EFFECT OF INCREASED IODIDE INTAKE ON THYROID FUNCTION IN SUBJECTS ON CHRONIC LITHIUM THERAPY

1977 ◽  
Vol 84 (2) ◽  
pp. 290-296 ◽  
Author(s):  
S. W. Spaulding ◽  
G. N. Burrow ◽  
J. N. Ramey ◽  
R. K. Donabedian
Keyword(s):  
Thyroid Function ◽  
Potassium Iodide ◽  
Lithium Therapy ◽  
Thyroid Function Tests ◽  
Fourth Patient ◽  
Function Tests ◽  
Before And After ◽  
Serum Tsh

ABSTRACT Thyroid function tests were obtained in 10 patients on chronic lithium therapy before and after the administration of potassium iodide 250 mg q. i. d. Mean serum TSH rose by 8.9 μU/ml and mean serum T3 rose from 70 to 101 ng/dl. Two patients became hypothyroid; a third showed a rise in TSH without any change in T3 or T4. A fourth patient developed hyperthyroidism probably secondary to the Jod-Basedow phenomenon. Pharmacologic doses of iodine should be administered with caution to patients on chronic lithium therapy.

Subclinical hypothyroidism

2011 ◽  
pp. 543-547
Author(s):  
Jayne A. Franklyn
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Expert Panel ◽  
Elevated Serum ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Free Triiodothyronine ◽  
Function Tests ◽  
Serum Tsh

Subclinical hypothyroidism is defined biochemically as the association of a raised serum thyroid-stimulating hormone (TSH) concentration with normal circulating concentrations of free thyroxine (T4) and free triiodothyronine (T3). The term subclinical hypothyroidism implies that patients should be asymptomatic, although symptoms are difficult to assess, especially in patients in whom thyroid function tests have been checked because of nonspecific complaints such as tiredness. An expert panel has recently classified individuals with subclinical hypothyroidism into two groups (1): (1) those with mildly elevated serum TSH (typically TSH in the range 4.5–10.0 mU/l) and (2) those with more marked TSH elevation (serum TSH >10.0 mU/l).

scholarly journals EVALUATION OF THYROID FUNCTION TESTS BEFORE AND AFTER SYSTEMIC ISOTRETINOIN TREATMENT OF ACNE VULGARIS PATIENTS

2021 ◽  
Vol 50 (3) ◽  
pp. 1989-1996
Author(s):  
Fayrouz Adel Ahmed ◽  
Amr Mohamed Zaky ◽  
Sameh Mohamed Abd El-Qodos
Keyword(s):  
Thyroid Function ◽  
Acne Vulgaris ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Before And After

Hair Loss in the Course of Lithium Treatment: A Report of Two Cases*

1983 ◽  
Vol 28 (2) ◽  
pp. 132-133 ◽  
Author(s):  
Ramzy Yassa ◽  
Jambur Ananth
Keyword(s):  
Thyroid Function ◽  
Hair Loss ◽  
Side Effect ◽  
Lithium Treatment ◽  
Lithium Therapy ◽  
The Other ◽  
Thyroid Function Tests ◽  
Underlying Factor ◽  
Function Tests ◽  
Benign Thyroid

Two cases of hair loss attributed to lithium therapy are presented. In one case, lithium did not have to be discontinued, and in the other, hair loss led to noncompliance. This side effect is usually benign. Thyroid function tests should always be performed to exclude hypothyroidism as the underlying factor for this symptom.

scholarly journals A Case of Euthyroid Graves’ Ophthalmopathy in a Patient Sero-Negative for TSH Receptor Autoantibody

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Asami Hotta ◽  
Tomohiro Tanaka ◽  
Haruka Kato ◽  
Shota Kakoi ◽  
Yuki Shimizu ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Pulse Therapy ◽  
Tsh Receptor ◽  
Thyroid Autoantibodies ◽  
Thyroid Function Tests ◽  
Normal Thyroid Function ◽  
Function Tests ◽  
Graves Ophthalmopathy ◽  
History Of ◽  
Serum Tsh

We report of a case of Graves’ ophthalmopathy presented solely with symptoms of the eyes with normal thyroid function tests and negative immunoreactive TSH receptor autoantibody. 40-year-old male was referred to our hospital due to 2-month history of ocular focusing deficit without any signs or symptoms of hyper- or hypothyroidism. Serum thyroid function tests and 99mTc uptake were both within the normal range. Anti-thyroid autoantibodies were all negative except for the cell-based assay for serum TSH receptor stimulating activity. Since orbital CT scan and MRI gave typical results compatible with Graves’ ophthalmopathy, we treated the patients with corticosteroid pulse therapy and orbital radiation therapy, leading to a partial improvement of the symptoms. This case gives insights into the potential pathophysiologic mechanism underlying Graves’ ophthalmopathy and casts light upon the difficulties of establishing the diagnosis in a euthyroid case with minimal positive results for anti-thyroid autoantibodies.

Goiter in Children

1984 ◽  
Vol 5 (9) ◽  
pp. 259-272
Author(s):  
Thomas P. Foley
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Thyroid Function ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Thyroid Antibodies ◽  
Presumptive Diagnosis ◽  
Function Tests ◽  
Serum Tsh

The diagnostic evaluation of the patient with thyromegaly will be determined by the clinical history and an examination of the thyroid gland (Table 9). In most instances the diagnosis will not be in doubt, and only a few tests will be necessary. For example, the euthyroid adolescent female with an asymmetrically or symmetrically enlarged, firm thyroid gland has a presumptive diagnosis of CLT, and only tests of thyroid function (T4 and TSH) and thyroid antibodies may be needed for confirmation. Similarly, the patient with clinical symptoms and signs of hyperthyroidism, exophthalmus, and a diffusely enlarged, soft thyroid gland has a presumptive diagnosis of Graves disease. The necessary tests include only a measurement of T4, an estimate of free T4, and WBC and differential counts prior to the initiation of antithyroid drug therapy. [See table in the PDF file] In the absence of an obvious diagnosis, the clinician will select the specific diagnostic tests depending upon the examination of the thyroid gland. The cause of smooth, symmetrical, diffuse enlargement of the thyroid gland can be suspected with careful history for familial disease, history of exposure to goitrogens and goitrogenic drugs, and the determination of thyroid antibodies in serum. If the clinical history is suggestive of hyperthyroidism, the tests of thyroid function tests should include determination of serum T3 concentration; if the history is compatible with euthyroidism or hypothyroidism, thyroid function tests should include determination of serum TSH concentration for the presence of compensated primary hypothyroidism. If results of these tests are normal, no additional tests are necessary, and the patient should be reassured and seen again in six months. If the patient has a test that is negative for thyroid antibodies and an elevation of serum TSH concentration, a radioactive [123I]iodide uptake and perchlorate discharge test will be helpful in the diagnosis of familial dyshormonogenesis. The patient with constitutional symptoms of inflammatory disease, history of a recent upper tract respiratory infection, and a tender or nontender enlarged thyroid gland may have subacute thyroiditis; a low or absent uptake of radioiodine with high-normal or elevated T4 and T3 concentrations will be suggestive of that diagnosis. In patients with thyromegaly and mild symptoms of hyperthyroidism, a TRH test will help to discriminate hyperthyroxinemia secondary to increased or abnormal serum thyroxine binding proteins from early Graves disease, factitious hyperthyroidism, toxic thyroiditis, and TSH-mediated hyperthyroidism. The T3 suppression test is a definitive diagnostic test for early, mild Graves disease. The euthyroid patient with mild-to-moderate thyromegaly and tests that are negative for thyroid antibodies usually deserves no further diagnostic evaluation, but should be followed with a presumptive diagnosis of idiopathic goiter or mild CLT. On follow-up evaluation, initially at six-month intervals and subsequently at yearly intervals, the patient should have a clinical and biochemical assessment until thyromegaly regresses and the gland is normal in size and consistency. The patient with a nontender, firm, irregular enlargement of the thyroid gland usually has CLT. If results of thyroid function tests are normal and tests for thyroid antibodies are negative, the patient should be seen again in four to six months and serum thyroid antibody determinations again performed. Another test that may give abnormal results in patients with CLT is the perchlorate discharge test. The approach to the patient with the solitary thyroid nodule differs from that of the previously described clinical presentations. The most important studies for the patient with a thyroid nodule are those designed to determine the structure and consistency of the thyroid gland, namely, ultrasonography to distinguish between solid and cystic lesions, and the radionuclide scan to determine whether the nodule is functioning (hot) or nonfunctioning (cold). To assure that the thyroid nodule is not associated with a nonsurgical lesion such as Hashimoto thyroiditis, serum thyroid antibody determinations are important. As malignancy of the thyroid gland is usually not associated with abnormalities of thyroid function, it is important to perform laboratory tests to exclude hyperthyroidism (a serum T3 determination) and hypothyroidism (a serum TSH determination) at the time of initial evaluation. Additional tests are usually not necessary unless the patient had mild hyperthyroidism with an autonomously functioning nodule, in which case the T3 suppression test and TRH test are often useful; rarely, the TSH stimulation test is helpful in determing whether thyroid tissue throughout the remainder of the gland is suppressed. A solitary, solid, nonfunctioning (cold) nodule requires excisional biopsy.

Hypothyroidism in patients treated with lithium: a review and two case reports

1973 ◽  
Vol 3 (3) ◽  
pp. 337-342 ◽  
Author(s):  
M. J. Crowe ◽  
G. G. Lloyd ◽  
S. Bloch ◽  
R. M. Rosser
Keyword(s):  
Thyroid Function ◽  
Case Reports ◽  
Lithium Treatment ◽  
Lithium Therapy ◽  
The Other ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Different Types

SYNOPSISTwo different types of hypothyroidism can occur during lithium administration, one with evidence of underlying thyroiditis, the other without. Two cases are reported, one of type 1, the other of type 2, and 17 other cases of lithium-induced hypothyroidism in the literature are reviewed. The literature on the occurrence of goitre during lithium treatment, and that on the alteration of thyroid function tests are also reviewed. Possible mechanisms for the disturbance of thyroid function are discussed and recommendations for managing this complication of lithium therapy are made.

Comparison of Various Treatment Schedules for Accelerating the Elimination of Radioiodine from the Thyroid and the Human Body

1975 ◽  
Vol 14 (03) ◽  
pp. 219-227
Author(s):  
D. P. Livadas ◽  
J. Sfontouris ◽  
A. D. Pharmakiotis ◽  
B. Malamos ◽  
D. A. Koutras
Keyword(s):  
Thyroid Function ◽  
Potassium Iodide ◽  
Plasma Protein ◽  
Human Body ◽  
The Body ◽  
Potassium Perchlorate ◽  
Thyroid Function Tests ◽  
Treatment Scheme ◽  
Function Tests ◽  
All Treatment

SummaryIn 68 euthyroid patients undergoing 131I thyroid function tests the thyroidal, urinary and plasma protein-bound radioactivity has been serially measured for 14 days. The patients were subdivided in controls and 9 groups treated with potassium iodide, Carbimazole, potassium Perchlorate and TSH, singly or in combination. The aim was to devise a treatment scheme for accelerating the release of iodine from the thyroid and the elimination from the body in cases of accidental radioiodine poisoning if the patient is seen after the radioiodine has already been taken up by the gland. All treatment schedules were effective, but TSH injections gave the best results, especially if combined with Carbimazole and potassium Perchlorate. This combination is the treatment of choice under these circumstances.

Lithium Therapy and Thyroid Function Tests

1984 ◽  
Vol 11 (1) ◽  
pp. 39-43 ◽  
Author(s):  
L. Smigan ◽  
A. Wahlin ◽  
L. Jacobsson ◽  
L. von Knorring
Keyword(s):  
Thyroid Function ◽  
Lithium Therapy ◽  
Thyroid Function Tests ◽  
Function Tests

scholarly journals Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Ulla Feldt-Rasmussen ◽  
Anne-Sofie Bliddal Mortensen ◽  
Åse Krogh Rasmussen ◽  
Malene Boas ◽  
Linda Hilsted ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Thyroid Diseases ◽  
Interindividual Variation ◽  
Reference Ranges ◽  
Thyroid Function Tests ◽  
Autoimmune Thyroid ◽  
Function Tests ◽  
Serum Tsh ◽  
In Pregnancy

Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable for thyroid dysfunction also in pregnancy. However, using serum TSH for control of treatment of maternal thyroid autoimmunity infers a risk for compromised foetal development. Peripheral thyroid hormone values are highly different among laboratories, and there is a need for laboratory-specific gestational age-related reference ranges. Equally important, the intraindividual variability of the thyroid hormone measurements is much narrower than the interindividual variation (reflecting the reference interval). The best laboratory assessment of thyroid function is a free thyroid hormone estimate combined with TSH. Measurement of antithyroperoxidase and/or TSH receptor antibodies adds to the differential diagnosis of autoimmune and nonautoimmune thyroid diseases.

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