scholarly journals Lithium and the thyroid

1996 ◽  
Vol 20 (6) ◽  
pp. 354-355 ◽  
Author(s):  
Carol Paton ◽  
Dominic Beer
Keyword(s):  
Thyroid Disease ◽  
Adult Population ◽  
Thyroid Stimulating Hormone ◽  
Lifetime Risk ◽  
Thyroid Autoantibodies ◽  
Thyroid Disorders ◽  
The Common ◽  
Stimulating Hormone

The common thyroid disorders are all autoimmune in origin, with the lifetime risk of thyroid disease being 1–2%. Thyroid autoantibodies are present in 9% of the adult population and 12.7% of women, with the frequency rising steeply in women over 45 years of age (Myers & West, 1987). In addition, 20% of the over 60–year-olds have an abnormal (raised) thyroid stimulating hormone (TSH). The presence of both raised TSH and thyroid autoantibodies is associated with the development of clinical hypothyroidism at the rate of 5% per year (Myers & West, 1987).

scholarly journals Management of thyroid disease in pregnancy – Room for improvement in the first trimester

2016 ◽  
Vol 9 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Helen Robinson ◽  
Philip Robinson ◽  
Michael D’Emden ◽  
Kassam Mahomed
Keyword(s):  
General Practitioner ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
In Pregnancy ◽  
Stimulating Hormone

Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.

scholarly journals Wrong Biochemistry Results: Two Case Reports and Observational Study in 5310 Patients on Potentially Misleading Thyroid-stimulating Hormone and Gonadotropin Immunoassay Results

2002 ◽  
Vol 48 (11) ◽  
pp. 2023-2029 ◽  
Author(s):  
Adel AA Ismail ◽  
Paul L Walker ◽  
Julian H Barth ◽  
Kryzsztof C Lewandowski ◽  
Rick Jones ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Observational Study ◽  
Early Identification ◽  
Prospective Observational Study ◽  
Case Reports ◽  
Clinical Care ◽  
Thyroid Stimulating Hormone ◽  
The Common ◽  
Almost All ◽  
Stimulating Hormone

Abstract Background: Immunoassays are used in almost all medical and surgical specialties, but they suffer from interference from proteins such as antibodies in some patients’ sera. Such interferences are usually reported in the literature only as case reports after the introduction of a new assay. Methods: We undertook a prospective observational study on 5310 patients for whom the common immunoassay tests for thyroid-stimulating hormone (TSH) and/or gonadotropins were requested. All TSH and gonadotropin results were critically assessed for a mismatch between the clinical details and analytical results to identify samples suspected of analytical unreliability. These were tested further by three approaches to screen for interference. Results: From the 5310 sets of results, 59 patients’ samples were identified as suspect and were tested further. Analytically incorrect results were found in 28 (0.53% of the total studied). The magnitude of interference varied, but in 23 of 28 patients (82%), it was considered large enough to have a potentially adverse effect on cost and/or the clinical care of these patients. Two cases, described in detail, illustrate the adverse effect of error on patient care and cost, and the second highlights the difficulties and limitations of current approaches for identifying interference and inaccuracy in immunoassays. Conclusions: Because millions of TSH/gonadotropin tests are carried out in UK hospital laboratories alone, our data suggest that thousands of patients could be adversely affected by errors from interferences. Early identification of interference in cases with unusual results could be valuable.

scholarly journals A raised thyroid stimulating hormone result - a 12-month follow-up study in general practice

2010 ◽  
Vol 2 (1) ◽  
pp. 29 ◽  
Author(s):  
Veronique Gibbons ◽  
John Conaglen ◽  
Ross Lawrenson
Keyword(s):  
General Practice ◽  
Quantitative Research ◽  
Best Practice ◽  
Adult Population ◽  
Laboratory Data ◽  
Reference Interval ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Stimulating Hormone

INTRODUCTION: Subclinical hypothyroidism (SCH) is common in older patients. AIM: To review the management of patients identified with a raised thyroid stimulating hormone (TSH) result in a 12-month period and compare this to current guidelines from the New Zealand Best Practice Advocacy Centre (BPAC). METHODS: We collected laboratory data on thyroid function tests (TFTs) that were reported between December 2005 and November 2006 from two general practices with an adult population of approximately 21 000. Data were collected on symptoms, investigations, thyroid medication, family history and comorbidities. We used chi-squared tests to compare findings by age, gender and ethnicity. RESULTS: Older women of European descent were more likely to be to have initial results suggesting SCH. The number of follow-up tests ranged from 0 to 5 tests in a 12-month period. Forty-eight percent of individuals did not have any follow-up investigations. Seventy-three percent of FT4 tests taken are requested concurrently with TSH. Of those who had a repeat TSH test, just over 40% had a result within the reference interval. Twenty-eight percent had two TSH results consistent with SCH. Thirty-five percent of patients with antibody results were positive. The most commonly-recorded symptoms were tiredness and weight gain. DISCUSSION: We found inconsistencies in the management of SCH which were not related to patient characteristics such as age, gender or ethnicity. Further research is needed to determine if SCH is associated with increased morbidity and to provide a clear rationale for management of patients with SCH. KEYWORDS: Hypothyroidism; family practice; quantitative research; general practice

5 - Timing and Clinical Characteristics of Women Without Thyroid Disease Who Received Thyroid-Stimulating Hormone (TSH) Testing During Pregnancy

2019 ◽  
Vol 43 (7) ◽  
pp. S3-S4
Author(s):  
Jennifer Yamamoto ◽  
Amy Metcalfe ◽  
Kara Nerenberg ◽  
Rshmi Khurana ◽  
Alex Chin ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Clinical Characteristics ◽  
Thyroid Stimulating Hormone ◽  
Stimulating Hormone

THYROID-STIMULATING HORMONE AND TRIIODOTHYRONINE AS AIDS IN THE DIAGNOSIS OF THYROID DISORDERS

1960 ◽  
Vol 9 (3) ◽  
pp. 194-199 ◽  
Author(s):  
BRYAN HUDSON ◽  
DORA WINIKOFF ◽  
H. PINCUS TAFT ◽  
F. I. R. MARTIN
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Stimulating Hormone

scholarly journals A vital region for human glycoprotein hormone trafficking revealed by an LHB mutation

2016 ◽  
Vol 231 (3) ◽  
pp. 197-207 ◽  
Author(s):  
Iulia Potorac ◽  
Adolfo Rivero-Müller ◽  
Ashutosh Trehan ◽  
Michał Kiełbus ◽  
Krzysztof Jozwiak ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Pubertal Development ◽  
Gene Mutations ◽  
Thyroid Stimulating Hormone ◽  
Beta Subunits ◽  
Glycoprotein Hormones ◽  
Glycoprotein Hormone ◽  
Pubertal Delay ◽  
The Common ◽  
Stimulating Hormone

Glycoprotein hormones are complex hormonally active macromolecules. Luteinizing hormone (LH) is essential for the postnatal development and maturation of the male gonad. Inactivating Luteinizing hormone beta (LHB) gene mutations are exceptionally rare and lead to hypogonadism that is particularly severe in males. We describe a family with selective LH deficiency and hypogonadism in two brothers. DNA sequencing of LHB was performed and the effects of genetic variants on hormone function and secretion were characterized by mutagenesis studies, confocal microscopy and functional assays. A 20-year-old male from a consanguineous family had pubertal delay, hypogonadism and undetectable LH. A homozygous c.118_120del (p.Lys40del) mutation was identified in the patient and his brother, who subsequently had the same phenotype. Treatment with hCG led to pubertal development, increased circulating testosterone and spermatogenesis. Experiments in HeLa cells revealed that the mutant LH is retained intracellularly and showed diffuse cytoplasmic distribution. The mutated LHB heterodimerizes with the common alpha-subunit and can activate its receptor. Deletion of flanking glutamic acid residues at positions 39 and 41 impair LH to a similar extent as deletion of Lys40. This region is functionally important across all heterodimeric glycoprotein hormones, because deletion of the corresponding residues in hCG, follicle-stimulating hormone and thyroid-stimulating hormone beta-subunits also led to intracellular hormone retention. This novel LHB mutation results in hypogonadism due to intracellular sequestration of the hormone and reveals a discrete region in the protein that is crucial for normal secretion of all human glycoprotein hormones.

The Antibody Response in Human Autoimmune Thyroid Disease

1997 ◽  
Vol 92 (6) ◽  
pp. 529-541 ◽  
Author(s):  
Richard S. McIntosh ◽  
M. Suhail Asghar ◽  
Anthony P. Weetman
Keyword(s):  
Antibody Response ◽  
Thyroid Disease ◽  
Hormone Receptor ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Thyroid Autoantigens ◽  
Reactive Antibody ◽  
Stimulating Hormone

1. The analysis of the antibody response in autoimmune thyroid disease has followed several historical trends. It was the investigation of thyroid-reactive antibody that allowed the initial characterization of the three principle thyroid autoantigens, thyroglobulin, thyroid peroxidase and the thyroid stimulating hormone receptor. 2. Analysis can be grouped under two broad areas: analysis of the physiological and pathological effects of the antibody, and analysis of the structure of the antibodies themselves. This review will focus on the latter. 3. Within recent years there has been a great increase in knowledge of thyroid-reactive antibody structure, principally through the adoption of phage display combinatorial library methodologies. While this latter technique has established some general principles for antibodies to thyroglobin and especially thyroid peroxidase, there is still a substantial gap in our knowledge of the antibody response to the thyroid stimulating hormone receptor. 4. Thyroid peroxidase antibodies have a relatively restricted V-region usage, and there is a correlation between the V-regions used and the epitope on thyroid peroxidase bound. In particular the Vκ light chain, Vκl(O12), is associated with reactivity to one epitope. 5. The purpose of this review is to bring together the latest results concerning the molecular analysis of the antibody response in autoimmune thyroid disease, to highlight areas of ignorance and conflict, and to discuss the methods adopted to circumvent the problems associated with analysis of the antibody response.

scholarly journals Molecular regulation of follicle-stimulating hormone synthesis, secretion and action

2018 ◽  
Vol 60 (3) ◽  
pp. R131-R155 ◽  
Author(s):  
Nandana Das ◽  
T Rajendra Kumar
Keyword(s):  
Molecular Mechanisms ◽  
Follicle Stimulating Hormone ◽  
Thyroid Stimulating Hormone ◽  
Α Subunit ◽  
Physiological Regulation ◽  
Hormone Synthesis ◽  
The Common ◽  
Blocking Antibodies ◽  
Recombinant Human Fsh ◽  
Stimulating Hormone

Follicle-stimulating hormone (FSH) plays fundamental roles in male and female fertility. FSH is a heterodimeric glycoprotein expressed by gonadotrophs in the anterior pituitary. The hormone-specific FSHβ-subunit is non-covalently associated with the common α-subunit that is also present in the luteinizing hormone (LH), another gonadotrophic hormone secreted by gonadotrophs and thyroid-stimulating hormone (TSH) secreted by thyrotrophs. Several decades of research led to the purification, structural characterization and physiological regulation of FSH in a variety of species including humans. With the advent of molecular tools, availability of immortalized gonadotroph cell lines and genetically modified mouse models, our knowledge on molecular mechanisms of FSH regulation has tremendously expanded. Several key players that regulate FSH synthesis, sorting, secretion and action in gonads and extragonadal tissues have been identified in a physiological setting. Novel post-transcriptional and post-translational regulatory mechanisms have also been identified that provide additional layers of regulation mediating FSH homeostasis. Recombinant human FSH analogs hold promise for a variety of clinical applications, whereas blocking antibodies against FSH may prove efficacious for preventing age-dependent bone loss and adiposity. It is anticipated that several exciting new discoveries uncovering all aspects of FSH biology will soon be forthcoming.

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