PubMed · 48772
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D M Oxon. 1975-05-10. Cuthbert Leslie Cope.. https://pubmed.ncbi.nlm.nih.gov/48772/
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Comparative endocrine studies have notably advanced understanding of ecological factors that contribute to variation in human reproductive function. Such research has relied on methodological advances that permit hormone determinations in samples that are easily and safely collected, stored, and transported, most recently on measurement of steroids in saliva. This report seeks to further expand the scope of endocrine research by demonstrating the value of blood spot samples collected by finger prick. As a sampling strategy, finger-prick blood spot collection offers the advantages of short collection time, low invasiveness, repeatability, absence of postcollection processing, low biohazard risk, and ease of sample storage and transport. We document good sample stability and present sensitive assay methods for a range of steroids and proteins (FSH, LH, PRL, T, E2, DHEAS, androstenedione, cortisol, SHGB) in blood spots that require sample volumes of 3-12 microliters and display good reliability, specificity, precision, accuracy, and convertibility of results to plasma/serum equivalent concentrations. Laboratory evaluation was augmented by a feasibility study at a remote site in Papua New Guinea that confirmed validity and stability of blood spot collections under field conditions. Research applications of blood spot sampling are illustrated with a series of studies, including cross-sectional surveys for developmental and life span endocrinology, a longitudinal, population-based developmental epidemiologic study of puberty, and serial sampling in a dynamic study of neuroendocrine response to suckling. We conclude that the sampling features and wide range of measurable biomolecules of blood spots do constitute a methodological advance for endocrine research.
Endocrinologists were the first physicians to treat hyperthyroid patients with radioiodine. They performed the initial studies to determine dose requirements for treatment and devised the first diagnostic tests during radioiodine. Today very few endocrinologists use radioiodine in their practice, and most refer their patients to radiologists or nuclear medicine physicians for treatment. This policy poorly serves the patient and the public. It delays treatment, is inconvenient for patients, increases the cost of treatment (by adding another layer of specialty consultation), and potentially increases the possibility of error in administration of radioiodine--all undesirable effects. The actual administration of radioiodine is but a portion of the care of the patient, and it should be incorporated into the overall treatment of hyperthyroidism. Endocrinologists with their broad base of experience in all forms of thyroid disease and access to various forms of thyroid testing are in the best position to judge the timing and appropriateness of radioiodine treatment. The American Association of Clinical Endocrinologists has started an initiative with the aim of getting endocrinologists who are presently licensed to continue using radioiodine and helping other endocrinologists become licensed to treat their patients.
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