scholarly journals Iodine Status Has No Impact on Thyroid Function in Early Healthy Pregnancy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
F. Brucker-Davis ◽  
P. Ferrari ◽  
J. Gal ◽  
F. Berthier ◽  
P. Fenichel ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Maternal Smoking ◽  
Smoking Status ◽  
Thyroid Volume ◽  
Normal Thyroid ◽  
Iodine Status ◽  
Thyroid Screening ◽  
Normal Thyroid Function ◽  
Healthy Pregnancy ◽  
The Impact

Aim. To assess the impact of iodine status in early pregnancy on thyroid function.Methods. Women >18 years old seen at their first prenatal consult before 12 weeks of amenorrhea and without personal thyroid history were proposed thyroid screening and were eligible if they had strictly normal thyroid tests (fT4 > 10th percentile, TSH < 2.5 mUI/L, negative anti-TPO antibodies). Evaluation included thyroid ultrasound, extensive thyroid tests, and ioduria (UIE).Results. 110 women (27.5 y, 8 weeks of amenorrhea, smoking status: 28% current smokers) were enrolled. Results are expressed as medians. UIE was 116 μg/L. 66.3% of women had iodine deficiency (ID) defined as UIE < 150. FT4 was 14.35 pmol/L; TSH 1.18 mUI/L; fT3 5 pmol/L; thyroglobulin 17.4 ng/mL; rT3 0.27 ng/mL; thyroid volume: 9.4 ml. UIE did not correlate with any thyroid tests, but correlated negatively with thyroid volume. UIE and all thyroid tests, except fT3, correlated strongly withβhCG. Smoking correlated with higher thyroid volume and thyroglobulin and with lower rT3.Conclusions. In pregnant women selected for normal thyroid function, mild ID is present in 66% during the 1st trimester. The absence of correlation between UIE and thyroid tests at that stage contrasts with the impact ofβhCG and, to a lesser degree, maternal smoking.

P3414Differences in total life expectancy and life expectancy with and without non-communicable diseases within the reference range of thyroid function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Bano ◽  
L Chaker ◽  
F U S Mattace-Raso ◽  
R P Peeters ◽  
O H Franco
Keyword(s):  
Life Expectancy ◽  
Thyroid Function ◽  
Communicable Diseases ◽  
Reference Ranges ◽  
Men And Women ◽  
Non Communicable Diseases ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Total Life Expectancy ◽  
The Impact

Abstract Background Variations in thyroid function within the reference ranges are associated with an increased risk of diseases and death. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without non-communicable diseases (NCD) remains unknown. Purpose We aimed to investigate the association of thyroid function with total LE and LE with and without NCD among euthyroid subjects. Methods Participants of the Rotterdam Study without known thyroid disease and with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels within the reference ranges were eligible. NCD were defined as the presence of cardiovascular disease, diabetes mellitus type 2, or cancer. We used multistate life tables to calculate the total LE and LE with and without NCD among TSH and FT4 tertiles, in men and women. LE estimates were obtained using prevalence, incidence rates and hazard ratios for three transitions (healthy to NCD, healthy to death and NCD to death). Analyses were adjusted for sociodemographic and cardiovascular risk factors. Results The mean (standard deviation) age of 7644 participants was 64.5 (9.7) years and 52.2% were women. Over a median follow-up of 8 years, we observed 1396 incident NCD events and 1422 deaths. Compared with those in the lowest tertile, men and women in the highest TSH tertile lived 1.5 (95% confidence interval [CI], 0.8; 2.3) and 1.5 (95% CI, 0.8; 2.2) years longer, respectively; of which 1.4 (95% CI, 0.5; 2.3) and 1.3 (95% CI, 0.3; 2.1) years with NCD. Compared with those in the lowest tertile, the difference in LE for men and women in the highest FT4 tertile was −3.7 (95% CI, −5.1 to −2.2) and −3.3 (95% CI, −4.7; −1.9), respectively; of which −1.8 (95% CI, −3.1 to −0.7) and −2.0 (95% CI, −3.4 to −0.7) years without NCD. Life expectancy in TSH and FT4 tertiles Conclusions There are meaningful differences in total LE, LE with and without NCD within the reference ranges of thyroid function. People with low-normal thyroid function live more years with and without NCD than those with high-normal thyroid function. These findings support a reevaluation of the current reference ranges of thyroid function.

scholarly journals Management of Thyrotoxicosis Induced by PD1 or PD-L1 Blockade

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A841-A841
Author(s):  
Alessandro Brancatella ◽  
Isabella Lupi ◽  
Lucia Montanelli ◽  
Debora Ricci ◽  
Nicola Viola ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Checkpoint Inhibitors ◽  
Thyroid Volume ◽  
Clinical Severity ◽  
Response To Treatment ◽  
Thyroid Function Tests ◽  
Thyroid Ultrasound ◽  
Normal Thyroid ◽  
Normal Thyroid Function

Abstract Context: Thyrotoxicosis is a common immune-related adverse event in patients treated with PD1 or PD-L1 checkpoint inhibitors. A detailed endocrinological assessment, including thyroid ultrasound and scintigraphy is missing, as are data on response to treatment and follow-up. Objectives: To better characterize the thyrotoxicosis secondary to immune checkpoint inhibitors, gaining insights into pathogenesis and informing management. Methods: We conducted a prospective cohort study of 20 consecutive patients who had normal thyroid function before starting immunotherapy and then experienced thyrotoxicosis upon PD1 or PD-L1 blockade. Clinical assessment was combined with thyroid ultrasound, scintigraphy, and longitudinal thyroid function tests. Results: Five patients had normal scintigraphic uptake (Sci+), no serum antibodies against the TSH receptor, and remained hyperthyroid throughout follow-up. The other 15 patients had no scintigraphic uptake (Sci-) and experienced destructive thyrotoxicosis followed by hypothyroidism (N= 9) or euthyroidism (N= 6). Hypothyroidism was more readily seen in those with normal thyroid volume than in those with goiter (P= 0.04). Among Sci- subjects, a larger thyroid volume was associated to a longer time to remission (P&lt;0.05). Methimazole (MMI) was effective only in Sci+ subjects (P&lt;0.05). Conclusions: Administration of PD1 or PD-L1 blocking antibodies may induce two different forms of thyrotoxicosis that appear similar in clinical severity at onset: a type 1 characterized by persistent hyperthyroidism that requires treatment with MMI, and a type 2 characterized by destructive and transient thyrotoxicosis that evolves to hypo- or eu-thyroidism. Thyroid scintigraphy and ultrasound help differentiating and managing these two forms of iatrogenic thyrotoxicosis

scholarly journals Management of thyrotoxicosis induced by PD1 or PD-L1 blockade

2021 ◽  
Author(s):  
Alessandro Brancatella ◽  
Isabella Lupi ◽  
Lucia Montanelli ◽  
Debora Ricci ◽  
Nicola Viola ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Checkpoint Inhibitors ◽  
Thyroid Volume ◽  
Clinical Severity ◽  
Response To Treatment ◽  
Thyroid Function Tests ◽  
Thyroid Ultrasound ◽  
Normal Thyroid ◽  
Normal Thyroid Function

Abstract Background Thyrotoxicosis is a common immune-related adverse event in patients treated with PD1 or PD-L1 blockade. A detailed endocrinological assessment, including thyroid ultrasound and scintigraphy is lacking, as are data on response to treatment and follow-up. Aim of this study was to better characterize the thyrotoxicosis secondary to immune checkpoint inhibitors, gaining insights into pathogenesis and treatment. Methods We conducted a retrospective study of 20 consecutive patients who had normal thyroid function before starting immunotherapy and then experienced thyrotoxicosis upon PD1 or PD-L1 blockade. Clinical assessment was combined with thyroid ultrasound, 99mTechnecium scintiscan and longitudinal thyroid function tests. Results Five patients had normal scintigraphic uptake (Sci+), no serum antibodies against the TSH receptor and remained hyperthyroid throughout follow-up. The other 15 patients had no scintigraphic uptake (Sci-) and experienced destructive thyrotoxicosis followed by hypothyroidism (N= 9) or euthyroidism (N= 6). Hypothyroidism was more readily seen in those with normal thyroid volume than in those with goiter (P= 0.04). Among Sci- subjects, a larger thyroid volume was associated to a longer time to remission (P&lt;0.05). Methimazole (MMI) was effective only in Sci+ subjects (P&lt;0.05). Conclusion Administration of PD1 or PD-L1 blocking antibodies may induce two different forms of thyrotoxicosis that appear similar in clinical severity at onset: a type 1 characterized by persistent hyperthyroidism that requires treatment with MMI and a type 2 characterized by destructive and transient thyrotoxicosis that evolves to hypo- or euthyroidism. Thyroid scintigraphy and ultrasound help differentiating and managing these two forms of iatrogenic thyrotoxicosis.

Dosimetric analysis for thyroid disorders after radiotherapy to the neck

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17025-e17025
Author(s):  
Z. Akgun ◽  
B. Atasoy ◽  
Z. Ozen ◽  
B. Gulluoglu ◽  
M. U. Abacioglu
Keyword(s):  
Radiation Dose ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Volume ◽  
Dose Effect ◽  
Thyroid Peroxidase ◽  
Thyroid Disorders ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Dose Volume

e17025 Background: In our study, we aimed to evaluate the possible predictors of thyroid disorders after radiotherapy to the neck, focusing on radiation dose-volume factors. Methods: Thyroid function was measured in 65 patients treated with radiation ports including the thyroid, between 2005 and 2008. All of the radiation-induced thyroid dysfunction was determined with an endpoint of abnormal thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and thyroxine (fT4), thyroglobulin antibodies (ATG), thyroid peroxidase antibodies (TPA), thyroid binding globulin (TBG) levels. In 65 patients, radiation dose-volume parameters were calculated; e.g. total volume of the thyroid, mean radiation dose to the thyroid, and percentage of the thyroid volume which received radiation doses of no less than 10–50 Gy (V10-V50). The evaluated risk factors for thyroid dysfunction included these dose-volume parameters, sex, age, treatment modality and primary disease. Results: Most patients (72.3%) had a normal thyroid function, 17 (26.2%) hypothyroidism, 1 (1.5%) hyperthyroidism, and 12 (18.4%) thyroiditis with normal thyroid function. Four of 17 patients with hypothyroidism had overt hypothyroidism. In our analysis, DVHs (dose volume histograms) were calculated and no associations were found between the V10, V20, V40, and V50 percentages and thyroid disorders. V30 and minimum absorbed thyroid dose (Dmin) more than 25 Gy appeared to be correlated with high TSH values (p = 0.01 and p = 0.04, respectively). The patients with hypothyroidism were between 40–60 years. Female gender was associated with a higher incidence of TBG abnormality. Baseline TSH values were available in 16 patients, and hypothyroidism was diagnosed in 4 (25%) of them. No correlation was found between tumor-related variables and incidence of thyroid disorders. Conclusions: Thyroid disorders after radiation therapy to the neck still represent a clinically underestimated problem. Further prospective well designed studies on dose-effect relationship for radiotherapy-induced thyroid toxicity are therefore needed, and thyroid should be considered as an organ at risk in all patients treated for head and neck tumors. No significant financial relationships to disclose.

Radioiodine treatment of feline hyperthyroidism in Germany

2002 ◽  
Vol 41 (06) ◽  
pp. 245-251 ◽  
Author(s):  
M. Knietsch ◽  
T. Spillmann ◽  
E.-G. Grünbaum ◽  
R. Bauer ◽  
M. Puille
Keyword(s):  
Radiation Exposure ◽  
Radiation Protection ◽  
Thyroid Function ◽  
Radioiodine Therapy ◽  
Whole Body ◽  
Radioiodine Treatment ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Body Activity ◽  
Thyroid Uptake

SummaryAim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with 131I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German “Strahlenschutzverordnung”. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT3 and FT4 were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 ± 10%, effective halflife 2.5 ± 0.7 days. Whole body activity <1 MBq was reached 13 ± 4 days after application of 131I. Radiation exposure of cat owners was estimated as 1.97 Sv/MBq for adults. Conclusion: Radioiodine therapy of feline hyper-thyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are higly desirable.

scholarly journals Thyroid dysfunction is associated with the loss of hepatitis B surface antigen in patients with chronic hepatitis B undergoing treatment with α-interferon

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110251
Author(s):  
Wenfan Luo ◽  
Shuai Wu ◽  
Hongjie Chen ◽  
Yin Wu ◽  
Jie Peng
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Hepatitis B Surface Antigen ◽  
Hbv Dna ◽  
Interferon Treatment ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Hbsag Loss

Objective To investigate the influence of thyroid dysfunction on the antiviral efficacy of α-interferon in adult patients with chronic hepatitis B (CHB). Methods We performed a retrospective study of 342 patients with CHB who underwent interferon treatment for >12 weeks. Patients with thyroid dysfunction before or during treatment were defined as the thyroid dysfunction group (n = 141) and those with normal thyroid function were defined as the normal thyroid function group (n = 201). The prevalences of hepatitis B virus (HBV) DNA undetectability, low hepatitis B surface antigen (HBsAg) titre (<250 IU/mL), HBsAg loss, and hepatitis B envelope antigen loss were compared. Results During interferon treatment, 69 of 270 (25.6%) participants with normal thyroid function at baseline developed thyroid dysfunction, whereas 11 of 72 (15.3%) with thyroid dysfunction at baseline regained normal thyroid function. The thyroid dysfunction group had significantly higher prevalences of low HBsAg titre (29.8% vs. 18.9%) and HBV DNA undetectability (66.0% vs. 40.3%). Multivariate logistic regression analysis showed that thyroid dysfunction was associated with HBsAg loss (odds ratio 4.945, 95% confidence interval 1.325–18.462). Conclusions These results suggest that thyroid dysfunction is not an absolute contraindication, but is associated with HBsAg loss, in patients with CHB undergoing α-interferon treatment.

scholarly journals Thyroid-stimulating hormone decreases the risk of osteoporosis by regulating osteoblast proliferation and differentiation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuo Deng ◽  
Wenwen Zhang ◽  
Yanling Zhang ◽  
Mengqi Zhang ◽  
Zhikun Huan ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Stimulating Hormone ◽  
Mrna Levels ◽  
Dependent Manner ◽  
Osteoblast Proliferation ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Gene And Protein Expression ◽  
Proliferation And Differentiation ◽  
Stimulating Hormone

Abstract Background As the incidence of secretory osteoporosis has increased, bone loss, osteoporosis and their relationships with thyroid-stimulating hormone (TSH) have received increased attention. In this study, the role of TSH in bone metabolism and its possible underlying mechanisms were investigated. Methods We analyzed the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and TSH and the bone mineral density (BMD) levels of 114 men with normal thyroid function. In addition, osteoblasts from rat calvarial samples were treated with different doses of TSH for different lengths of time. The related gene and protein expression levels were investigated. Results A comparison of the BMD between the high-level and low-level serum TSH groups showed that the TSH serum concentration was positively correlated with BMD. TSH at concentrations of 10 mU/mL and 100 mU/mL significantly increased the mRNA levels of ALP, COI1 and Runx2 compared with those of the control (P < 0.05, P < 0.01). Bone morphogenetic protein (BMP)2 activity was enhanced with both increased TSH concentration and increased time. The protein levels of Runx2 and osterix were increased in a dose-dependent manner. Conclusions The circulating concentrations of TSH and BMD were positively correlated with normal thyroid function in males. TSH promoted osteoblast proliferation and differentiation in rat primary osteoblasts.

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