scholarly journals The results of neonatal TSH screening do not agree with indicators of the optimal iodine status of pregnant women in the Republic of Georgia

2018 ◽  
Vol 14 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Nelli Barnabishvilli ◽  
Gregory A. Gerasimov ◽  
Teimuraz Azikuri
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Thyroid Stimulating Hormone ◽  
Capital City ◽  
Iodine Nutrition ◽  
Iodine Status ◽  
Significant Difference ◽  
High Prevalence ◽  
The Republic ◽  
Tsh Levels

Background. Georgia historically was a country with moderate to severe iodine deficiency and high prevalence of endemic goiter. A representative countrywide iodine survey conducted in Georgia in 2017 confirmed optimal iodine nutrition of the population with median UIC 298 mcg/L in SAC and 211 mcg/L in PW. Aim. The aim of this study was to assess status of iodine nutrition of population in Georgia. Methods. The assesement based on the proportion of neonatal Thyroid-Stimulating Hormone (TSH) levels >5mIU/L from 2009 to 2015 and compare these data with the results of direct assessment of iodine status made during the 2017 national survey. Results. From 2009 to 2015 the proportion of newborns with TSH >20 mIU/L decreased threefold: from 0.45 to 0.15%. This trend was observed in all regions of the country with significant difference between the capital city and Western in Eastern parts of the country. There has been also significant reduction of the prevalence of TSH >5 mIU/L in Georgia from 4.46% in 2009 to 3.5% in 2015. However, only in Tbilisi the frequency of elevated TSH was below 3% – the cutoff level for adequate iodine nutrition. In other regions (Western and Eastern Georgia) prevalence of TSH >5 mIU/L was 3.8% and 4.4% respectively that could be falsely interpreted as mild iodine deficiency. Conclusions. Although neonatal TSH is useful to detect moderate to severe iodine deficiency, it should be cautiously recommended for the evaluation of iodine status in iodine sufficient to mildly iodine deficient regions.

scholarly journals Neonatal Thyroid-Stimulating Hormone Screening as an Indirect Method for the Assessment of Iodine Status in Central Siberia

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Iodine Deficiency ◽  
Screening Program ◽  
Thyroid Stimulating Hormone ◽  
The Arctic ◽  
Central Siberia ◽  
Iodine Status ◽  
The Republic ◽  
Stimulating Hormone

Background: Iodine deficiency is associated with goiter and impaired brain function. Neonatal thyroid-stimulating hormone (TSH) screening for congenital hypothyroidism used as an indicator of the degree of iodine deficiency and of its control. An increased frequency of thyroid-stimulating hormone (TSH) measurements above 5 mIU/L in newborn screening corresponds to the impaired iodine status of the population. The aim: to estimate the iodine deficiency and the effectiveness of iodine prophylaxis in Krasnoyarsk territory, Republics of Tuva and Khakassia according the results of neonatal TSH_screening. Methods: An 18-year analysis was performed in 34,980 newborns participating in the national thyroid newborn screening program. The TSH concentration was measured in dry blood spots collected by heel stick on filter paper, 96 hours after birth, using DELFIA method. Results: According to the data of the congenital hypothyroidism screening the rate of TSH < 5 mU/1 was 11.8% in Krasnoyarsk territory (23.9% in 2000) and corresponded to mild iodine deficiency. In different regions of Krasnoyarsk territory the rate of TSH < 5 mU/1 in the newborn varied from 3.5% to 23.7%. The highest values were marked in the Arctic peninsula Taimyr, in cities Zheleznogorsk (nuclear facility) and Sosnovoborsk, in Irbeysky, Suchobuzimsky, Eniseysky, Tuchtetsky, Novoselovsky regions (20.9–23.7%). In the Republic of Khakasia the rate of TSH < 5 mU/1 was 12.5%. In the Republic of Tyva the rate of TSH < 5 mU/1 was – 6.6% (38.6% in 1997; 11.5% in 2000). These results indicate mild iodine deficiency. Conclusion: Our investigations show mild iodine deficiency in Central Siberia demanding continuous adequate iodine prevention. Additional assessment of the iodine intake in the regions with mild iodine deficiency is needed to prevent suboptimal cognitive and psychomotor outcomes.

scholarly journals Newborn Screening for Thyroid-stimulating Hormone as an Indicator for Assessment of Iodine Status in the Republic of Macedonia

2016 ◽  
Vol 35 (4) ◽  
pp. 385-389 ◽  
Author(s):  
Violeta Anastasovska ◽  
Mirjana Kocova
Keyword(s):  
Newborn Screening ◽  
Iodine Deficiency ◽  
Screening Program ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Iodine Status ◽  
The Republic ◽  
National Prevalence ◽  
Iodine Sufficiency ◽  
Stimulating Hormone

SummaryBackground:Iodine deficiency is associated with goiter and impaired brain function leading to cretinism. An increased frequency of thyroid-stimulating hormone (TSH) measurements above 5 mIU/L on newborn screening points toward an impaired iodine status of the population.Methods:A 13-year retrospective analysis was performed in 228,266 newborns participating in the national thyroid newborn screening program. The TSH concentration was measured in dry blood spots collected by heel stick on filter paper, 48 hours after birth, using fluoroimmunometric DELFIA method.Results:Out of 236,378 live-born infants, 228,266 (96.6%) have been screened for TSH, of which 198,213 (86.8%) were retrospectively evaluated for TSH levels above 5 mIU/L. Neonates with congenital hypothyroidism, prematurity, and low birth weight were excluded from the evaluation, as well as the inadequately sampled neonates (13.2%). A national prevalence of 3.08% newborns (n=6,105) with TSH > 5 mIU/L was found. Higher percentages were noted in two regions of the country, indicating possible mild iodine deficiency in these regions and shifting the overall average to above 3%.Conclusions:Our results indicate overall iodine sufficiency in the Macedonian population. Additional assessment of the iodine intake in the regions with suspected mild iodine deficiency is needed to prevent suboptimal cognitive and psychomotor outcomes.

scholarly journals Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population?

2020 ◽  
Vol 23 (14) ◽  
pp. 2467-2477
Author(s):  
Małgorzata Trofimiuk-Müldner ◽  
Joanna Konopka ◽  
Grzegorz Sokołowski ◽  
Agnieszka Dubiel ◽  
Małgorzata Kieć-Klimczak ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
School Children ◽  
Nutrition Status ◽  
Iodine Nutrition ◽  
Lactating Women ◽  
Iodine Status ◽  
Iodine Prophylaxis ◽  
Significant Difference ◽  
Thyroglobulin Level

AbstractObjective:The monitoring of the populations’ iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland.Design:The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women).Setting:The study was conducted in 2017 within the National Health Programme in five regions of Poland.Participants:The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6–12 years).Results:In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l.Conclusions:Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.

The Association of Therapy Adherence and Thyroid Function in Adult Patients with Phenylketonuria

2019 ◽  
Vol 75 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Csaba Sumanszki ◽  
Erika Kiss ◽  
Erika Simon ◽  
Erika Galgoczi ◽  
Aron Soos ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
Thyroid Stimulating Hormone ◽  
Healthy Controls ◽  
Serum Thyroglobulin ◽  
Therapy Adherence ◽  
Iodine Status ◽  
Amino Acid Mixtures ◽  
Therapy Compliance

Background: The standard, lifelong therapy of phenylketonuria (PKU) is a natural protein-restricted diet complemented with phenylalanine (Phe)-free L-amino acid mixtures that provide the daily necessary micronutrients. Objective: To assess thyroid function and structure and the iodine status of early-treated adult PKU (ETPKU) patients in Hungary. Methods: Sixty-nine PKU patients (aged 18–41 years) and 50 healthy controls were enrolled in the study. Thyroid hormones, serum thyroglobulin, thyroid antibodies, urinary iodine, and selenium concentrations were measured, and thyroid ultrasound was performed. Results: The incidence of thyroid dysfunction was infrequent (n = 2). Blood Phe was negatively correlated with thyroid-stimulating hormone (TSH), and PKU patients had higher free thyroxine and lower TSH levels than healthy controls. Although optimal iodine status was found in the entire PKU population, by dividing the patients according to their therapy compliance, we observed that lower therapy adherence was associated with mild iodine deficiency and lower urinary selenium levels. Conclusions: The results of this study suggest that iodine status is strongly influenced by the adherence to therapy in ETPKU patients. No or not enough medical food consumption combined with a low-Phe diet can lead to subclinical iodine deficiency.

scholarly journals Iodine deficiency in pregnant women in Sweden: a national cross-sectional study

2019 ◽  
Vol 59 (6) ◽  
pp. 2535-2545 ◽  
Author(s):  
Sofia Manousou ◽  
Maria Andersson ◽  
Robert Eggertsen ◽  
Sandra Hunziker ◽  
Lena Hulthén ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Geometric Mean ◽  
Iodized Salt ◽  
National Study ◽  
Urinary Iodine Concentration ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
Iodine Status ◽  
Supplement Use

Abstract Purpose Voluntary salt iodization at 50 mg/kg salt ensures adequate iodine nutrition in Swedish school-aged children, but iodine status in pregnant women is uncertain. Methods We conducted a cross-sectional national study of 743 pregnant women, at median gestational age of 23 weeks (IQR 9, 38), recruited from maternal health care centers. We measured: urinary iodine concentration (UIC) and urinary creatinine concentration in spot urine samples; thyroglobulin (Tg), thyroid-stimulating hormone (TSH), and total thyroxine (tT4) on dried blood spots (DBS); and thyreoperoxidase antibodies in serum samples. Data on dietary supplement use were obtained, and women were classified as supplement users (consuming multivitamins containing ≥ 150 µg iodine/day) and non-supplement users (no supplements or < 150 µg iodine/day from supplements). Results Overall median UIC [bootstrapped 95% confidence interval (CI)] was 101 µg/L (95, 108; n = 737): 149 µg/L (132, 164) in supplement users (n = 253) and 85 µg/L (79, 92) in non-supplement users (n = 440) (p < 0.001). Overall geometric mean DBS-Tg (95% CI) was 22.1 μg/L (20.8, 23.5; n = 675) and the prevalence of elevated DBS-Tg was 19%. DBS-Tg was lower in supplement users (n = 229) than in non-supplement users (n = 405) (19.1 vs 24.4 μg/L, p < 0.001). DBS-TSH, DBS-tT4, and S-TPOab positivity did not differ between the two groups. Conclusions Pregnant women in Sweden have inadequate iodine nutrition. Women not taking iodine supplements containing ≥ 150 µg iodine/day are affected by mild iodine deficiency and are at higher risk for increased thyroid activity, while maintaining euthyroidism. Iodine intake should be improved in women both before and after conception by promotion of iodized salt instead of non-iodized salt. We urge regular monitoring of iodine status in the general Swedish population, as well as in risk groups.

scholarly journals Can postpartum maternal urinary iodine be used to estimate iodine nutrition status of newborns?

2016 ◽  
Vol 115 (7) ◽  
pp. 1226-1231 ◽  
Author(s):  
Pantea Nazeri ◽  
Parvin Mirmiran ◽  
Mehdi Hedayati ◽  
Yadollah Mehrabi ◽  
Hossein Delshad ◽  
...  
Keyword(s):  
Urinary Iodine ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Nutrition Status ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
Young Infants ◽  
Significant Difference ◽  
Heel Prick ◽  
Postpartum Mothers

AbstractI deficiency can lead to detrimental effects, particularly in neonates and young infants. The aim of this study was to explore whether postpartum maternal urinary I can be used to estimate the I status of newborns. In this cross-sectional study conducted in Tehran, lactating mothers and newborns, within 3–5 d postpartum, were randomly selected. Urine samples were collected from each mother and newborn, and a heel-prick blood sample was obtained from all newborns as part of the routine national newborn screening programme. According to the WHO criteria, median urinary I concentration (UIC) <100 µg/l and frequency over 3 % of thyroid stimulating hormone (TSH) >5 mIU/l was considered as I insufficiency. A total of 147 postpartum women and neonates, aged 27·8 (sd5·3) years and 4·2 (sd0·6) d, respectively, completed this study. The median UIC was 68·0 (interquartile range (IQR) 39·4–133·5) and 212·5 (IQR 92·3–307·3) µg/l in postpartum mothers and newborns, respectively. The median neonatal TSH was 1·00 (IQR 0·50–1·70) mIU/l. There was no significant difference in the neonatal UIC and TSH of infants whose mothers had deficient and sufficient urinary I. In the multiple linear regression, neonatal UIC value was associated with maternal urinary I (P=0·048) and parity (P=0·039); a significant association was observed between neonatal TSH and infant sex (P=0·038) and birth weight (P=0·049). The findings of our study demonstrate that, despite postpartum mothers being mildly I deficient, I status of their infants was adequate as assessed by UIC and TSH values. It seems factors other than maternal urinary I may influence the I status in newborns.

scholarly journals Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?

2014 ◽  
Vol 58 (7) ◽  
pp. 731-736 ◽  
Author(s):  
Raquel de Carvalho Abi-Abib ◽  
Mário Vaisman
Keyword(s):  
Treatment Protocol ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Sample Median ◽  
Significant Difference ◽  
The Mean ◽  
One Year ◽  
Dose Dependent ◽  
Entire Treatment ◽  
Tsh Levels

Objective It is believed that gastric pH interferes in levothyroxine absorption. Omeprazole, which acts by blocking the secretion of gastric acid, might interfere in hypothyroidism control in patients using levothyroxine and this effect could be dose dependent. The present study aimed to investigate this possibility. Subjects and methods Twenty-one patients with primary hypothyroidism who had been using a stabilized levothyroxine dosage for at least one year were selected and randomly assigned to take omeprazole at the dosage of 40 mg or 20 mg per day. The mean levels of thyroid-stimulating hormone (TSH) before and 3 months after omeprazole usage were compared in the entire sample and in each group. Results Ten patients concluded the entire treatment protocol in the 20 mg group and nine patients in the 40 mg group. There was no significant difference in TSH levels before and 3 months after omeprazole treatment in the entire patient sample (median levels: 2.28 vs. 2.30 mU/L, respectively: p = 0.56). Analysis of each subgroup (20 and 40 mg) showed no significant variation in TSH levels before and 3 months after omeprazole treatment (median levels: 2.24 vs. 2.42 mU/L, p = 0.62, and 2.28 vs. 2.30 mU/L, p = 0.82, respectively). No significant difference in the absolute (p = 0.93) or relative (p = 0.87) delta were observed between the two subgroups. Conclusion Omeprazole in the dosage of 20 or 40 mg/day does not interfere in a clinically relevant manner in the treatment of patients with hypothyroidism that was previously under control.

Effects of Chronic Suppression or Oversuppression of Thyroid-Stimulating Hormone on Psychological Symptoms and Sleep Quality in Patients with Differentiated Thyroid Cancer

2021 ◽  
Vol 53 (10) ◽  
pp. 683-691
Author(s):  
Seher Çetinkaya Altuntaş ◽  
Çiçek Hocaoğlu
Keyword(s):  
Thyroid Cancer ◽  
Sleep Quality ◽  
Differentiated Thyroid Cancer ◽  
Sleep Problems ◽  
Psychological Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Sensitivity Index ◽  
Significant Difference ◽  
The Mean ◽  
Tsh Levels

AbstractIn differentiated thyroid cancer (DTC), the standard treatment includes total thyroidectomy and lifetime levothyroxine (LT4) replacement. However, long-term exogenous LT4 has become controversial due to the adverse effects of oversuppression. The study included 191 patients (aged 18–76 years) with a prospective diagnosis of non-metastatic DTC and 79 healthy individuals. The patients with DTC were stratified into three groups according to their TSH levels: suppressed thyrotropin if TSH was below 0.1 μIU/ml, mildly suppressed thyrotropin if TSH was between 0.11 and 0.49 μIU/ml, and low-normal thyrotropin if THS was between 0.5 and 2 μIU/ml. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), Short Symptom Inventory (SSI), and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants. It was found that the BDI, BAI, SSI and PSQI scores were worse in patients with DTC (p=0.024, p=0.014, p=0.012, and p=0.001, respectively). According to theTSH levels, the mean ASI was found to be higher in the suppressed and mildly suppressed thyrotropin groups (19±14.4 vs. 10.6±11.1; 16.4±14.9 vs. 10.6±11.1, p=0.024, respectively), the mean SSI was found higher in the suppressed group (61.0±55.5 vs. 35.1±37.0, p=0.046), and the mean PSQI was higher in all three groups (7.94±3.97 vs. 5.35±4.13; 7.21±4.59 vs. 5.35±4.13; 7.13±4.62 vs. 5.35±4.13, p=0.006) when compared with the controls. No significant difference was found between the groups. A positive correlation was detected in the duration of LT4 use and BDI and SSI, and a weak, negative correlation was detected between TSH levels and ASI and PSQI. Based on our study, it was found that depression, anxiety disorders, and sleep problems were more prevalent in patients with DTC, being more prominent in the suppressed TSH group. These results were inversely correlated with TSH values and positively correlated with the duration of LT4 use. Unnecessary LT4 oversuppression should be avoided in patients with DTC.

Iodine deficiency in Calabria: Characterization of endemic goiter and analysis of different indicators of iodine status region-wide

2002 ◽  
Vol 25 (3) ◽  
pp. 201-207 ◽  
Author(s):  
G. Costante ◽  
L. Grasso ◽  
E. Schifino ◽  
M. F. Marasco ◽  
U. Crocetti ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Endemic Goiter ◽  
Iodine Status

scholarly journals The Prevalence of Thyroid Autoimmunity in Children with Developmental Dyslexia

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Roberta Degrandi ◽  
Flavia Prodam ◽  
Giulia Genoni ◽  
Giorgio Bellomo ◽  
Gianni Bona ◽  
...  
Keyword(s):  
Developmental Dyslexia ◽  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Thyroid Ultrasonography ◽  
Free Triiodothyronine ◽  
Significant Difference ◽  
High Prevalence ◽  
Systematic Determination

Background and Objectives. An association between developmental dyslexia and autoimmune disorders has been postulated. We aimed to evaluate the prevalence of thyroid autoimmunity in pediatric subjects with developmental dyslexia. Methods. We enrolled pediatric subjects with developmental dyslexia and, as a control group, healthy age- and sex-matched subjects without developmental dyslexia. Thyroid function was evaluated in subjects with developmental dyslexia measuring serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4). Thyroid autoimmunity was evaluated in all subjects measuring antithyroid peroxidase (TPO-Ab) and antithyroglobulin (TG-Ab) antibodies. In subjects with developmental dyslexia, thyroid ultrasonography (US) was also performed. Results. We enrolled 51 subjects with developmental dyslexia ( M : F = 39 : 12 , mean age 12.4 ± 9 years) and 34 controls ( M : F = 24 : 10 , mean age 10.8 ± 4 years). TPO-Ab positivity was significantly higher in subjects with developmental dyslexia compared to controls (60.8% vs. 2.9%, p < 0.001 ), while no significant difference was found in TG-Ab positivity (16% vs. 5.8%). Thyroid US performed in 49 subjects with developmental dyslexia revealed a thyroiditis pattern in 60%. Conclusions. We found an extremely high prevalence of thyroid autoimmunity in children with developmental dyslexia. Further studies are needed to confirm our observations, but our findings may change the approach to this disorder and eventually lead to a systematic determination of thyroid autoimmunity in children with developmental dyslexia.

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