Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Thyroid Function Tests”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,027 records · Page 57Linked to original sources
PubMed1991

Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carcinoma.

The development of hypothyroidism following combined treatment for pharyngeal and laryngeal cancer has received little attention in the literature. We prospectively studied 32 patients over 4 years to determine the incidence of such hypothyroidism and to examine the effect of hemithyroidectomy associated with a combined treatment modality. All patients were men with pharyngeal or laryngeal squamous cell carcinomas and no prior history of thyroid disease. Treatment consisted of radical surgery (30 of 32 patients), followed by postoperative radiotherapy (31 patients). The results of thyroid function tests (free triiodothyronine, free thyroxine, and thyroid-stimulating hormone [TSH]) were all normal preoperatively; tests were repeated every 3 months after treatment. Elevation of TSH values in two successive blood samples was required to make a diagnosis of hypothyroidism. Of 12 patients who underwent hemithyroidectomy as part of total pharyngolaryngectomy and postoperative radiotherapy, 7 became hypothyroid a mean of 6 months after treatment. Twenty patients had similar combined treatment but without thyroid resection. Hypothyroidism developed a mean of 10 months after treatment in only four patients in this group (p less than 0.05). We conclude that hypothyroidism frequently develops following combined treatment for pharyngeal and laryngeal cancer even when thyroid resection has not been performed. Patients should be evaluated postoperatively and carefully monitored by means of serial thyroid function tests.

Carcinoma, Squamous Cell↗
PubMed1997

Graves' disease following thyrotoxic painless thyroiditis. Analysis of antibody activities against the thyrotropin receptor in two cases.

The exact immunologic mechanisms that lead to the emergence and progression of painless ("silent") thyroiditis remain unclear. We report two cases of painless postpartum thyroiditis followed by Graves' disease, where extensive immunologic evaluation supported a possible pathogenetic association. The time course of changes in thyroid function tests, 123I thyroidal uptake values, and thyrotropin receptor antibodies (TSHRAbs) were documented. The existence of stimulating TSHRAbs (TSAbs) activating the cyclic adenosine monophosphate (cAMP) and phosphatidylinositol 4,5-bisphosphate (PIP2) signal cascades and their functional epitopes, as well as two different thyrotropin-binding inhibitory immunoglobulins (TBII) were documented in both patients at the time of diagnosis of Graves' disease. We suggest that susceptible persons may develop an immunologic response that can trigger the appearance of a mixture of species of TSHRAbs, which in turn may lead to the sequential occurrence of painless thyroiditis and Graves' disease. Additionally, the multiple phases of hyperthyroidism and hypothyroidism that can occur in these patients may reflect the existence and changing spectrum of TSHRAbs in their sera.

Adolescent↗
PubMed1997

Endocrinologic causes of peripheral neuropathy. Pins and needles in a stocking-and-glove pattern and other symptoms.

In the Western world, diabetes is the biggest cause of peripheral neuropathy, usually distal symmetric polyneuropathy but some times another polyneuropathy or a focal neuropathy. In addition, hypothyroidism and acromegaly can cause carpal tunnel syndrome and other sensory complaints. A complete blood cell count, nerve-conduction tests, thyroid-function tests (needed in all patients with carpal tunnel syndrome), and when necessary, needle electromyography can help confirm the diagnosis. Treatment of underlying disease is the most successful management approach: Tight glucose control in diabetic patients, thyroid hormone replacement therapy in patients with hypothyroidism, and removal of the pituitary adenoma in patients with acromegaly are of proven benefit. Significant symptomatic relief of dysesthesias can be obtained with use of capsaicin cream, tricyclic antidepresants, anticonvulsant agents, or an antiarrhythmic drug.

Diabetic Neuropathies↗
PubMed1994

Familial dysalbuminaemic hyperthyroxinaemia and inherited partial TBG deficiency: first report.

BACKGROUND: Abnormalities of the serum thyroid hormone binding proteins are not uncommon but, when properly assessed, they do not present diagnostic difficulties. In contrast, the presence of two inherited defects of thyroid hormone transport, of the type presented in the family described here, may cause a major problem in diagnosis and has not been described previously. METHODS: All conventional thyroid function tests were carried out. In addition, thyroid hormone binding to serum proteins was assessed by agarose gel electrophoresis, and thyroxine binding globulin by immunoassays and by immunodiffusion. The affinity of TBG for thyroxine and its maximal binding capacity were assessed by Scatchard analysis. RESULTS: Tests carried out on 22 members of the family revealed familial dysalbuminaemic hyperthyroxinaemia in 10 family subjects. All five living siblings of the propositus had familial dysalbuminaemic hyperthyroxinaemia and two tested transmitted this trait to their children and grandchildren. This was not the case with the propositus. Partial thyroxine binding globulin deficiency only, inherited presumably from the propositus' mother, was found in two family members. Both thyroxine binding globulin deficiency and familial dysalbuminaemic hyperthyroxinaemia were detected in the propositus and in his male nephew, masking the typical laboratory abnormalities associated with each of these defects. CONCLUSIONS: Coexistence of two inherited defects of thyroid hormone transport proteins produce atypical thyroid function test abnormalities, which can be misinterpreted as thyroid hormone dysfunction.

Adult↗
PubMedDate not supplied

Thyroid function in patients with Alzheimer disease: implications on response to anticholinesterase treatment.

Increasing evidence supports an extensive interrelationship between thyroid hormones and the cholinergic system, which is selectively and early affected in Alzheimer disease (AD). The aim of the present study was to explore thyroid function in patients with AD before and after acetylcholinesterase inhibition treatment to possibly identify variances in response. Thyroid function tests were evaluated in 28 AD patients and 24 age and sex-matched controls. Nineteen of the patients were reevaluated after (4 mo) treatment with donepezil. Serum thyrotropin (TSH), triiodothyronine (T3), thyroxine (T4), the free fractions (fT3, fT4) and thyroid autoantibodies were determined using standard methods. All subjects were clinically euthyroid. Patients presented with higher fT4 and anti-thyroperoxidase levels, as compared with the controls. Significant reduction in T4, fT3, fT4, and anti-thyroperoxidase levels were observed 4 months after treatment. Responders had higher T4 and fT4, than nonresponders, followed by significant reductions after treatment. The above, within the normal range alterations, may represent a direct effect on hormone release from the thyroid gland and/or increased conversion of T4 to T3 within the brain. Higher T4 and fT4 levels before treatment might predict a favorable response to donepezil treatment.

Aged↗
PubMed2004

A patient with low free T4 and low thyroid-stimulating hormone without hypopituitarism.

A 39-year-old entertainer was referred in November 2000 for suspected secondary hypothroidism found during a routine insurance check. Thyroid stimulating hormone (TSH) was 0.30 mIU/L (NR 0.47-4.68 mIU/L) and total T4 was 21.6 nmol/l (NR 57.9-154.4 nmol/l). She had enjoyed good past health and gave birth to a baby girl at 32 weeks gestation in July 2000. She was clinically euthyroid and there was no goiter. Menses was regular with oral contraception. Thyroid function was rechecked with free T4 7.9 pmol/1 (NR 10.2-19.6 pmol/1) and TSH 5.44 mIU/l (NR 0.3-4 mIU/l). Further inquiry revealed that she had been taking a weight reducing drug since December 1999 for fear of potential weight gain during pregnancy. This was identified to be Tri-iodothyroacetic acid (Triac). Serial thyroid function tests showed gradual recovery of thyroid function after Triac was stopped.

Adult↗
PubMed1983

[Transient biological hypothyroidism in an infant carrier of celiac disease].

This is the first report of a coeliac infant with biochemical findings of primary thyroid failure (decreased T4, decreased FT4, decreased T3, increased TSH). No clinical signs of this disorders and no thyromegaly were observed. Biochemical indices of thyroid function reverted to normal after two months on a gluten-free diet. Thyroid function impairment is suggested to be related with the active phase of coeliac disease.

Celiac Disease↗
PubMed1998

Treatment of nausea and vomiting in pregnancy. When should it be treated and what can be safely taken?

Nausea and vomiting are both common in early pregnancy. Most cases are mild and do not require treatment. However, persistent vomiting and severe nausea can progress to hyperemesis if the woman is unable to maintain adequate hydration, and fluid and electrolyte as well as nutritional status are jeopardised. Hyperemesis gravidarum is a diagnosis of exclusion, characterised by prolonged and severe nausea and vomiting, dehydration, ketosis and bodyweight loss. Investigation may show hyponatraemia, hypokalaemia, a low serum urea level, metabolic hypochloraemic alkalosis and ketonuria. The haematocrit is raised and the specific gravity of the urine is increased. There may be associated liver function test abnormalities and abnormal thyroid function tests, with biochemical thyrotoxicosis with raised free thyroxine levels and/or suppressed thyroid-stimulating hormone levels. The pathophysiology of hyperemesis is poorly understood. Various hormonal, mechanical and psychological factors have been implicated. Studies have demonstrated a direct relationship between the severity of hyperemesis, the degree of biochemical hyperthyroidism and the levels of human chorionic gonadotrophin (hCG). Management of hyperemesis should include hospitalisation, intravenous fluid and electrolyte replacement, thiamine (vitamin B1) supplementation, use of conventional antiemetics and psychological support. Most patients improve spontaneously with the help of the above measures without long term sequelae. Conventionally, antiemetics are not usually prescribed, especially before 12 weeks gestation, except for women with hyperemesis. This reluctance relates to fears which are often unfounded concerning the teratogenic effects of antiemetics. Severe hyperemesis, refractory to conventional management with intravenous fluids and antiemetics is a rare, miserable and disabling condition, associated with multiple hospital admissions, time away from work and the family, and psychological morbidity. If inadequately or inappropriately treated, it may cause Wernicke's encephalopathy, central pontine myelinolysis and death. In extreme cases, women may request, or their obstetricians recommend, termination of the pregnancy. There are uncontrolled data supporting a beneficial effect of corticosteroids in these women, and a randomised placebo-controlled trial is currently in progress.

Antiemetics↗
PubMed2003

Newborn screening for congenital hypothyroidism in Khon Kaen University Hospital, the first three years, a preliminary report.

Between January 2000 and December 2002, 9,558 of 10,868 live births at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand, were screened for congenital hypothyroidism (CH). Dried blood spot thyroid stimulating hormone (TSH) was collected at age 48 hours or older. The cut-off TSH level for recall test was > 25 mu/L. Serum thyroxine (T4), Free T4 and TSH were performed during the confirmatory test. Six of 24 infants recalled for confirmatory thyroid function tests had abnormal tests. Primary CH was confirmed in 3 infants and thyroxine treatment was given. Two of the three infants had thyroid dysgenesis, one had normal thyroid gland. Three infants showed borderline CH from the confirmatory test, only one had borderline CH from the second confirmatory test and also received thyroxine treatment. Twenty infants with false positives during the screening and confirmatory tests were regularly followed-up for growth, development and thyroid function tests. The incidence of primary CH in this sole tertiary care government hospital in Northeast Thailand was 1:3,186. Routine newborn CH screening would ensure early detection and treatment.

Congenital Hypothyroidism↗
PubMedDate not supplied

[Subclinical thyroid disease--should we treat, should we screen for it?].

Subclinical thyroid disease is defined by an abnormally high (subclinical hypothyroidism) or low (subclinical hyperthyroidism) serum thyrotropin (TSH) with peripheral thyroid hormone concentrations within the laboratory reference ranges. Such abnormalities in thyroid function tests are very common in the population and have been extensively dealt with in textbooks and reviews. Subclinical hypothyroidism is common especially in elderly women. There is no clear evidence to date that subclinical hypothyroidism causes clinical hearth disease. However, mild thyroid gland failure, evidenced solely by elevation of the serum TSH concentration, may be associated with increased morbidity, particularly for cardiovascular disease and subtly decreased myocardial contractility. In subclinical hypothyroidism both cardiac structures and function remain normal at rest, but impaired ventricular function as well as cardiovascular and respiratory adaptation to effort may became unmasked during exercise. These changes are reversible when euthyroidism is restored. Subclinical hypothyroidism does result in small increase in low density lipoprotein cholesterol and a decrease in high density lipoprotein, changes that enhance the risk for development of atherossclerosis and coronary artery disease. Because undetected subclinical hypothyroidism during pregnancy may adversely affect the neuropsychological development and survival of the fetus and be associated with hypertension and toxemia, screening pregnant women has been advocated. In addition, data suggesting that subclinical hypothyroidism is associated with ovulatory dysfunction and infertility may make screening worthwhile in this population as well. The combination of an undetectable serum thyrotropin concentration, as measured by an assay with a threshold of detection that is 0.1 mU per liter or less, and normal serum triiodothyronine and thyroxine concentrations (usually at the upper end of the normal range) is known as subclinical hyperthyroidism. This condition reflects the facts that before clinical features of thyrotoxicosis are apparent, the thyrotrophs usually respond to minor increments in thyroid hormone concentrations, which remain within the normal range, by switching off the production and secretion of thyrotropin. In the absence of clinical signs of thyroid disease, and even after additional investigations such as isotope uptake and imaging and measurement of the thyrotropin receptor antibody concentration, it may be difficult to decide whether the pattern seen on thyroid function tests is a consequence of nonthyroidal illness and concomitant medication, underlyling thyroid autonomous function or the initial phase of thyroiditis. Routine screening for thyroid disease with thyroid function tests is not recommended for asymptomatic children or adults. This recommendation does not mean that clinicians should not monitor thyroid function in patients with a previous history of thyroid disease. There is insufficient evidence to recommend for or against screening for thyroid disease with thyroid function tests in high-risk patients, including elderly persons, postpartum women, and persons with Down syndrome, but recommendations may be made on other grounds, such as the higher prevalence of disease and the increased likelihood that symptoms of thyroid disease will be overlooked in these patients. If screening is performed, the preferred test is measurement of thyroid-stimulating hormone (TSH) using a sensitive immunometric or similar assay, because of its superior sensitivity and specificity.

Female↗
PubMed1985

Thyroid dysfunction in Down syndrome.

We investigated the thyroid function of 151 patients with Down syndrome. Compared with a control group of 89 siblings nearest in age to their brother or sister with Down syndrome, the mean thyroid-stimulating hormone (TSH) value was significantly higher in patients with Down syndrome than in subjects without Down syndrome. However, the mean thyroxine (T4) levels in both groups were nearly the same. In the Down syndrome group there was a trend for TSH values to increase and for T4 values to decrease with advancing age. Of the 151 patients with Down syndrome, ten had both significantly elevated TSH levels (greater than or equal to 9.5 microU/mL) and significantly decreased T4 levels (less than or equal to 5.5 micrograms/dL), 21 had only abnormally high TSH values, seven had only markedly increased T4 levels (greater than or equal to 12.0 micrograms/dL), and three had only significantly decreased T4 levels. The intellectual function of patients with both abnormal TSH and T4 levels was significantly lower (mean IQ, 41.7) than that of Down syndrome patients with only increased TSH values (mean IQ, 53.8) and that of Down syndrome patients with normal thyroid function (mean IQ, 55.3). This study provides further evidence that there is an increased prevalence of thyroid dysfunction in patients with Down syndrome.

Adolescent↗
PubMed1978

Thyroid function during pregnancy with special reference to hydatidiform mole and hyperemesis.

The thyroid function tests, serum protein-bound iodine (PBI), serum triiodothyronine reaction (T3-test) and serum cholesterol were measured in three groups of pregnant women: 1) 57 with normal pregnancy, 2) 35 with hyperemesis and 3) 14 with hydatidiform mole. A pattern of high values of PBI and T3-test and relatively low values of cholesterol in most of the patients with hydatidiform mole, and in almost one third of the patients with hyperemesis was found. A positive correlation of the volume of molar tissue and the values of PBI was observed. The treatment of patients with hyperemesis mostly resulted in normalisation of the thyroid function tests, while this was not the case in patients with mole. It is suggested that there might be a common cause of the thyroid stimulation in patients with mole and hyperemesis.

Cholesterol↗
PubMed1997

Thyroid dysfunction in patients with amyloid goitre.

OBJECTIVES: Widespread amyloid deposition in the thyroid gland causes diffuse, clinically apparent enlargement of the thyroid (amyloid goitre: AG). The aim of this study was to clarify the abnormalities of thyroid function in patients with AG. DESIGN: Thirty patients with secondary amyloidosis were retrospectively analysed. Their thyroid status was evaluated using the results of routine thyroid function tests and measurement of thyroid autoantibodies. Thyroid needle biopsy was carried out to identify amyloid deposition in the thyroid gland. RESULTS: Thyroid enlargement was observed in 19 (63%) of 30 patients with amyloidosis. Eleven of these 19 patients had a thyroid biopsy and/or autopsy and amyloid deposition was histologically revealed in 10 (defined as AG) of these 11 patients. Nine of 10 patients (90%) with AG had abnormalities of thyroid function, including five patients with hypothyroidism, one with hyperthyroidism, one with transient hypothyroidism, and two with low T3 syndrome. Five had thyroid autoantibodies. The patient with hyperthyroidism had positive thyroid stimulating antibody (TSAb) and high 131I thyroidal uptake, suggesting the coexistence of Graves' disease. Another patient suffered from thyroidal pain and showed transient hypothyroidism, high level of serum thyroglobulin and low thyroidal uptake of 123I, the clinical course being compatible with subacute thyroiditis. CONCLUSIONS: The incidence of thyroid abnormalities accompanied by AG, although asymptomatic, is unexpectedly high. Thyroid function should therefore be regularly assessed during follow-up of patients with systemic amyloidosis.

Adult↗
PubMed1991

Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom.

Increasing use of assays for TSH with improved sensitivity as a first-line test of thyroid function has raised questions regarding prevalence and clinical significance of abnormal results, especially values below normal. We have assessed the thyroid status of 1210 patients aged over 60 registered with a single general practice by measurement of serum TSH using a sensitive assay. High TSH values were more common in females (11.6%) than males (2.9%). TSH values below normal were present in 6.3% of females and 5.5% of males, with values below the limit of detection of the assay present in 1.5% of females and 1.4% of males. Anti-thyroid antibodies were found in 60% of those with high TSH but only 5.6% of those with subnormal TSH. Eighteen patients were hypothyroid (high TSH, low free thyroxine) and one thyrotoxic (low TSH, raised free thyroxine) at initial testing. Seventy-three patients with elevated TSH but normal free T4 were followed for 12 months; 13 (17.8%) developed low free T4 levels and commenced thyroxine, TSH returned to normal in four (5.5%) and 56 (76.7%) continued to have high TSH values. Sixty-six patients with TSH results below normal were followed. Of the 50 subjects with low but detectable TSH at initial testing, 38 (76%) returned to normal at 12 months; of those 16 with undetectable TSH followed, 14 (87.5%) remained low at 12 months. Only one subject (who had an undetectable TSH) developed thyrotoxicosis. In view of the marked prevalence of thyroid dysfunction in the elderly, we suggest that screening of all patients over 60 should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗