Prevalence of thyroid dysfunction and effect of contrast medium on thyroid metabolism in cardiac patients undergoing coronary angiography

2013 ◽  
Vol 54 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Paolo Marraccini ◽  
Massimiliano Bianchi ◽  
Antonio Bottoni ◽  
Alessandro Mazzarisi ◽  
Michele Coceani ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Contrast Medium ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Low T3 Syndrome ◽  
Free T4 ◽  
Free T3 ◽  
Iodinated Contrast ◽  
Low T3

Background Iodinated contrast media (CM) may influence thyroid function. Precautions are generally taken in patients with hyperthyroidism, even if subclinical, whereas the risks in patients with hypothyroidism or low triiodothyronine (T3) syndrome are not considered as appreciable. Purpose To assess the presence and type of thyroid dysfunction in patients admitted for coronary angiography (CA), to assess the concentration of free-iodide in five non-ionic CM, and to evaluate changes in thyroid function after CA in patients with low T3 syndrome. Material and Methods We measured free T3, free thyroxine (T4), and thyroid-stimulating hormone (TSH) in 1752 consecutive patients prior to CA and free-iodide in five non-ionic CM. Urinary free-iodide before and 24 h after CA, and thyroid hormone profile 48 h after CA were also made in 17 patients with low T3 syndrome. Patients were followed up for an average duration of 63.5 months. Results The patients were divided into four groups: euthyroidism (60%), low T3 syndrome (28%), hypothyroidism (10%), and hyperthyroidism (2%). The free-iodide resulted far below the recommended limit of 50 μg/mL in all tested CM. In low T3 syndrome, 24-h free-iodide increased after CA from 99.9± 63 ug to 12276±9285 ug (P< 0.0001). A reduction in TSH (4.97±1.1 vs. 4.17±1.1 mUI/mL, P < 0.01) and free T3 (1.44±0.2 vs. 1.25±0.3 pg/mL, P < 0.01), with an increase in free T4 (11.3±2.9 vs. 12.5±3.4 pg/dL, P < 0.001), was found. Patients with functional thyroid disease in the follow-up had a significant lower rate survival compared to euthyroid patients (90.7 vs. 82.2%, P < 0.00001). Conclusion Thyroid dysfunction is frequent in patients who perform a CA, and low T3 syndrome is the predominant feature. The administration of contrast medium may further compromise the thyroid function.

scholarly journals Effect of Contrast Media used in Coronary Angiography on Thyroid Function

2019 ◽  
pp. 339-344
Author(s):  
Khaled S. El-Hadidy ◽  
Rania E. Sheir ◽  
M.N. Salem ◽  
Ahmed M. EL-Dien ◽  
Yasser A. Abd El-Hady
Keyword(s):  
Coronary Angiography ◽  
Contrast Media ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Free T4 ◽  
Iodinated Contrast ◽  
Significant Difference

Radiocontrast-induced thyroid dysfunction prevalence has not been assessed accurately. It is greater among patients with pre-existing thyroid disease. Aim of this work to investigate effect of iodinated radiographic contrast media used in coronary angiography on the thyroid function in euthyroid patients. This study was conducted on 85 patients underwent elective coronary angiography. Baseline assessment of Free Thyroxine (FT4) and Thyroid-stimulating hormone (TSH) for the patients and three months later after Coronary Angiography. We observed that there was a statistically significant increase of TSH levels from baseline till 3 months following administration of contrast media (P-value=0.007). However, there was no statistical significant difference of Free T4 level from baseline till 3 (P-value=0.765). The incidence of increased TSH above normal range was 2.4% after 3 months ( 2 subclinical hypothyroidism cases). We noticed that there were no effect of age, gender, hypertension, diabetes, type of contrast, creatinine level or GFR on increased the level of TSH above normal value after 3 months. So, administration of Iodinated Contrast Media (ICM) associated with thyroid dysfunction mainly subclinical hypothyroidism so we should closely monitor patients after receiving ICM especially who have thyroid dysfunction.

scholarly journals Aspects of hormonal testing of thyroid function in patients with type 1 diabetes mellitus and chronic kidney disease

2021 ◽  
Vol 17 (1) ◽  
pp. 32-37
Author(s):  
A.G. Sazonova ◽  
T.V. Mokhort ◽  
N.V. Karalovich
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
Free T4 ◽  
Free T3 ◽  
Peripheral Conversion

Background. Chronic kidney disease (CKD) is known to affect the thyroid axis, including thyroid hormone metabolism. It has been established that a decrease in renal function can be combined with changes in thyroid function. Thyroid dysfunction also has implications for renal blood flow, glomerular filtration rate (GFR), tubular transport, electrolyte homeostasis, and glomerular structure. The purpose of the study was to determine the features of thyroid function in patients with type 1 diabetes mellitus (T1DM) and CKD and develop recommendations for hormonal testing of thyroid pathology. Materials and methods. One hundred and twenty-one patients with T1DM with CKD were divided into 3 groups: group 1 — 78 individuals with GFR ≤ 60 ml/min/1.73 m2, group 2 — 20 people receiving renal replacement therapy (RRT), group 3 — 23 patients after renal transplantation (RT) with adequate graft function (the duration of the renal transplant is 3.62 (1.47; 4.28) years). Results. In T1DM and CKD group, the diagnostic value of thyroid-stimulating hormone is reduced due to the absence of differences in its values with a decrease in T4 and T3. Free T3 is the most sensitive marker of thyroid dysfunction in CKD. Thyroid disorders in T1D and CKD patients have a non-immune genesis. T1DM patients on RRT after hemodialysis (HD) procedure have an increase in total and free T4 and free T3, consequently, monitoring of thyroid disorders should be done immediately after the HD session. The restoration of normal values of peripheral conversion index and free T3 occurs within 1–2 years after TR, depending on the duration of RRT receiving. After more than 3 post-transplantation years, there is an increase in peripheral conversion index, which characterizes the imbalance of peripheral thyroid hormones towards a decrease in free T3 with relatively stable free T4. Conclusions. Thyroid dysfunctions are typical for all stages of the pathological process in CKD in patients with type 1 diabetes mellitus, including patients at the terminal stage and after successful kidney transplantation. The changes in thyroid hormones are associated with the RRT experience and can potentially affect the survival of patients.

scholarly journals Free T3 to free T4 ratio less than 2.0 suggests low T3 syndrome rather than central hypothyroidism from the age of two to eighteen years

2017 ◽  
Vol 64 (2) ◽  
pp. 213-219 ◽  
Author(s):  
Risa Nomura ◽  
Kentaro Miyai ◽  
Rie Kuge ◽  
Takashi Okura ◽  
Masahiro Goto ◽  
...  
Keyword(s):  
Low T3 Syndrome ◽  
Free T4 ◽  
Central Hypothyroidism ◽  
Free T3 ◽  
Low T3

A Study of Clinical Profile of Thyroid Disorders in Children in A Tertiary Care Hospital, Kurnool

2021 ◽  
Vol 8 (2) ◽  
pp. 966-970
Author(s):  
Vedartham Ramesh ◽  
Keyword(s):  
Prevalence Rate ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Age Group ◽  
Free T4 ◽  
Female Ratio ◽  
Free T3

Background: Thyroid hormone abnormalities are the commonest endocrine disorder in India and also the commonest preventable cause of mental retardation, so we want to determine the prevalence of thyroid dysfunction in children at kurnool district. Materials and Methods: A hospital based prospective observational study performed in new born and children below 18 years fulfilling the inclusion criteria visiting the pediatric OPD and IPD in Viswabharathi medical college, Kurnool if they had clinical suspicion of thyroid dysfunction. If suspicion of hypothyroidism, Free T4, Total T4, TSH levels and if suspicion of hyperthyroidism Free T3 and TSH were done. Results: Out of 70 case 3 cases (4.3%) are hyperthyroidism and 67 cases (95.7%) are hypothyroidism in these 3 (4.3%) cases had family history of thyroid disorders, male to female ratio was 1.3:6 and prevalence rate was high in the age group of 10 - 12 years 32.9% (23 cases). 13 (18.6%) cases had thyroid enlargement and 48 (68.57%) cases had anaemia. Treatment was started according to standard guidelines. Conclusion: The higher prevalence rate of thyroid disorders in childhood that to in female children and age group of 10 - 12 years in and around kurnool. Hence, screening of all new-borns and children should be mandatory as early diagnosis and treatment helps in prevention of complications of thyroid disorders. KEY WORDS: Free T3, Free T4, Goiter, Hyperthyroidism, Hypothyroidism, and Thyroid stimulating hormone.

scholarly journals THYROID FUNCTION AND MENTAL HEALTH IN CHILDBEARING AGE WOMEN

2021 ◽  
Vol 13 (1) ◽  
pp. 75-84
Author(s):  
Suryati Kumorowulan ◽  
Yusi Dwi Nurcahyani ◽  
Leny Latifah ◽  
Diah Yunitawati
Keyword(s):  
Mental Health ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Childbearing Age ◽  
Free T4 ◽  
Hormone Levels ◽  
Childbearing Age Women ◽  
Thyroid Hormone Levels

Background. Thyroid dysfunction is frequently associated with psychiatric problems, such as anxiety or depression. On the other hand, thyroid dysfunction patients have little reason to be concerned about their mental health. Childbearing age women are included in the priority category because they require  excellent health conditions to prepare for pregnancy and parenthood. Objective. This study aimed to investigate relationship between thyroid function (as evaluated by thyroid hormone levels and thyroid stimulating hormone (TSH) levels) with mental health in childbearing age women. Method. This study is a cross sectional study, with childbearing age women (aged 15 years and up) who are already menstruating but have not yet reached menopause. The research was conducted in Yogyakarta City and Bukittinggi City with a total sample of 487 people. This study’s independent variables were TSH and free T4 levels. The dependent variables were anxiety and depression. Other things to consider are height, body weight, and age. Blood samples had used to measure TSH and free T4 levels. All respondents were interviewed to assess whether they were depressed or anxious using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results. There is a significant difference in score of BAI (21.1±11,67 vs 19.7±11.18, p<0.000) and BDI (10.1±8.06 vs 9.50±7.36, p<0.000) between groups. Other results found that disfunction thyroid hormone levels (TSH <0.3 mIU/mL) was related to depression (OR 2.324 95% CI 1.072–5.041, p<0.05; AOR 2.718 95% CI 1.028–7.186, p<0.05), but not associated with anxiety. Conclusion. Thyroid dysfunction, particularly low thyroid stimulating hormone levels, has been linked to higher risk of depression in childbearing age women.

scholarly journals SAT-477 Melanoma Treated with Pembrolizumab Leading to Thyroiditis and Subsequent Hypothyroidism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Heather Fishel
Keyword(s):  
Thyroid Function ◽  
T Cell Activation ◽  
Thyroid Dysfunction ◽  
Subsequent Development ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Specific Patient ◽  
Normal Thyroid ◽  
Free T3 ◽  
History Of

Abstract Background: Pembrolizumab (PD-1) is an immune checkpoint inhibitor used for treating melanoma and has been associated endocrine immune-related adverse events. Case Presentation: 76-year-old Caucasian male presented for evaluation of abnormal thyroid labs. Significant co-morbidities included recurrent melanoma, heart failure, atrial fibrillation, coronary artery disease, type 2 diabetes, hypertension. Patient’s melanoma was being treated with Pembrolizumab. Further history revealed no family/personal history of thyroid disease but a history of mouth cancer treated with radiation over 30 years ago. He denied any recent glucocorticoid or biotin use. Symptoms included worsening fatigue, weight loss, and diarrhea. He was afebrile and vitally stable. Physical exam was unremarkable. Prior to this year, patient had normal thyroid labs. Recent thyroid labs showed TSH of 0.01 uIU/mL (normal 0.34-4.94 uIU/mL), confirmed with repeat labs a week later (TSH: &lt; 0.01, Free T4: 2.23 ng/dL, normal Free T4: 0.7-1.48 ng/dL). There was a high suspicion that these labs were related to Pembrolizumab, but other etiologies were evaluated. Completed thyroid uptake and scan showed no evidence of increased activity (4-hour uptake: 1.6%, 24-hour update: 1.2%). Repeat thyroid labs indicated recovering thyroid function with a TSH: 0.14 uIU/mL, Free T4: 0.49 ng/dL, Free T3: 1.5 pg/mL (normal Free T3 2.3-4.2 pg/mL), TSI: 96% (normal &lt; 140%), TPO Ab: 111 IU/mL (normal TPO Ab &lt; 9 IU/mL). One month later thyroid tests resulted as TSH: 72.81 uIU/mL, Free T4: &lt; 0.40. He was started on levothyroxine, which was titrated over several weeks. Discussion: Pembrolizumab (PD-1) is an IgG4 programmed cell death 1-directed monoclonal antibody, whose mechanism of action is to inhibit cancer cells ability impede T-cell activation. However, because of this mechanism, some T-cells, will remain activated, leading to autoimmune diseases. PD-1 has been associated with thyroid dysfunction, with an incidence rate as high as 14-20%. The clinical presentation varies from isolated thyrotoxicosis to overt hypothyroidism. In our patient, he developed thyrotoxicosis with subsequent development of hypothyroidism. Generally, the timing of thyroid dysfunction after the initiation of PD-1 ranges from 3 to 40 weeks, with the median onset at week 6. Baseline TSH and free T4 should be obtained with rechecking of these labs monthly for the first 6 months. For patients who present with thyrotoxicosis, Grave’s disease should be ruled out, and initial treatment should include beta-blockers. Hypothyroidism should be treated with levothyroxine with titration to normal thyroid function tests. What remains to be determined is the mechanism in which PD-1 causes thyroid dysfunction and if specific patient characteristics, such as thyroid antibodies, can be used to risk stratify the likelihood of a patient developing thyroid dysfunction.

scholarly journals Thyroid Function Test in Patients with Chronic Kidney Disease

2021 ◽  
pp. 150-158
Author(s):  
V. Abhinaya ◽  
S. Magesh Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Function Test ◽  
Free T4 ◽  
Cross Sectional ◽  
Male Predominance ◽  
Low T3

Background: Kidneys have a significant role in the metabolism, degradation and excretion of thyroid hormones. Both thyroid hormones and kidney functions have a multifaceted mutual interdependence. Objectives: To find out the possible association between the severity of chronic kidney disease and thyroid dysfunction; To estimate the correlation between thyroid dysfunction and various stages of chronic kidney disease. Materials and Methods: A prospective Cross-sectional study was done on 50 patients with Chronic kidney disease who were not on dialysis and fulfilled all the inclusion criteria at Saveetha medical college over a period of 6 months. Free T3, Free T4 and TSH levels were estimated for those patients. Results: Results of this study showed that majority of subjects included in our study were in the age group of 50-60 years with Male predominance. Out of 50 patients included in our study, 8 patients(16%) were found to hypothyroidism; 5 patients (10%) were having subclinical hypothyroidism; 20 patients (40%) were having low T3 syndrome and 17 patients (34%) were having normal functioning thyroid gland. Staging of CKD was done in relation to the glomerular filtration rate .Most of the patients(n=20) were in Stage 5 of Chronic kidney disease out of which 18 patients were having thyroid disorders. Conclusion: There is a positive correlation between the severity of CKD and thyroid dysfunction. Hence a routine thyroid function status should be evaluated in each and every patient of CKD to reduce the morbidity and mortality rate of CKD patients as well as reduce the social burden and health expenditure.

scholarly journals A CASE OF FAMILIAL NONAUTOIMMUNE HYPERTHYROIDISM DURING PREGNANCY

2020 ◽  
Vol 6 (2) ◽  
pp. e94-e97
Author(s):  
Yuka Okazaki ◽  
Naoko Arata ◽  
Nagayoshi Umehara ◽  
Taisuke Yamauchi ◽  
Junnichi Tajiri ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Germ Line ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Free T4 ◽  
Serum Free ◽  
Free T3 ◽  
Gestational Week ◽  
Tshr Gene ◽  
Stimulating Hormone

Objective: Familial nonautoimmune hyperthyroidism (FNAH) is a rare disease. To date there are few, if any, reports of pregnancies in women with FNAH. Our objective here is to present such a case. Methods: Free thyroxine (free T4), free triiodothyronine (free T3), thyroid-stimulating hormone (TSH), and antibodies related to the thyroid were measured. Fetal thyroid function indicators including thyroid volume and ossification were checked using ultrasound. Thyroid-stimulating hormone receptor (TSHR) gene analyses were performed. Results: The patient was a 30-year-old woman with no past medical history. She was introduced to our hospital in the fifth gestational week for pregnancy care because her family history revealed that her mother had nonautoimmune hyperthyroidism with a TSHR-activating germ-line mutation (Asn406Ser). The serum free T4 was 1.88 ng/dL (normal, 0.62 to 1.19 ng/dL), free T3 was 3.27 pg/mL (normal, 2.55 to 3.88 pg/mL), TSH was 0.02 μIU/mL (normal, 0.007 to 3.619 μIU/mL), and TSHR was negative which were considered to be consistent with mild primary hyperthyroidism. Serum free T4, free T3, and TSH concentrations were monitored every 4 to 6 weeks with a peak free T4 of 2.23 ng/dL noted at gestational week 9. The patient had no signs related to hyperthyroidism throughout pregnancy. The patient delivered a 3,518 g girl at 40 weeks of gestation. Genetic analysis of her TSHR gene showed heterozygous Asn406Ser mutation. The offspring did not show any signs of prenatal hyperthyroidism, and thyroid function at day 6 after delivery revealed a free T4 of 2.41 ng/dL (normal, 1.83 to 2.91 ng/dL) and a TSH of 3.55 μIU/mL (normal, 0.51 to 4.57 μIU/mL). Conclusion: Women with FNAH and mild thyrotoxicosis prior to pregnancy may have continuous hyperthyroidism with additional change due to the series of human chorionic gonadotropin secretion during pregnancy.

Thyroid Function in Gestational Trophoblastic Tumors

1986 ◽  
Vol 72 (2) ◽  
pp. 205-209
Author(s):  
Franca Vergadoro ◽  
Laura Tabacchi ◽  
Pietro Barbacini ◽  
Laura Vassena ◽  
Flavia Zanaboni ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Hydatidiform Mole ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Free T4 ◽  
Free T3 ◽  
Normal Limits ◽  
Trophoblastic Tumors

Thyroid function was assessed in a total of 15 cases, 7 of whom had choriocarcinoma and 8 hydatidiform mole, by measuring free T3, free T4, thyroxin-binding globulin (TBG), basal thyroid-stimulating hormone (TSH) and after the thyrotropin-releasing hormone test (ΔTSH). Free T3, free T4 and TBG were investigated in the same number of healthy women within the first three months of pregnancy. Only 13.4% of the cases presented elevated levels of free T3 and T4 and TBG; TSH and ΔTSH were within normal limits. Both thyroid hormones and TBG returned to within normal limits when β-human chorionic gonadotropin became undetectable. One patient was found to be hypothyroid. Comparison with the control group showed no significant differences except in TBG levels, which were higher in controls. A significant, direct correlation was found between levels of free T3 and T4 and TBG and the pattern of human chorionic gonadotropin.

scholarly journals A study on thyroid dysfunction in acne vulgaris

2019 ◽  
Vol 5 (4) ◽  
pp. 736
Author(s):  
Shreya Srinivasan ◽  
Jayakar Thomas
Keyword(s):  
Thyroid Function ◽  
Acne Vulgaris ◽  
Thyroid Function Test ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Antibodies ◽  
Male Population ◽  
Free T4 ◽  
Free T3 ◽  
Function Test

<p class="abstract"><strong>Background:</strong> This study was done to evaluate the role of thyroid function i.e., free T3, free T4 and thyroid stimulating hormone (TSH) in relation to the occurrence of acne vulgaris.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients clinically diagnosed with acne vulgaris were subjected to a thyroid function test and results were evaluated.<strong></strong></p><p class="abstract"><strong>Results:</strong> While all the 50 patients had normal free T3 and free T4 levels, 9 (18%) of the 50 patients displayed an elevated TSH level. Gender distribution among the patients with elevated TSH learned more towards the male population with 6 patients while there were only 3 female patients with elevated TSH.</p><p><strong>Conclusions:</strong> There have been few studies regarding the role of thyroid function in acne vulgaris in relation to free T3, free T4 and TSH, though the presence of thyroid antibodies have been highlighted in quite a few studies. This study has shown the insignificance of thyroid function in acne vulgaris thus accentuating the negative.</p>

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