scholarly journals Serum TSH within the Reference Range as a Predictor of Future Hypothyroidism and Hyperthyroidism: 11-Year Follow-Up of the HUNT Study in Norway

2012 ◽  
Vol 97 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Lars J. Vatten ◽  
Kristian Midthjell ◽  
Trine Bjøro
Keyword(s):  
Reference Range ◽  
Hunt Study ◽  
Serum Tsh

Associations Between Thyroid and Blood Pressure in Euthyroid Adults: A 9-Year Longitudinal Study

2018 ◽  
Vol 50 (03) ◽  
pp. 236-241 ◽  
Author(s):  
Hengameh Abdi ◽  
Safoora Gharibzadeh ◽  
Erfan Tasdighi ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Reference Range ◽  
Estimating Equation ◽  
Population Based ◽  
Free T4 ◽  
Men And Women ◽  
Increased Risk ◽  
Dichotomous Outcomes ◽  
Serum Tsh

AbstractLongitudinal studies considering associations between thyroid function in the reference range (RR) with blood pressure (BP) are scarce and contradictory. We aimed to investigate the associations of serum thyrotropin (TSH) and free T4 (FT4) with different components of BP also incident prehyperetension (preHTN) and HTN during a 9-year follow-up. A sum of 2282 euthyroid individuals from an ongoing population-based cohort study were selected. A sex-stratified multivariate generalized estimating equation (GEE) method was employed. Moreover, a multivariate transitional model was used considering preceding BP status as a predictor of dichotomous outcomes of preHTN and HTN. Multivariate-adjusted GEE analysis revealed a decreasing trend for systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP) throughout the study period in both men and women, either adjusted for serum TSH or FT4 levels. Serum FT4 within the RR was positively associated with all BP parameters in total population and in men, but serum TSH had a statistically significant mild increasing effect only on SBP, DBP and MAP of men. Multivariate transitional model found no association between serum TSH levels within the reference range (RR) and BP status; regarding serum FT4, a 1 ng/dl higher FT4 was associated with 40% increased risk of preHTN [OR (95% CI), 1.40 (1.02–1.90)], but not with HTN [OR (95% CI), 0.93 (0.80–1.09)]. It is concluded that serum FT4 within the RR is more strongly associated with BP parameters compared to TSH. This association is not consistent between men and women. Moreover, higher FT4 is associated with increased risk of preHTN.

scholarly journals Weight Gain and Serum TSH Increase within the Reference Range after Hemithyroidectomy Indicate Lowered Thyroid Function

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Tina Toft Kristensen ◽  
Jacob Larsen ◽  
Palle Lyngsie Pedersen ◽  
Anne-Dorthe Feldthusen ◽  
Christina Ellervik ◽  
...  
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Thyroid Function ◽  
Reference Range ◽  
Matched Control ◽  
Follow Up Study ◽  
Median Serum ◽  
Laboratory Reference ◽  
Serum Tsh

Background. Weight gain is frequently reported after hemithyroidectomy but the significance is recently discussed. Therefore, the aim of the study was to examine changes in body weight of hemithyroidectomized patients and to evaluate if TSH increase within the reference range could be related to weight gain.Methods. In a controlled follow-up study, two years after hemithyroidectomy for benign euthyroid goiter, postoperative TSH and body weight of 28 patients were compared to preoperative values and further compared to the results in 47 matched control persons, after a comparable follow-up period.Results. Two years after hemithyroidectomy, median serum TSH was increased over preoperative levels (1.23 versus 2.08 mIU/L,P<0.01) and patients had gained weight (75.0 versus 77.3 kg,P=0.02). Matched healthy controls had unchanged median serum TSH (1.70 versus 1.60 mIU/L,P=0.13) and weight (69.3 versus 69.3 kg,P=0.71). Patients on thyroxin treatment did not gain weight. TSH increase was significantly correlated with weight gain (r=0.43,P<0.01).Conclusion. Two years after hemithyroidectomy for benign euthyroid goiter, thyroid function is lowered within the laboratory reference range. Weight gain of patients who are biochemically euthyroid after hemithyroidectomy may be a clinical manifestation of a permanently decreased metabolic rate.

scholarly journals Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fereidoun Azizi ◽  
Hengameh Abdi ◽  
Atieh Amouzegar
Keyword(s):  
Low Dose ◽  
Reference Range ◽  
Antithyroid Drug ◽  
Therapeutic Modality ◽  
Thyroid Status ◽  
Antithyroid Drug Therapy ◽  
Daily Dose ◽  
Prevention Of Relapse

Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143.

scholarly journals Coagulation derangement and risk factors for valve thrombosis following transcatheter aortic valve implantation

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001496
Author(s):  
Tiffany Patterson ◽  
Harriet Hurrell ◽  
Jack Lee ◽  
Giulia Esposito ◽  
Utkarsh Dutta ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Reference Range ◽  
Multivariable Analysis ◽  
Single Centre ◽  
Transcatheter Aortic Valve ◽  
Coagulation Testing ◽  
Valve Thrombosis ◽  
Valve Implantation ◽  
Transfemoral Tavi

AimsDurability of transcatheter aortic valve implantation (TAVI) is key to its expansion. We sought to identify incidence of valve thrombosis and predictors of valve thrombosis in our single centre with associated coagulation testing pre-TAVI and post-TAVI.Methods and resultsThis single-centre observational study comprised patients undergoing transfemoral TAVI discussed in the Heart Team meeting . Patients were followed up with echocardiography at 120 days to identify incidence of elevated transvalvular gradient and multivariable analysis was performed to identify factors associated with an increased odds of developing valve thrombosis. In addition, 11 patients underwent baseline, day 1 and day 120 post-TAVI coagulation testing. Between August 2017 and August 2019, 437 consecutive patients underwent transfemoral TAVI. Of these patients, 207/437 (47.4%) had 3-month follow-up echo data available and were analysed. Of these patients, 26/207 (12.6%) had elevated transvalvular gradients. These patients tended to be younger (80±14 vs 83±6 years; p=0.047) with a lower ejection fraction (49±13 vs 54%±11%; p=0.021), with a greater proportion of the population experiencing atrial fibrillation (14/21, 54% vs 68/181, 38%; p=0.067). Following multivariable analysis, there remained a trend towards higher eccentricity index associated with elevated gradients. Baseline (pre-TAVI) elevation of thrombin antithrombin levels (56±63; reference range 1.0–4.1 ng/L) and PF 1+2 (791±632; reference range 69–229 ng/mL) normalised at 120 days post-TAVIConclusionThis study demonstrated that in the cohort of patients undergoing transfemoral TAVI in our centre: younger age, poor ejection fraction, atrial fibrillation and increased baseline eccentricity of the aortic valve annulus were present to a greater extent in patients exhibiting elevated transvalvular gradients at 3-month follow-up. Further work is required to delineate the extent of coagulation derangement and confirm predictors of thrombosis.

Evolution of Hashimoto thyroiditis in children with type 1 diabetes mellitus (TIDM)

2020 ◽  
Vol 33 (12) ◽  
pp. 1525-1531
Author(s):  
Feneli Karachaliou ◽  
Nikitas Skarakis ◽  
Evangelia Bountouvi ◽  
Theodora Spyropoulou ◽  
Eleni Tsintzou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Randomized Trials ◽  
Elevated Serum ◽  
Hashimoto Thyroiditis ◽  
Diabetes Mellitus Type 1 ◽  
Overt Hypothyroidism ◽  
Normal Ranges ◽  
Serum Tsh

AbstractObjectivesTreatment of children with Hashimoto thyroiditis (HT) and particularly of those with coexistent diabetes mellitus type 1 (TIDM) and normal/mildly elevated serum TSH is controversial. The aim of the study was to evaluate the natural course of HT in children with TIDM compared with children with no other coexistent autoimmunity and investigate for possible predictive factors of thyroid function deterioration.MethodsData from 96 children with HT, 32 with T1DM (23 girls, nine boys) mean (sd) age: 10.6 (2.3) years, and 64 age and sex-matched without T1DΜ (46 girls, 18 boys), mean (sd) age: 10.2 (2.9) years were evaluated retrospectively. They all had fT4 and TSH values within normal ranges and available data for at least three years’ follow-up.ResultsDuring the follow-up period, 11 children (34.4%) with TIDM exhibited subclinical hypothyroidism and two children (6.2%) progressed to overt hypothyroidism compared to 12 (18.8%) and two (3.1%) among children without TIDM, respectively. Among children with HT, a higher percentage (40.6%) of children with T1DM progressed to subclinical or overt hypothyroidism, compared with children (21.9%) with similar characteristics but without TIDM or other coexistent autoimmunity.ConclusionsThe annual conversion rate from euthyroidism to hypothyroidism in children with T1DM was significantly higher compared to sex and age-matched children without TIDM. Prospective randomized trials are needed to support the view of an earlier intervention therapy even in milder degrees of thyroid failure in these children.

scholarly journals TSH reference range in older adults: a Brazilian study

2014 ◽  
Vol 58 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Pedro Weslley Rosario ◽  
Maria Regina Calsolari
Keyword(s):  
Older Adults ◽  
Thyroid Dysfunction ◽  
Elderly Population ◽  
Thyroid Nodules ◽  
Reference Range ◽  
Adult Population ◽  
Free T4 ◽  
Upper Limit ◽  
Thyroperoxidase Antibodies ◽  
Serum Tsh

Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 older adults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population.

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