7624) was selected, and all women (n = 2276) whose child was diagnosed with seizures, specific developmental disorder (SDD), autism spectrum disorder......BACKGROUND: Maternal thyroid dysfunction may adversely affect fetal brain development, but more evidence is needed to refine this hypothesis. The aim of this study was to evaluate potential fetal programming by abnormal maternal thyroid function on child neurodevelopmental disorders. METHODS...

Correlation between Oxidative Stress and Thyroid Function in Patients with Nephrotic Syndrome

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Sangita U. Sawant

2011-01-01

Full Text Available Background. The present study is to look for a correlation between oxidative stress and thyroid function in patients with the nephrotic syndrome in the remission phase as well as in a persistent proteinuric state. Introduction. Nephrotic syndrome is a form of chronic kidney disease due to which blood loses protein through the urine. We wanted to know if there was an increased loss of thyroid hormones in urine affecting thyroid function. Methods. 60 patients with nephrotic syndrome and 20 healthy non-proteinuric individuals as control subjects were enrolled in the study. We measured their serum tri-iodothyronine, thyroxine and thyroid-stimulating hormone. Estimation of lipid peroxidation (LPx catalase, superoxide dismutase (SOD, and Glutathione peroxidase (GPx were carried out by standard methods. Results. TSH was elevated in the nephrotic patients compared to controls, while TT4 and TT3 were significantly lower in the patients than in controls. Lipid Peroxidation and GPx were significantly higher in the nephrotic syndrome patients than in the controls, while SOD and catalase were significantly lower than in patients than in the control subjects. Conclusion. Nephrotic patients can lose significant amounts of thyroid hormones along with protein in urine, which can affect thyroid status, but this is reversible on remission.

Study on the incidence and etiology of subclinical thyroid function disorders

International Nuclear Information System (INIS)

Gu Jingxin; Xie Xiuhai; Huang Chenyang; Fu Junyan; Lu Weiguo; Chen Kejing

2006-01-01

Objective: To study the incidence and etiology of subclinical thyroid function disorders in 12592 subjects tested. Methods: The etiology of 874 patients with abnormal serum TSH (with IRMA) found in the tested 12592 patients, whose serum T 3 , T 4 , FT 3 , FT 4 , TSH, TGA and TMA were also detected with RIA was analyzed. Results: 874 of 12592 patients had abnormal TSH levels (6.94%). Among them, TSH was elevated in 397 patients (3.15%) and decreased in 477 patients (3.79%). Most of them were associated with obvious related thyroid or other thronic diseases such as hyperthyroidism after therapy, thyroxine replacement treatment of hypothyroidism and other thyroid diseases (thyroiditis, diffuse nontoxic goiter). In the remaining apparently disease-free 143 subjects, there were with subclinical hypothyroidism and 34 (3.89% of 874) with subclinical hyperthyroidism. Also among the 874 patients, 30.78% (n=269) patients had elevated TGA and TMA[16.82% (n=147) had elevated TSH and TGA, TMA simultaneously, 13.96% (n=122) had decreased TSH and elevated TGA and TMA simultaneously]. In the 874 patients, 256 (29.29%) were older than 60. Conclusion: Elderly people has higher incidence of subclinical thyroid function disorders. We should pay more attention to the detection of this condition, especially in elderly patients. (authors)

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

NARCIS (Netherlands)

Kuppens, S.M.I.; Kooistra, L.; Hasaart, T.H.M.; Donk, M.W.; Vader, H.; Oei, S.G.; Pop, V.J.

2011-01-01

Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Methods Prospective cohort study in 141 women (= 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were

Peculiarities of hypothalamic-pituitary thyroid function in children born from the Chornobyl NPP accident survivors

International Nuclear Information System (INIS)

Kopylova, O.V.; Stepanenko, O.A.

2015-01-01

The 168 children born to parents exposed after the Chernobyl accident were examined to study the hypothalamic-pituitary-thyroid system function in descendants of the Chernobyl survivors. Clinical, hormonal, ultrasound examinations and challenge test with tyroliberynum were conducted. Some abnormalities that might explain the functional strain of the hypothalamic-pituitary system were identified being of a great role in origination and progress of thyroid disease. The prolonged strain leads to decreased production of thyroid hormone, which causes an increased secretion of thyroid stimulating hormone. Under the influence of TSH the thyroid gland in the first stage becomes increased in its mass, which leads to the formation of endemic goiter. Stable and permanent thyroid gland enlargement often leads to formation of the nodular goiter and other proliferative processes, namely to carcinogenesis

Twenty cases of ectopic thyroid gland detected by thyroid scintigraphy

International Nuclear Information System (INIS)

Hashimoto, Teisuke; Kubo, Atsushi; Hashimoto, Shozo

1988-01-01

20 cases of ectopic thyroid gland were detected out of 5,261 thyroid scintigraphy from 1973. Except for 1 case, all cases were female. Considering of thyroid function, 11 cases were euthyroid and rest of 9 cases were hypothyroid function. Clinical symptom of hypothyroid cases were mainly retarded linear growth and high value of serum TSH and in case of euthyroid cases were sublingual tumor and fullness or tightness in throat. Thyroid scintigraphy is very useful to diagnose the sublingual tumor whether it is ectopic thyroid gland or not. In case of congenital hypothyroidism children, ectopic thyroid gland causing hypothyroidism is definitely diagnosed by thyroid scintigraphy. (author)

Effect of Rifampin on Thyroid Function Test in Patients on Levothyroxine Medication.

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Hye In Kim

Full Text Available Levothyroxine (LT4 and rifampin (RIF are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose.We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA/American Association of Clinical Endocrinologists (AACE guidelines were identified, and risk factors of increased LT4 dose were analyzed.After administering RIF, median serum thyroid-stimulating hormone (TSH level (2.58 mIU/L, interquartile range [IQR] 0.21-7.44 was significantly higher than that before RIF (0.25 mIU/L, IQR, 0.03-2.62; P < 0.001. An increased LT4 dose was required for 50% of patients in the TSH suppression group for thyroid cancer and 26% of patients in the replacement group for hypothyroidism. Risk factor analysis showed that remaining thyroid gland (odds ratio [OR] 9.207, P = 0.002, the time interval between starting RIF and TSH measurement (OR 1.043, P = 0.019, and baseline LT4 dose per kg body weight (OR 0.364, P = 0.011 were clinically relevant variables.In patients receiving LT4, serum thyroid function test should be performed after starting RIF treatment. For patients with no remnant thyroid gland and those receiving a lower LT4 dose, close observation is needed when starting RIF and TB medication.

Role of the Orexin System on the Hypothalamus-Pituitary-Thyroid Axis

Science.gov (United States)

Messina, Antonietta; De Fusco, Carolina; Monda, Vincenzo; Esposito, Maria; Moscatelli, Fiorenzo; Valenzano, Anna; Carotenuto, Marco; Viggiano, Emanuela; Chieffi, Sergio; De Luca, Vincenzo; Cibelli, Giuseppe; Monda, Marcellino; Messina, Giovanni

2016-01-01

Hypocretin/orexin (ORX) are two hypothalamic neuropeptides discovered in 1998. Since their discovery, they have been one of the most studied neuropeptide systems because of their projecting fields innervating various brain areas. The orexinergic system is tied to sleep-wakefulness cycle, and narcolepsy is a consequence of their system hypofunction. Orexinergic system is also involved in many other autonomic functions such as feeding, thermoregulation, cardiovascular and neuroendocrine regulation. The main aim of this mini review article is to investigate the relationship between ORX and thyroid system regulation. Although knowledge about the ORX system is evolving, its putative effects on hypothalamic-pituitary-thyroid (HPT) axis still appear unclear. We analyzed some studies about ORX control of HPT axis to know better the relationship between them. The studies that were analyzed suggest Hypocretin/ORX to modulate the thyroid regulation, but the nature (excitatory or inhibitory) of this possible interaction remains actually unclear and needs to be confirmed. PMID:27610076

Chapter 3. Thyroid

International Nuclear Information System (INIS)

Tubiana, M.; Perez, R.

1975-01-01

In the context of a functional thyroid exploration study the physiopathology of the thyroid was reviewed on the basis of data supplied by the use of radioisotopes, especially radioiodine. It was pointed out in this respect that the functional activity of the thyroid is closely bound up with the iodine metabolism. The different stages of the iodine metabolism were therefore described in relation to the methods used for their exploration: study of iodine intake to the thyroid and uptake measurement; hormonogenesis and secretion of hormone iodine; transport and circulation of thyroid hormones; exploration of the hypothalamus-pituitary gland-thyroid axis. It was pointed out in addition that the morphological examination often complements the thyroid function exploration and is carried out whenever thyroid palpation reveals an anomaly. Data obtained by scintigraphy are given in this repect. Furthermore the remarkable capacity of hyperthyroid tissues to concentrate radioactive iodine may be used therapeutically to perform an endogenous irradiation of the thyroid. The treatment of both hyperthyroidism and thyroid cancers with radioactive iodine was studied [fr

Black Thyroid Associated with Thyroid Carcinoma

Directory of Open Access Journals (Sweden)

Emad Kandil

2010-01-01

Full Text Available Objective. Black thyroid is a rare pigmented change seen almost exclusively in patients upon minocycline ingestion, and the process has previously been thought to be generally benign. There have been 61 reported cases of black thyroid. We are aware of 13 cases previously reported in association with thyroid carcinoma. This paper reports six patients with black thyroid pigmentation in association with thyroid carcinoma. Design. The medical records of six patients who were diagnosed with black thyroid syndrome, all of whom underwent thyroid surgery, were reviewed. Data on age, gender, race, preoperative fine needle aspiration biopsy (FNA, thyroid function levels, and pathology reports were collected. Main Outcome. The mean age was 60 years. There were 5 females, 4 of whom were African American. All patients were clinically and biochemically euthyroid. Black pigmentation was not diagnosed in preoperative FNA, and only one patient had a preoperative diagnosis of papillary thyroid carcinoma. The other patients underwent surgery and were found to have black pigmentation of the thyroid associated with carcinoma. Conclusions. FNA does not diagnose black thyroid, which is associated with thyroid carcinoma. Thyroid glands with black pigmentation deserve thorough pathologic examination, including several sections of each specimen.

First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

International Nuclear Information System (INIS)

Oexle, C.; Reinhardt, M.; Moser, E.

1998-01-01

Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

Normal thyroid function values in Ethiopians

International Nuclear Information System (INIS)

Wassie, Emnetu; Abdulkadir, Jemal

1990-01-01

Thyroid function values were determined in 56 healthy nongoitrous adult Ethiopians. The mean triiodothyronine (T3) values for 20 males and 36 females were 1.42+-0.32 nmol/L and 1.51+-0.25 nmol/L, and thyroxine (T4) values were 119 22 nmol/L and 116+21 nmol/L respectively. The mean thyrotropin (TSH) values for males and females were identical at 1.86+-0.94 mu/L. Radioactive iodine uptake (RAIU) at 2 hours was 8.6+-4.4% in males and 11.3+-4.3% in females, and at 24 hours 31.7+-11.7% and 38.9+-11.1% respectively. The difference between males and females were significant at both 2 and 24 hours (P<0.05). The ranges for the 3 hormones derived from the mean 2SD values are close to these supplied with the kits but the Ethiopian RAIU values are higher than the values currently applicable in developed countries, probably indicative of the lower level of dietary iodine available to the population here. The values obtained in this study are offered to serve as normal reference for the interpretation of thyroid function results in Ethiopian patients. A strategy for the rational utilization of the available in vitro tests is suggested

Therapeutic outcome after radioiodine and surgery treatment of toxic thyroid adenoma

International Nuclear Information System (INIS)

Petrovski, Zlatko P.

2005-01-01

Full text: Purpose: The aim of the study was to evaluate late follow-up results in surgery and radioiodine treatment of toxic thyroid adenoma and compare incidence of hypothyroidism and recurrence hyperthyroidism in treated patients. Material and Methods: We observed 93 treated patients (77 female, 26 male, age range 18-76 years) with adenoma toxicum. 29 (32.2 %) patients underwent surgery (adenectomia), while 64 (67.8 %) patients received 131 I therapy (555-1100 MBq).The long term results of the treatment were followed 1-15 years after therapy (median 9,2 years). Results: Recurrent hyperthyroidism occurred in 4/29 (13.8%) patients after surgery adenectomia in comparison to 5/64 (7.8 %) patients after radioiodine therapy. The patients after enucleation of autonomous nodule of the thyroid show increase incidence of late recurrent hyperthyroidism. These results are likely to be due to persistent functional autonomy in the parenchyma surrounding the autonomous adenoma. Apparently this persistent autonomy could be successfully removed by radioiodine. Appear of hypothyroidism was observed in 6/64 (9.3 %) patients treated with 131 I, while after surgery had in 3/29 (10.3 %) patients. Incidence of hypothyroidism between operated patients and radioiodine treated patients was approximately the same. Conclusion: Radioiodine therapy is useful, economical and effective treatment of toxic thyroid adenoma that provides a safe protection in preventing late recurrent hyperthyroidism and is more successful therapy that surgery treatment. (author)

Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism.

Science.gov (United States)

Miao, Q; Zhang, S; Guan, Y H; Ye, H Y; Zhang, Z Y; Zhang, Q Y; Xue, R D; Zeng, M F; Zuo, C T; Li, Y M

2011-01-01

Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy. Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized. Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri. The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy.

An Experimental Comparison of Two Different Technetium Source Activities Which Can Imitate Thyroid Scintigraphy in Case of Thyroid Toxic Nodule

OpenAIRE

Miftari, Ramë; Fejza, Ferki; Bicaj, Xhavit; Nura, Adem; Topciu, Valdete; Bajrami, Ismet

2014-01-01

Purpose: In cases of thyroid toxic autonomous nodule, anterior projection of Tc-99m pertechnetate image shows a hot nodule that occupies most, or the entire thyroid lobe with near-total or total suppression of the contra lateral lobe. In this case is very difficult to distinguish toxic nodule from lobe agenesis. Our interest was to estimate and determinate the rate of radioactivity when the source with high activity can make total suppression of the second source with low activity in same con...

Effect of drugs on the thyroid function tests

International Nuclear Information System (INIS)

Cardoso, G.P.; Faria, A.C.S. de; Carvalho, M.C. de; Guimaraes, M.M.; Cordeiro, J.G.H.; Santa Casa do Rio de Janeiro

1984-01-01

The effects of drugs in the results of thyroid function tests, which could lead to misinterpretation of the real clinical state of the patients, are reviewed. The aspects of the metabolism of the thyreoidean hormones which could be related to these alterations are presented. (Author) [pt

Implication from thyroid function decreasing during chemotherapy in breast cancer patients: chemosensitization role of triiodothyronine

Science.gov (United States)

2013-01-01

Background Thyroid hormones have been shown to regulate breast cancer cells growth, the absence or reduction of thyroid hormones in cells could provoke a proliferation arrest in G0-G1 or weak mitochondrial activity, which makes cells insensitive to therapies for cancers through transforming into low metabolism status. This biological phenomenon may help explain why treatment efficacy and prognosis vary among breast cancer patients having hypothyroid, hyperthyroid and normal function. Nevertheless, the abnormal thyroid function in breast cancer patients has been considered being mainly caused by thyroid diseases, few studied influence of chemotherapy on thyroid function and whether its alteration during chemotherapy can influence the respose to chemotherapy is still unclear. So, we aimed to find the alterations of thyroid function and non-thyroidal illness syndrome (NTIS) prevalence druing chemotherapy in breast cancer patients, and investigate the influence of thyroid hormones on chemotherapeutic efficacy. Methods Thyroid hormones and NTIS prevalence at initial diagnosis and during chemotherapy were analyzed in 685 breast diseases patients (369 breast cancer, 316 breast benign lesions). The influence of thyroid hormones on chemotherapeutic efficacy was evaluated by chemosensitization test, to compare chemotherapeutic efficacy between breast cancer cells with chemotherapeutics plus triiodothyronine (T3) and chemotherapeutics only. Results In breast cancer, NTIS prevalence at the initial diagnosis was higher and increased during chemotherapy, but declined before the next chemotherapeutic course. Thyroid hormones decreased signigicantly during chemotherapy. T3 can enhance the chemosensitivity of MCF-7 to 5-Fu and taxol, with progression from G0-G1 phase to S phase. The similar chemosensitization role of T3 were found in MDA-MB-231. We compared chemotherapeutic efficacy among groups with different usage modes of T3, finding pretreatment with lower dose of T3, using

Association between Birth Characteristics and Cardiovascular Autonomic Function at Mid-Life.

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Nelli Perkiömäki

Full Text Available Low birth weight is associated with an increased risk of cardiovascular diseases in adulthood. As abnormal cardiac autonomic function is a common feature in cardiovascular diseases, we tested the hypothesis that low birth weight may also be associated with poorer cardiac autonomic function in middle-aged subjects.At the age of 46, the subjects of the Northern Finland Birth Cohort 1966 were invited to examinations including questionnaires about health status and life style and measurement of vagally-mediated heart rate variability (rMSSD from R-R intervals (RRi and spontaneous baroreflex sensitivity (BRS in both seated and standing positions. Maternal parameters had been collected in 1965-1966 since the 16th gestational week and birth variables immediately after delivery. For rMSSD, 1,799 men and 2,279 women without cardiorespiratory diseases and diabetes were included and 902 men and 1,020 women for BRS. The analyses were adjusted for maternal (age, anthropometry, socioeconomics, parity, gestational smoking and adult variables (life style, anthropometry, blood pressure, glycemic and lipid status potentially confounding the relationship between birth weight and autonomic function.In men, birth weight correlated negatively with seated (r = -0.058, p = 0.014 and standing rMSSD (r = -0.090, p<0.001, as well as with standing BRS (r = -0.092, p = 0.006. These observations were verified using relevant birth weight categories (<2,500 g; 2,500-3,999 g; ≥4,000 g. In women, birth weight was positively correlated with seated BRS (r = 0.081, p = 0.010, but none of the other measures of cardiovascular autonomic function. These correlations remained significant after adjustment for potential confounders (p<0.05 for all.In men, higher birth weight was independently associated with poorer cardiac autonomic function at mid-life. Same association was not observed in women. Our findings suggest that higher, not lower, birth weight in males may contribute to less

Ethylene thiourea: thyroid function in two groups of exposed workers

Energy Technology Data Exchange (ETDEWEB)

Smith, D.M.

1984-08-01

Ethylene thiourea is manufactured at one factory in the United Kingdom and is mixed into masterbatch rubber at another. Clinical examinations and thyroid function tests were carried out over a period of three years on eight process workers and five mixers and on matched controls. The results show that the exposed mixers, but not exposed process workers, have significantly lower levels of total thyroxine (T4) than the controls. One mixer had an appreciably raised level of thyroid stimulation hormone (TSH).

Ethylene thiourea: thyroid function in two groups of exposed workers.

Science.gov (United States)

Smith, D M

1984-08-01

Ethylene thiourea is manufactured at one factory in the United Kingdom and is mixed into masterbatch rubber at another. Clinical examinations and thyroid function tests were carried out over a period of three years on eight process workers and five mixers and on matched controls. The results show that the exposed mixers, but not exposed process workers, have significantly lower levels of total thyroxine (T4) than the controls. One mixer had an appreciably raised level of thyroid stimulation hormone (TSH).

Hyperfunctioning thyroid cancer: a five-year follow-up.

Science.gov (United States)

Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

2010-02-01

Differentiated thyroid cancer rarely occurs in association with hyperfunctioning nodules. We describe a case of a 47-year-old woman who developed symptoms of hyperthyroidism associated with a palpable thyroid nodule. Thyroid scintigraphy showed an autonomous nodule, and fine-needle aspiration biopsy was suggestive of papillary carcinoma. Laboratorial findings were consistent with the diagnosis of hyperthyroidism. The patient underwent thyroidectomy and a papillary carcinoma of 3.0 x 3.0 x 2.0 cm, follicular variant, was described by histological examination. The surrounding thyroid tissue was normal. Postoperatively, the patient received 100 mCi of (131)I, and whole body scans detected only residual uptake. No evidence of metastasis was detected during five years of follow-up. Hot thyroid nodules rarely harbor malignancies, and this case illustrated that, when a carcinoma occurs the prognosis seems to be very good with no evidence of metastatic dissemination during a long-term follow-up.

Cardiovascular autonomic function in Cushing's syndrome.

Science.gov (United States)

Fallo, F; Maffei, P; Dalla Pozza, A; Carli, M; Della Mea, P; Lupia, M; Rabbia, F; Sonino, N

2009-01-01

Cardiac autonomic dysfunction is associated with increased cardiovascular mortality. No data on sympathovagal balance are available in patients with Cushing's syndrome, in whom cardiovascular risk is high. We studied 10 patients with newly diagnosed Cushing's syndrome (1 male/9 females; age mean+/-SD, 47+/-10 yr) and 10 control subjects matched for age, sex, body mass index, and cardiovascular risk factors. In both groups there were 7 patients with arterial hypertension, 3 with diabetes mellitus, and 2 with obesity. Cardiac autonomic function was evaluated by analysis of short time heart rate variability (HRV) measures in frequency domain over 24-h, daytime, and nighttime. The 24-h ambulatory blood pressure monitoring and echocardiography were also performed. In comparison with controls, patients with Cushing's syndrome had lower 24-h (1.3+/-0.6 vs 3.7+/-1.5, mean+/-SD, p<0.01), daytime (2.0+/-1.4 vs 4.5+/-1.6, p<0.01), and night-time (1.0+/-0.4 vs 3.5+/-2.3, p<0.01) low-frequency/ high frequency (LF/HF) power ratio. In the presence of similar LF power, the difference was due to elevation in HF power in Cushing's syndrome compared to controls: 24-h, 12.7+/-6.7 vs 5.8+/-2.8, p<0.01; daytime, 10.2+/-7.3 vs 4.5+/-2.1, p<0.05; nighttime, 14.2+/-7.0 vs 7.8+/-4.7, p<0.05. Eight Cushing patients vs 4 controls had a non-dipping blood pressure profile. At echocardiography, Cushing patients had a greater left ventricular mass index and/or relative wall thickness, and impaired diastolic function, compared with controls. Compared to controls, patients with Cushing's syndrome showed a sympathovagal imbalance, characterized by a relatively increased parasympathetic activity. Whether this autonomic alteration is meant to counterbalance cortisol-induced effects on blood pressure and cardiac structure/function or has a different pathophysiological significance is still unknown.

Iodine intake as a determinant of thyroid disorders in populations

DEFF Research Database (Denmark)

Laurberg, Peter; Cerqueira, Charlotte; Ovesen, Lars

2010-01-01

in elderly people, and the prevalence of thyroid enlargement and nodularity is high. The average serum TSH tends to decrease with age in such populations caused by the high frequency of autonomous thyroid hormone production. On the other hand, epidemiological studies have shown that hypothyroidism is more...... by high levels of iodine is especially common in people affected by thyroid autoimmunity (Hashimoto's thyroiditis). In populations with high iodine intake, the average serum thyroid-stimulating hormone (TSH) tends to increase with age. This phenomenon is especially pronounced in Caucasian populations...... with a genetically determined high tendency to thyroid autoimmunity. A small tendency to higher serum TSH may be observed already when iodine intake is brought from mildly deficient to adequate, but there is at present no evidence that slightly elevated serum TSH in elderly people leads to an increase in morbidity...

Generation of Functional Thyroid Tissue Using 3D-Based Culture of Embryonic Stem Cells.

Science.gov (United States)

Antonica, Francesco; Kasprzyk, Dominika Figini; Schiavo, Andrea Alex; Romitti, Mírian; Costagliola, Sabine

2017-01-01

During the last decade three-dimensional (3D) cultures of pluripotent stem cells have been intensively used to understand morphogenesis and molecular signaling important for the embryonic development of many tissues. In addition, pluripotent stem cells have been shown to be a valid tool for the in vitro modeling of several congenital or chronic human diseases, opening new possibilities to study their physiopathology without using animal models. Even more interestingly, 3D culture has proved to be a powerful and versatile tool to successfully generate functional tissues ex vivo. Using similar approaches, we here describe a protocol for the generation of functional thyroid tissue using mouse embryonic stem cells and give all the details and references for its characterization and analysis both in vitro and in vivo. This model is a valid approach to study the expression and the function of genes involved in the correct morphogenesis of thyroid gland, to elucidate the mechanisms of production and secretion of thyroid hormones and to test anti-thyroid drugs.

Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women.

Science.gov (United States)

Sekhri, Tarun; Juhi, Juhi Agarwal; Wilfred, Reena; Kanwar, Ratnesh S; Sethi, Jyoti; Bhadra, Kuntal; Nair, Sirimavo; Singh, Satveer

2016-01-01

Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester. SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis. The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester. The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.

Maternal thyroid function and child educational attainment: prospective cohort study.

Science.gov (United States)

Nelson, Scott M; Haig, Caroline; McConnachie, Alex; Sattar, Naveed; Ring, Susan M; Smith, George D; Lawlor, Debbie A; Lindsay, Robert S

2018-02-20

To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Prospective cohort study. Avon Longitudinal Study of Parents and Children cohort in the UK. 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Maternal thyroid dysfunction in early pregnancy does not have a

Tumour suppressive function of HUWE1 in thyroid cancer

Indian Academy of Sciences (India)

It has been found to be dysregulated in various cancer typeand its functions in ... investigated by knocking down HUWE1 in three authentic thyroid cancer cell lines, ... overexpression of HUWE1 significantly inhibited tumourgrowth in vivo using ...

The effect of diltiazem on the manifestations of hyperthyroidism and thyroid function tests.

Science.gov (United States)

Keleştimur, F; Aksu, A

1996-01-01

The aim of this study is to evaluate the effect of diltiazem on the symptoms and signs of hyperthyroidism and thyroid function tests and to assess whether diltiazem can be used associated with an anti-thyroid drug, propylthiouracil. Twenty-two patients with hyperthyroidism were included in a prospective, randomized and placebo controlled study. Group 1 (n:12) patients received diltiazem, 60 mg twice a day, for 30 days. Group 2 (n:10) patients received placebo for 30 days. The patients in both groups were given propylthiouracil, 100 mg three times a day, for the last 20 days of the study period. The patients remained in the hospital during the first 10 days. A standardized hyperthyroid symptom score (HSS) and thyroid function tests including thyroid-stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), total thyroxine (T4) and total triiodothyronine (T3) were evaluated before and after 10 and 30 days of the study period. HSS decreased from 27.80 +/- 4.54 to 22.51 +/- 4.04 after 10 days of diltiazem therapy in Group 1 (p 0.01). No significant changes in thyroid function tests have occurred in both groups after 10 days of treatment. Diltiazem can be used in patients with hyperthyroidism to alleviate adrenergic manifestations. It can also be safely combined with propylthiouracil.

Ultrasound-guided interstitial laser photocoagulation of an autonomous thyroid nodule

DEFF Research Database (Denmark)

Døssing, Helle; Bennedbaek, Finn Noe; Hegedüs, Laszlo

2003-01-01

effects and often necessitates multiple treatment sessions. We present a case of a 17-year-old female successfully treated with ultrasound (US)-guided percutaneous interstitial laser photocoagulation (ILP) for an AFTN. Initially, she had a serum thyrotropin (TSH) of 0.01 mU/L and normal peripheral thyroid.......9 mL (40% reduction) without further alterations during an additional 9 months of follow-up. Side effects were transient thyrotoxicosis and local pain as seen with PEI. To our knowledge, this is the first reported case of ILP used in a patient with a pretoxic thyroid nodule. US-guided thermic tissue...

Correlation between serum lead and thyroid diseases: papillary thyroid carcinoma, nodular goiter, and thyroid adenoma.

Science.gov (United States)

Li, Hui; Li, Xiang; Liu, Jie; Jin, Langping; Yang, Fan; Wang, Junbo; Wang, Ouchen; Gao, Ying

2017-10-01

Studies have showed that lead was associated with human health. However, the effects of lead on thyroid functions are inconsistent, and studies based on Chinese population are fragmentary. To evaluate the correlation between lead and thyroid functions of Chinese with different thyroid diseases, we conducted a hospital-based study. Ninety-six papillary thyroid carcinoma (PTC), 10 nodular goiter (NG), and 7 thyroid adenoma (TA) patients were recruited from the First Affiliated Hospital of Wenzhou Medical University, China. Serum triiodothyronine (T3), free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone (TSH) were evaluated with chemiluminescent microparticle immunoassay. Serum lead was assessed with ICP-MASS. Partial correlation was used to explore the correlations of serum lead and thyroid diseases. Compared to PTC, the level of lead was significantly higher in TA, and lower in NG (p lead was negatively correlated with TSH (r s  =  - 0.27, p lead at quartile4 (r s  = 0.61, p lead and FT3 or FT4 in any group. The results suggested that lead might have different etiological roles in these three thyroid diseases.

Thyroid disorders in mild iodine deficiency.

Science.gov (United States)

Laurberg, P; Nøhr, S B; Pedersen, K M; Hreidarsson, A B; Andersen, S; Bülow Pedersen, I; Knudsen, N; Perrild, H; Jørgensen, T; Ovesen, L

2000-11-01

Comparative epidemiologic studies in areas with low and high iodine intake and controlled studies of iodine supplementation have demonstrated that the major consequence of mild-to-moderate iodine deficiency for the health of the population is an extraordinarily high occurrence of hyperthyroidism in elderly subjects, especially women, with risk of cardiac arrhythmias, osteoporosis, and muscle wasting. The hyperthyroidism is caused by autonomous nodular growth and function of the thyroid gland and it is accompanied by a high frequency of goiter. Pregnant women and small children are not immediately endangered but the consequences of severe iodine deficiency for brain development are grave and a considerable safety margin is advisable. Moreover, a shift toward less malignant types of thyroid cancer and a lower radiation dose to the thyroid in case of nuclear fallout support that mild-to-moderate iodine deficiency should be corrected. However, there is evidence that a high iodine intake may be associated with more autoimmune hypothyroidism, and that Graves' disease may manifest at a younger age and be more difficult to treat. Hence, the iodine intake should be brought to a level at which iodine deficiency disorders are avoided but not higher. Iodine supplementation programs should aim at relatively uniform iodine intake, avoiding deficient or excessive iodine intake in subpopulations. To adopt such a strategy, surveillance programs are needed.

Maternal thyroid function in pregnancy may program offspring blood pressure, but not adiposity at 20 y of age

DEFF Research Database (Denmark)

Rytter, Dorte; Andersen, Stine L; Bech, Bodil H

2016-01-01

BACKGROUND: Experimental evidence exists indicating that maternal thyroid hormones during pregnancy may affect the metabolic set point and cardio-vascular function in the offspring. The objective of this study was to investigate the association between maternal thyroid function in week 30...... circumference. CONCLUSION: Maternal thyroid function during third trimester of pregnancy may affect long-term blood pressure in the offspring....

Longitudinal Changes in Thyroid Function in the Oldest Old and Survival: The Cardiovascular Health Study All-Stars Study

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Waring, Avantika C.; Arnold, Alice M.; Newman, Anne B.; Bùžková, Petra; Hirsch, Calvin

2012-01-01

Context: Data on thyroid function in the oldest old are sparse, and existing studies show conflicting evidence on the relationship between thyroid function and mortality in this age group. Objective: We describe longitudinal changes in thyroid function in a cohort of elderly individuals and determine the relationship between thyroid function and mortality. Design, Setting, and Participants: Eight hundred forty-three participants in the Cardiovascular Health Study All Stars Study who were not taking thyroid medications and had thyroid function testing in 2005–2006 (mean age 85 yr). Main Outcome Measure: Thyroid-stimulating hormone (TSH), free T4 (FT4), total T3, and thyroid peroxidase antibody status were measured in 1992–1993 and 2005–2006. Deaths were ascertained through February 2011. Results: There was a statistically significant 13% increase in TSH, 1.7% increase in FT4, and 13% decrease in total T3 over the 13-yr period. Two hundred eighty-seven deaths occurred over a median follow-up of 5.1 yr. There was no association between subclinical hypothyroidism[hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.66–1.43], TSH level (HR per milliunits per liter 0.94, 95% CI 0.88–1.01), or persistent thyroid peroxidase antibody positivity (HR 1.09, 95% CI 0.62–1.92), and death. However, FT4 was positively associated with death (HR per nanograms per deciliter 2.57, 95% CI 1.32–5.02). Conclusions: TSH increased over time in these older individuals. This elevation was not associated with increased or decreased mortality, although higher FT4 levels were associated with death. These findings raise concern for treatment of mild elevations of TSH in advanced age. Further studies are needed to determine the potential benefit of treating age-related changes in thyroid function. PMID:22879629

Sex- and age-dependent effects of thyroid hormone on glial morphology and function

OpenAIRE

Noda, Mami; Mori, Yuki; Yoshioka, Yusaku

2016-01-01

Thyroid hormones (THs) are essential for the development and function of the central nervous system (CNS), not only for neuronal cells but also for glial development and differentiation. In adult CNS, both hypo- and hyper-thyroidism may affect psychological condition and potentially increase the risk of cognitive impairment and neurodegeneration including Alzheimer’s disease (AD). We have reported non-genomic effects of tri-iodothyronine (T3) on microglial functions and its signaling in vitro...

Comparative proteomic analysis to dissect differences in signal transduction in activating TSH receptor mutations in the thyroid.

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Krause, Kerstin; Boisnard, Alexandra; Ihling, Christian; Ludgate, Marian; Eszlinger, Markus; Krohn, Knut; Sinz, Andrea; Fuhrer, Dagmar

2012-02-01

In the thyroid, cAMP controls both thyroid growth and function. Gain-of-function mutations in the thyroid-stimulating hormone receptor (TSHR) lead to constitutive cAMP formation and are a major cause of autonomous thyroid adenomas. The impact of activating TSHR mutations on the signal transduction network of the thyrocyte is not fully understood. To gain more insights into constitutive TSHR signaling, rat thyrocytes (FRTL-5 cells) with stable expression of three activating TSHR mutants (mutTSHR: A623I, L629F and Del613-621), which differ in their functional characteristics in vitro, were analyzed by a quantitative proteomic approach and compared to the wild-type TSHR (WT-TSHR). This study revealed (1) differences in the expression of Rab proteins suggesting an increased TSHR internalization in mutTSHR but not in the WT-TSHR; (2) differential stimulation of PI3K/Akt signaling in mutTSHR vs. WT-TSHR cells, (3) activation of Epac, impairing short-time Akt phosphorylation in both, mutTSHR and WT-TSHR cells. Based on the analysis of global changes in protein expression patterns, our findings underline the complexity of gain-of-function TSHR signaling in thyrocytes, which extends beyond pure cAMP and/or IP formation. Moreover, evidence for augmented endocytosis in the mutTSHR, adds to a new concept of TSHR signaling in thyroid autonomy. Further studies are required to clarify whether the observed differences in Rab, PI3K and Epac signaling may contribute to differences in the phenotypic presentation, i.e. stimulation of function and growth of thyroid autonomy in vivo. Copyright © 2011 Elsevier Ltd. All rights reserved.

Study of Thyroid Function in Children with Attention Deficit ...

African Journals Online (AJOL)

Study of Thyroid Function in Children with Attention Deficit Hyperactivity Disorder and Aggressive Behavior. ... Results: There was a significantly lower IQ (p<0.05) among patients (84.2±16.4%) when compared to controls (100.9±5.4%).

Cardiac autonomic function and hot flashes among perimenopausal and postmenopausal women.

Science.gov (United States)

Gibson, Carolyn J; Mendes, Wendy Berry; Schembri, Michael; Grady, Deborah; Huang, Alison J

2017-07-01

Abnormalities in autonomic function are posited to play a pathophysiologic role in menopausal hot flashes. We examined relationships between resting cardiac autonomic activity and hot flashes in perimenopausal and postmenopausal women. Autonomic function was assessed at baseline and 12 weeks among perimenopausal and postmenopausal women (n = 121, mean age 53 years) in a randomized trial of slow-paced respiration for hot flashes. Pre-ejection period (PEP), a marker of sympathetic activation, was measured with impedance cardiography. Respiratory sinus arrhythmia (RSA), a marker of parasympathetic activation, was measured with electrocardiography. Participants self-reported hot flash frequency and severity in 7-day symptom diaries. Analysis of covariance models were used to relate autonomic function and hot flash frequency and severity at baseline, and to relate changes in autonomic function to changes in hot flash frequency and severity over 12 weeks, adjusting for age, body mass index, and intervention assignment. PEP was not associated with hot flash frequency or severity at baseline or over 12 weeks (P > 0.05 for all). In contrast, there was a trend toward greater frequency of moderate-to-severe hot flashes with higher RSA at baseline (β = 0.43, P = 0.06), and a positive association between change in RSA and change in frequency of moderate-to-severe hot flashes over 12 weeks (β = 0.63, P = 0.04). Among perimenopausal and postmenopausal women with hot flashes, variations in hot flash frequency and severity were not explained by variations in resting sympathetic activation. Greater parasympathetic activation was associated with more frequent moderate-to-severe hot flashes, which may reflect increased sensitivity to perceiving hot flashes.

Sarcoidosis and Thyroid Autoimmunity

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Piera Fazzi

2017-08-01

Full Text Available Most of the studies have shown a higher risk for subclinical and clinical hypothyroidism, antithyroid autoantibodies [overall antithyroid peroxidase antibodies (TPOAb], and in general, thyroid autoimmunity, overall in the female gender in patients with sarcoidosis (S. A significantly higher prevalence of clinical hypothyroidism and Graves’ disease was also described in female S patients with respect to controls. Gallium-67 (Ga-67 scyntigraphy in S patients, in the case of thyroid uptake, suggests the presence of aggressive autoimmune thyroiditis and hypothyroidism. For this reason, ultrasonography and thyroid function should be done in the case of Ga-67 thyroid uptake. In conclusion, thyroid function, TPOAb measurement, and ultrasonography should be done to assess the clinical profile in female S patients, and the ones at high risk (female individuals, with TPOAb positivity, and hypoechoic and small thyroid should have periodically thyroid function evaluations and suitable treatments.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

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van der Donk Riet W

2011-01-01

Full Text Available Abstract Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%, 41/48 (85% in multipara and 36/93 (39% in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555

Request of thyroid function tests from Primary Care in Spain.

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Salinas, Maria; López-Garrigós, Maite; Pomares, Francisco J; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

2016-01-01

Laboratory tests are crucial for diagnosis and monitoring of thyroid disorders. It is therefore necessary to study the pattern and variability in requests of thyroid function tests. The study objectives were to compare the inter-regional variability in the request of laboratory thyroid tests by general practitioners (GPs) in Spain, and to investigate the potential economic savings if the goals set for some suitability indicators were reached. Test requests per 1,000 inhabitants and test ratios (free thyroxine (FT4)/thyrotropin (TSH), free triiodothyronine (FT3)/TSH, thyroglobulin antibody (TgAb)/peroxidase antibody (TPOAb)) were compared between the different areas, according to their setting, location, and management. The resulting savings if each department achieved the goals for indicator (0.25 for FT4/TSH, 0.1 for FT3/TSH) were estimated. Seventy-six laboratories covering a population of 17,679,195 inhabitants participated in the study. TSH was requested significantly less in urban-rural areas, and the requests for FT3/1,000 inhabitants, FT3/TSH, and TgAb/TPOAb were higher in departments with private management. The savings generated if specifications for the ratios of related tests were met would be 937,260.5 €. The high variability reported in requests for thyroid function and autoimmunity tests in Spain suggests the need for implementing strategies to improve use of such tests. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Thyroid Scan and Uptake

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Full Text Available ... scan and thyroid uptake provide information about the structure and function of the thyroid. The thyroid is ... computer, create pictures offering details on both the structure and function of organs and tissues in your ...

Amiodarone: Effects on thyroid function and the peripheral metabolism of the thyroid hormones

International Nuclear Information System (INIS)

Braverman, L.E.; Safran, M.; Bambini, G.; Pinchera, A.; Martino, E.

1985-01-01

In addition to the effects of Amiodarone on the peripheral metabolism of the thyroid hormones and on pituitary TSH secretion, a major complication of therapy is the relatively high frequency of iodide-induced thyroid dysfunction. The mean T 4 and T 3 concentration following Amiodarone application was measured in euthyroid, hypothyroid and hyperthyroid patients and in control patients with and without cardiac disorders. Furthermore, the serum TSH was determined in euthyroid Amiodarone-treated euthyroid patients. 131 I uptake was studied in patients with Amiodarone-associated thyrotoxicosis. The difficulties of the therapy of Amiodarone-induced hyper-thyroidism are outlined. Preliminary studied of the effect of Amiodarone and its analogues on the metabolism of thyroid hormones in the rat indicate that Amiodarone may act as a thyroid hormone agonist in the pituitary. (MG)

correlation between cytology and thyroid function test

African Journals Online (AJOL)

Damary

2006-10-01

Oct 1, 2006 ... the hormones tri-iodothyronine T3 and thyroxine T4, which are in turn regulated by thyroid stimulating hormone (TSH), produced by the anterior pituitary gland. Diseases of the thyroid gland usually result in thyroid enlargement (goiter) which can be due to infections, cystic changes, autoimmune diseases, ...

The functional condition of fetoplacental system in pregnant women with thyroid gland autoimmune pathology

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T. A. Melikova

2016-10-01

Full Text Available Some kind of specific system: placenta - thyroid gland - is said to be formed during pregnancy. Regulation of thyroid hormone metabolism depends on the state of the fetoplacental complex (FPC. The nature of the relationship of thyroid gland (TG with the FPC affects the course of pregnancy, fetal growth and the formation of his own pituitary-thyroid system. Goal. To study the characteristics of the hormonal function of fetoplacental complex in pregnant women with autoimmune thyroid disease. Materials and methods. The study included 102 pregnant women: group I – 29 women with euthyroid as the outcome of autoimmune thyroiditis (AIT, 25 women with a diagnosis of hypothyroidism as a form of AIT were included into the second group, in III group – 23 women with autoimmune hyperthyroidism. The control group consisted of 25 healthy women. Hypophysial and thyroid system hormonal profile and FPK of pregnant women were detected in dynamics. Results. It is revealed that reliable change of hormonal indexes of function of hypophysial and thyroid system leads to weighable changes of indexes of FPK and the AFP level in mother's blood, i.e. to a placentary failure, are result of it: early and late gestosis (54.5 %, chronic fetal hypoxia (21.7 %, discoordination of patrimonial activity (5.2 %, premature births (17.2 %, threat of an abortion (7.4 %. Conclusions. According to our data the most accurate diagnostic criterion for the development of primary placental insufficiency in pregnant women with thyroid conditions can be considered the change in the level of estriol, progesterone, placental lactogen and AFP in the dynamics of gestation. Their determination can be considered as predictor for early treatment and prevention of placental insufficiency.

Thyroid diseases

International Nuclear Information System (INIS)

Noma, Koji

1992-01-01

This chapter reviews the correlation between thyroid disease, other than cancer, and radiation in the literature. Radiation-induced thyroid disturbance is discussed in the context of external and internal irradiation. External irradiation of 10 to 40 Gy may lower thyroid function several months or years later. Oral administration of I-131 is widely given to patients with Basedow's disease; it may also lower thyroid function with increasing radiation doses. When giving 70 Gy or more of I-131, hypothyroidism has been reported to occur in 20-30% and at least 10%. Thyroiditis induced with internal I-131 irradiation has also been reported, but no data is available concerning external irradiation-induced thyroiditis. The incidence of nodular goiter was found to be several ten times higher with external irradiation than internal irradiation. Thyroid disturbance is correlated with A-bomb survivors. A-bomb radiation can be divided into early radiation within one minute after A-bombing and the subsequent residual radiation. Nodular goiter was significantly more frequent in the exposed group than the non-exposed group; it increased with increasing radiation doses and younger age (20 years or less) at the time of exposure. The incidence of decrease in thyroid function was higher with increasing radiation doses. However, in the case of Nagasaki, the incidence of hypothyroidism was significantly higher in the low-dose exposed group, especially A-bomb survivors aged 10-39 at the time of exposure and women. (N.K.)

Physiological changes in thyroid function during pregnancy: an approach to the interpretation of thyroid tests = Cambios fisiológicos de la función tiroidea en el embarazo: bases para la interpretación de las pruebas tiroideas

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Córdoba Ramírez, Nathalia

2013-04-01

Full Text Available A proper understanding of thyroid physiology and its changes through pregnancy is critical to suspect diseases affecting the functioning of the hypothalamic-pituitary-thyroid axis, and to make a proper interpretation of the tests that measure its function. Alterations in thyroid function tests are common during pregnancy, and it may be difficult to distinguish them from those due to disease. Clinical hypothyroidism and hyperthyroidism are rare during pregnancy (0.2% to 0.36%, but subclinical forms are more frequent (around 2%. Iodine is essential as substrate for thyroid hormone synthesis, and the requirements vary according to the population and the moment of pregnancy. Infertile couples have five to ten times more thyroid disorders; for that reason they should be studied as to thyroid function when searching for the cause of the infertility. Autoimmunity has been associated with maternal and perinatal complications such as abortion, preterm delivery and postpartum thyroiditis; some studies have shown that their incidence decreases with levothyroxine. This review includes the following aspects: thyroid physiology during pregnancy, thyroid function and fertility, iodine and pregnancy, anti-thyroid antibodies and pregnancy, thyroid function tests during pregnancy, and screening for thyroid disorders in pregnant women.

Effect of Thyroid on Lipid Profile and Renal Function: An ...

African Journals Online (AJOL)

filtration rate.[7,8] However, clinical studies on hypothyroid subjects are very few and not much data is available on how hypothyroidism influences renal function in human beings. Hence, we conducted this observational study to see the relation of the thyroid hormone with hepatic and renal functions. Subjects and Methods.

Accessing Autonomic Function Can Early Screen Metabolic Syndrome

Science.gov (United States)

Dai, Meng; Li, Mian; Yang, Zhi; Xu, Min; Xu, Yu; Lu, Jieli; Chen, Yuhong; Liu, Jianmin; Ning, Guang; Bi, Yufang

2012-01-01

Background Clinical diagnosis of the metabolic syndrome is time-consuming and invasive. Convenient instruments that do not require laboratory or physical investigation would be useful in early screening individuals at high risk of metabolic syndrome. Examination of the autonomic function can be taken as a directly reference and screening indicator for predicting metabolic syndrome. Methodology and Principal Findings The EZSCAN test, as an efficient and noninvasive technology, can access autonomic function through measuring electrochemical skin conductance. In this study, we used EZSCAN value to evaluate autonomic function and to detect metabolic syndrome in 5,887 participants aged 40 years or older. The EZSCAN test diagnostic accuracy was analyzed by receiver operating characteristic curves. Among the 5,815 participants in the final analysis, 2,541 were diagnosed as metabolic syndrome and the overall prevalence was 43.7%. Prevalence of the metabolic syndrome increased with the elevated EZSCAN risk level (p for trend metabolic syndrome components (p for trend metabolic syndrome after the multiple adjustments. The area under the curve of the EZSCAN test was 0.62 (95% confidence interval [CI], 0.61–0.64) for predicting metabolic syndrome. The optimal operating point for the EZSCAN value to detect a high risk of prevalent metabolic syndrome was 30 in this study, while the sensitivity and specificity were 71.2% and 46.7%, respectively. Conclusions and Significance In conclusion, although less sensitive and accurate when compared with the clinical definition of metabolic syndrome, we found that the EZSCAN test is a good and simple screening technique for early predicting metabolic syndrome. PMID:22916265

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

International Nuclear Information System (INIS)

Rink, T.; Schroth, H.J.; Dembowski, W.; Klinger, K.

2000-01-01

Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto's thyroiditis and 30 hyperthyroid patients with Graves' disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto's thyroiditis showed slightly decreased Tg levels. In Graves' disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range ( [de

Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part; Radioiodtherapie bei kombinierter Schilddruesenautonomie. Ergebnisse nach Korrektur fuer disseminierte Anteile

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Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J. [Klinik fuer Nuklearmedizin, Klinikum Augsburg (Germany); Wengenmair, H.; Kopp, J. [Medizinische Physik und Strahlenschutz, Klinikum Augsburg (Germany)

2006-07-01

Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

Dual ectopic thyroid associated with thyroid hemiagenesis.

Science.gov (United States)

Nakamura, Shigenori; Masuda, Teruyuki; Ishimori, Masatoshi

2018-01-01

We report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for congenital hypothyroidism until 11 years of age. Ultrasonography revealed an atrophic right thyroid (1.0 × 1.6 × 2.6 cm in size) and a mass (2.3 × 1.0 × 3.5 cm in size) in the upper part of the neck. No left lobe of the thyroid was detected. On further evaluation, Tc-99m pertechnetate thyroid scintigraphy and CT showed ectopic thyroid tissue in the lingual region and infrahyoid region. Thus, she was diagnosed as having dual ectopic thyroid and thyroid hemiagenesis. The atrophic right thyroid was thought be non-functional. Treatment with L-T4 was started to reduce the size of the dual ectopic thyroid tissue. This may be the first reported case of dual ectopic thyroid associated with hemiagenesis detected only by ultrasonography. Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid.The cause of congenital hypothyroidism should be examined.Clinical manifestation of ectopic thyroid may appear when the treatment with L-T4 is discontinued.Annual follow-up is needed in all children when their thyroid hormone replacement is stopped.

Effects of the Thyroid Status Correction on the Functional State of Digestive System in Children with Diffuse Nontoxic Goiter

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M.Ye. Mamenko

2013-11-01

Full Text Available Objective: to study the effects of the diffuse non-toxic goiter treatment on the functional state of the digestive system in children. Materials and methods. The screening survey was based on lunior comprehensive schools (695 children aged 5–11 years: questioning of families, anthropometry and examination of children, detection of ioduria, palpation of the thyroid gland. In-depth examination of children with goiter (n = 88: ultrasonography of the thyroid gland and the digestive system, determination of levels of thyroid stimulating hormone, free thyroxine, serotonin, melatonin, vasoactive intestinal peptide. Results. The high incidence of non-toxic diffuse goiter (25.8 %, associated with a reduction in functional activity of the thyroid gland to the minimum thyroid dysfunction (42.0 % and subclinical hypothyroidism (10.2 %, was detected in school-aged children. The presence of goiter leads to a static increase of the chances for functional gastrointestinal disorders developing (odds ratio 2.33, p = 0.000, mainly due to the hypokinetic conditions. The administration of potassium iodide preparations leads to the decreasing in goiter rate in high compliance up to the 27.3 % and to the normalization of the functional state of the pituitary-thyroid system (thyroid stimulating hormone — 1.66 mIU/L, that is associated with increased level of serotonin (6.14 ng/ml and vasoactive intestinal peptide (117.86 ng/ml and decreased melatonin concentration (2.5 pmol/l. In children who consistently for six months received preparations of potassium iodide, along with the normalization of thyroid status we noted the decrease of the frequency of complaints from the digestive system. Conclusions. The treatment of diffuse nontoxic goiter by potassium iodide preparations allows to achieve reduction of thyroid size and to normalize functional activity of thyroid-pituitary system. Increase in the functional activity of the pituitary-thyroid system helps reduce the

Thyroid Function Variations Within the Reference Range Do Not Affect Quality of Life, Mood, or Cognitive Function in Community-Dwelling Older Men.

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Samuels, Mary H; Kaimal, Rajani; Waring, Avantika; Fink, Howard A; Yaffe, Kristine; Hoffman, Andrew R; Orwoll, Eric; Bauer, Douglas

2016-09-01

Variations in thyroid function within the laboratory reference range have been associated with a number of clinical outcomes. However, quality of life, mood, and cognitive function have not been extensively studied, and it is not clear whether mild variations in thyroid function have major effects on these neurocognitive outcomes. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) Study, a cohort of community-dwelling men aged 65 years and older in the United States. A total of 539 participants who were not taking thyroid medications and had age-adjusted TSH levels within the reference range underwent detailed testing of quality of life, mood, and cognitive function at baseline. The same quality of life, mood, and cognitive outcomes were measured again in 193 of the men after a mean follow-up of 6 years. Outcomes were analyzed using thyrotropin (TSH) and free thyroxine (FT4) levels as continuous independent variables, adjusting for relevant covariates. At baseline, there were no associations between TSH or FT4 levels and measures of quality of life, mood, or cognition in the 539 euthyroid men. Baseline thyroid function did not predict changes in these outcomes over a mean of 6 years in the 193 men in the longitudinal analysis. Variations in thyroid function within the age-adjusted laboratory reference range are not associated with variations in quality of life, mood, or cognitive function in community-dwelling older men.

Genome-wide analysis of Pax8 binding provides new insights into thyroid functions

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Ruiz-Llorente Sergio

2012-04-01

Full Text Available Abstract Background The transcription factor Pax8 is essential for the differentiation of thyroid cells. However, there are few data on genes transcriptionally regulated by Pax8 other than thyroid-related genes. To better understand the role of Pax8 in the biology of thyroid cells, we obtained transcriptional profiles of Pax8-silenced PCCl3 thyroid cells using whole genome expression arrays and integrated these signals with global cis-regulatory sequencing studies performed by ChIP-Seq analysis Results Exhaustive analysis of Pax8 immunoprecipitated peaks demonstrated preferential binding to intragenic regions and CpG-enriched islands, which suggests a role of Pax8 in transcriptional regulation of orphan CpG regions. In addition, ChIP-Seq allowed us to identify Pax8 partners, including proteins involved in tertiary DNA structure (CTCF and chromatin remodeling (Sp1, and these direct transcriptional interactions were confirmed in vivo. Moreover, both factors modulate Pax8-dependent transcriptional activation of the sodium iodide symporter (Nis gene promoter. We ultimately combined putative and novel Pax8 binding sites with actual target gene expression regulation to define Pax8-dependent genes. Functional classification suggests that Pax8-regulated genes may be directly involved in important processes of thyroid cell function such as cell proliferation and differentiation, apoptosis, cell polarity, motion and adhesion, and a plethora of DNA/protein-related processes. Conclusion Our study provides novel insights into the role of Pax8 in thyroid biology, exerted through transcriptional regulation of important genes involved in critical thyrocyte processes. In addition, we found new transcriptional partners of Pax8, which functionally cooperate with Pax8 in the regulation of thyroid gene transcription. Besides, our data demonstrate preferential location of Pax8 in non-promoter CpG regions. These data point to an orphan CpG island-mediated mechanism

Dual thyroid ectopia

International Nuclear Information System (INIS)

Al-Akeely, Mohammed H.

2003-01-01

Ectopic thyroid gland is a rare embryological fault of thyroid development .Dual ectopic thyroid is more rare and only 8 cases have been reported in the literature. The author presents a case of dual ectopic thyroid in a 16 year old boy with an anterior red neck mass, which is gradually growing in size particularly in last 2 years. The initial diagnosis was thyroglossal duct cyst. Thyroid function test revealed elevated thyroid-stimulating hormone. Ultrasound of the neck did not show thyroid gland in its normal pre tracheal position. Thyroid scan (Technetium 99)revealed the diagnosis of dual thyroid ectopia(lingual and subhyoid). (author)

TSH alone is not sufficient to exclude all patients with a functioning thyroid nodule from undergoing testing to exclude thyroid cancer

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Hurtado-Lopez, Luis-Mauricio; Monroy-Lozano, Blanca-Estela [General Hospital of Mexico, Mexico City (Mexico); Martinez-Duncker, Carlos [Hospital Infantil de Mexico Federico Gomez, Medicina Nuclear Molecular, Mexico City, DF (Mexico)

2008-06-15

The purpose of the study was to analyze whether the thyroid-stimulating hormone (TSH) alone avoids tests to exclude malignancy in all patients with functional thyroid nodules (FTN). Sixty-nine patients with FTN on {sup 99m}Tc scintigraphy, radioiodine uptake test (RIU), {sup 99m}Tc thyroid uptake, TSH assay, T3, and T4 obtained within 48 h were retrospectively identified out of 2,356 thyroid scans performed from January 2000 to April 2007. FTNs were classified as causing total, partial, or no inhibition of the thyroid as group 1, 2, or 3, respectively. TSH was subnormal in 21 of 69 (30.43%) patients. In group 1 (N = 23, 33.3%), TSH was subnormal, normal, and high in eight, nine, and six patients; in group 2 (N = 17, 24.6%), TSH was subnormal, normal, and high in four, six, and seven patients, and in group 3 (N = 29, 42%), TSH was subnormal, normal, and high in 9, 13, and 7 patients, respectively. TSH was significantly lower in group 1. In T3, T4, {sup 99m}Tc thyroid uptake, and RIU, there were no differences between the three groups. Only 30.43% of patients had subnormal TSH. TSH alone cannot avoid tests to exclude malignancy in all patients with FTN. FTN existence can only be accurately assessed by thyroid scintigraphy. The current incidence of FTN may be unknown because scintigraphy is not routinely performed in all patients with thyroid nodules. Thyroid scintigraphy of patients with high TSH can detect diseases such as Hashimoto's thyroiditis and identify patients with FTN in whom no further diagnostic procedures would be needed in patients with normal TSH levels with nondiagnostic fine-needle aspiration results. (orig.)

Thyroid size change by CT monitoring after sorafenib or sunitinib treatment in patients with renal cell carcinoma: Comparison with thyroid function

International Nuclear Information System (INIS)

Kitajima, Kazuhiro; Takahashi, Satoru; Maeda, Tetsuo; Yoshikawa, Takeshi; Ohno, Yoshiharu; Fujii, Masahiko; Miyake, Hideaki; Fujisawa, Masato; Sugimura, Kazuro

2012-01-01

Objective: Hypothyroidism is a common complication in patients receiving tyrosine kinase inhibitors. We evaluated the relationship between thyroid size evident on CT and thyroid function in patients with advanced renal cell carcinoma (RCC) receiving tyrosine kinase inhibitors. Materials and methods: Forty-two patients with metastatic RCC receiving tyrosine kinase inhibitors (sorafenib n = 25; sunitinib n = 17) and, followed-up for ≥12 months were eligible. Patients who had ever shown an elevated thyroid-stimulating hormone (TSH) level of >10 mU/l were defined as having “hypothyroidism”. CT scans were performed before, and 3, 6, 9, and 12 months after the start of treatment. The area of the thyroid in the maximum section at each examination was measured and compared with that before treatment. Using repeated-measures ANOVA, differences in thyroid size were compared over time between patients with and without “hypothyroidism”, in relation to the type of drug employed. Results: Twenty-one patients (sorafenib 9, sunitinib 12) developed “hypothyroidism” 95 ± 88 days (range 12–315 days) after the start of treatment. In such patients, the thyroid was reduced in size to 89 ± 16% after 3 months, 81 ± 21% after 6 months, 71 ± 21% after 9 months and 68 ± 21% after 12 months, whereas the patients without “hypothyroidism” maintained a thyroid size of 90 ± 12% even after 12 months (p = 0.0030). Among the patients with “hypothyroidism”, those treated with sunitinib tended to show greater thyroid size reduction than those with sorafenib (59 ± 23% vs. 79 ± 13%, after 12 months). Conclusion: Tyrosine kinase inhibitors cause an apparent thyroid size reduction in patients with “hypothyroidism”

Thyroid size change by CT monitoring after sorafenib or sunitinib treatment in patients with renal cell carcinoma: Comparison with thyroid function

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Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Takahashi, Satoru; Maeda, Tetsuo; Yoshikawa, Takeshi; Ohno, Yoshiharu; Fujii, Masahiko [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan); Miyake, Hideaki; Fujisawa, Masato [Department of Urology, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017 (Japan)

2012-09-15

Objective: Hypothyroidism is a common complication in patients receiving tyrosine kinase inhibitors. We evaluated the relationship between thyroid size evident on CT and thyroid function in patients with advanced renal cell carcinoma (RCC) receiving tyrosine kinase inhibitors. Materials and methods: Forty-two patients with metastatic RCC receiving tyrosine kinase inhibitors (sorafenib n = 25; sunitinib n = 17) and, followed-up for ≥12 months were eligible. Patients who had ever shown an elevated thyroid-stimulating hormone (TSH) level of >10 mU/l were defined as having “hypothyroidism”. CT scans were performed before, and 3, 6, 9, and 12 months after the start of treatment. The area of the thyroid in the maximum section at each examination was measured and compared with that before treatment. Using repeated-measures ANOVA, differences in thyroid size were compared over time between patients with and without “hypothyroidism”, in relation to the type of drug employed. Results: Twenty-one patients (sorafenib 9, sunitinib 12) developed “hypothyroidism” 95 ± 88 days (range 12–315 days) after the start of treatment. In such patients, the thyroid was reduced in size to 89 ± 16% after 3 months, 81 ± 21% after 6 months, 71 ± 21% after 9 months and 68 ± 21% after 12 months, whereas the patients without “hypothyroidism” maintained a thyroid size of 90 ± 12% even after 12 months (p = 0.0030). Among the patients with “hypothyroidism”, those treated with sunitinib tended to show greater thyroid size reduction than those with sorafenib (59 ± 23% vs. 79 ± 13%, after 12 months). Conclusion: Tyrosine kinase inhibitors cause an apparent thyroid size reduction in patients with “hypothyroidism”.

A STUDY ON CARDIOVASCULAR AUTONOMIC FUNCTIONS IN CAREGIVERS OF STROKE PATIENTS

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Ghouse Mubarak

2017-08-01

Full Text Available BACKGROUND Stroke (cerebrovascular accident is an important cause of disability in countries like India and longterm care of these bedridden patients is usually undertaken by the family members. A caregiver is a person who takes responsibility for those who cannot completely care for themselves. Taking care of a chronically ill member in the family usually causes stress to the caregiver causing disturbances in the autonomic function. Thus, the present study is undertaken to find out the effect of longterm caregiving on cardiovascular autonomic functions in a caregiver. MATERIALS AND METHODS 57 caregivers of post-stroke bedridden patients, both male and female, were included in this longitudinal study. Parasympathetic activity was assessed by observing the heart rate changes to immediate standing from lying down position, heart rate changes during deep breathing and heart rate changes during Valsalva manoeuvre. Sympathetic activity was assessed by observing blood pressure changes on immediate standing from lying down position and blood pressure changes during sustained hand grip. RESULTS The results of the present study showed statistically significant decrease in Valsalva ratio, decrease in the heart rate following deep breathing and statistically significant increase in systolic blood pressure in response to immediate standing suggestive of autonomic imbalance. CONCLUSION Our findings suggest that longterm caregiving is accompanied by dysfunction of the cardiac autonomic nervous system, and these individuals are more prone to autonomic neuropathy.

Thyroid and hypophysial function in radiation therapy of breast cancer

International Nuclear Information System (INIS)

Yakimova, T.P.; Lozinskaya, I.N.

1984-01-01

In breast cancer a decrease in triiodothyronine concentration was revealed with the normal level of thyroxine that may be associated with the disturbed peripharal metabolism into triiodothyronine. The lowering of thyroid functional activity is noted during radiation therapy of patients at menopause. Administration of thyroidin during radiation therapy to elderly patients with the 3 stage of the disease compensated for hormone deficiency producing a sparing effect on the thyroid, and influenced the therapeutic results favorably. A high level of the somatotropic hormone was observed in patients, of the reproductive age and at menopause, the level of insulin was increased in all the patients

Evaluation of percutaneous ethanol injections in benign thyroid nodules.

Science.gov (United States)

Perez, Camila Luhm Silva; Fighera, Tayane Muniz; Miasaki, Fabiola; Mesa Junior, Cleo Otaviano; Paz Filho, Gilberto Jorge da; Graf, Hans; Carvalho, Gisah Amaral de

2014-12-01

The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of nodules were evaluated for normalization of TSH levels. Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases. This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function.

{sup 131}I-induced changes in rat thyroid gland function

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Torlak, V.; Capkun, V.; Stanicic, A. [Clinical Hospital Split, Split (Croatia). Dept. of Nuclear Medicine; Zemunik, T. [University of Split, Split (Croatia). Dept. of Medical Biology]. E-mail: tzemunik@bsb.mefst.hr; Modun, D. [University of Split, Split (Croatia). Dept. of Pharmacology; Pesutic-Pisac, V. [Clinical Hospital Split, Split (Croatia). Dept. of Pathology; Markotic, A. [University of Split, Split (Croatia). School of Medicine. Dept. of Biochemistry; Pavela-Vrancic, M. [University of Split, Split (Croatia). Faculty of Natural Sciences. Dept. of Chemistry

2007-08-15

Therapeutic doses of {sup 131}I administered to thyrotoxic patients may cause thyroid failure. The present study used a rat model to determine thyroid function after the administration of different doses of {sup 131}I (64-277 {mu}Ci). Thirty male Fisher rats in the experimental group and 30 in the control group (untreated) were followed for 6 months. The animals were 4 months old at the beginning of the experiment and were sacrificed at an age of 9 months. Hormone concentration was determined before {sup 131}I administration (4-month-old animals) and three times following {sup 131}I administration, when the animals were 7, 8, and 9 months old. The thyroid glands were removed and weighed, their volume was determined and histopathological examination was performed at the end of the experiment. Significant differences in serum triiodothyronine and thyroid-stimulating hormone concentration, measured at the age of 7, 8, and 9 months, were found in the experimental group. During aging of the animals, the concentration of thyroxin fell from 64.8 {+-} 8.16 to 55.0 {+-} 6.1 nM in the control group and from 69.4 {+-} 6.9 to 25.4 {+-} 3.2 nM in the experimental group. Thyroid gland volume and weight were significantly lower in the experimental than in the control group. Thyroid glands from the experimental group showed hyaline thickness of the blood vessel wall, necrotic follicles, a strong inflammatory reaction, and peeling of necrotic cells in the follicles. In conclusion, significant differences in hormone levels and histopathological findings indicated prolonged hypothyroidism after {sup 131}I administration to rats, which was not {sup 131}I dose dependent. (author)

Clinical and laboratory evaluation of thyroid function following total laryngectomy in laryngeal cancer

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Motasaddi Zarandy M

2007-07-01

Full Text Available Background: Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer. Methods: In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma (mean age 53.6 years. Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone (TSH, free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery. Results: All patients had normal thyroid function before treatment; however, after 6 months, five patients (16.1% were hypothyroid. Of these, three patients (9.6% had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients (6.5% showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism. Conclusion: Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery.

Thyrotoxic Graves' disease with normal thyroidal technetium-99m pertechnetate uptake

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Ikekubo, Katsuji; Hino, Megumu; Ito, Hidetomi; Koh, Toshikiyo; Ishihara, Takashi; Kurahachi, Hiroyuki (Kobe City General Hospital (Japan)); Kasagi, Kanji; Hidaka, Akinari; Mori, Toru

1990-07-01

We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate ({sup 99m}Tc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analyzed. Thyroid uptake and scintigraphic examinations by means of {sup 99m}Tc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high {sup 99m}Tc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal {sup 99m}Tc uptake exists and {sup 99m}Tc uptake study and TBII activity measurement is very useful for the diagnosis. The normal {sup 99m}Tc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis. (author).

Cardiac autonomic function in patients with diabetes improves with practice of comprehensive yogic breathing program

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Viveka P Jyotsna

2013-01-01

Full Text Available Background: The aim of this study was to observe the effect comprehensive yogic breathing (Sudarshan Kriya Yoga [SKY] and Pranayam had on cardiac autonomic functions in patients with diabetes. Materials and Methods: This is a prospective randomized controlled intervention trial. Cardiac autonomic functions were assessed in 64 diabetics. Patients were randomized into two groups, one group receiving standard therapy for diabetes and the other group receiving standard therapy for diabetes and comprehensive yogic breathing program. Standard therapy included dietary advice, brisk walking for 45 min daily, and administration of oral antidiabetic drugs. Comprehensive yogic breathing program was introduced to the participants through a course of 12 h spread over 3 days. It was an interactive session in which SKY, a rhythmic cyclical breathing, preceded by Pranayam is taught under the guidance of a certified teacher. Cardiac autonomic function tests were done before and after 6 months of intervention. Results: In the intervention group, after practicing the breathing techniques for 6 months, the improvement in sympathetic functions was statistically significant (P 0.04. The change in sympathetic functions in the standard therapy group was not significant (P 0.75.Parasympathetic functions did not show any significant change in either group. When both parasympathetic and sympathetic cardiac autonomic functions were considered, there was a trend toward improvement in patients following comprehensive yogic breathing program (P 0.06. In the standard therapy group, no change in cardiac autonomic functions was noted (P 0.99. Conclusion: Cardiac autonomic functions improved in patients with diabetes on standard treatment who followed the comprehensive yogic breathing program compared to patients who were on standard therapy alone.

Radioimmunoassay and the hormones of thyroid function

International Nuclear Information System (INIS)

Stahl, R.J.

1975-01-01

Radioimmunoassay (RIA) has provided the tools for wide-reaching investigations that have changed and continue to change many important concepts of thyroid physiology and pathophysiology. The RIA for human thyrotropin (TSH) was developed in 1965; development of the RIA for triiodothyronine (T 3 ), thyroxine(T 4 ), thyroxine-binding globulin (TBG), and recently, thyrotropin-releasing hormone (TRH) and thyroglobulin (Tg) followed. The capacity to measure nanogram and picogram concentrations with relative ease and speed has permitted the demonstration of dynamic relationships of the intrathyroidal and circulating thyroid hormones to each other and to the pituitary and hypothalamic regulating hormones. Evidence for the presence of cross-influences between TRH and other hypothalamic regulating hormones on the secretion of pituitary hormones has accumulated. The impact of the new information on clinical practice is now becoming evident. There is new appreciation of the value of assaying serum T 3 and TSH concentrations in the clinical management of patients with disturbed function of the thyroid, pituitary, or hypothalamus. The necessary components for RIA performance can be purchased separately or in kit form from commercial sources. With appropriate quality-control procedures, precise, sensitive, and reliable data can be generated. Awareness of the specific technical problems relating to the RIA of these hormones is absolutely necessary to assure reliable results. The availability of kits or their components permits the performance of these studies in the community hospital and in reliable commercial-service laboratories. (U.S.)

Physiological Study on the Relation of Heart Rate Variability in Ageing and Thyroid Hormone Disorder

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Elsayed A. M. Shokr

2016-04-01

Full Text Available The present study aimed to investigate whether cardiac autonomic dysfunction in aging human might be related to an underlying thyroid disturbance. ageing has been associated with hypothyroidism and cardiac autonomic dysfunction. On the basis of body mass index (BMI, 150 patients were grouped into three groups (n = 50 48 years ± 2, 55 years ± 2 and 63 years ± 2. Electrocardiogram was recorded using PowerLab system and the time and frequency domain measures of heart rate variability (HRV were calculated. Fasting blood samples were drawn for measurement of serum thyroid stimulating hormone (TSH, total thyroxin (T4 and total triiodothyronine (T3 concentrations. The levels of TSH, T4 and T3 were not significantly different between the groups. The frequency domain HRV parameter reflecting parasympathetic tone (high-frequency normalized units, HFnu was significantly reduced in aging third groups group. The parameters which reflect sympathetic activation (Heart rate, low-frequency normalized units; LFnu and the LF/HF ratio were significantly increased in the aging group. HFnu was significantly and negatively correlated with age, whereas LFnu and LF/HF ratio were significantly and positively correlated with the above mentioned parameters. No significant relationships were noted between the HRV parameters and the levels of TSH or thyroid hormones. Cardiac autonomic dysfunction in aging human is not linked with underlying thyroid disturbance.

Exercise improves cardiac autonomic function in obesity and diabetes.

Science.gov (United States)

Voulgari, Christina; Pagoni, Stamatina; Vinik, Aaron; Poirier, Paul

2013-05-01

Physical activity is a key element in the prevention and management of obesity and diabetes. Regular physical activity efficiently supports diet-induced weight loss, improves glycemic control, and can prevent or delay type 2 diabetes diagnosis. Furthermore, physical activity positively affects lipid profile, blood pressure, reduces the rate of cardiovascular events and associated mortality, and restores the quality of life in type 2 diabetes. However, recent studies have documented that a high percentage of the cardiovascular benefits of exercise cannot be attributed solely to enhanced cardiovascular risk factor modulation. Obesity in concert with diabetes is characterized by sympathetic overactivity and the progressive loss of cardiac parasympathetic influx. These are manifested via different pathogenetic mechanisms, including hyperinsulinemia, visceral obesity, subclinical inflammation and increased thrombosis. Cardiac autonomic neuropathy is an underestimated risk factor for the increased cardiovascular morbidity and mortality associated with obesity and diabetes. The same is true for the role of physical exercise in the restoration of the heart cardioprotective autonomic modulation in these individuals. This review addresses the interplay of cardiac autonomic function in obesity and diabetes, and focuses on the importance of exercise in improving cardiac autonomic dysfunction. Copyright © 2013 Elsevier Inc. All rights reserved.

Autonomic function in manganese alloy workers

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Barrington, W.W.; Angle, C.R.; Willcockson, N.K.; Padula, M.A. [Univ. of Nebraska Medical Center, Omaha, NE (United States); Korn, T.

1998-07-01

The observation of orthostatic hypotension in an index case of manganese toxicity lead to this prospective attempt to evaluate cardiovascular autonomic function and cognitive and emotional neurotoxicity in eight manganese alloy welders and machinists. The subjects consisted of a convenience sample consisting of an index case of manganese dementia, his four co-workers in a frog shop for gouging, welding, and grinding repair of high manganese railway track and a convenience sample of three mild steel welders with lesser manganese exposure also referred because of cognitive or autonomic symptoms. Frog shop air manganese samples 9.6--10 years before and 1.2--3.4 years after the diagnosis of the index case exceeded 1.0 mg/m{sup 3} in 29% and 0.2 mg/m{sup 3} in 62%. Twenty-four-hour electrocardiographic (Holter) monitoring was used to determine the temporal variability of the heartrate (RR{prime} interval) and the rates of change at low frequency and high frequency. MMPI and MCMI personality assessment and short-term memory, figure copy, controlled oral word association, and symbol digit tests were used.

The role of polyhalogenated aromatic hydrocarbons on thyroid hormone disruption and cognitive function: a review.

Science.gov (United States)

Builee, T L; Hatherill, J R

2004-11-01

Thyroid hormones (TH) are essential to normal brain development, influencing behavior and cognitive function in both adult and children. It is suggested that conditions found in TH abnormalities such as hypothyroidism, hyperthyroidism and generalized resistance to thyroid hormone (GRTH) share symptomatic behavioral impulses found in cases of attention deficit hyperactivity disorder (ADHD) and other cognitive disorders. Disrupters of TH are various and prevalent in the environment. This paper reviews the mechanisms of TH disruption caused by the general class of polyhalogenated aromatic hydrocarbons (PHAH)'s acting as thyroid disrupters (TD). PHAHs influence the hypothalamus-pituitary-thyroid (HPT) axis, as mimicry agents affecting synthesis and secretion of TH. Exposure to PHAH induces liver microsomal enzymes UDP-glucuronosyltransferase (UGT) resulting in accelerated clearance of TH. PHAHs can compromise function of transport and receptor binding proteins such as transthyretin and aryl hydrocarbon receptors (Ahr). Glucose metabolism and catecholamine synthesis are disrupted in the brain by the presence of PHAH. Further, PHAH can alter brain growth and development by perturbing cytoskeletal formation, thereby affecting neuronal migration, elongation and branching. The complex relationships between PHAH and cognitive function are examined in regard to the disruption of T4 regulation in the hypothalamus-pituitary-thyroid axis, blood, brain, neurons, liver and pre and postnatal development.

Radioiodine-treatment (RIT) of functional thyroidal autonomy

International Nuclear Information System (INIS)

Meller, J.; Sahlmann, C.O.; Becker, W.

2002-01-01

Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

Effect of chronic L-thyroxine-suppressive therapy on cardiac function in patients with differentiated thyroid carcinoma: Radionuclide techniques

International Nuclear Information System (INIS)

Ziada, G.; Farouk, S.; Zidan, A.; Mustafa, S.; El-Reffaie, S.

2005-01-01

Differentiated thyroid carcinoma (DTC) is usually treated by a combination of surgery, radioiodine (I-131) and suppressive doses of thyroid hormones [L-thyroxine (Eltroxine)]. It is well-known that thyroid hormone affects the function of cardiovascular system. However there is no study to objectively substantiate this phenomenon. The objective of this study was to assess the left ventricular function with the help of radionuclide ventriculography in patients of DTC. Various parameters of systolic function [ejection fraction (EF), peak ejection rate (PER) and time to peak ejection rate (TPER)], diastolic function [peak filling rate (PFR) and time to peak filling rate (TPFR)] and heart rate were determined. Ten healthy control subjects and 50 patients of DTC on suppressive doses of eltroxine following surgery and radio-iodine (I-131) therapy were evaluated. The patients were divided into 5 groups according to their clinical status and thyroid hormone profile. These groups were: euthyroid, sub-clinical hypothyroid, hypothyroid, sub-clinical hyperthyroid and hyperthyroid groups. The results of the study revealed that Eltroxine significantly affected left ventricular function. Although it did not affect the systolic function, the diastolic function was significantly impaired. Prolongation of TPER was noted in hypothyroid patients, while the same was significantly decreased in hyper- and sub-clinical hyper-thyroids patients. Such abnormalities in cardiac function would be responsible for serious morbidity and could affect the lives of patients' in several ways. Hence, early effective treatment of thyroid function is important in patients of DTC, which would improve their quality of life and avoid long-term serious or irreversible cardiovascular disorder. (author)

The effect of low-dose ionizing radiation on structural functional state of thyroid gland. Communication 2

International Nuclear Information System (INIS)

Lukashova, O.P.

1999-01-01

Twelve rabbits were used to study the ultrastructure of thyroid cells after mercazolilum administration during 2.5 month (1 mg/kg of the body mass) to intact and exposed to total x-ray radiation at the total dose of 0.75 Gy animals. Prolonged administration of mercazolilum to intact rabbits causes the development of considerable morpho functional changes in the thyroid gland suggesting disturbances of thyroid secretion. 2-3 month after the preparation withdrawal thyroid 's ultrastructure restores almost completely. Mercazolilum administration to the irradiated rabbits prevents the development of structural disturbances in the thyroid epithelium characteristic for the action of separate factors. Thyroid ultrastructure in rabbits 2-3 month after the preparation withdrawal in similar to that observed at irradiation only. Normalization of thyroid ultrastructure at administration of mercazolilum to the irradiated animals suggest that inhibition of thyroid activity after the exposure to radiation is reversible and can be due to disturbances in thyroid homeostasis regulation

Phthalates Are Metabolised by Primary Thyroid Cell Cultures but Have Limited Influence on Selected Thyroid Cell Functions In Vitro

DEFF Research Database (Denmark)

Hansen, Juliana Frohnert; Brorson, Marianne Møller; Boas, Malene

2016-01-01

Phthalates are plasticisers added to a wide variety of products, resulting in measurable exposure of humans. They are suspected to disrupt the thyroid axis as epidemiological studies suggest an influence on the peripheral thyroid hormone concentration. The mechanism is still unknown as only few...... in vitro studies within this area exist. The aim of the present study was to investigate the influence of three phthalate diesters (di-ethyl phthalate, di-n-butyl phthalate (DnBP), di-(2-ethylhexyl) phthalate (DEHP)) and two monoesters (mono-n-butyl phthalate and mono-(2-ethylhexyl) phthalate (MEHP......)) on the differentiated function of primary human thyroid cell cultures. Also, the kinetics of phthalate metabolism were investigated. DEHP and its monoester, MEHP, both had an inhibitory influence on 3'-5'-cyclic adenosine monophosphate secretion from the cells, and MEHP also on thyroglobulin (Tg) secretion from...

Thyroid Scan and Uptake

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Full Text Available ... information. The thyroid scan and thyroid uptake provide information about the structure and function of the thyroid. The thyroid is a gland in the neck that controls metabolism , a chemical process that regulates the rate at which the body ...

Thyroid hormones and menstrual cycle function in a longitudinal cohort of premenopausal women.

Science.gov (United States)

Jacobson, Melanie H; Howards, Penelope P; Darrow, Lyndsey A; Meadows, Juliana W; Kesner, James S; Spencer, Jessica B; Terrell, Metrecia L; Marcus, Michele

2018-03-08

Previous studies have reported that hyperthyroid and hypothyroid women experience menstrual irregularities more often compared with euthyroid women, but reasons for this are not well-understood and studies on thyroid hormones among euthyroid women are lacking. In a prospective cohort study of euthyroid women, this study characterised the relationship between thyroid hormone concentrations and prospectively collected menstrual function outcomes. Between 2004-2014, 86 euthyroid premenopausal women not lactating or taking hormonal medications participated in a study measuring menstrual function. Serum thyroid hormones were measured before the menstrual function study began. Women then collected first morning urine voids and completed daily bleeding diaries every day for three cycles. Urinary oestrogen and progesterone metabolites (estrone 3-glucuronide (E 1 3G) and pregnanediol 3-glucuronide (Pd3G)) and follicle-stimulating hormone were measured and adjusted for creatinine (Cr). Total thyroxine (T 4 ) concentrations were positively associated with Pd3G and E 1 3G. Women with higher (vs lower) T 4 had greater luteal phase maximum Pd3G (Pd3G = 11.7 μg/mg Cr for women with high T 4 vs Pd3G = 9.5 and 8.1 μg/mg Cr for women with medium and low T 4 , respectively) and greater follicular phase maximum E 1 3G (E 1 3G = 41.7 ng/mg Cr for women with high T 4 vs E 1 3G = 34.3 and 33.7 ng/mg Cr for women with medium and low T 4 , respectively). Circulating thyroid hormone concentrations were associated with subtle differences in menstrual cycle function outcomes, particularly sex steroid hormone levels in healthy women. Results contribute to the understanding of the relationship between thyroid function and the menstrual cycle, and may have implications for fertility and chronic disease. © 2018 John Wiley & Sons Ltd.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

Science.gov (United States)

2011-01-01

Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%), 41/48 (85%) in multipara and 36/93 (39%) in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p breech (OR: 0.30, 95% CI: 0.10-0.93) and placenta anterior (OR: 0.31, 95% CI: 0.11-0.85) were independently related to ECV success. Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555 PMID:21269431

Analysis of pituitary-thyroid functional condition in neurotic type of endemic cretinism in Beijing

International Nuclear Information System (INIS)

Zhao Peiqin; Yuan Shenyuan; Wang Ruihua; Xiao Feng

1992-01-01

The authors reported 57 patients with endemic cretinism from 1981 to 1984, 41 of which were proved to be nervous endemic cretinism. The severe mental disorders were the main manifestations. But thyroid gland function was mostly normal. Tg-Ab was negative. The location size, shape of thyroid and distribution of radioactive 131 I in thyroid gland were normal. The main cause of this disease is deficiency of thyroxine and iodine during embryo period, resulting in irreversible damages in proliferation, differentiation and maturation of nervous system

Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age.

Science.gov (United States)

Andersen, Stine Linding; Andersen, Stig; Liew, Zeyan; Vestergaard, Peter; Olsen, Jørn

2018-02-01

Abnormal maternal thyroid function in pregnancy may impair fetal brain development, but more evidence is needed to refine and corroborate the hypothesis. To estimate the association between maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age. Follow-up study. A cohort of 1153 women and their children sampled from the Danish National Birth Cohort. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured in stored biobank sera from early pregnancy. Child neuropsychological test results (Wechsler Intelligence Scale/Test of Everyday Attention), test of motor function (Movement Assessment Battery), and results of parent and teacher reports (Behavior Rating Inventory of Executive Function/Strengths and Difficulties Questionnaire). Altogether 145 children (12.6%) were born to mothers with abnormal thyroid function in the early pregnancy. High maternal TSH and low fT4 were associated with lower child verbal intelligence quotient (adjusted mean difference TSH ≥ 10 mIU/L vs 0.1 to 2.49 mIU/L, -8.9 [95% confidence interval (CI), -15 to -2.4]; fT4 function was also associated with adverse motor function and teacher-reported problems of executive function and behavior, and these associations were dominated by exposure to maternal hypothyroxinemia. Maternal thyroid hormone abnormalities were associated with adverse neuropsychological function of the child at 5 years of age. For intelligence, marked hypothyroidism was important, whereas for motor function and executive and behavior problems, maternal hypothyroxinemia was predominant. Copyright © 2017 Endocrine Society

Early thyroxine treatment in Down syndrome and thyroid function later in life.

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Zwaveling-Soonawala, Nitash; Witteveen, M Emma; Marchal, Jan Pieter; Klouwer, Femke C C; Ikelaar, Nadine A; Smets, Anne M J B; van Rijn, Rick R; Endert, Erik; Fliers, Eric; van Trotsenburg, A S Paul

2017-05-01

The hypothalamus-pituitary-thyroid (HPT) axis set point develops during the fetal period and first two years of life. We hypothesized that thyroxine treatment during these first two years, in the context of a randomized controlled trial (RCT) in children with Down syndrome, may have influenced the HPT axis set point and may also have influenced the development of Down syndrome-associated autoimmune thyroiditis. We included 123 children with Down syndrome 8.7 years after the end of an RCT comparing thyroxine treatment vs placebo and performed thyroid function tests and thyroid ultrasound. We analyzed TSH and FT4 concentrations in the subgroup of 71 children who were currently not on thyroid medication and had no evidence of autoimmune thyroiditis. TSH concentrations did not differ, but FT4 was significantly higher in the thyroxine-treated group than that in the placebo group (14.1 vs 13.0 pmol/L; P  = 0.02). There was an increase in anti-TPO positivity, from 1% at age 12 months to 6% at age 24 months and 25% at age 10.7 years with a greater percentage of children with anti-TPO positivity in the placebo group (32%) compared with the thyroxine-treated group (18.5%) ( P  = 0.12). Thyroid volume at age 10.7 years (mean: 3.4 mL; range: 0.5-7.5 mL) was significantly lower ( P  treatment during the first two years of life led to a mild increase in FT4 almost 9 years later on and may point to an interesting new mechanism influencing the maturing HPT axis set point. Furthermore, there was a trend toward less development of thyroid autoimmunity in the thyroxine treatment group, suggesting a protective effect of the early thyroxine treatment. Lastly, thyroid volume was low possibly reflecting Down-specific thyroid hypoplasia. © 2017 European Society of Endocrinology.

Effective half-life of sup 131 I during treatment of autonomous thyroid disease. Untersuchungen zur effektiven Halbwertszeit des sup 131 J bei der Radiojodbehandlung der Schilddruesenautonomie

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Mueller, B.; Bares, R.; Buell, U. (Technische Hochschule Aachen (Germany, F.R.). Klinik fuer Nuklearmedizin)

1991-06-01

In order to compute effective half-life of {sup 131}I after application of therapeutic doses (T{sub eff}), the time course of whole-body radioactivity was evaluated retrospectively in 115 patients with benign thyroid diseases (multinodular autonomous adenoma, solitary autonomous adenoma or Graves' disease). Because of a large overlap of T{sub eff} in the various diseases analyzed, courses of all patients who did (group Ts, 24 cases) or did not (group kTs, 91 cases) receive antithyroid drugs during therapy were summarized. In group Ts a mean T{sub eff} of 5.0+-0.9 d was found which was significantly (p<0.01) lower than the mean T{sub eff} of 6.3+-0.9 d in group kTs. We believe that the mean T{sub eff} is a practical alternative in radioiodine dosimetry if an exact determination of T{sub eff} cannot be performed because of shortage of time. (orig.).

IMPORTANCE OF THYROID FUNCTION TEST IN DIABETES

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Mohd.

2015-05-01

Full Text Available BACKGROUND : Thyroid disorder and Diabetes are both hormone and endocrine and problems. When thyroid disease occurs in someone with diabetes, it can make blood glucose control more difficult. The incidence and occurrence of thyroid diseases in general population is increasing more and more day by day . As the prevalence of diabetes and thyroid both is more in India, correlation of these two diseases was studied in this study. MATERIAL AND METHOD: this study was conducted on 105 diabetic (both type I and II patients attending Outpatient Department. Thyroid tests including TSH, and T4 were measured using enzyme immune assay. RESULTS: We have enrolled 105 patients which are Prediabetes, and Type 2 Diabetes Mellitus. Out of these 55 are male and 50 patients are females. 68 patients are on oral hypoglycemic drugs and 28 patients are on insulin with oral hypoglycemic agents, 09 patients were only on Diabetic D iet. We have observed that patient with diabetes predominantly females were having abnormal thyroid levels than compared to control group. Hypothyroidism was seen to be more common in females than in males in both the control and study group. Similarly hyp erthyroidism also seems to be common in females compared to males in both diabetic and non - diabetic groups (Perros P 1995. DISCUSSION: Abnormal thyroid hormone levels were observed more commonly in study group than in control group. Hypothyroidism was see n to be more common in females than in males in both the control and study group. Similarly hyperthyroidism also seems to be common in females compared to males in both diabetic and non - diabetic groups

Thyroid hormone is required for hypothalamic neurons regulating cardiovascular functions

NARCIS (Netherlands)

Mittag, J.; Lyons, D.J.; Sällström, J.; Vujoviv, M.; Dudazy-Gralla, S.; Warner, A.; Wallis, K.; Alkemade, A.; Nordström, K.; Monyer, H.; Broberger, C.; Arner, A.; Vennström, B.

2013-01-01

Thyroid hormone is well known for its profound direct effects on cardiovascular function and metabolism. Recent evidence, however, suggests that the hormone also regulates these systems indirectly through the central nervous system. While some of the molecular mechanisms underlying the hormone’s

Accessing autonomic function can early screen metabolic syndrome.

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Kan Sun

Full Text Available BACKGROUND: Clinical diagnosis of the metabolic syndrome is time-consuming and invasive. Convenient instruments that do not require laboratory or physical investigation would be useful in early screening individuals at high risk of metabolic syndrome. Examination of the autonomic function can be taken as a directly reference and screening indicator for predicting metabolic syndrome. METHODOLOGY AND PRINCIPAL FINDINGS: The EZSCAN test, as an efficient and noninvasive technology, can access autonomic function through measuring electrochemical skin conductance. In this study, we used EZSCAN value to evaluate autonomic function and to detect metabolic syndrome in 5,887 participants aged 40 years or older. The EZSCAN test diagnostic accuracy was analyzed by receiver operating characteristic curves. Among the 5,815 participants in the final analysis, 2,541 were diagnosed as metabolic syndrome and the overall prevalence was 43.7%. Prevalence of the metabolic syndrome increased with the elevated EZSCAN risk level (p for trend <0.0001. Moreover, EZSCAN value was associated with an increase in the number of metabolic syndrome components (p for trend <0.0001. Compared with the no risk group (EZSCAN value 0-24, participants at the high risk group (EZSCAN value: 50-100 had a 2.35 fold increased risk of prevalent metabolic syndrome after the multiple adjustments. The area under the curve of the EZSCAN test was 0.62 (95% confidence interval [CI], 0.61-0.64 for predicting metabolic syndrome. The optimal operating point for the EZSCAN value to detect a high risk of prevalent metabolic syndrome was 30 in this study, while the sensitivity and specificity were 71.2% and 46.7%, respectively. CONCLUSIONS AND SIGNIFICANCE: In conclusion, although less sensitive and accurate when compared with the clinical definition of metabolic syndrome, we found that the EZSCAN test is a good and simple screening technique for early predicting metabolic syndrome.

Patients With Fibromyalgia Have Significant Autonomic Symptoms But Modest Autonomic Dysfunction.

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Vincent, Ann; Whipple, Mary O; Low, Phillip A; Joyner, Michael; Hoskin, Tanya L

2016-05-01

Research suggests that disordered autonomic function may be one contributor to deconditioning reported in fibromyalgia; however, no study to date has assessed these variables simultaneously with comprehensive measures. To characterize physical fitness and autonomic function with the use of clinically validated measures and subjective questionnaires between patients with fibromyalgia and healthy controls. Cross-sectional, observational, controlled study. Community sample of patients with fibromyalgia and healthy controls. Thirty patients with fibromyalgia and 30 pain and fatigue-free controls. Participants completed a battery of self-report questionnaires and physiological measures, including clinically validated measures of physical fitness and autonomic function. Six-Minute Walk Test total distance, maximal oxygen consumption as assessed by cardiopulmonary exercise testing, total steps using activity monitor, Composite Autonomic Scoring Scale as assessed by Autonomic Reflex Screen, total metabolic equivalents per week using the International Physical Activity Questionnaire, and self-reported autonomic symptoms via the 31-item Composite Autonomic Symptom Score questionnaire. Autonomic function, as assessed by self-report, was significantly different between patients and controls (P physical activity was not significantly different between patients and controls (P = .99), but levels of moderate and vigorous physical activity as measured by actigraphy were significantly lower in patients (P = .012 and P = .047, respectively). Exercise capacity (6-Minute Walk) was poorer in patients (P = .0006), but there was no significant difference in maximal volume of oxygen consumption (P = .07). Patients with fibromyalgia report more severe symptoms across all domains, including physical activity and autonomic symptoms, compared with controls, but the objective assessments only showed modest differences. Our results suggest that patients with widespread subjective impairment of

The Changes of Serum TSH in Various States of Thyroid Function

International Nuclear Information System (INIS)

Ro, Heung Kyu

1975-01-01

The serum concentrations of thyrotropin (TSH) were measured by means of radioimmunoassay, in 98 cases of normal controls, 51 cases of hyperthyroidism, 80 cases of primary hypothyroidism and 4 cases of secondary hypothyroidism to evaluate the diagnostic significance in various functional states of the thyroid. The obtained data were analyzed in correlation with other thyroid function test values in various phases of the functional thyroid diseases. The results were as follows: 1) The serum TSH concentration in normal control group was (1.3-8.0 μU/ml). 2) The measurement of serum TSH was more significant in diagnostic accuracy compared with that of serum T 4 (75.0±12.2%). Free T-4 Index (64.2±15.2%), serum T 3 (41.0±21.0%) or T 3 resin uptake (41.1±15.8%) in evaluation of primary hypothyroidism. 3) In case of overt hypothyroidism, the serum TSH and T 4 were both abnormal, compatible with the clinical diagnosis, while in case of preclinical or mild hypothyroidism, the serum T 4 (41.2±23.8% or 50.0±25.0%) was much less reliable than serum TSH. 4) In the treatment of primary hypothyroidism with desiccated thyroid, the administration of 1 grain of the hormone per day was sufficient to suppress the serum concentration of TSH to normal range. It showed that the measurement of serum TSH concentration was a significant criteria in evaluating the efficiency of the treatment of hypothyroidism. 5) The measurement of serum TSH concentration is a very significant method in the early detection of hypothyroidism induced during or after the treatment of the hyperthyroidism with antithyroid drugs or radioactive Iodine ( 131 I).

Thyroid function in the newborn child

International Nuclear Information System (INIS)

Zakharieva, V.; Shtereva, K.

1982-01-01

Assessment is made of the thyroid parameters in the early neonatal period against the background of age-related physiological peculiarities of the thyroid function. One hundred infants, born in the Institute of Obstetrics and Gynecology over the period 25th to 42nd gestation week, are studied. The umbilical cord serum levels of thyroxine, triiodothyronine and thyroiy-stimulating (TSH) levels are measured by a radioimmunologic method. The values of thyroxine disclose a steady increase with the progress of the gestation age of the fetus, and at childbirth they are higher than in adults. Triiodothyronine is lowered in all instances, and only in full-term infants it augments to reach the lowermost limit of the norm for adults. Reverse triiodothyronine is strongly elevated in all neonates, rather marked in premature infants. TSH exhibits no dependence whatsoever on the gestation age of the fetus, and at childbirth it is slightly above the uppermost limit of the norm for adults. Being aware of the peculiarities outlined has an essenti;l practical bearing on the correct interpretation of the results of ho of the results of hormonal studies, which in turn is closely linked to the problem of early detection and treatment of congenital hypothyroidism. (author)

Anticonvulsants and thyroid function.

Science.gov (United States)

Yeo, P P; Bates, D; Howe, J G; Ratcliffe, W A; Schardt, C W; Heath, A; Evered, D C

1978-01-01

Serum total and free thyroid hormone concentrations were estimated in 42 patients with epilepsy taking anticonvulsants (phenytoin, phenobarbitone, and carbamazepine either singly or in combination). There was a significant reduction in total thyroxine (TT4), free thyroxine (FT4), and free triiodothyronine (FT3) in the treated group compared with controls. Free hormone concentrations were lower than total hormone concentrations, suggesting that increased clearance of thyroid hormones occurs in patients receiving anticonvulsants. Detailed analysis indicated that phenytoin had a significant depressant effect on TT4, FT4, FT3, and reverse T3 (rT3). Phenobarbitone and carbamazepine had no significant main effects, but there were significant interactions between phenytoin and carbamazepine for TT4 and FT4. phenobarbitone and carbamazepine for FT3, and phenytoin and phenobarbitone for rT3. PMID:656820

Marked improvement of thyroid function and autoimmunity by Aloe barbadensis miller juice in patients with subclinical hypothyroidism

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Daniela Metro

2018-03-01

Full Text Available Some natural compounds decrease serum levels of thyroid autoantibodies, but results are inconsistent and thyroid function has been evaluated infrequently; moreover, the effects of Aloe on thyroid autoimmunity and function have been examined in very few studies. This study stems from the observation of one co-author, who has Hashimoto’s thyroiditis (HT-related subclinical hypothyroidism (SCH. Upon checking her biochemical thyroid panel when taking daily Aloe barbardensis Miller juice (ABMJ for thyroid-unrelated reasons, she noticed a decrease in serum thyroperoxidase autoantibodies (TPOAb and thyrotropin (TSH and an increase in serum free thyroxine (FT4. Based on this observation, we enrolled 30 consecutive HT women with levothyroxine-untreated SCH and high TPOAb levels. All of them took ABMJ (50 ml daily for nine months and were tested for serum TSH, FT4, free triiodothyronine (FT3 and TPOAb. Measurements were performed at baseline and at months 3 and 9. TSH, FT4 and TPOAb improved significantly already at month 3 and further (−61%, +23% and −56% at month 9. However, FT3 decreased significantly at month 3 (−16% with no further decrease at month 9, so that the FT4:FT3 ratio increased significantly (+33% and + 49%. At baseline, 100% of women had TSH > 4.0 mU/L and TPOAb > 400 U/ml, but frequencies fell to 0% and 37%, respectively, at month 9. In contrast, a control group (namely, 15 untreated SCH women of comparable age and baseline levels of TSH, FT4, FT3 and TPOAb had no significant changes in any index. We conclude that the daily intake of 100 ml ABMJ for 9 months in women with HT-related SCH decreases the burden of thyroid autoimmune inflammation. In addition, ABMJ rescues thyrocyte function, with decreased need for conversion of the prohormone T4 into the more active T3 through ABMJ-induced inhibition of T4 deiodination. Keywords: Aloe vera, Subclinical hypothyroidism, Thyroid autoimmunity, Thyroid function

Evaluation of thyroid function in female subjects living in the high natural background radiation area of Karunagappally, Kerala

International Nuclear Information System (INIS)

Sreekumar, A.; Nair, Raghu Ram K.; Jayalakshmi, P.; Sebastian, P.; Akiba, S.

2010-01-01

Radiation exposure has been reported to cause non cancer thyroid abnormalities like diffuse goiter and thyroid nodules. The present study was undertaken to see if there are any morphological and functional changes taking place in the thyroid due to chronic low level radiation exposure. 257 female subjects living in the four high background radiation panchayats of Chavara, Neendakara, Alappad and Panmana were selected for the study after getting informed consent. 5 ml of blood was drawn from these subjects for assessing thyroid function. The subjects were all staying in the same area since their birth and had not moved out for more than one year at a stretch. The average age of the subjects was 40.5y with a range of 17-66y. The cumulative dose had a mean of 226.3 mGy and a range of 20.6-937.8 mGy. 95 subjects from the low background area of Oachira and Thevalakkara were selected as controls in the age group of 18-63y with a mean age of 47.1y. The mean cumulative dose of this group was 35.9 mGy with a minimum of 5.3 mGy and a maximum of 106.8 mGy. 5 ml blood was collected from these subjects for thyroid function studies. All the subjects underwent ultrasound examination of the thyroid using a 10 MHz frequency linear probe. The following parameters were studied to assess thyroid function: Free T4, TSH, Antithyroglobulin antibody (ATG), Parathyroid hormone. Ultrasound images showed the following common features: Normal - 171, Suggestive of Thyroiditis - 106, Multinodular Goitre - 63, Diffuse Goitre - 5, Solitary Nodule - 31. 73 subjects had elevated TSH and 190 subjects had raised ATG. A significant numbers of subjects had features of thyroiditis. A comparative evaluation with control subjects will be done to assess its significance with reference to cumulative dose

The diagnostic effects of s-TSH and TRH stimulating test on subclinical thyroid function

International Nuclear Information System (INIS)

Lu Shujun; Wang Wenliang; Lu Shuyan; Zheng Linong; Hu Changjun; Fang Xiaozheng; Zheng Huian; Ma Meizhen

2002-01-01

The study was carried out to investigate the diagnostic effects of supersensitive TSH on diagnosing subclinical thyroid function with only once s-TSH detection and with TRH stimulating tests. TRH stimulating tests have been undertaken for 90 patients with different thyroid disease and 58 normal subjects. Diagnostic basal levels of s-TSH test in control group, subclinical hyperthyroidism group and subclinical hypothyroidism group were 2.20 +- 1.85 mIU/L, 0.54 +- 0.3 mIU/L and 9.08 +- 6.3 mIU/L, respectively, the levels of subclinical hyperthyroidism and subclinical hypothyroidism group were significantly higher than that of normal subjects group (P s -TSH>30 mIU/L. Dynamic observing of TRH stimulating tests have more effect than that of only once s-TSH detection in diagnosing subclinical thyroid function

Opposite variations in maternal and neonatal thyroid function induced by iodine supplementation during pregnancy

DEFF Research Database (Denmark)

Nøhr, S B; Laurberg, P

2000-01-01

Whereas the consequences of extremes in iodine intake are well described, much less is known about the effect of more moderate variations in maternal iodine intake on fetal thyroid function. The present study performed in Denmark with mild to moderate iodine deficiency dealt with the effect...... (P iodine intake in both mothers and neonates. The results suggest that the fetal thyroid, at least in areas of mild iodine deficiency, is more sensitive to the inhibitory effect of iodine...... of maternal iodine supplementation on thyroid function in the mother at term and in the fetus/neonate. Serum was collected consecutively from pregnant women at term (n = 144) and from cord blood (n = 139). Forty-nine women had a regular intake of vitamin and mineral tablets with iodine (150 microg/day) during...

Comparison level of thyroid and thyroid related hormones between sudanese males and females

International Nuclear Information System (INIS)

Madani, H.; Hassan, AME.; Basama, N. K.; Mohamed, W.A.S.; Eltayeb, N. H.; Elsayed, B. B.

2012-12-01

The function of the thyroid gland is under the control of pituitary gland through the thyroid stimulating hormone (TSH). It secretes the thyroid hormones tetra-iodo-thyronine (T 4 ) and Tri-iodo-thyronine (T 3 ). More secretion of thyroid hormones (hyperthyroidism) and low secretion (hypothyroidism) sometimes happen. This study was carried out to determine thyroid disorders in patients referred to radioimmunoassay (RIA) laboratory of Sudan Atomic Energy Commission (SAEC) during 2006-2010 for the thyroid function test. Disorders were detected using radioimmunoassay and Immuno radiometric assay. The total number of patients referred during these years were found to be 4700 sudanese patients, among them 4165 were females representing 88.6% compared to 535 males representing 11.4%. The total concentration of thyroid hormones thyroxine (T 4 ), tri iodine thyronine (T 3 ) and thyroid simulating stimulating hormones (TSH) were d terminated the prevalence of euthyroid was (66.5%), hypothyroidism was (11.8%) and of hyperthyroidism was (21.7%). These percentages did not vary significantly with sex. (Author)

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism.

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Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K; Vivekanandan, Muthupillai

2016-01-01

Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Associations between urinary diphenyl phosphate and thyroid function.

Science.gov (United States)

Preston, Emma V; McClean, Michael D; Claus Henn, Birgit; Stapleton, Heather M; Braverman, Lewis E; Pearce, Elizabeth N; Makey, Colleen M; Webster, Thomas F

2017-04-01

Triphenyl phosphate (TPHP) is a commonly used organophosphate flame retardant and plasticizer with widespread human exposure. Data on health effects of TPHP are limited. Recent toxicological studies suggest TPHP may alter thyroid function. We used repeated measures to assess the temporal variability in urinary concentrations of the TPHP metabolite, diphenyl phosphate (DPHP), and to examine relationships between DPHP concentrations and thyroid hormones. We sampled 51 adults at months 1, 6, and 12 from 2010 to 2011. Urine samples were analyzed for DPHP. Serum samples were analyzed for free and total thyroxine (fT 4 , TT 4 ), total triiodothyronine (TT 3 ), and thyroid stimulating hormone (TSH). We assessed variability in DPHP using intraclass correlation coefficients (ICCs) and kappa statistics. We used linear mixed-effects models to examine associations between DPHP and thyroid hormones. DPHP was detected in 95% of urine samples. Mean DPHP concentrations were 43% higher in women than men. DPHP showed high within-subject variability (ICC range, 0.13-0.39; kappa range, 0.16-0.39). High versus low (≥2.65 vs. <2.65ng/mL) DPHP in all participants was associated with a 0.43μg/dL (95% confidence interval: 0.15, 0.72) increase in mean TT 4 levels. In sex-stratified analyses, high versus low DPHP was associated with a 0.91μg/dL (95% CI: 0.47, 1.36) increase in mean TT 4 in women. The association was attenuated in men (βeta=0.19; 95% CI: -0.15, 0.52). We found no significant associations between DPHP and fT 4 , TT 3 , or TSH. We found evidence that TPHP exposure may be associated with increased TT 4 levels, especially in women. Copyright © 2017 Elsevier Ltd. All rights reserved.

Thyroid function tests in patients taking thyroid medication in Germany: Results from the population-based Study of Health in Pomerania (SHIP

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Hannemann Anke

2010-08-01

Full Text Available Abstract Background Studies from iodine-sufficient areas have shown that a high proportion of patients taking medication for thyroid diseases have thyroid stimulating hormone (TSH levels outside the reference range. Next to patient compliance, inadequate dosing adjustment resulting in under- and over-treatment of thyroid disease is a major cause of poor therapy outcomes. Using thyroid function tests, we aim to measure the proportions of subjects, who are under- or over-treated with thyroid medication in a previously iodine-deficient area. Findings Data from 266 subjects participating in the population-based Study of Health in Pomerania (SHIP were analysed. All subjects were taking thyroid medication. Serum TSH levels were measured using immunochemiluminescent procedures. TSH levels of 2.15 mIU/L in subjects younger than 50 years and 2.09 mIU/L in subjects 50 years and older, were defined as decreased or elevated, according to the established reference range for the specific study area. Our analysis revealed that 56 of 190 (29.5% subjects treated with thyroxine had TSH levels outside the reference range (10.0% elevated, 19.5% decreased. Of the 31 subjects taking antithyroid drugs, 12 (38.7% had TSH levels outside the reference range (9.7% elevated, 29.0% decreased. These proportions were lower in the 45 subjects receiving iodine supplementation (2.2% elevated, 8.9% decreased. Among the 3,974 SHIP participants not taking thyroid medication, TSH levels outside the reference range (2.8% elevated, 5.9% decreased were less frequent. Conclusion In concordance with previous studies in iodine-sufficient areas, our results indicate that a considerable number of patients taking thyroid medication are either under- or over-treated. Improved monitoring of these patients' TSH levels, compared to the local reference range, is recommended.

Thyroid function tests in patients taking thyroid medication in Germany: Results from the population-based Study of Health in Pomerania (SHIP).

Science.gov (United States)

Hannemann, Anke; Friedrich, Nele; Haring, Robin; Krebs, Alexander; Völzke, Henry; Alte, Dietrich; Nauck, Matthias; Kohlmann, Thomas; Schober, Hans-Christof; Hoffmann, Wolfgang; Wallaschofski, Henri

2010-08-16

Studies from iodine-sufficient areas have shown that a high proportion of patients taking medication for thyroid diseases have thyroid stimulating hormone (TSH) levels outside the reference range. Next to patient compliance, inadequate dosing adjustment resulting in under- and over-treatment of thyroid disease is a major cause of poor therapy outcomes. Using thyroid function tests, we aim to measure the proportions of subjects, who are under- or over-treated with thyroid medication in a previously iodine-deficient area. Data from 266 subjects participating in the population-based Study of Health in Pomerania (SHIP) were analysed. All subjects were taking thyroid medication. Serum TSH levels were measured using immunochemiluminescent procedures. TSH levels of 2.15 mIU/L in subjects younger than 50 years and 2.09 mIU/L in subjects 50 years and older, were defined as decreased or elevated, according to the established reference range for the specific study area. Our analysis revealed that 56 of 190 (29.5%) subjects treated with thyroxine had TSH levels outside the reference range (10.0% elevated, 19.5% decreased). Of the 31 subjects taking antithyroid drugs, 12 (38.7%) had TSH levels outside the reference range (9.7% elevated, 29.0% decreased). These proportions were lower in the 45 subjects receiving iodine supplementation (2.2% elevated, 8.9% decreased). Among the 3,974 SHIP participants not taking thyroid medication, TSH levels outside the reference range (2.8% elevated, 5.9% decreased) were less frequent. In concordance with previous studies in iodine-sufficient areas, our results indicate that a considerable number of patients taking thyroid medication are either under- or over-treated. Improved monitoring of these patients' TSH levels, compared to the local reference range, is recommended.

The Relationship between Thyroid Function and Recent History of Suicide Attempt in Patients with Major Depression

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Abbas Eshraghi

2016-03-01

Full Text Available Background and Objectives: Todays, evaluation of the relationship between thyroid function and some psychiatric diseases have been identified. However, studies on the relationship between thyroid function and suicide attempt are limited. The present study was carried out with the aim of evaluating thyroid function in patients attempting suicide. Methods: In this descriptive analytical study during the years 2011 and 2012, 88 patients with major depression and recent history of suicide attemp and 89 patients with major depression without history of recent suicide, who were hospitalized in the psychiatric ward of Hazrat Rasoul Akram Hospital in Tehran, were included in the study. The studied variables in this research included demographic variables, such as age, gender as well as clinical findings, such as thyroid function tests, including TSH, T3, T4. thyroid function tests were requested for patients when hospitalized with a diagnosis of major depression during the years 2011 and 2012, that these values were extracted from the patients’ medical records. Results: The two groups were matched in terms of age and gender. In patients with recent suicide attempt, 5 (5.6% cases of clinical hypothyroidism and 6 (6.8% cases of subclinical hypothyroidism, were reported. In the major depression patients without recent suicide attempt, there were 3 (3.3% cases of clinical hypothyroidism and 6 (6.7% cases of subclinical hypothyroidism, and the two groups had no significant difference in terms of the incidence of thyroid disease (p=0.75. Conclusion: According to the results of the present study, lower levels of T3 and T3 to T4 ratio can be one of the factors related to the recent history of suicide in patients with major depression.

Thyrotropin receptor mutations and thyroid hyperfunctioning adenomas ten years after their first discovery: unresolved questions.

Science.gov (United States)

Arturi, F; Scarpelli, D; Coco, A; Sacco, R; Bruno, R; Filetti, S; Russo, D

2003-04-01

Ten years after the first description of activating mutations in the thyroid stimulating hormone receptor (TSHR) gene in sporadic autonomous hyperfunctioning thyroid adenomas, there is general agreement in assigning a major pathogenic role of this genetic abnormality, acting via the constitutive activation of the cAMP pathway, in both the growth and functional characteristic of these tumours. From the beginning, however, the pathophysiological and clinical relevance of somatic TSHR mutations has been debated and some arguments still exist against a fully causative role of these mutations and the practical value of detecting these mutations for the diagnosis, treatment and prognosis of thyroid hot nodules. Some major issues will be examined herein, including (a) the frequency of TSHR alterations in various reports showing that the genetic abnormality underlying the pathogenesis of a substantial subset of thyroid tumours has yet to be identified; (b) the limitations of the present experimental models, which suggest greater caution in the interpretation of in vitro results; (c) the still unresolved question of absence of genotype-phenotype correlation. Clarification of these issues may hopefully provide new and useful tools for improving the clinical management of this disease.

The natural history of thyroid autonomy and hot nodules.

Science.gov (United States)

Corvilain, B

2003-02-01

Solitary hyperfunctioning thyroid adenomas are benign monoclonal tumors characterized by their capacity to grow and produce thyroxine (T4) and triiodothyronine (T3) autonomously, i.e. in the absence of thyrotropin (TSH). Mutations of the TSH receptor (TSH-R) have been found in the majority of solitary hyperfunctioning thyroid adenomas. On radioisotope scanning they generally appear as hot nodules because they concentrate radioiodide or 99mTc pertechnate, whereas the normal surrounding and contralateral tissue concentrate little isotopes. A toxic adenoma probably evolves gradually from a small autonomously hyperfunctioning adenoma that initially is only slightly more active than the extranodular tissue. This has been referred to as a "warm" nodule or a "compensated" adenoma. The diagnostic criterion for this designation is the persistence of detectable serum TSH maintaining some radioiodine uptake by the extranodular tissue. This "compensated" adenoma persists as long as the autonomous hormone output is not sufficient to suppress thyrotropin, i.e. to cause hyperthyroidism. The rate of development of thyrotoxicosis in patients with hyperfunctioning adenomas who are euthyroid initially is about 4% per year and depends on the size of the adenoma, iodine intake and age of the patient. No clear relationship can be establish between the nature of the TSH receptor mutations and the phenotype of the tumor.

Serum Fetuin-A Levels and Thyroid Function inMiddle-aged and Elderly Chinese.

Science.gov (United States)

Deng, Xin Ru; Ding, Lin; Wang, Tian Ge; Xu, Min; Lu, Jie Li; Li, Mian; Zhao, Zhi Yun; Chen, Yu Hong; Bi, Yu Fang; Xu, Yi Ping; Xu, Yu

2017-06-01

Serum fetuin-A levels are reportedly elevated in hyperthyroidism. However, there are few relevant epidemiologic studies. We conducted a cross-sectional study in Songnan community, China in 2009 to investigate the association between serum fetuin-A concentrations and thyroid function. A total of 2,984 participants aged 40 years and older were analyzed. Multivariable linear regression analysis revealed that serum fetuin-A concentra- tions were positively associated with log (free triiodothyronine) and were inversely associated with log (thyroid peroxidase antibody) after adjustment (both P < 0.05). Compared with the participants in the lowest tertile of free triiodo-thyronine and free thyroxine level, those in the highest tertile had higher fetuin-A concentrations. Additionally, high serum fetuin-A concentrations were related to high thyroid function (odds ratio 1.27, 95% confidence interval 1.01-1.61), after adjustment for conventional risk factors. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency

DEFF Research Database (Denmark)

Vejbjerg, Pernille; Knudsen, Nils; Perrild, Hans

2008-01-01

The aim of the study was to investigate whether the influence of smoking on thyroid volume and function changes in relation to a higher iodine intake in the population. The study comprised a total of 8,219 individuals each examined in one of two separate cross-sectional studies performed before (n...... = 4,649) and after (n = 3,570) a mandatory iodization of salt in year 2000 in two areas with established mild and moderate iodine deficiency. Participants answered questionnaires regarding life style factors and a thyroid ultrasonography was performed. Blood samples were analysed for serum thyroid...... of smoking on thyroid volume seems to be dependent on iodine intake, whereas the effect on function seems mainly to depend on other factors....

Thyroid function, Alzheimer's disease and postoperative cognitive dysfunction: a tale of dangerous liaisons?

Science.gov (United States)

Mafrica, Federica; Fodale, Vincenzo

2008-05-01

Hypothyroidism and hyperthyroidism are commonly present conditions in adults, leading to neurological symptoms, affecting the central and peripheral nervous system, and to neurocognitive impairment. Several studies investigated a possible association between Alzheimer's disease (AD) and thyroid dysfunctions. Increasing evidence supports an extensive interrelationship between thyroid hormones and the cholinergic system, which is selectively and early affected in AD. Moreover, thyroid hormones negatively regulate expression of the amyloid-beta protein precursor (AbetaPP), which plays a key role in the development of AD. A condition, the so called euthyroid sick syndrome (ESS), characterized by reduced serum T_{3} and T_{4} concentrations without increased serum thyroid stimulation hormone secretion, occurs within hours after major surgery. After surgery, elderly patients often exhibit a transient, reversible state of cognitive alterations. Delirium occurs in 10-26% of general medical patients over 65, and it is associated with a significant increase in morbidity and mortality. Modifications in thyroid hormone functioning may take place as a consequence of psycho-physical stress caused by surgery, and probably as a consequence of reduced conversion of T4 into T3 by the liver engaged in metabolizing anesthetic drugs. Therefore, modifications of thyroid hormones post-surgery, might play a role in the pathogenesis of postoperative cognitive dysfunction.

Autonomic nervous system function in young children with functional abdominal pain or irritable bowel syndrome

Science.gov (United States)

Adults with irritable bowel syndrome (IBS) have been reported to have alterations in autonomic nervous system function as measured by vagal activity via heart rate variability. Whether the same is true for children is unknown. We compared young children 7 to 10 years of age with functional abdominal...

Functional status of thyroid of Chernobyl accident consequences liquidators after 10 years after disaster

International Nuclear Information System (INIS)

Ilieva, A.A.

1997-01-01

Analysis of Chernobyl accident consequences liquidators' complaints is carried out and their clinical surveillance is conducted as well. Pronounced disorders of neuro-immune-endocrine system of the liquidators majority and ahill reflex latency half-period prolongation have been observed. By data of ultrasonic study the majority of examined ones have thyroid hyperplasia without features of chronic autoimmune inflammation and formation of adenomatous knots. Thyroid levels of hormone concentration are reduced. There is direct dependence between hormones levels and irradiation dose. The is concluded, that in delayed period after irradiation by low doses the hypo-function status of thyroid is observing

Assessment of thyroid function in patients with laryngeal carcinoma treated surgically and with radiotherapy

International Nuclear Information System (INIS)

Skoneczny, J.; Kulczynski, B.; Sowinski, J.

1975-01-01

In 40 patients with laryngeal carcinoma after total laryngectomy and radiotherapy the triiodotyronine binding index, total thyroxine level, serum free thyroxine index were determined before, during and after treatment. At the same time thyroid iodine uptake was determined by the routine method. Surgical treatment as well as radiotherapy caused lowering of thyroid functions. These changes had a high tendency for return to normal values, not earlier, however, than 6 months after treatment. The authors stress that endocrine thyroid disturbances may have an important influence on delay of psychic rehabilitation and speech training in laryngectomized patients. (author)

Morphology of subcortical brain nuclei is associated with autonomic function in healthy humans.

Science.gov (United States)

Ruffle, James K; Coen, Steven J; Giampietro, Vincent; Williams, Steven C R; Apkarian, A Vania; Farmer, Adam D; Aziz, Qasim

2018-01-01

The autonomic nervous system (ANS) is a brain body interface which serves to maintain homeostasis by influencing a plethora of physiological processes, including metabolism, cardiorespiratory regulation and nociception. Accumulating evidence suggests that ANS function is disturbed in numerous prevalent clinical disorders, including irritable bowel syndrome and fibromyalgia. While the brain is a central hub for regulating autonomic function, the association between resting autonomic activity and subcortical morphology has not been comprehensively studied and thus was our aim. In 27 healthy subjects [14 male and 13 female; mean age 30 years (range 22-53 years)], we quantified resting ANS function using validated indices of cardiac sympathetic index (CSI) and parasympathetic cardiac vagal tone (CVT). High resolution structural magnetic resonance imaging scans were acquired, and differences in subcortical nuclei shape, that is, 'deformation', contingent on resting ANS activity were investigated. CSI positively correlated with outward deformation of the brainstem, right nucleus accumbens, right amygdala and bilateral pallidum (all thresholded to corrected P right amygdala and pallidum (all thresholded to corrected P Left and right putamen volume positively correlated with CVT (r = 0.62, P = 0.0047 and r = 0.59, P = 0.008, respectively), as did the brainstem (r = 0.46, P = 0.049). These data provide novel evidence that resting autonomic state is associated with differences in the shape and volume of subcortical nuclei. Thus, subcortical morphological brain differences in various disorders may partly be attributable to perturbation in autonomic function. Further work is warranted to investigate these findings in clinical populations. Hum Brain Mapp 39:381-392, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Radionuclides in thyroid cancer

International Nuclear Information System (INIS)

Mahadev, V.

1980-01-01

The three main areas of application of radionuclides in thyroid disease will be reviewed. Firstly thyroid radionuclide imaging in thyroid swellings, in relationship to lumps in the neck and ectopic thyroid tissue such as retrosternal goitre, and lingual goitre will be described. Future developments in the field including tomographic scanning, using the coded aperture method, and fluorescent scans and ultrasound are reviewed. The second area of application is the assessment and evaluation of thyroid function and the therapy of Grave's Disease and Plummer's Disease using radioiodine. The importance of careful collection of the line of treatment, results of treatment locally and the follow-up of patients after radioiodine therapy will be described. The third area of application is in the diagnosis and therapy of thyroid cancer. Investigation of thyroid swelling, and the diagnosis of functioning metastases are reported. The therapeutic iodine scan as the sole evidence of functioning metastatic involvement is recorded. Histological thyroid cancer appears to be increasingly encountered in clinical practice and the plan of management in relation to choice of cases for therapeutic scanning is discussed with case reports. Lastly the role of whole body scanning in relationship to biochemical markers is compared. In the changing field of nuclear medicine radionuclide applications in thyroid disease have remained pre-eminent and this is an attempt to reassess its role in the light of newer developments and local experience in the Institute of Radiotherapy, Oncology and Nuclear Medicine. (author)

Influence of different thyroid functional statuses on human serum IL-8, TNF levels

International Nuclear Information System (INIS)

Wei Feng; Jiao Yanxiang; Guang Yancen; Zhang Zhu; Wei Cuiying

2003-01-01

Objective: To evaluate the effect of different statuses of thyroid function (hyperthyroidism and hypothyroidism as well as euthyroid status) on serum IL-8, TNF levels. Methods: Serum IL-8, TNF levels of 95 hyperthyroidism patients (41 males, 54 females), 53 hypothyroidism patients (23 males, 30 females), 45 euthyroid controls (24 males, 21 females) were measured with RIA. Results: 1. Serum IL-8 levels in hyperthyroidism (Graves' disease) patients were significantly higher than those in controls. (F=2.93, p 0.05). IL-8 and TNF levels were also not correlated to age and thyroid hormone levels. Conclusion: Both IL-8 and TNF took part in many auto-immure pathological processes including hyper-and hypo-thyroidism

Age, place of living and education influences the pregnancy universal thyroid function screening program attendance - questionnaire study.

Science.gov (United States)

Milewicz, Tomasz; Zuk, Małgorzata; Stochmal, Ewa; Hubalewska-Dydejczyk, Alicja; Galicka-Latała, Danuta; Juszczyk, Leszek; Krzysiek, Józef

2011-01-01

The aim of this study was to assess attendance at the universal screening programme for thyroid function in pregnancy and attempt to evaluate the influence of age, number of past pregnancies, level of education, and place of residence on the attendance. The study was performed by means of a questionnaire. Our study was performed on the basis of an anonymous questionnaire handed out to 543 women aged 16-45 years, on the third day of their puerperal stay in one of five obstetric wards in southern Poland. The questionnaire contained questions about participation in plasma level measurements of TSH, fT4, total T4, thyroid antibodies or thyroid ultrasound scanning at least once in pregnancy. The rate of attendance at any examination of thyroid function among pregnant women was 26.7%. The highest attendance rate (32.7%) was found among women living in provincial capitals or with higher education (41.3%), whereas the lowest was among women who had completed only primary school (11%) and those living in county towns (15%). The number of previous pregnancies did not influence the thyroid screening attendance. Women over 21 years of age participated in this screening programme more frequently (27.1-30%). Less than one third of pregnant women participated in the thyroid function screening. Place of living, education level, and age were the main factors influencing the attendance rate.

Can thyroid parotid ratio replace radioactive iodine uptake as a new objective parameter in the evaluation of thyroid function in cases of hyperthyroidism? A comparative study

International Nuclear Information System (INIS)

Malhotra, G.; Seshadri, N.; Gupta, A.; Das, B.K.; Gambhir, S.; Pradhan, P.K.; Bhagat, J.K.

2002-01-01

Aim: Radioactive iodine uptake (RAIU) measurements are used to distinguish other causes of thyrotoxicosis from hyperthyroidism. However it is a cumbersome technique requiring patients' visit for two or more days. Thyroid to parotid ratio (TP ratio) which is a ratio of Technetium-99m pertechnetate counts in thyroid to those in parotid glands is a new objective parameter for evaluation of thyroid function. The aim of present study was to compare TP ratio with RAIU in patients of thyrotoxicosis. Materials and Methods: The study group comprised of 15 patients (13 males and 2 females) who were clinically and biochemically hyperthyroid. All of these patients underwent Tc-99m pertechnetate thyroid scintigraphy followed by RAIU on two separate occasions. The technetium thyroid scan was done 20 minutes after intravenous application of 185 MBq (5 mCi) of the radiotracer. Both anterior and oblique views of the neck region were acquired under a standard large field of view gamma camera with LEAP collimation. The TP ratio was calculated from anterior view by drawing the region of interest over the thyroid and two regions of interest over each parotid gland. The counts of thyroid region were compared with each parotid and average of two sides was taken as TP ratio. The radioactive iodine uptake was estimated at 2,4,24, and 48 hours after oral administration of 925 KBq (25 microcuries) of I-131 in all patients with a thyroid probe by the standard technique. Apart from this 10 controls (5 males and 5 females) who were clinically and biochemically euthyroid were also included in the study and they underwent same studies as the cases. All patients with nodular disease of thyroid, past history of thyroiditis and parotitis were excluded from the study. Results: The scintigraphic findings in all patients revealed a diffusely concentrating thyroid gland with no evidence of hot or cold areas. The RAIU and TP ratio in both cases and controls is presented.: S.E: Standard error. There was a

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison's disease with primary hypothyroidism

Science.gov (United States)

Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K.; Vivekanandan, Muthupillai

2016-01-01

Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations. PMID:27042409

Age-dependent association of thyroid function with brain morphology and microstructural organization : Evidence from brain imaging

NARCIS (Netherlands)

Chaker, Layal; Cremers, Lotte G M; Korevaar, Tim I.M.; De Groot, Marius; Dehghan, Abbas; Franco, Oscar H.; Niessen, W.J.; Ikram, M. Arfan; Peeters, Robin P.; Vernooij, Meike W.

2018-01-01

Thyroid hormone (TH) is crucial during neurodevelopment, but high levels of TH have been linked to neurodegenerative disorders. No data on the association of thyroid function with brain imaging in the general population are available. We therefore investigated the association of

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Functional state of the pituitary-thyroid system in children with allergic dermatosis

Directory of Open Access Journals (Sweden)

T.V. Sorokman

2017-11-01

Full Text Available Background. Approximately 10 % of the pediatric population suffers from atopic dermatitis, and this disease is most common skin allergic pathology. The influence of thyroid hormones on the development of atopy is known. Study purpose was to evaluate the features of the functional status of the pituitary-thyroid system in children with allergic dermatosis. Materials and methods. 72 children aged from 7 to 18 years were divided into 4 groups: group I — patients who suffer from atopic dermatitis (n = 29, II — children with allergic contact dermatitis (n = 17, III group — patients with simple contact dermatitis (n = 16, IV group — healthy children (n = 10. The levels of thyroxine, thyroid stimulating hormone, antibodies to thyroglobulin (TG were determined. Results. Erythema was found in 95.2 %, edema — in 43.5 %, exudation — in 37.1 %, excoriation — in 43.5 %, lichenification — in 56.4 % of the total group of patients. Dysfunctions of the pituitary-thyroid system, both at the central and peripheral level, were determined. The frequency of antibodies to TG detection in children of the first group was high and exceeded the average population values by 3.7 times (36.7 %, χ2 = 17.5, p < 0.05. The level of TG in all of observed patients was significantly higher than that of in the comparison group. The frequency of detection of antibo­dies to TG in the group of patients with the disease experience more than 10 years exceeded the average population values by 3.2 times (34.0 %, χ2 = 8.1, p < 0.05. Conclusions. Changes in the morpho-functional state of the pituitary-thyroid system, mainly of an autoimmune nature, are revealed in children with allergic dermatosis.

Effect of Cushing's syndrome - Endogenous hypercortisolemia on cardiovascular autonomic functions.

Science.gov (United States)

Jyotsna, V P; Naseer, Ali; Sreenivas, V; Gupta, Nandita; Deepak, K K

2011-02-24

Cushing's syndrome is associated with increased cardiovascular morbidity and mortality. It's also associated with other cardiac risk factors like hypertension, diabetes mellitus and obesity. Cardiovascular autonomic function impairment could predict cardiovascular morbidity and mortality. Twenty five patients with Cushing's syndrome without diabetes and twenty five age matched healthy controls underwent a battery of cardiovascular autonomic function tests including deep breath test, Valsalva test, hand grip test, cold pressor test and response to standing from lying position. The rise in diastolic blood pressure on hand grip test and diastolic BP response to cold pressor test in Cushing's patients were significantly less compared to healthy controls (9.83 ± 3.90 vs 20.64 ± 9.55, p<0.001 and 10.09 ± 4.07 vs 15.33 ± 6.26, p<0.01 respectively). The E:I ratio on deep breathing test was also less in the patients in comparison to controls (1.36 ± 0.21 vs 1.53 ± 0.19, p<0.01). Seven patients underwent the same battery of tests 6 months after a curative surgery showing a trend towards normalization with significant improvement in expiratory to inspiratory ratio and sinus arrhythmia delta heart rate. To conclude, this study showed that chronic endogenous hypercortisolism in Cushing's is associated with an impaired sympathetic cardiovascular autonomic functioning. After a curative surgery, some of the parameters tend to improve. Copyright © 2010 Elsevier B.V. All rights reserved.

Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress.

Science.gov (United States)

Brown, Daniel K; Barton, Jo L; Gladwell, Valerie F

2013-06-04

A randomized crossover study explored whether viewing different scenes prior to a stressor altered autonomic function during the recovery from the stressor. The two scenes were (a) nature (composed of trees, grass, fields) or (b) built (composed of man-made, urban scenes lacking natural characteristics) environments. Autonomic function was assessed using noninvasive techniques of heart rate variability; in particular, time domain analyses evaluated parasympathetic activity, using root-mean-square of successive differences (RMSSD). During stress, secondary cardiovascular markers (heart rate, systolic and diastolic blood pressure) showed significant increases from baseline which did not differ between the two viewing conditions. Parasympathetic activity, however, was significantly higher in recovery following the stressor in the viewing scenes of nature condition compared to viewing scenes depicting built environments (RMSSD; 50.0 ± 31.3 vs 34.8 ± 14.8 ms). Thus, viewing nature scenes prior to a stressor alters autonomic activity in the recovery period. The secondary aim was to examine autonomic function during viewing of the two scenes. Standard deviation of R-R intervals (SDRR), as change from baseline, during the first 5 min of viewing nature scenes was greater than during built scenes. Overall, this suggests that nature can elicit improvements in the recovery process following a stressor.

Fluoride exposure and indicators of thyroid functioning in the Canadian population: implications for community water fluoridation.

Science.gov (United States)

Barberio, Amanda M; Hosein, F Shaun; Quiñonez, Carlos; McLaren, Lindsay

2017-10-01

There are concerns that altered thyroid functioning could be the result of ingesting too much fluoride. Community water fluoridation (CWF) is an important source of fluoride exposure. Our objectives were to examine the association between fluoride exposure and (1) diagnosis of a thyroid condition and (2) indicators of thyroid functioning among a national population-based sample of Canadians. We analysed data from Cycles 2 and 3 of the Canadian Health Measures Survey (CHMS). Logistic regression was used to assess associations between fluoride from urine and tap water samples and the diagnosis of a thyroid condition. Multinomial logistic regression was used to examine the relationship between fluoride exposure and thyroid-stimulating hormone (TSH) level (low/normal/high). Other available variables permitted additional exploratory analyses among the subset of participants for whom we could discern some fluoride exposure from drinking water and/or dental products. There was no evidence of a relationship between fluoride exposure (from urine and tap water) and the diagnosis of a thyroid condition. There was no statistically significant association between fluoride exposure and abnormal (low or high) TSH levels relative to normal TSH levels. Rerunning the models with the sample constrained to the subset of participants for whom we could discern some source(s) of fluoride exposure from drinking water and/or dental products revealed no significant associations. These analyses suggest that, at the population level, fluoride exposure is not associated with impaired thyroid functioning in a time and place where multiple sources of fluoride exposure, including CWF, exist. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Thyroid Scan and Uptake

Medline Plus

Full Text Available ... information about your thyroid’s size, shape, position and function that is often unattainable using other imaging procedures. ... thyroid uptake. It is a measurement of thyroid function, but does not involve imaging. Nuclear medicine is ...

State of esophageal transport function in patients with nodular goiter and in patients operated on for thyroid cancer

International Nuclear Information System (INIS)

Purizhanskij, I.I.; Lyzhina, V.D.; Ogneva, T.V.; Pashev, N.; Minchev, D.; Mladenov, V.

1989-01-01

A study was made of changes of esophageal transport function in 10 patients with thyroid adenoma and in 27 patients after surgical and radiotherapeutic management for thyroid cancer. The results were compared with those of a control group. Significant data on changes on esophageal transport function in patients with thyroid adenoma were unnoticed. Esophageal dysfunction after operation and radioactive iodine therapy for cancer was detected in 55%. Dysfunction was thought to be caused by dysphagia which showed direct correlation with the severity of hypothyroidism

Study on the changes of leptin levels in females with abnormal thyroid function

International Nuclear Information System (INIS)

Xie Kejian; Zhang Qi; Xu Yundi; Guan Yu

2002-01-01

Objective: To study the changes of leptin levels in females with abnormal thyroid function. Methods: Serum leptin levels were determined with RIA in 60 cases of hyperthyroidism, 36 cases of hypothyroidism and 30 normal controls. In patients with thyroid dysfunction and treated, serum leptin levels were again measured after completion of therapy. Results: The serum leptin levels were positively correlated to BMI in all the cases (p 0.05). The serum leptin levels in hypothyroid patients after treatment (6.77 ± 2.35 μg/L) were significantly higher than those before treatment (4.19 ± 1.84 μg/L) (p < 0.05). No obvious differences in the levels of serum leptin were observed before and after treatment in the hyperthyroid group. Conclusion: Normal thyroid hormone levels may be an important factor to achieve an adequate leptin gene expression so as to maintain an energy metabolic balance and thyroid dysfunction will influence the normal regulation of leptin

The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

Science.gov (United States)

Biondi, Bernadette; Bartalena, Luigi; Cooper, David S.; Hegedüs, Laszlo; Laurberg, Peter; Kahaly, George J.

2015-01-01

Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associated with increased risk of coronary heart disease mortality, incident atrial fibrillation, heart failure, fractures and excess mortality in patients with serum TSH levels treatment is indicated in patients older than 65 years with grade 2 SHyper to potentially avoid these serious cardiovascular events, fractures and the risk of progression to overt hyperthyroidism. Treatment could be considered in patients older than 65 years with TSH levels 0.1-0.39 mIU/l (grade 1 SHyper) because of their increased risk of atrial fibrillation, and might also be reasonable in younger (treatment due to the low risk of progression to overt hyperthyroidism and the weaker evidence for adverse health outcomes. PMID:26558232

Thyrocyte-specific Gq/G11 deficiency impairs thyroid function and prevents goiter development

OpenAIRE

Kero, Jukka; Ahmed, Kashan; Wettschureck, Nina; Tunaru, Sorin; Wintermantel, Tim; Greiner, Erich; Schütz, Günther; Offermanns, Stefan

2007-01-01

The function of the adult thyroid is regulated by thyroid-stimulating hormone (TSH), which acts through a G protein–coupled receptor. Overactivation of the TSH receptor results in hyperthyroidism and goiter. The Gs-mediated stimulation of adenylyl cyclase–dependent cAMP formation has been regarded as the principal intracellular signaling mechanism mediating the action of TSH. Here we show that the Gq/G11-mediated signaling pathway plays an unexpected and essential role in the regulation of th...

Guideline for in vivo- and in vitro procedures for thyroid diseases. Version 2; Leitlinie zur Schilddruesendiagnostik. Version 2

Energy Technology Data Exchange (ETDEWEB)

Dietlein, M.; Dressler, J.; Gruenwald, F.; Joseph, K.; Leisner, B.; Moser, E.; Reiners, C.; Rendl, J.; Schicha, H.; Schneider, P.; Schober, O. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany)

2003-06-01

The version 2 of the guideline for diagnostic standards of thyroid disorders is an update of the guideline published in 1999 and describes standards of in vitro and in vivo procedures. The following statements are modified: In vitro procedures: When measurement of the TSH-receptor antibodies is indicated, the guideline recommends the use of a second generation assay (recombinant human TSH-receptor as antigen). The functional assay sensitivity for the measurement of thyroglobulin should reach a value {<=}1 ng/ml. Moleculargenetic tests (RET proto-oncogen) are indicated in patients with a newly diagnosed medullary thyroid cancer and in the relatives of patients with hereditary medullary thyroid cancer. In vivo procedures: The sonographic examination should use a probe with a frequency of at least 7.5 MHz. Indications for the thyroid scintigraphy: nodule size {>=}1 cm in diameter, autonomous goitre/nodule with clinical or subclinical hyperthyroidism, necessity of a differentiation between Graves' disease and chronic lymphocytic thyroiditis, therapy control after a definitive treatment and - in individual cases - the follow-up of untreated autonomous nodules. (orig.) [German] Mit der Version 2 der Leitlinie zur Schilddruesendiagnostik wird die 1999 publizierte Leitlinie aktualisiert. Die Leitlinie behandelt sowohl In-vitro- als auch In-vivo-Diagnostik. Die Aenderungen umfassen folgende Aspekte: In-vitro-Diagnostik: Zur Messung der Antikoerper gegen den TSH-Rezeptor werden Assaysysteme der zweiten Generation empfohlen, bei denen der rekombinante humane TSH-Rezeptor als Antigen eingesetzt wird. Die funktionelle Assaysensitivitaet der Thyreoglobulinbestimmung sollte {<=}1 ng/ml betragen. Molekulargenetische Untersuchungen (RET Protoonkogen) haben ihren Platz bei der Erstmanifestation eines medullaeren Schilddruesenkarzinoms und im Familienscreening, falls eine hereditaere Form des medullaeren Schilddruesenkarzinoms vorliegt. In-vivo-Diagnostik: Die sonographische

Strategic planning of treatment for hyperthyroid disease

International Nuclear Information System (INIS)

Hoeffer, R.

1994-01-01

Strategic planning of treatment of hyperthyroid disease must correspond to the pathophysiological mechanism of elevation of thyroid hormone serum concentration, i.e. excess stimulation, autonomous thyroid function, destruction induced hyperthyoroxinemia. In cases of excess stimulation one should go to extremes to save the essentially 'normal' thyroid gland and life-long antithyroid drug treatment confronts with total ablation of the thyroid gland in non remitting disease. Size and quantity of regions of autonomously functioning follicles/cells will be the determinant of therapeutic strategy in cases of autonomous thyroid function. Selective surgery confronts with radioiodine treatment aiming at 'restitutio ad integrum'. In destruction induced hyperthyroxinemia antiintlammatory and symptomatic measures may help to bridge the time to the return of normal hormone concentrations. Based on these considerations a detailed therapeutic strategy for hyperthyroid disease can be designed. (author)

The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population

DEFF Research Database (Denmark)

Vejbjerg, Pernille; Knudsen, Nils; Perrild, Hans

2006-01-01

without overt thyroid disease. Design: A cross-sectional investigation of 4649 randomly selected adult subjects. Methods: Blood samples were analysed for serum TSH, thyroid hormones and thyroid autoantibodies. US of the thyroid was performed. Results: Participants with decreased echogenicity (n = 379) had...

Stereology of the thyroid gland in Indo-Pacific bottlenose dolphin (Tursiops aduncus in comparison with human (Homo sapiens: quantitative and functional implications.

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Brian Chin Wing Kot

Full Text Available The mammalian thyroid gland maintains basal metabolism in tissues for optimal function. Determining thyroid volume is important in assessing growth and involution. Volume estimation is also important in stereological studies. Direct measurements of colloid volume and nuclear-to-cytoplasmic ratio of the follicular cells may provide important information about thyroid gland function such as hormone storage and secretion, which helps understand the changes at morphological and functional levels. The present study determined the colloid volume using simple stereological principle and the nuclear-to-cytoplasmic ratio of 4 Indo-Pacific bottlenose dolphins and 2 human thyroid glands. In both dolphin and human thyroid glands, the size of the follicles tended to be quite variable. The distribution of large and small follicles within the thyroid gland was also found to be random in both the dolphin and human thyroid gland; however, the size of follicles appeared to decrease as a function of increasing age in the dolphin thyroid gland. The mean colloid volume of the dolphin thyroid gland and human thyroid gland was 1.22×10(5 µm(3 and 7.02×10(5 µm(3 respectively. The dolphin and human subjects had a significant difference in the mean colloid volume. The mean N/C ratio of the dolphin thyroid follicular epithelia and human follicular epithelia was 0.50 and 0.64 respectively. The dolphin and human subjects had a significant difference in the mean N/C ratio. This information contributes to understanding dolphin thyroid physiology and its structural adaptations to meet the physical demands of the aquatic environment, and aids with ultrasonography and corrective therapy in live subjects.

Relationship between thyroid functions and urinary growth hormone secretion in patients with hyper- and hypothyroidism.

Science.gov (United States)

Murao, K; Takahara, J; Sato, M; Tamaki, M; Niimi, M; Ishida, T

1994-10-01

Thyroid hormone plays an important role in growth hormone (GH) synthesis and secretion. To study the relationship between thyroid function and urinary GH secretion in the hyperthyroid and hypothyroid states, we measured thyroid hormones, simultaneously with serum and urinary GH levels, in 54 patients with thyroid diseases. GH-releasing hormone (GRH) test was performed in 18 patients in order to evaluate serum and urinary GH responses to GRH in hyper- and hypothyroid states. Serum thyroid hormone levels were strongly correlated with the urinary GH levels in the patients, and the correlation was greater than that between serum thyroid hormone and serum GH levels. Urinary GH levels were significantly higher in the hyperthyroid patients than in the euthyroid and hypothyroid patients, although serum GH levels were not significantly different among these three groups. Serum GH response to GRH was significantly decreased in hyperthyroid patients as compared to euthyroid patients. However, urinary GH levels after GRH administration were not decreased in the hyperthyroid patients. These results suggest that hyperthyroid states increase GH in urine and may accelerate the urinary clearance of GH.

Effective visualization of suppressed thyroid tissue by means of baseline 99mTc-methoxy isobutyl isonitrile in comparison with 99mTc-pertechnetate scintigraphy after TSH stimulation.

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Vattimo, A; Bertelli, P; Burroni, L

1992-01-01

Baseline 99mTc-MIBI thyroid scintigraphy was compared with 99mTc-pertechnetate scintigraphy after TSH stimulation in seven patients with suppressed thyroid tissue due to an autonomously functioning thyroid nodule (AFTN). In all patients the suppressed thyroid tissue was visualized by means of both baseline 99mTc-MIBI and post-TSH 99mTc-pertechnetate scintigraphy, and in some cases the former technique provided better visualization. In one patient presenting a "warm" nodule T3-suppression did not affect the nodular/extranodular uptake ratio of 99mTc-MIBI, whereas the 99mTc-pertechnetate uptake ratio increased significantly. This leads us to hypothesize that the thyroid uptake of 99mTc-MIBI is not related to TSH control, but rather to other mechanisms such as the blood flow. Since exogenous TSH is no longer available, 99mTc-MIBI scintigraphy can be successfully used in the place of repeated 99mTc-pertechnetate scintigraphy after TSH stimulation in the assessment of AFTN.

Value of radioimmuno-assay of triiodothyronine and thyrotropic hormone in the diagnosis of thyroid disease

International Nuclear Information System (INIS)

Hesch, R.D.; Emrich, D.; Muehlen, A. von zur; Breuel, H.P.; Goettingen Univ.

1975-01-01

Results of a purely in-vitro test were compared with previously available methods in 425 patients. For triiodothyronine, a normal range must be differentiated from the so-called euthyroid range (0.8-2.0 ng/ml) for patients with euthyroid goitre. The accuracy for triiodothyronine is then more than 95% and in hyperthyroidism 97.5%. It is, therefore, superior to other in-vitro measurements. But a disadvantage is that it is easily influenced by thyroid and extrathyroid factors. Similar accuracy is obtained for the TRH function test (thyrotropine-releasing hormone). Notable is a 'negative' TRH test in 20% of patients with euthyroid goitre. The significance of triiodothyronine determination is decreased in autonomous adenoma, in which the TRH test has an accuracy of 96.5%. In rare diseases of the thyroid all diagnostic possibilities must be taken into account. In ordinary practice a stepwise course is suggested. RT 3 U, T 4 , T 3 and thyroid scan with sup(99m)Tc pertechnetate are useful as basic tests. PBI is still thought to be important. The second step involves the TRH test rather than 131 I function test. Triiodothyronine determination is best for therapeutic and follow-up purposes, a situation in which TRH test is of limited value. (orig.) [de

Do unliganded thyroid hormone receptors have physiological functions?

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Chassande, O

2003-08-01

Thyroid hormone (TH) is required for the development of vertebrates and exerts numerous homeostatic functions in adults. TH acts through nuclear receptors which control the transcription of target genes. Unliganded and liganded thyroid hormone receptors (TRs) have been shown to exert opposite effects on the transcription of target genes in vitro. However, the occurance of an aporeceptor activity in vivo and its potential physiological significance has not been clearly addressed. Several data generated using experimental hypothyroidism and thyrotoxicosis in wild type and TR knockout mice support the notion that apoTRs have an intrinsic activity in several tIssues. ApoTRs, and in particular TRalpha1, are predominant during the early stages of vertebrate development and must be turned into holoTRs for post-natal development to proceed normally. However, the absence of striking alterations of embryonic and fetal development in mice devoid of TRs indicates that apoTRs do not play a fundamental role. During development, as well as in adults, apoTRs rather appears as a system which increases the range of transcriptional responses to moderate variations of T3.

Recovery from diabetes insipidus and preservation of thyroid function after craniopharyngioma removal and pituitary stalk sectioning.

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Ogawa, Yoshikazu; Niizuma, Kuniyasu; Tominaga, Teiji

2017-11-01

Craniopharyngioma is a slow-growing tumor, but long-term tumor control with maintenance of quality of life is sometimes very difficult to achieve, and hypothalamic disturbance should be strictly avoided in the treatment. However, management of the pituitary gland and/or pituitary stalk varies among surgeons and institutions. This retrospective review identified 44 patients, 24 males and 20 females with craniopharyngiomas who were initially treated by surgery through the extended transsphenoidal approach with pituitary stalk sectioning at a single institute. If the tumor bed involved the posterior lobe of the pituitary gland, pituitary stalk, anterior and/or mid portion of the third ventricle floor, these structures were removed en-bloc together with the tumor. The closest attention was paid to preserve fine arteries running along the surface of optic chiasm and the lateral walls of the third ventricle. Surgical outcome and changes in postoperative endocrinological status were investigated. Gross total removal was achieved in 40 of 44 patients (91%), and all patients could discharge without autonomic and/or thermal disturbances. Tumor remnants were identified with tight adhesion to the perforating arteries in 2 cases, tight adhesion to mammillary bodies in 1, and optic chiasm in 1. Administration of anti-diuretic hormone could be discontinued in 23 of 44 patients (52.3%) with improved diabetes insipidus (DI), although no patient could discontinue glucocorticoid administration. Preservation of thyroid function was achieved in another 23 of 44 patients (52.3%), and recovery from DI was correlated with preservation of thyroid function (p=0.016). Pituitary dysfunction is partially reversible even with pituitary stalk sectioning. Regrowth of tumor in the anterior and/or mid portion of the third ventricle floor including pituitary stalk can possibly be prevented by aggressive tumor removal, and co-achievement of long-term tumor control with maintenance of quality of life

The effects of carbamazepine on thyroid functions in childhood epilepsy

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Mehmet İbrahim Turan

2013-12-01

Full Text Available Objective: To investigate the effects of carbamazepinetherapy on thyroid function tests in childrenMethods: The carbamazepine group consisted of 58 childrenunder observation for epilepsy, and the control groupof 54 healthy children. Age of onset, length of drug use,drug dosage and laboratory parameters including free triiodothyronine(FT3, free thyroxin (FT4 and thyrotropin(TSH were recorded. These data were then comparedagainst those from the control group.Results: In the carbamazepine group, FT3 was 3.86 ±0.43 pg/mL, FT4 was 1.15 ± 0.18 mg/dL and TSH: 2.58 ±1.33 ml U/L. In the control group, FT3 was 4.13 ± 0.59 pg/mL, FT4 1.34 ± 0.13 mg/dL and TSH was 2.06 ± 0.89 mlU/L. No statistically significant difference between rates ofsubclinical hypothyroidism was determined between thetwo groups (p=0.196.Conclusion: Although, carbamazepine reduces thyroidhormone concentrations, rarely causes hypothyroidism.Key words: Child, carbamazepine, thyroid function tests

A comparative study of lipid profile and autonomic functions in vegetarian and non-vegetarian postmenopausal women

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Arunima Chaudhuri

2013-01-01

Full Text Available Background: The prevalence of dyslipedaemia, autonomic dysfunction leading to cardiovascular diseases, increases with menopause and an ageing population. Autonomic dysfunction as measured by lower heart rate variability is an established risk factor for cardiac death. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases and are also linked to other cardiovascular risk factors. Objectives: To compare lipid profile and autonomic functions of postmenopausal women on vegetarian and non- vegetarian diet. Materials and Methods: 120 Postmenopausal women (menopausal duration and age-matched without any gross systemic disease from an Industrial population were selected. Sixty women were on vegetarian diet and 60 on non-vegetarian diet. BMI and waist/hip ratios were calculated, lipid profile was analyzed, and autonomic function tests were carried out. A comparison was done between the two groups using Students t test. Pearson′s correlation coefficient was calculated between the independent variable (lipid profile parameters and the dependent variables (deep breath test, valsalva ratio, 30:15 ratio, OTT, IHG, CPT to understand the effect of lipid profile on autonomic control of heart. Results : Significant increases in total cholesterol, triglyceride, LDL, cholesterol/HDL ratio were noticed in women on non-vegetarian diet. Results of autonomic function tests, i.e. valsalva ratio, deep breath test, 30: 15R-R intervals ratio, isometric hand grip test, cold pressor test, and orthostatic tolerance test were significantly worsened in postmenopausal women on non-vegetarian diet. Conclusion: Dietary factors may be an important cause of alteration of lipid metabolism. Increased cholesterol decreases heart rate variability and increased LDL cholesterol decreases baroreceptor sensitivity thereby worsening autonomic functions in postmenopausal women.

High Iodine and Salt Intakes and Obesity do not Modify the Thyroid Function in Mexican Schoolchildren.

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Méndez-Villa, Lorena; García-Solís, Pablo; Solís-S, Juan Carlos; García-Gutiérrez, David Gustavo; Pérez-Mora, Valeria Alejandra; Robles-Osorio, Ludivina; Sampson-Zaldívar, Eduardo

2016-08-01

Mexico is considered as a nutritional transition country with a high prevalence of overweight and obesity, and recent studies have reported a high iodine intake in children. Both high iodine intake and obesity have been associated with thyroid dysfunction. Our aim was to assess iodine and salt intake and thyroid function in Mexican schoolchildren with normal weight and obesity. A cross-sectional study was performed during 2012-2013 in schoolchildren from Queretaro, Mexico. Six hundred seventy-eight schoolchildren were evaluated to obtain nutrition status, urinary iodine concentration (UIC) and thyroid volume (TVol). The prevalence of overweight and obesity was 47.3 %, the median UIC was 428 μg/L and TVol was normal in all schoolchildren; however, obese girls had a higher TVol than normal weight at the age of 8, 10 and 12 years. A subsample of schoolchildren was divided in 6-8 and 9-12-year-old groups, in order to compare thyroid function (thyrotropin, free T4, and anti-thyroid antibodies); iodine and salt intake were estimated with 24-h urinary samples. No differences in thyroid function were observed in both age groups. In the 6-8-year-old group, obese schoolchildren had higher iodine intake than normal-weight children (415.5 vs. 269.1 μg/day, p obese schoolchildren had higher salt intake than normal-weight children (6.2 vs. 3.8 g/day, p < 0.05), but no differences in iodine intake. Dietary patterns could explain the differences between both age groups. Further studies are needed to identify the main sources of iodine intake in Mexican populations.

Interaction between organophosphate pesticide exposure and PON1 activity on thyroid function

International Nuclear Information System (INIS)

Lacasana, Marina; Lopez-Flores, Inmaculada; Rodriguez-Barranco, Miguel; Aguilar-Garduno, Clemente; Blanco-Munoz, Julia; Perez-Mendez, Oscar; Gamboa, Ricardo; Gonzalez-Alzaga, Beatriz; Bassol, Susana; Cebrian, Mariano E.

2010-01-01

Organophosphate pesticides are widely used in agricultural purposes. Recently, a few studies have demonstrated the ability of these chemicals to alter the function of the thyroid gland in human. Moreover, the paraoxonase-1 enzyme (PON1) plays an important role in the toxicity of some organophosphate pesticides, with low PON1 activity being associated with higher pesticide sensitivity. This study evaluates the interaction between exposure to organophosphate compounds and PON1 enzyme activity on serum levels of TSH and thyroid hormones in a population of workers occupationally exposed to pesticides. A longitudinal study was conducted on a population of floriculture workers from Mexico, during two periods of high and low-intensity levels of pesticide application. A structured questionnaire was completed by workers containing questions on sociodemographic characteristics and other variables of interest. Urine and blood samples were taken, and biomarkers of exposure (dialkylphosphates), susceptibility (PON1 polymorphisms and activity) and effect (thyroid hormone levels) were determined. Interaction between dialkylphosphates and PON1 polymorphisms or PON1 activity on hormone levels was evaluated by generalized estimating equation (GEE) models. A significant interaction was found between serum diazoxonase activity and total dialkylphosphates (ΣDAP) on TSH levels. Thus, when PON1 activity was increased we observed a decrease in the percentage of variation of TSH level for each increment in one logarithmic unit of the ΣDAP levels. This interaction was also observed with the PON1 192 RR genotype. These results suggest a stronger association between organophosphate pesticides and thyroid function in individuals with lower PON1 activity.

Genetics Home Reference: Hashimoto thyroiditis

Science.gov (United States)

... Facebook Twitter Home Health Conditions Hashimoto thyroiditis Hashimoto thyroiditis Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Hashimoto thyroiditis is a condition that affects the function of ...

Thyroid function in HIV patients treated with highly active antiretroviral therapy (HAART)

International Nuclear Information System (INIS)

Madeddu, Gr.; Calia, G.M.; Lovigu, C.; Mannazzu, M.; Mura, M.S.; Spanu, A.; Solinas, P.; Falchi, A.; Madeddu, G.

2002-01-01

Aim: Altered thyroid function parameters have been reported in HIV patients also during therapy. We further investigated whether thyroid disorders occur in HIV patients both naive or on HAART. Materials and Methods: We enrolled 168 HIV patients aged 20 to 62 yrs, 110M and 58F: 95 patients (G1) were on HAART including protease inhibitors-PI (36.89±13.0 mths); 58 (G2) were on HAART (Nevirapine or Efavirenz) without PI (13.22±8.68 mths) and previously submitted to other HAART regimens (28.10±12.3 mths); 15 (G3) were naive. In all patients and in 44 age-sex matched normal subjects (C) we measured in serum by IRMA, FT3 and FT4 (pg/ml), TSH (μU/ml), antithyroid peroxidase (TPO) and hTG (U/ml) antibodies (Ab). Results: Thyroid function test abnormalities were found in 18/153 patients treated with HAART (11.7%), 9 G1 and 9 G2 patients, while the tests were normal in naive cases. Both FT3 and FT4 were above normal range and TSH suppressed in one G1 patient with clinical signs of hyperthyroidism; FT4 was low and TSH elevated in 2 G2 cases with slight clinical signs of hypothyroidism. Moreover, TSH values >3.5 μU/ml and normal FT3 and FT4 levels were ascertained in 7 further cases as probable subclinical hypothyroidism. Only FT4 was low in 3 further cases and FT3 high in 5 others, all asymptomatic. hTG-Ab were present in 2 subclinical hypothyroidism patients and in 3 further cases with normal thyroid tests. Mean TSH levels were higher but not significantly in G1 than in G2; both were higher than in G3 and C. FT4 levels were significantly lower in G1 (12.294±2.938; p<0.002), G2 (11.091±2.453; p<0.00002) and G3 (10.186±2.537; p<0.00004) than in C (13.734±2.205). FT4 was significantly lower in G2 (p<0.006) and G3 ( p<0.01) than in G1; there was no difference between G2 and G3. FT3 was higher in G1 (3.711±0.559) and G2 (3.60±0.581) than in G3 (3.42±0.549) and C (3.452±0.343); the difference was significant (p<0.01) only between G1 and C. Neither FT3, FT4 nor TSH

Thyrotoxicosis caused by functioning metastatic thyroid carcinoma. A rare and elusive cause of hyperthyroidism with low radioactive iodine uptake

International Nuclear Information System (INIS)

Ober, K.P.; Cowan, R.J.; Sevier, R.E.; Poole, G.J.

1987-01-01

A patient with progressively worsening thyrotoxicosis, refractory to medical therapy, is described. Repeated measurements of thyroidal RAI uptake over a 13 month period were low consistently and could not be explained by iodine ingestion, thyroiditis, or administration of exogenous thyroid hormone. An I-131 scan ultimately revealed striking activity at the base of the skull, reflecting ectopic excessive production of thyroid hormone by a solitary functioning metastatic thyroid carcinoma. The thyrotoxic state resolved after large doses of therapeutic I-131. Typical features of this rare cause of hyperthyroidism are discussed

Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison′ s disease with primary hypothyroidism

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Jaya Prakash Sahoo

2016-01-01

Full Text Available Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical was defined as high thyroid stimulating hormone (TSH with/without low free thyroxine (fT4. TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

Tiratricol-induced periodic paralysis: a review of nutraceuticals affecting thyroid function.

Science.gov (United States)

Cohen-Lehman, Janna; Charitou, Marina M; Klein, Irwin

2011-01-01

To review the potential adverse effects of thyroid hormone-based nutraceuticals and describe a case of thyrotoxic periodic paralysis (TPP) after abuse of a dietary supplement containing 3,5,3'-triiodothyroacetic acid (tiratricol). We review the literature on potential dangers and therapeutic misadventures of thyroid hormone-based nutraceuticals and present the clinical, laboratory, and radiologic data of a bodybuilder in whom hypokalemic TPP developed after use of "Triax Metabolic Accelerator". A 23-year-old white man developed lower extremity paralysis, diaphoresis, and palpitations in the setting of low serum potassium levels. Laboratory results showed suppressed thyroid-stimulating hormone, low levels of free and total thyroxine, low total triiodothyronine level, and very low 24-hour radioiodine uptake. The patient ultimately admitted to taking a supplement containing tiratricol for approximately 2 months, and hypokalemic TPP was diagnosed. He was treated with potassium supplementation and a β-adrenergic blocking agent, which completely resolved his symptoms. Results of thyroid function tests normalized or approached normal 1 week after hospitalization, and future use of dietary supplements was strongly discouraged. Despite 2 warnings by the US Food and Drug Administration, products containing tiratricol are still available for sale on the Internet. This report illustrates both an unusual adverse effect of a nutraceutical containing tiratricol and the importance of educating our patients about the risks versus benefits of using these widely available but loosely regulated products.

Evaluation of Thyroid Disorders During Head-and-Neck Radiotherapy by Using Functional Analysis and Ultrasonography

International Nuclear Information System (INIS)

Bakhshandeh, Mohsen; Hashemi, Bijan; Mahdavi, Seyed Rabie; Nikoofar, Alireza; Edraki, Hamid Reza; Kazemnejad, Anoshirvan

2012-01-01

Purpose: To evaluate thyroid function and vascular changes during radiotherapy for patients with head and neck cancer. Methods and Materials: Fifty patients treated with primary or postoperative radiotherapy for various cancers in the head and neck region were prospectively evaluated. The serum samples (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]), the echo level of the thyroid gland, and color Doppler ultrasonography (CDU) parameters of the right inferior thyroid artery (RITA) of the patients were measured before and at regular intervals during radiotherapy. The thyroid gland dose-volume histograms of the patients were derived from their computed tomography-based treatment plans. Results: There was a significant fall in TSH level (p 2 ). There were significant rises in the patients’ pulsatility index, resistive index, peak systolic velocity, blood volume flow levels, and RITA diameter (p < 0.0001), as detected by CDU during radiotherapy, compared to those parameters measured before the treatment. Hypoechogenicity and irregular echo patterns (p < 0.0001) were seen during radiotherapy compared to those before treatment. There was significant Pearson’s correlation between the CDU parameters and T4, FT4, and TSH levels. Conclusions: Radiation-induced thyroiditis is regarded as primary damage to the thyroid gland. Thyroiditis can subsequently result in hypothyroidism or hyperthyroidism. Our results demonstrated that changes in thyroid vessels occur during radiotherapy delivered to patients. Vessel changes also can be attributed to the late effect of radiation on the thyroid gland. The hypoechogenicity and irregular echo patterns observed in patients may result from the increase in intrathyroidal flow.

Monitoring of recurrent and superior laryngeal nerve function using an Airwayscope™ during thyroid surgery.

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Ijichi, Kei; Sasano, Hiroshi; Harima, Megumi; Murakami, Shingo

2017-10-01

In thyroid surgery, intraoperative identification and preservation of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve external branch (SLNEB) are crucial. Several reports have proposed that electromyography (EMG) monitoring is an acceptable adjunct for identification and preservation of the RLN. However, a limited number of hospitals have access to an EMG monitoring system. Therefore, the development of another viable monitoring method is required. The aim of the present study was to design a new RLN and SLNEB monitoring method combining an Airwayscope™ (AWS) and a facial nerve stimulator. The facial nerve-stimulating electrode stimulates the RLN or SLNEB, so that the movement of the vocal cord may be observed with an AWS. This monitoring method was performed on 10 patients with a thyroid tumor. In all the cases, RLN and SLNEB were identified and vocal cord function was preserved. All the patients exhibited normal vocal cord function following surgery. Thus, the new RLN and SLNEB monitoring method using an AWS and a facial nerve stimulator is useful in thyroid surgery, and this method may be used as a reliable and available alternative to EMG monitoring to ensure the normal function of the vocal cord.

Environmental Issues in Thyroid Diseases.

Science.gov (United States)

Ferrari, Silvia Martina; Fallahi, Poupak; Antonelli, Alessandro; Benvenga, Salvatore

2017-01-01

Environmental factors are determinant for the appearance of autoimmune thyroid diseases (AITD) in susceptible subjects. Increased iodine intake, selenium, and vitamin D deficiency, exposure to radiation, from nuclear fallout or due to medical radiation, are environmental factors increasing AITD. Cigarette smoking is associated with Graves' disease and Graves' ophthalmopathy, while it decreases the risk of hypothyroidism and thyroid autoimmunity. Viral infections are important environmental factors in the pathogenesis of AITD, too, particularly human parvovirus B19 (EVB19) and hepatitis C virus. Among the many chemical contaminants, halogenated organochlorines and pesticides variably disrupt thyroid function. Polychlorinated biphenyls and their metabolites and polybrominated diethyl ethers bind to thyroid transport proteins, such as transthyretin, displace thyroxine, and disrupt thyroid function. Among drugs, interferon- and iodine-containing drugs have been associated with AITD. Moreover intestinal dysbiosis causes autoimmune thyroiditis. To reduce the risk to populations and also in each patient, it is necessary to comprehend the association between environmental agents and thyroid dysfunction.

Radioiodine therapy of thyroid functional autonomies: Experience at a single university referral hospital centre in Czech Republic

International Nuclear Information System (INIS)

Kraft, O.

2006-01-01

This paper presents the results of I-131 therapy in patients suffering from various types of functional autonomies of the thyroid gland. The efficacy and adverse effects of radioiodine therapy are presented. Seven hundred ninety-nine patients (age range= 33 to 86 years; average age= 58.7 years; Male: Female = 7.4:1) with unifocal, multifocal and disseminated functional autonomies of thyroid gland were treated with at least one therapeutic dose of I-131. Baseline Tc-99m pertechnetate thyroid scans, radioactive iodine uptake studies and ultrasonography were performed in all cases prior to radio iodine therapy. Baseline serum total and free thyroxine (T-T4 and F-T4), total triiodothyronine (T-T3) and TSH levels were estimated in all cases. Effective half life of radio iodine in the thyroids was also determined in all patients prior to therapy and a few patients were subjected to TRH stimulation tests. Following treatment all patients were evaluated after a period of 4-6 months. Further follow up evaluations were done at one year in 545 patients and at two years in 254 patients. Complete elimination of functional autonomy was achieved in 733 (91.74%) patients with a single therapeutic dose of I-131, while 62 (7.76%) patients required two doses of I-131 and only 4 (0.5%) patients required three therapeutic doses of I-131. Following I-131 therapy, the suppression of TSH levels in serum disappeared in 607 (76%) of treated patients. An average volume reduction of 38% was noted in the thyroid gland following I-131. Side effects were minimal and only a few patients complained of transient neck pressure, pain and neck swelling. Postradiation hypothyroidism was diagnosed in 36 patients (4.5%). We conclude that radio iodine treatment is the most comfortable and economical approach to the treatment of the thyroid functional autonomies. The results of our approach show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects

The axolotl (Ambystoma mexicanum), a neotenic amphibian, expresses functional thyroid hormone receptors.

Science.gov (United States)

Safi, Rachid; Bertrand, Stéphanie; Marchand, Oriane; Duffraisse, Marilyne; de Luze, Amaury; Vanacker, Jean-Marc; Maraninchi, Marie; Margotat, Alain; Demeneix, Barbara; Laudet, Vincent

2004-02-01

Neotenic amphibians such as the axolotl (Ambystoma mexicanum) are often unable to undergo metamorphosis under natural conditions. It is thought that neoteny represents a deviation from the standard course of amphibian ontogeny, affecting the thyroid axis at different levels from the central nervous system to peripheral organs. Thyroid hormone receptors (TRs) that bind the thyroid hormone (TH) T(3) have been described in axolotl. However, the full sequences of TR were needed to better characterize the TH response and to be able to assess their functional capacity at the molecular level. We report that each of the alpha and beta axolotl TRs bind both DNA and TH, and they activate transcription in response to TH in a mammalian cell-based transient transfection assay. Moreover, both TRs are expressed in axolotl tissues. Interestingly, each TR gene generates alternatively spliced isoforms, harboring partial or total deletions of the ligand-binding domain, which are expressed in vivo. Further, we found that in the axolotl, TH regulates the expression of stromelysin 3 and collagenase 3, which are TH target genes in Xenopus. Taken together, these results suggest that axolotl TRs are functional and that the molecular basis of neoteny in the axolotl is not linked to a major defect in TH response in peripheral tissues.

Cooperative Control for Multiple Autonomous Vehicles Using Descriptor Functions

Directory of Open Access Journals (Sweden)

Marta Niccolini

2014-01-01

Full Text Available The paper presents a novel methodology for the control management of a swarm of autonomous vehicles. The vehicles, or agents, may have different skills, and be employed for different missions. The methodology is based on the definition of descriptor functions that model the capabilities of the single agent and each task or mission. The swarm motion is controlled by minimizing a suitable norm of the error between agents’ descriptor functions and other descriptor functions which models the entire mission. The validity of the proposed technique is tested via numerical simulation, using different task assignment scenarios.

Altered Autonomic Functions and Distressed Personality Traits in Male Adolescents with Internet Gaming Addiction.

Science.gov (United States)

Kim, Nahyun; Hughes, Tonda L; Park, Chang G; Quinn, Laurie; Kong, In Deok

2016-11-01

Internet gaming addiction (IGA) has been associated with many negative health outcomes, especially for youth; however, few studies have examined the physiological parameters and personality features related to this addiction. This study aimed to identify differences in autonomic functions and distressed (type D) personality traits among Korean adolescent males with and without IGA. In a cross-sectional study, 68 adolescent males were recruited in a Korean city using convenience and snowball sampling methods. For each subject, heart rate variability (HRV) parameters were measured as autonomic functions and questionnaires were used to identify IGA and type D personality traits. Data were analyzed using descriptive analyses, t tests, χ 2 tests, and Pearson's correlation. Most HRV parameters significantly differed between the IGA and non-IGA groups (all p gaming was related to alterations in autonomic functions and distressed personality traits in male adolescents. These findings provide further understanding of the IGA phenomenon and highlight the need for interventions that address male adolescents with IGA.

Short-term overt hypothyroidism induces sympathovagal imbalance in thyroidectomized differentiated thyroid carcinoma patients

NARCIS (Netherlands)

Heemstra, Karen A.; Burggraaf, Jacobus; van der Klaauw, Agatha A.; Romijn, Johannes A.; Smit, Johannes W. A.; Corssmit, Eleonora P. M.

2010-01-01

Thyroid hormone impacts on the cardiovascular system. (Subclinical) hyperthyroidism results in sympathovagal imbalance due to decreased vagal tone. However, conflicting data have been reported on the effects of hypothyroidism on the activity of the autonomic nervous system (ANS). In hypothyroidism,

Thyroid function disorders--Guidelines of the Netherlands Association of Internal Medicine

NARCIS (Netherlands)

Muller, A. F.; Berghout, A.; Wiersinga, W. M.; Kooy, A.; Smits, J. W. A.; Hermus, A. R. M. M.

2008-01-01

Thyroid function disorders are common with a female to male ratio of 4 to 1. In adult women primary hypothyroidism and thyrotoxicosis have a prevalence of 3.5/1000 and 0.8/1000, respectively. This guideline is aimed at secondary care providers especially internists, but also contains relevant

Thyroid hormone signaling in the hypothalamus

NARCIS (Netherlands)

Alkemade, Anneke; Visser, Theo J.; Fliers, Eric

2008-01-01

PURPOSE OF REVIEW: Proper thyroid hormone signaling is essential for brain development and adult brain function. Signaling can be disrupted at many levels due to altered thyroid hormone secretion, conversion or thyroid hormone receptor binding. RECENT FINDINGS: Mutated genes involved in thyroid

Thyroid functions in young diabetics

International Nuclear Information System (INIS)

Hafiez, A.A.; Ismail, A.A.; Awadeen, M.R.; Abbas, E.Z.; Farag, M.S.A.

1982-01-01

Assessment of the thyroid-pituitary axis was performed in uncontrolled (20 cases) and controlled (22 cases) insulin-dependent young diabetics who were university students attending the university hospital. A third age-matching group (21 normal subjects) was also investigated. The plasma glucose level was determined after fasting as well as 2 hours after an oral glucose meal (50 g). Thyroxine (T 4 ), triiodeothyronine (T 3 ) and thyroid stimulating hormone (TSH) were assayed by RIA. The data obtained showed a lowered level of T 3 and T 4 and a raised level of TSH in uncontrolled young diabetics as compared to corresponding values for age matching normals. The group of controlled diabetics showed near normal T 3 and increased T 4 levels, but still lower than normal. TSH levels dropped significantly to the normal level. (author)

Substantial interobserver variation of thyroid volume and function by visual evaluation of thyroid (99m)Tc scintigraphy

DEFF Research Database (Denmark)

Soelberg, Kerstin; Grupe, Peter; Boel-Jørgensen, Henrik

2014-01-01

(99m)Tc-pertechnetate scintigraphy is much used in the evaluation of patients with nodular goitre. We investigated the ability of experienced observers to estimate the thyroid 24-h (131)I uptake (RAIU) and the thyroid volume by visual evaluation of the scintigram.......(99m)Tc-pertechnetate scintigraphy is much used in the evaluation of patients with nodular goitre. We investigated the ability of experienced observers to estimate the thyroid 24-h (131)I uptake (RAIU) and the thyroid volume by visual evaluation of the scintigram....

Prospective randomized controlled intervention trial: Comprehensive Yogic Breathing Improves Cardiac autonomic functions and Quality of life in Diabetes

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V P Jyotsna

2012-01-01

Full Text Available Aims and Objectives: To assess the effect of Comprehensive Yogic Breathing Program on glycemic control, quality of life, and cardiac autonomic functions in diabetes. Material and Methods: This is a prospective randomized controlled intervention trial. Cardiac autonomic functions were assessed in 120 diabetics. Patients were randomized into two groups, one group receiving standard therapy for diabetes (n = 56 and the other group receiving standard therapy for diabetes and comprehensive yogic breathing program (n = 64. Standard therapy included advice on diet, walk, and oral antidiabetic drugs. Comprehensive yogic breathing program was an interactive session in which Sudarshan kriya yoga, a rhythmic cyclical breathing, preceded by Pranayam was taught under guidance of a certified teacher. Change in fasting, post prandial blood sugars, glycated hemoglobin, and quality of life were assessed. Cardiac autonomic function tests were done before and six months after intervention. Results: There was significant improvement in psychological (P = 0.006 and social domains (P = 0.04 and total quality of life (P = 0.02 in the group practicing comprehensive yogic breathing program as compared to the group following standard therapy alone. In the group following breathing program, the improvement in sympathetic cardiac autonomic functions was statistically significant (P = 0.01, while the change in the standard group was not significant (P = 0.17. When both parasympathetic and sympathetic cardiac autonomic functions were considered, there was a trend toward improvement in patients following comprehensive yogic breathing program (P = 0.07. In the standard therapy group, no change in cardiac autonomic functions was noted (P = 0.76. The parameters of glycemic control were comparable in both groups. Conclusion: There was significant improvement in quality of life and cardiac autonomic functions in the diabetes patients practicing comprehensive yogic breathing

Flavonoids, Thyroid Iodide Uptake and Thyroid Cancer-A Review.

Science.gov (United States)

Gonçalves, Carlos F L; de Freitas, Mariana L; Ferreira, Andrea C F

2017-06-12

Thyroid cancer is the most common malignant tumor of the endocrine system and the incidence has been increasing in recent years. In a great part of the differentiated carcinomas, thyrocytes are capable of uptaking iodide. In these cases, the main therapeutic approach includes thyroidectomy followed by ablative therapy with radioiodine. However, in part of the patients, the capacity to concentrate iodide is lost due to down-regulation of the sodium-iodide symporter (NIS), the protein responsible for transporting iodide into the thyrocytes. Thus, therapy with radioiodide becomes ineffective, limiting therapeutic options and reducing the life expectancy of the patient. Excessive ingestion of some flavonoids has been associated with thyroid dysfunction and goiter. Nevertheless, studies have shown that some flavonoids can be beneficial for thyroid cancer, by reducing cell proliferation and increasing cell death, besides increasing NIS mRNA levels and iodide uptake. Recent data show that the flavonoids apingenin and rutin are capable of increasing NIS function and expression in vivo. Herein we review literature data regarding the effect of flavonoids on thyroid cancer, besides the effect of these compounds on the expression and function of the sodium-iodide symporter. We will also discuss the possibility of using flavonoids as adjuvants for therapy of thyroid cancer.

Flavonoids, Thyroid Iodide Uptake and Thyroid Cancer—A Review

Science.gov (United States)

Gonçalves, Carlos F. L.; de Freitas, Mariana L.; Ferreira, Andrea C. F.

2017-01-01

Thyroid cancer is the most common malignant tumor of the endocrine system and the incidence has been increasing in recent years. In a great part of the differentiated carcinomas, thyrocytes are capable of uptaking iodide. In these cases, the main therapeutic approach includes thyroidectomy followed by ablative therapy with radioiodine. However, in part of the patients, the capacity to concentrate iodide is lost due to down-regulation of the sodium-iodide symporter (NIS), the protein responsible for transporting iodide into the thyrocytes. Thus, therapy with radioiodide becomes ineffective, limiting therapeutic options and reducing the life expectancy of the patient. Excessive ingestion of some flavonoids has been associated with thyroid dysfunction and goiter. Nevertheless, studies have shown that some flavonoids can be beneficial for thyroid cancer, by reducing cell proliferation and increasing cell death, besides increasing NIS mRNA levels and iodide uptake. Recent data show that the flavonoids apingenin and rutin are capable of increasing NIS function and expression in vivo. Herein we review literature data regarding the effect of flavonoids on thyroid cancer, besides the effect of these compounds on the expression and function of the sodium-iodide symporter. We will also discuss the possibility of using flavonoids as adjuvants for therapy of thyroid cancer. PMID:28604619

Cardiac Autonomic Function Is Associated With the Coronary Microcirculatory Function in Patients With Type 2 Diabetes

DEFF Research Database (Denmark)

von Scholten, Bernt Johan; Hansen, Christian Stevns; Hasbak, Philip

2016-01-01

Cardiac autonomic dysfunction and cardiac microvascular dysfunction are diabetic complications associated with increased mortality, but the association between these has been difficult to assess. We applied new and sensitive methods to assess this in patients with type 2 diabetes mellitus (T2DM......). In a cross-sectional design, coronary flow reserve (CFR) assessed by cardiac (82)Rb-positron emission tomography/computed tomography, cardiac autonomic reflex tests, and heart rate variability indices were performed in 55 patients with T2DM, without cardiovascular disease, and in 28 control subjects. Cardiac....... A heart rate variability index, reflecting sympathetic and parasympathetic function (low-frequency power), and the late heart-to-mediastinum ratio, reflecting the function of adrenergic receptors and sympathetic activity, were positively correlated with CFR after adjustment for age and heart rate...

Evaluation of cardiac autonomic function in overweight males: A cross-sectional study

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Debasish Das

2017-01-01

Full Text Available Background and Aim: Cardiovascular autonomic function tests (CAFTs are non-invasive tests that can assess both sympathetic and parasympathetic autonomic functions. Autonomic dysfunction may be considered as a risk factor for obesity and vice versa. For measurement of obesity, body mass index (BMI is a simple, valid and inexpensive method. Hence, this study was designed to evaluate the effect of obesity based on BMI criteria on autonomic nervous system based on CAFT in young adult males. Methods: A cross-sectional study was carried out on 43 young adult males in the age group of 18–25 years with an age-matched control (n = 43 group. After initial screening, anthropometric measurements were recorded. CAFTs were performed and recorded by the Cardiac Autonomic Neuropathy Analysis System (CANWin. Unpaired t- test was done to compare the parameters of study and control groups in Microsoft Excel® 2010. Results: Parasympathetic test parameters of study and control groups when expressed in mean ± standard deviation were not found statistically significant (P > 0.05. The fall in systolic blood pressure (BP in orthostatic test of study group (12.19 ± 4.8 mmHg was significantly (P = 0.0001 higher than that of control group (7.33 ± 5.16 mmHg. Increase in diastolic BP in isometric handgrip exercise test of study group (11.84 ± 5.39 mmHg was significantly less (P = 0.004 than that of control group (16.39 ± 8.71 mmHg. Conclusion: Overweight young males have altered sympathetic activity but parasympathetic activity did not show any significant difference when compared to normal weight males.

Thyroid Stimulating Hormone Receptor

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Murat Tuncel

2017-02-01

Full Text Available Thyroid stimulating hormone receptor (TSHR plays a pivotal role in thyroid hormone metabolism. It is a major controller of thyroid cell function and growth. Mutations in TSHR may lead to several thyroid diseases, most commonly hyperthyroidism. Although its genetic and epigenetic alterations do not directly lead to carcinogenesis, it has a crucial role in tumor growth, which is initiated by several oncogenes. This article will provide a brief review of TSHR and related diseases.

Evaluation of Thyroid Disorders During Head-and-Neck Radiotherapy by Using Functional Analysis and Ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Bakhshandeh, Mohsen [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Hashemi, Bijan, E-mail: bhashemi@modares.ac.ir [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Mahdavi, Seyed Rabie [Department of Medical Physics, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Nikoofar, Alireza [Department of Radiation Oncology, Hafte-Tir Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Edraki, Hamid Reza [Department of Radiology, Panzdahe-Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Kazemnejad, Anoshirvan [Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)

2012-05-01

Purpose: To evaluate thyroid function and vascular changes during radiotherapy for patients with head and neck cancer. Methods and Materials: Fifty patients treated with primary or postoperative radiotherapy for various cancers in the head and neck region were prospectively evaluated. The serum samples (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]), the echo level of the thyroid gland, and color Doppler ultrasonography (CDU) parameters of the right inferior thyroid artery (RITA) of the patients were measured before and at regular intervals during radiotherapy. The thyroid gland dose-volume histograms of the patients were derived from their computed tomography-based treatment plans. Results: There was a significant fall in TSH level (p < 0.0001) but an increase in FT4 (p < 0.0001) and T4 (p < 0.022) levels during the radiotherapy course. The threshold dose required to produce significant changes was 12 Gy (Biologically Effective Dose in 2-Gy fractions, BED{sub 2}). There were significant rises in the patients' pulsatility index, resistive index, peak systolic velocity, blood volume flow levels, and RITA diameter (p < 0.0001), as detected by CDU during radiotherapy, compared to those parameters measured before the treatment. Hypoechogenicity and irregular echo patterns (p < 0.0001) were seen during radiotherapy compared to those before treatment. There was significant Pearson's correlation between the CDU parameters and T4, FT4, and TSH levels. Conclusions: Radiation-induced thyroiditis is regarded as primary damage to the thyroid gland. Thyroiditis can subsequently result in hypothyroidism or hyperthyroidism. Our results demonstrated that changes in thyroid vessels occur during radiotherapy delivered to patients. Vessel changes also can be attributed to the late effect of radiation on the thyroid gland. The hypoechogenicity and irregular echo patterns observed in patients

Analysis of Autonomic Nervous System Functional Age and Heart Rate Variability in Mine Workers

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Vasicko T

2016-04-01

Full Text Available Introduction: Heavy working conditions and many unpropitious factors influencing workers health participate in development of various health disorders, among other autonomic cardiovascular regulation malfunction. The aim of this study is to draw a comparison of autonomic nervous system functional age and heart rate variability changes between workers with and without mining occupational exposure.

relationship of thyroid and adrenal function to growth rate in bos ...

African Journals Online (AJOL)

of thyroid function, lower energy turnover and therefore thermal stability of B. indicus breeds (Fuller, 1969). The significant negative correlations between growth rates and plasma cortisol levels agree with the finding that cattle with low levels of glucocorticoid activity tend to grow more rapidly (Purchas, 1970; Hafs et ai. 1971) ...

Hashimoto's Thyroiditis Pathology and Risk for Thyroid Cancer

Science.gov (United States)

Paparodis, Rodis; Imam, Shahnawaz; Todorova-Koteva, Kristina; Staii, Anca

2014-01-01

Background: Hashimoto's thyroiditis (HT) has been found to coexist with differentiated thyroid cancer (DTC) in surgical specimens, but an association between the two conditions has been discounted by the medical literature. Therefore, we performed this study to determine any potential relationship between HT and the risk of developing DTC. Methods: We collected data for thyrotropin (TSH), thyroxine (T4), thyroid peroxidase antibody (TPO-Ab) titers, surgical pathology, and weight-based levothyroxine (LT4) replacement dose for patients who were referred for thyroid surgery. Patients with HT at final pathology were studied further. To estimate thyroid function, patients with preoperative hypothyroid HT (Hypo-HT) were divided into three equal groups based on their LT4 replacement: LT4-Low (1.43 μg/kg). A group of preoperatively euthyroid (Euth-HT) patients but with HT by pathology was also studied. All subjects were also grouped based on their TPO-Ab titer in TPO-high (titer >1:1000) or TPO-low/negative (titer thyroid glands (LT4-Low) but not in fully hypothyroid HT (LT4-Mid and LT4-High). High TPO-Ab titers appear to protect against DTC in patients with HT. PMID:24708347

Relational Stability in the Expression of Normality, Variation, and Control of Thyroid Function

Science.gov (United States)

Hoermann, Rudolf; Midgley, John E. M.; Larisch, Rolf; Dietrich, Johannes W.

2016-01-01

Thyroid hormone concentrations only become sufficient to maintain a euthyroid state through appropriate stimulation by pituitary thyroid-stimulating hormone (TSH). In such a dynamic system under constant high pressure, guarding against overstimulation becomes vital. Therefore, several defensive mechanisms protect against accidental overstimulation, such as plasma protein binding, conversion of T4 into the more active T3, active transmembrane transport, counter-regulatory activities of reverse T3 and thyronamines, and negative hypothalamic–pituitary–thyroid feedback control of TSH. TSH has gained a dominant but misguided role in interpreting thyroid function testing in assuming that its exceptional sensitivity thereby translates into superior diagnostic performance. However, TSH-dependent thyroid disease classification is heavily influenced by statistical analytic techniques such as uni- or multivariate-defined normality. This demands a separation of its conjoint roles as a sensitive screening test and accurate diagnostic tool. Homeostatic equilibria (set points) in healthy subjects are less variable and do not follow a pattern of random variation, rather indicating signs of early and progressive homeostatic control across the euthyroid range. In the event of imminent thyroid failure with a reduced FT4 output per unit TSH, conversion efficiency increases in order to maintain FT3 stability. In such situations, T3 stability takes priority over set point maintenance. This suggests a concept of relational stability. These findings have important implications for both TSH reference limits and treatment targets for patients on levothyroxine. The use of archival markers is proposed to facilitate the homeostatic interpretation of all parameters. PMID:27872610

G raves’ disease – anti-thyroid autoantibodies and function thyroid status

International Nuclear Information System (INIS)

Slavova, M.; Rusev, T; Donchev, M.; Dekova, M.; Tsarovska, T

2013-01-01

Full text: Introduction: Hyperthyroidism is an autoimmune disease in the pathogenesis of which a key role play the antibodies against the thyroid stimulating hormone receptor (TRAb). The aim of this study is to analyze the immune and hormonal status in patients with Graves' disease, who are on thyreostatic therapy and in remission. Materials and methods: 67 patients were studied - 11 men and 56 women - with Graves' disease, mean age 49.7 years (range - 20-76 ). Of these, 55 were on thyreostatic therapy (two subgroups: 27 - treated up to 24 months , and 28 with relapsed disease ) and 12 were in remission up to a year. Patient's condition is assessed as a complex of clinical, biochemical, including hormonal, immune status and ultrasonography of the thyroid gland. We examined thyroid stimulating hormone, free thyroxine, free triiodothyronine, antityreoperoxidase antibodies (Anti-TPO) and TRAb. The patients on therapy are: in hyperthyroidism - 10/ 14 with subclinical hyperthyroidism - 9/8, euthyroid - 7/6 and with subclinical hypothyroidism - 1/0. Results: The patients with hyperthyroidism ( 43.6% ) in both thyreostatic therapy groups have a significantly higher average values of TRAb. The patients with subclinical hyperthyroidism and relapse showed higher levels of TRAb in comparison with those undergoing therapy to 24 months after diagnosing. The values of TRAb in the euthyroid patients in both groups of treatment were 1,5 IU / l. The Anti-TPO values were increased in 78.2% of the patients on therapy and 55.5% of those in remission. Conclusion: With the decrease of thyroid hormones during treatment of Hyperthyroidism the levels of TRAb and Anti-TPO decrease. The TRAb values are useful for the monitoring the effect of the thyreostatic treatment, determining the therapeutic approach in patients with a sustained reduction of TRAb in the course thyreostatic therapy and particularly for relapse

The evaluation of free thyroid hormones (FT4 and FT3) in the routine diagnosis of thyroid function

International Nuclear Information System (INIS)

Passath, A.; Leb, G.; Goebel, R.

1985-01-01

The validity of the free thyroid hormone parameters (FT 4 and FT 3 ) was verified in a random sample of 154 ambulatory patients with thyroid conditions. The ''euthyroid range'' of FT 4 was between 15.67 and 30.66 pmol/l; median 21.98 pmol/l. The distribution of the FT 4 readings peaked on the left and sloped to the right (log normal). In our laboratory, the ''euthyroid reference range'' of FT 4 is between 10-28 pmol/l. The ''euthyroid range'' of FT 3 extended from 4.6 to 9.7 pmol/l; median 6.63 pmol/l. The distribution of the readings was likewise log normal. The values of FT 4 and FT 3 are not significantly influenced by TBG concentration anomalies in otherwise healthy thyroid patients. For purposes of discrimination between euthyroidism and hyperthyroidism, FT 3 (95%) and FT 4 (90%) are better suited than the corresponding quotients for the free hormone fraction or the total hormone concentrations. On the other hand, the free hormone parameters are less suitable for the diagnosis of hypothyroidism. These results were deduced theoretically from mathematical function analyses between the TBG-independent free hormone parameters and the TBG-dependent hormone concentrations. (orig.) [de

Thyroiditis: an integrated approach.

Science.gov (United States)

Sweeney, Lori B; Stewart, Christopher; Gaitonde, David Y

2014-09-15

Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.

Radioiodine therapy of thyroid autonomy

Energy Technology Data Exchange (ETDEWEB)

Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

2002-08-01

Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

Radioiodine therapy of thyroid autonomy

International Nuclear Information System (INIS)

Reiners, Christoph; Schneider, Peter

2002-01-01

Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

The radio-iodine therapy of the functional autonomy. Indications, findings, risks

International Nuclear Information System (INIS)

Reiners, C.

1990-01-01

The functional autonomy of the thyroid is a disorder, which appears in connection with iodine deficit and befalls the complete organ. An absolute indication for a radio-iodine-therapy is given in case of hyperthyreoidism (these are 25 % of all at the functional autonomy). Contrary to the operation method the advantage of the I-131-therapy is, that all of the functional autonome-cells can be reached. The risk at the I-131-therapy is low. (Botek)

Circulating leptin and thyroid dysfunction

DEFF Research Database (Denmark)

Zimmermann-Belsing, Tina; Brabant, Georg; Holst, Jens Juul

2003-01-01

and triiodothyronine are involved in the starvation-induced decrease in thermogenesis. Both rodent and human studies of leptin have failed to show any consistent relationship between thyroid function and serum leptin concentrations. However, leptin might have an important role in thyroid pathophysiology due to thyroid...

A study on the observation system for autonomous, distributed and cooperative function in a future type nuclear power plant

International Nuclear Information System (INIS)

Matsuoka, Takeshi; Numano, Masayoshi; Someya, Minoru; Fukuto, Junji; Mitomo, Nobuo; Miyazaki, Keiko; Matsukura, Hiroshi; Niwa, Yasuyuki; Takahashi, Masato

2000-01-01

The concept of advanced future plants are discussed by five research institutes; Ship Research Institute, Electrotechnical Laboratory, The Institute of Physical and Chemical Research, Japan Atomic Energy Research Institute, and Power Reactor and Nuclear Fuel Development Corporation (Cross-over group). And, an autonomous plant is identified as a future type plant. In this future type plant, there are many agents that consist plant sub-systems or plant components and have artificial intelligence. They are distributed in plant and have autonomous functions, and cooperate each other to establish total plant function. Even if the plant has autonomous function, human operators have to always watch the plant state. Therefore, the needs of the observation system for autonomous, distributed, and cooperative functions are strongly required. The present paper has presented a new idea about the observation system, and developed fundamental functions for this observation system, that is, plant function model, auto-classification of plant states, three dimensional graphical display, expression of robot group's activity. Also, autonomous plant simulator has been developed for this research activity. Finally, the effectiveness of this observation system has been evaluated by experiments of operator's reaction to this system. (author)

International standards to document remaining autonomic function after spinal cord injury

DEFF Research Database (Denmark)

Krassioukov, Andrei; Biering-Sørensen, Fin; Donovan, William

2012-01-01

This is the first guideline describing the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI). This guideline should be used as an adjunct to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) including the ...

Impaired neural structure and function contributing to autonomic symptoms in congenital central hypoventilation syndrome.

Science.gov (United States)

Harper, Ronald M; Kumar, Rajesh; Macey, Paul M; Harper, Rebecca K; Ogren, Jennifer A

2015-01-01

Congenital central hypoventilation syndrome (CCHS) patients show major autonomic alterations in addition to their better-known breathing deficiencies. The processes underlying CCHS, mutations in the PHOX2B gene, target autonomic neuronal development, with frame shift extent contributing to symptom severity. Many autonomic characteristics, such as impaired pupillary constriction and poor temperature regulation, reflect parasympathetic alterations, and can include disturbed alimentary processes, with malabsorption and intestinal motility dyscontrol. The sympathetic nervous system changes can exert life-threatening outcomes, with dysregulation of sympathetic outflow leading to high blood pressure, time-altered and dampened heart rate and breathing responses to challenges, cardiac arrhythmia, profuse sweating, and poor fluid regulation. The central mechanisms contributing to failed autonomic processes are readily apparent from structural and functional magnetic resonance imaging studies, which reveal substantial cortical thinning, tissue injury, and disrupted functional responses in hypothalamic, hippocampal, posterior thalamic, and basal ganglia sites and their descending projections, as well as insular, cingulate, and medial frontal cortices, which influence subcortical autonomic structures. Midbrain structures are also compromised, including the raphe system and its projections to cerebellar and medullary sites, the locus coeruleus, and medullary reflex integrating sites, including the dorsal and ventrolateral medullary nuclei. The damage to rostral autonomic sites overlaps metabolic, affective and cognitive regulatory regions, leading to hormonal disruption, anxiety, depression, behavioral control, and sudden death concerns. The injuries suggest that interventions for mitigating hypoxic exposure and nutrient loss may provide cellular protection, in the same fashion as interventions in other conditions with similar malabsorption, fluid turnover, or hypoxic exposure.

Impaired Neural Structure and Function Contributing to Autonomic Symptoms in Congenital Central Hypoventilation Syndrome

Directory of Open Access Journals (Sweden)

Ronald M Harper

2015-10-01

Full Text Available Congenital central hypoventilation syndrome (CCHS patients show major autonomic alterations in addition to their better-known breathing deficiencies. The processes underlying CCHS, mutations in the PHOX2B gene, target autonomic neuronal development, with frame shift extent contributing to symptom severity. Many autonomic characteristics, such as impaired pupillary constriction and poor temperature regulation, reflect parasympathetic alterations, and can include disturbed alimentary processes, with malabsorption and intestinal motility dyscontrol. The sympathetic nervous system changes can exert life-threatening outcomes, with dysregulation of sympathetic outflow leading to high blood pressure, time-altered and dampened heart rate and breathing responses to challenges, cardiac arrhythmia, profuse sweating, and poor fluid regulation. The central mechanisms contributing to failed autonomic processes are readily apparent from structural and functional magnetic resonance imaging studies, which reveal substantial cortical thinning, tissue injury, and disrupted functional responses in hypothalamic, hippocampal, posterior thalamic, and basal ganglia sites and their descending projections, as well as insular, cingulate, and medial frontal cortices, which influence subcortical autonomic structures. Midbrain structures are also compromised, including the raphe system and its projections to cerebellar and medullary sites, the locus coeruleus, and medullary reflex integrating sites, including the dorsal and ventrolateral medullary nuclei. The damage to rostral autonomic sites overlaps metabolic, affective and cognitive regulatory regions, leading to hormonal disruption, anxiety, depression, behavioral control, and sudden death concerns. The injuries suggest that interventions for mitigating hypoxic exposure and nutrient loss may provide cellular protection, in the same fashion as interventions in other conditions with similar malabsorption, fluid turnover

Expression of new human inorganic pyrophosphatase in thyroid diseases: Its intimate association with hyperthyroidism

International Nuclear Information System (INIS)

Koike, Eisuke; Toda, Shuji; Yokoi, Fumiaki; Izuhara, Kenji; Koike, Norimasa; Itoh, Kouichi; Miyazaki, Kohji; Sugihara, Hajime

2006-01-01

Inorganic pyrophosphatase (PPase) controls the level of inorganic pyrophosphate produced by biosynthesis of protein, RNA, and DNA. Thus, PPase is essential for life. PPase expression is unclear in the thyroid. We cloned a new human PPase, phospholysine phosphohistidine inorganic pyrophosphate phosphatase (LHPPase), and established a rabbit polyclonal anti-LHPPase antibody. This is First study to determine the PPase expression by immunohistochemistry and Western blot. Intranuclear LHPPase expression of thyrocytes was enhanced most prominently in Graves' disease and autonomously functional thyroid nodule. To estimate a regulating factor of subcellular localization of LHPPase, we examined its expression of Graves' disease-derived thyrocytes in vitro with the disease-originated serum. Nuclear expression of LHPPase was lost in cultured thyrocytes even with the serum, while its cytoplasmic expression was retained. The data suggest that increased expression of LHPPase is associated with hyperthyroidism. Intranuclear expression of LHPPase may not be regulated by Graves' disease-derived serum factors

Childhood Exposure to Phthalates: Associations with Thyroid Function, Insulin-like Growth Factor I, and Growth

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Boas, Malene; Frederiksen, Hanne; Feldt-Rasmussen, Ulla; Skakkebæk, Niels E.; Hegedüs, Laszlo; Hilsted, Linda; Juul, Anders; Main, Katharina M.

2010-01-01

Background Phthalates are widely used chemicals, and human exposure is extensive. Recent studies have indicated that phthalates may have thyroid-disrupting properties. Objective We aimed to assess concentrations of phthalate metabolites in urine samples from Danish children and to investigate the associations with thyroid function, insulin-like growth factor I (IGF-I), and growth. Methods In 845 children 4–9 years of age, we determined urinary concentrations of 12 phthalate metabolites and serum levels of thyroid-stimulating hormone, thyroid hormones, and IGF-I. Results Phthalate metabolites were detected in all urine samples, of which monobutyl phthalate was present in highest concentration. Phthalate metabolites were negatively associated with serum levels of free and total triiodothyronine, although statistically significant primarily in girls. Metabolites of di(2-ethylhexyl) phthalate and diisononyl phthalate were negatively associated with IGF-I in boys. Most phthalate metabolites were negatively associated with height, weight, body surface, and height gain in both sexes. Conclusions Our study showed negative associations between urinary phthalate concentrations and thyroid hormones, IGF-I, and growth in children. Although our study was not designed to reveal the mechanism of action, the overall coherent negative associations between urine phthalate and thyroid and growth parameters may suggest causative negative roles of phthalate exposures for child health. PMID:20621847

Effect of radioiodine therapy on thyroid nodule size in patients with toxic adenomas

International Nuclear Information System (INIS)

Rajkovaca, Z.; Mijatovic, J.; Skrobis, M.; Kovacevic, P.

2005-01-01

Full text: Autonomously functioning toxic adenomas are a common cause of hyperthyroidism. Surgery, radioiodine and percutaneous ethanol injection into the nodule are effective therapies. Radioiodine therapy is increasingly used as first line therapy especially in elderly patients. Radioactive iodine I-131 seems to be a good therapeutic option with low incidence of post-therapy hypothyroidism. The important therapeutic effect has also been the regression in nodule size. The aim of this study was to investigate the effect of radioiodine therapy on the size of toxic adenomas. Forty-six patients with age range of 37-76 years (Mean age=60.9 years) were followed up for a period of 12 months after I-131 therapy for toxic adenomas. Thyroid hormone levels (T3, T4 and TSH) were determined. Each patient was subjected to ultrasound and radionuclide scanning of thyroid gland at 3,6 and 12 months following I-131 therapy. Successful treatment was defined as control of hyperthyroidism and reappearance of extra-glandular thyroid tissue on Thyroid scan, which were suppressed by the hyperactive nodule prior to therapy. The volumes of the thyroid pre and post-therapy were estimated by US using the formula of ellipsoid model (δ/2π6 x length x width x depth). The therapeutic dose of I-131 was calculated for each patient by the following formula: 12 mCi x 100/24 hrs RAIU. Patients received a single dose of I-131 and the range of administered I-131 dose was 825 1221 MBq. Results revealed that 42 patients (91%) became euthyroid in three months after I-131. All patients became euthyroid in 6 months. The adenomas were reduced in size from a mean of 18.23+11.21 ml to 7.38+3.48 ml during the 12 months follow up. This was highly significant (p<0.05, t=3.408). The extra-nodular thyroid volume did not change following therapy (12.2+7.4 ml pre-therapy vs. 11.8+7.1 ml post therapy at 12 months). The results of our study showed that I-131 can successfully treat not only the functional state of

Role of the functional status of the autonomic nervous system in the clinical course of purulent meningitis

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D. A. Zadiraka

2014-04-01

Full Text Available Purulent meningitis is defined by high indices of sickness and lethality rates, a great risk of cerebral and extracerebral complications development, steady residual consequences formation. During neuroinfections, the state of adaptation mechanisms, which is characterized by exhaustion of regulatory systems with the development of decompensation, plays a crucial part. Heart rate variability clearly reflects the degree of regulatory system tension caused by the influence of both physiological and pathological factors. Research aim: to increase the autonomic dysfunction diagnostics efficiency for patients suffering from purulent meningitis in the disease dynamics based on the complex of clinical evidence and functional status of autonomic nervous system. Materials and methods. There were 60 patients with purulent meningitis under medical observation. Wein’s questionnaire was used for the detection of clinical presentations of autonomic dysfunction. Functional status of autonomic nervous system was diagnosed using the method of computer-based cardiointervalometry. The screening group was formed of 20 healthy individuals. Research findings and theirs discussion. Cerebral meningeal symptom was dominant among the patients suffering from purulent meningitis at the peak of the disease. At hospitalization every fifth person (23,3% had the objective evidence of autonomic dysfunction in the form of a postural tremor of upper limbs and eyelids. The analysis of autonomic nervous system parameters functional status among the patients suffering from purulent meningitis at the peak of disease showed heart rate variability decrease in the main branches of autonomic regulation and the presence of autonomic imbalance towards vagotonia. Since the second week, clinical signs of autonomic dysfunction prevailed in the dynamics of patients suffering from purulent meningitis in the course of standard treatment, which was proved by Wein’s survey of the patients. The

Thyroid diseases and pregnancy

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Marco Grandi

2013-05-01

Full Text Available BACKGROUND Thyroid diseases and diabetes mellitus are the most common endocrine diseases during pregnancy. Internal Medicine doctors could be involved in the management of pregnant women affected by thyroid diseases, in particular if an Endocrine Unit lacks in the hospital; it is mandatory that they have the skills to cope with these diseases. METHODS In this work authors describe the most common thyroid abnormalities that can occur during pregnancy: hypothyroidism (clinical and subclinical, hyperthyroidism (clinical and sub-clinical, autoimmune thyroiditis (in particular the so called post-partum thyroiditis, nodular diseases and cancer. They discuss moreover the peculiar pathophysiologic mechanisms by which these diseases appear, the diagnostic tools and the therapies, according to their own experience and the more recent international guidelines. RESULTS AND CONCLUSIONS It is important to evaluate thyroid function tests before and during pregnancy, at 16th and 28th gestational week; it is mandatory to cure also the “sub-clinical” hypothyroidism during pregnancy, when TSH level are higher than 5 μIU/mL; the optimal dose of levo-thyroxine during pregnancy is, average, 30-50% higher than that used before pregnancy; it is not correct to treat mild or sub-clinical hyperthyroidism; propylthyouracil is the best drug to treat hyperthyroidism during pregnancy; the post-partum thyroiditis is generally transient, so that a careful monitoring of thyroid function is advisable, in particular after 9-12 months of therapy; thyroid cancer, if discovered during pregnancy, generally has no negative effects on the outcome of the pregnancy; it would be better to treat surgically thyroid cancer during the last trimester of the pregnancy.

Relationship between sensorimotor peripheral nerve function and indicators of cardiovascular autonomic function in older adults from the Health, Aging and Body Composition Study.

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Lange-Maia, Brittney S; Newman, Anne B; Jakicic, John M; Cauley, Jane A; Boudreau, Robert M; Schwartz, Ann V; Simonsick, Eleanor M; Satterfield, Suzanne; Vinik, Aaron I; Zivkovic, Sasa; Harris, Tamara B; Strotmeyer, Elsa S

2017-10-01

Age-related peripheral nervous system (PNS) impairments are highly prevalent in older adults. Although sensorimotor and cardiovascular autonomic function have been shown to be related in persons with diabetes, the nature of the relationship in general community-dwelling older adult populations is unknown. Health, Aging and Body Composition participants (n=2399, age=76.5±2.9years, 52% women, 38% black) underwent peripheral nerve testing at the 2000/01 clinic visit. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower-extremity peripheral neuropathy were collected by self-report. Cardiovascular autonomic function indicators included postural hypotension, resting heart rate (HR), as well as HR response to and recovery from submaximal exercise testing (400m walk). Multivariable modeling adjusted for demographic/lifestyle factors, medication use and comorbid conditions. In fully adjusted models, poor motor nerve conduction velocity (function or symptoms of peripheral neuropathy and indicators of cardiovascular autonomic function. Motor nerve function and indicators of cardiovascular autonomic function remained significantly related even after considering many potentially shared risk factors. Future studies should investigate common underlying processes for developing multiple PNS impairments in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.