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PubMed1975

A strategy for thyroid function tests.

The concept of decision-aiding ranges were introduced to improve diagnostic efficiency. The clinical uncertainty in distinguishing borderline cases of hyperthyroidism and hypothyroidism among 1559 consecutive requests for thyroid function tests was 47%. This was reduced to 22% by using the free thyroxine index and to under 2% by using specific tests determined by the decision-aiding ranges.

Bayes Theorem↗
PubMed1980

Changes in thyroid function tests during danazol therapy.

Danazol is a synthetic steroid with antigonadotropic properties useful in treating endometriosis, especially in young infertile women. Prior to its availability for clinical use in September 1976, thyroid function studies other than thyroid-stimulating hormone (TSH), which was normal, had not been reported. Soon after danazol began to be used in the infertility clinic to treat documented endometriosis, it was observed that changes occurred in thyroid function studies. While no patients manifested clinical evidence of hypothyroidism, all 8 patients receiving 800 mg of danazol daily for 1 to 5 months had laboratory evidence of decreased thyroid function. The triiodothyronine (T3) uptake was elevated and the total serum thyroxine (T4) was decreased. The finding that TSH and the free thyroid index (FTI) were normal confirmed that these patients were euthyroid during danazol therapy. The abnormality of thyroid function tests is believed to reflect an androgen-like reduction in thyroxine-binding protein rather than a true decrease in thyroid function or interference with the pituitary-thyroid axis.

Danazol↗
PubMed1986

The effect of tamoxifen therapy on thyroid function tests.

Serum tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) concentrations were measured in 50 postmenopausal patients with breast cancer receiving tamoxifen therapy. Ten patients (20%) showed an elevation of serum total T4 concentrations and two of these patients showed additional elevation of serum total T3 levels. One patient had a persistently raised free T4 concentration and was considered to be thyrotoxic. Serum thyroxine-binding globulin (TBG) was estimated in six patients with elevated total T4 concentrations and was found to be raised in each case. Total serum T4 concentrations rose in seven of ten additional patients after starting tamoxifen therapy. However this change did not reach statistical significance. This trend in serum T4 concentrations was not shown in ten normal volunteers taking tamoxifen for 1 week.

Breast Neoplasms↗
PubMed1971

Diazepam and tests of thyroid function.

The effect of diazepam on thyroid function tests was examined in 12 euthyroid patients requiring the drug for psychiatric reasons and in six patients with thyrotoxicosis. Assessment was made before and after four weeks' therapy.There was no significant difference in results from tests of thyroid iodide trapping and binding (thyroid radioiodine uptake, thyroid clearance, and absolute iodine uptake) except in the one-hour thyroid uptake in the euthyroid group, which was increased after diazepam. This increase occurred without alteration in serum thyroid stimulating hormone levels. No change occurred in either group in tests of thyroid hormone release (protein-bound iodine, T-3 resin uptake, or Thyopac-3 and free thyroxine index).Patients with suspected thyroid disease who are taking diazepam do not need to stop therapy while their thyroid status is being determined.

Adult↗
PubMed1990

Thyroid function tests in amyloid goitre.

We present two patients with amyloid goitre due to primary systemic amyloidosis which was confirmed at post-mortem. Both were clinically euthyroid but had hyperthyroxinaemia and other thyroid function tests suggestive of thyrotoxicosis.

Adult↗