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PubMed2004

Human fetal and cord serum thyroid hormones: developmental trends and interrelationships.

Thyroid hormone is essential for fetal and neonatal development in particular of the brain, but little is known about regulation of fetal thyroid hormone levels throughout human gestation. The purpose of this study was to clarify developmental trends and interrelationships among T(4), free T(4) (FT4), thyroxine-binding globulin (TBG), TSH, T(3), rT(3), and T(4) sulfate (T4S) levels in cord and fetal blood sera (n = 639, 15-42 wk gestation) and correlate infant levels (23-42 wk gestation) to maternal values (n = 428, 16-45 yr) and those of nonpregnant women (n = 233, 16-46 yr). In cord and fetal serum, T(4), T(3), and TBG levels increase with gestation until term; TSH, FT4, T4S, and rT(3) levels increase and peak in the late second/early third trimester and then decline to term; T(4)/TBG ratios increase until late second trimester and plateau to term. Term cord sera TSH, TBG, and all iodothyronine levels, except T(3), are higher than nonpregnant women. In the third trimester, cord serum FT4, TSH, rT(3), and T4S levels are also higher than corresponding maternal levels, but T(4), T(3), and TBG levels are lower than maternal values. The late second/early third trimester is a critical transition period in fetal thyroid hormone metabolism, which may be interrupted by preterm birth and contribute to postnatal thyroid dysfunction.

Cohort Studies↗
PubMed2005

[Prevalence of thyroid autoimmunity in a group of patients with type 1 diabetes mellitus in Londrina, PR].

UNLABELLED: Thyroid autoimmunity is a frequent comorbid condition subjects with in type 1 diabetes mellitus (DM1). We evaluated the prevalence of antithyroid autoantibodies (antimicrosomal, antithyroglobulin and antithyroid peroxidase), in addition to clinical (gender, age, DM duration) and laboratory (TSH, HbA1) characteristics of 101 patients (mean age 20 +/- 9.6 years; 62 female) followed at the HC/UEL. RESULTS: Autoantibodies were found in 31 subjects (30.7%). In the age group <12 years, 15% had thyroid antibodies; from 12 to 18 years, 32%, and >18 years, 35.7% (p= 0.22). Among the patients with positive antibodies, 40% had some thyroid dysfunction vs only 4.4% of those without antibodies (p<0.001). The average TSH was higher in the positive than in negative group (3.75 and 2.32microU/mL, respectively; p= 0.01). CONCLUSIONS: The prevalence of thyroid antibodies was 30.7%, in accordance to the literature.

Adolescent↗
PubMed2006

The importance of amiodarone pulmonary toxicity in the differential diagnosis of a patient with dyspnea awaiting a heart transplant.

Amiodarone is a class III antiarrhythmic medication used extensively to treat ventricular arrhythmias. It is pharmacologically classified as a cationic amphiphilic drug due to its polar and apolar components. During the past few years, amiodarone has proved to be an effective treatment therapy for patients with ventricular dysfunctions, regardless of the etiology, and in particular ventricular arrhythmia associated with Chagas disease. Nevertheless, despite its hemodynamic and electrophysiological benefits, amiodarone produces serious collateral effects such as a bluish skin discoloration, photosensitivity, thyroid dysfunction, corneal deposit, peripheral neuropathy, bone marrow suppression, hepatitis, heart blocks, pneumonitis, among others. The objective of this case report is to discuss one of the most serious complications related to amiodarone, pulmonary toxicity, which is described as a differential diagnosis for a chagasic patient that was on the waiting list for a heart transplant. Amiodarone pneumonitis is a relevant differential diagnosis for heart failure (HF) patients using amiodarone that are admitted to the emergency ward with dyspnea.

Adult↗
PubMedDate not supplied

[Physical therapy in the complex treatment of thyroiditis].

Pathogenetic approaches (clinico-anatomic, structural features of thyroid epithelium, echographic signs, functional activity of the thyroid) served the basis for division of inflammatory diseases into 4 groups. A wide spectrum of physiotherapeutic procedures are suggested for treatment of thyroiditis. There may be different combination of physiotherapy with medication. The response was assessed by ultrasonography and dopplerography evidence. Physiotherapy potentiates the action of drugs and can be also used as monotherapy in dysfunctional thyroid pathology.

Anti-Inflammatory Agents↗
PubMed1981

Surgical treatment for Graves' disease: a long term follow-up of 325 patients.

Postoperative thyroid status was classified into 6 categories on the basis of serum free thyroxine index (FTI), serum triiodothyronine (T-3) and serum TSH concentration. Review of 325 patients who underwent thyroidectomy for Graves' disease more than 4 years previously showed that 25 patients (7.7 per cent) had recurrent hyperthyroidism. Six patients (1.8 per cent) were classified as equivocal hyperthyroid since either FTI or T-3 was above the normal range. Two hundred and twenty-two patients (68.3 per cent) were unequivocally euthyroid and 33 patients (10.3 per cent) were euthyroid with elevated TSH levels. Twenty patients (6.2 per cent) were equivocal hypothyroid since either their FTI or T-3 values were below the normal range and TSH were increased. Hypothyroidism was present in 19 patients (5.8 per cent), of whom 11 had no clinical manifestation of thyroid dysfunction. The incidence of hypothyroidism did not correlate with the intervals between operation and review. The second review, performed in 189 patients 18 months after the first, showed that there was a change in thyroid functional status in 46 patients, of whom 32 had an increased level of function, including one hypothyroid and 7 equivocal hypothyroid patients who became euthyroid spontaneously. Thus postoperative hypothyroidism in some patients can recover without medication. Also thyroid function in some postoperative patients is not maintained at a fixed level but may fluctuate.

Adult↗
PubMed1997

Effects of low level radiation from the Chernobyl accident in a population with iodine deficiency.

UNLABELLED: To determine the effects of low dose radiation from 131I and 137Cs resulting from the Chernobyl disaster on the expression of endemic goiter in children, we studied children in regions with and without evidence of radiocontamination but comparable iodine insufficiency. We included 89 children in the study (radiocontaminated) region (SR) and 116 in the control region (CR) because they were either fetuses, infants, or pre-adolescents at the time of exposure. We evaluated thyroid dimensions by clinical examination and ultrasound; thyroid function by hormonal levels, and thyroglobulin measurement; histology of the thyroid by fine needle aspiration; and thyroid autoimmunity. SR subjects had 5 times the frequency of thyroid enlargement as those from CR, greatest in the younger patients. There were no instances of clinically apparent thyroid dysfunction. Antithyroid microsomal and antithyroglobulin antibodies were present in a markedly greater percentage of SR subjects. Fine needle biopsy demonstrated greater cellular proliferation in samples from SR. CONCLUSIONS: We have demonstrated findings of autoimmune thyroid disease at markedly increased frequency in a population of children with poor iodine nutriture who were exposed to low level radiation, compared to a more iodine deficient population not so exposed. These results suggest that low level radiation may induce thyroid gland changes in children who have inadequate iodine intake nutriture and reinforce the importance of adequate dietary iodine.

Adolescent↗
PubMed2006

The natural history of euthyroid Hashimoto's thyroiditis in children.

OBJECTIVE: To study the natural history of Hashimoto's thyroiditis (HT) in children and identify factors predictive of thyroid dysfunction. STUDY DESIGN: We evaluated 160 children (43 males and 117 females, mean age 9.10 +/- 3.6 years, with HT and normal (group 0; 105 patients) or slightly elevated (group 1; 55 patients) serum thyroid-stimulating hormone (TSH) concentrations. The patients were assessed at presentation and then followed for at least 5 years if they remained euthyroid or if their TSH did not rise twofold over the upper normal limit. RESULTS: At baseline, age, sex, thyroid volume, free thyroxine, free triiodothyronine, thyroid peroxidase antibody (TPOab), and thyroglobulin antibody (TGab) serum concentrations were similar in the 2 groups. During follow-up, 68 patients of group 0 remained euthyroid, and 10 patients moved from group 0 to group 1. In 27 patients, TSH rose twofold above the upper normal limit (group 2), and 9 of these patients developed overt hypothyroidism. Sixteen patients of group 1 ended up in group 0, 16 remained in group 1, and 23 moved to group 2. A comparison of the data of the patients who maintained or improved their thyroid status with those of the patients whose thyroid function deteriorated revealed significantly increased TGab levels and thyroid volume at presentation in the latter group. However, none of these parameters alone or in combination were of any help in predicting the course of the disease in a single patient. CONCLUSIONS: The presence of goiter and elevated TGab at presentation, together with progressive increase in both TPOab and TSH, may be predictive factors for the future development of hypothyroidism. At 5 years of follow-up, more than 50% of the patients remained or became euthyroid.

Child↗
PubMedDate not supplied

[Silent thyroiditis and postpartum thyroiditis].

OBJECTIVE: Six cases of silent thyroiditis are described. Clinical, analytical, therapeutical and prognostical features are reviewed. DESIGN: Descriptive and retrospective study. SETTING: Outpatient endocrinological clinic of a General Hospital PATIENTS OR OTHER PARTICIPANTS: Six women (age 26-41 years) that fulfil clinical and analytical criteria of silent thyroiditis. In 4 patients thyroiditis was diagnosed in the postpartum period and in the remaining 2 there was no relationship with pregnancy. MAIN MEASUREMENTS AND RESULTS: Serum levels of thyroid hormones and thyroglobulin and thyroid peroxidase antibodies were measured in all patients. Follow-up period was between 12 and 41 months. The 2 patients with the sporadic form of silent thyroiditis showed clinical and analytical data of thyrotoxicosis that spontaneously resolved. The remaining 4 patients presented with hypothyroidism. In one of them the hypothyroidism spontaneously resolved, in 2 it became permanent and in a further one it developed to subclinical hypothyroidism. CONCLUSIONS: Silent thyroiditis (sporadic or postpartum) is a frequent disorder, usually benign and transient. It can present in different clinic forms and evolve to resolution of permanent thyroid dysfunction.

Adult↗
PubMedDate not supplied

Reduction of thyroid hormone receptor c-ERB A alpha mRNA levels in the hippocampus of Alzheimer as compared to Huntington brain.

A history of thyroid dysfunction has been cited as a possible risk factor for Alzheimer's disease (AD). Neurologic symptoms displayed by hypothyroid patients resemble, in part, those manifested by Alzheimer patients. To determine if a relationship exists between thyroid hormone receptor message levels and AD, in situ hybridization with tritiated antisense RNA probes for thyroid hormone receptors was used to examine the expression of these genes in Alzheimer and Huntington brain tissue. Message levels for a thyroid hormone receptor highly expressed in brain (c-ERB A alpha) was reduced by 52% in CA1 and 43% in CA2 in Alzheimer hippocampus as compared to Huntington controls. In contrast, message levels for another form of thyroid hormone receptor (c-ERB A beta 1) in Alzheimer hippocampus were not significantly different from Huntington controls. Temporal and cerebellar levels of c-ERB A alpha were elevated by 1.6-fold whereas temporal but not cerebellar levels of c-ERB A beta 1 were elevated 2.0-fold in Alzheimer brain. There was no correlation between thyroid hormone receptor levels and brain weight, autopsy interval, patient age, or the extent of neurofibrillary degeneration. Instead, decreased thyroid hormone receptor mRNA levels in Alzheimer-affected hippocampus were due to an increase in the percentage of neurons expressing lower message levels for these proteins.

Alzheimer Disease↗
PubMed2026

Perinatal depression, maternal thyroid status and fetus/infant health and development: A systematic review.

BACKGROUND: Thyroid hormones are known to influence both maternal depression and child developmental outcomes, while maternal depression independently affects child outcomes. The potential interaction between thyroid dysfunction and depression in shaping child development remains insufficiently explored. The present study addresses such interplay. METHODS: Following PRISMA 2020 and JBI guidelines, three databases were searched through December 2025 for primary studies on maternal thyroid status, perinatal depression, and child development. Risk of bias (RoB) was assessed using validated tools. Due to clinical and methodological heterogeneity, data were synthesized narratively following SWiM guidelines. RESULTS: Eleven studies were included. Beyond independent risks for preterm birth and behavioral problems, limited evidence supports a synergistic model, while most studies likely reflect the simple co-occurrence of risks. Maternal thyroid peroxidase antibodies (TPO-Ab) were associated with child externalizing problems exclusively in the presence of clinical depression. High depressive symptoms also attenuated the cognitive benefits of prenatal iodine supplementation. Thyroid status appears to function as a risk moderator rather than a mediator. However, 50% of observational studies presented high RoB, primarily due to participant attrition. CONCLUSION: Findings are still scarce to support a synergistic risk model where specific maternal thyroid parameters (i.e. thyroid autoimmunity and iodine status) may moderate the impact of depressive symptoms on child development. Despite the high RoB in half of the studies, results highlight the need for integrated screening protocols. Simultaneously assessing mental health and thyroid status may optimize risk stratification for high-risk mother-infant dyads.

Female↗
PubMed2006

The role of selenium in thyroid autoimmunity and cancer.

The essential micronutrient selenium (Se) occurs in the form of the amino acid selenocysteine in selenoproteins which exert various effects, while maintaining the cell reduction-oxidation balance. The discovery that all three deiodinases that convert thyroxine (T4) into triiodothyronine (T3) contain selenocysteine illustrates how the production of the active thyroid hormone is dependent on Se status. The selenoenzyme families of glutathione peroxidases (GPx) and thioredoxin reductases (TRx) possess powerful antioxidant properties and form a complex defense system that protects thyrocytes from oxidative damage. Se supplementation in patients with autoimmune thyroiditis seems to modify the immune response, probably by enhancing plasma GPx activity and decreasing excess levels of hydrogen peroxide. However, the enhancement of immunocompetence may also be the result of the synergistic action of various selenoproteins and not exclusively of GPx. There is evidence supporting considerable oxidative stress in Graves' disease where Se supplementation, because of its free radical scavenging properties, may increase the enzymatic antioxidant activity. TRx has been found significantly elevated in GD revealing its involvement in the pathogenesis of this condition and representing a potential future target for therapeutical intervention. Low Se serum levels have also been associated with increased risk of thyroid cancer and may play a role in carcinogenesis. It is noteworthy, that the Food and Drug Administration has recently determined that there is sufficient evidence to warrant a qualified health claim for Se and cancer. Furthermore, the recent discovery that defects in the SECIS-binding protein 2 (SBP2), which is an indispensable protein for the incorporation of Se into the selenoproteins, result in thyroid dysfunction, together with the recognition of the many roles of selenoprotein P in Se distribution and storage in the human body, reveal not only the indispensability of Se and the selenoproteins as essential factors in thyroid metabolism and pathogenesis, but open up new prospects for enhanced treatment.

Animals↗
PubMed2002

Hypothyroidism in patients older than 55 years: an analysis of the etiology and assessment of the effectiveness of therapy.

BACKGROUND: Several epidemiological studies on the prevalence of hypothyroidism in the elderly have been reported; however, extensive series of elderly patients with thyroid dysfunction have not been studied. Our aim has been to assess the relative frequency of the diverse causes of hypothyroidism in a group of patients older than 55 years and the adequacy of control of thyroid function attained by levothyroxine therapy. METHODS: We performed a descriptive, observational, cross-sectional study in the setting of a hospital endocrinology clinic. From a total of 1581 patients older than 55 who were complaining of a thyroid disorder, we studied a group of 655 patients with hypothyroidism. There were 559 women (85.3%, age 65.01 +/- 7.90 years) and 96 men (14.7%, 65.36 +/- 8.39 years). In every patient, we collected etiology, presence of goiter, time of evolution from diagnosis and from therapy prescription, previous and present treatments, current thyroid functional status (free thyroxine and thyrotropin concentration), adequacy of disease control, and thyroid autoimmune status. RESULTS: The causes of hypothyroidism were as follows: autoimmune thyroiditis, 308 (47.0%); postoperative hypothyroidism, 175 (26.7%); therapy for previous thyrotoxicosis, 63 (9.6%); thyrotropin deficiency, 15 (2.3%); iodine excess, 6 (0.9%); subacute thyroiditis, 2 (0.3%); and unknown etiology, 86 (13.1%) patients. Most patients with autoimmune thyroiditis were positive for thyroid peroxidase antibodies at the time of the study (94.4%). Mean (+/- SD) age at diagnosis was 61.8 +/- 9.4 years in men and 59.8 +/- 9.7 years in women. Median (range) duration of hypothyroidism was 1.4 (0-18) years in men and 3 (0-45) years in women ( p <.05). Adequacy of therapy was studied in 385 patients treated with replacement doses of levothyroxine. Two hundred and sixty (67.5%) of these subjects attained good control, whereas 125 (32.5%) showed inadequate control of the disease at the time of the study. A model of logistic regression showed that adequacy of therapy was dependent on the duration of therapy, but independent of age, gender, degree of hypothyroidism, etiology, autoimmune status, age at diagnosis, and dose of levothyroxine. A 2-year follow-up study performed in 56 newly diagnosed patients showed that an adequate control of hypothyroidism was attained in 35 (62.5%) patients at 6 months, in 46 (82.1%) patients at 1 year, and in 49 (87.5%) at 2 years of therapy with levothyroxine. CONCLUSIONS: Autoimmune thyroiditis and postoperative hypothyroidism are the main causes of thyroid hypofunction in patients older than 55 years. The time from starting therapy is the main determinant of the adequacy of control of thyroid hypofunction in this population. With effective therapy and appropriate monitoring, more than 80% of the patients showed adequate control within 1 year of follow-up.

Cross-Sectional Studies↗
PubMed1992

Thyrotrophin-blocking antibodies in congenital hypothyroidism.

The role of transplacental transfer of maternal thyrotrophin (TSH)-blocking antibodies causing congenital hypothyroidism in Southern Chinese children was examined in this study. Twenty-two mothers of 24 patients with congenital hypothyroidism were studied 3-5 years after delivery. None of them had thyroid dysfunction at delivery or at the time of study. None had antithyroglobulin or antimicrosomal antibody. Only one mother was found to have TSH-binding inhibitory immunoglobulin (TBII), and her child had agenesis of the thyroid. This women had Graves disease in remission for 2 years before delivery. None had TSH-stimulated cAMP response inhibitory immunoglobulin (TSII). Ten of the 24 congenital hypothyroid children had transient neonatal hypothyroidism, seven had agenesis of the thyroid, six had dyshormonogenesis and one had a sublingual thyroid. As none of the mothers who had children with transient neonatal hypothyroidism had blocking antibodies at the time of study, the aetiology of the transient neonatal hypothyroidism remains unclear. These data suggest that maternal TSH-blocking antibodies do not play a role in most cases of sporadic congenital hypothyroidism.

Antibodies↗
PubMed1987

[Importance of the assay of T3 and T4 tears and plasma for the diagnosis of endocrine exophthalmos].

In the control subject, the thyroidal hormones have been found to be always present in similar quantities in both eyes tears. The proportion of T3 is much more important in the tears (23-40%) than in the plasma (1-2%). It is close to the concentration of deiodinated T4 found in many tissues. In ocular tissues, the T3 is thus very little or even not broken down. This led us to define the tear plasma relationship parameters. We studied lacrimo-plasmatic thyroidal parameters in cases with thyroidal dysfunction without ocular affection: 3 cases of hyperthyroidism, and 2 of hypothyroidism, to study modifications in case of endocrinal problems only. We also studied various types of exophthalmos: 31 cases of endocrine exophthalmos, whether the thyroidal plasma values were normal or not, and 2 cases of exophthalmia with expansive orbital hyperplasia in which there had been no previous thyroidal disturbance. An exophthalmia patient studied, including those with expansive orbital tissue, important changes, specific enough were associated in the tear/plasma parameters, correlated with the changes in the retro-orbital muscular tissues or fat detected by scanning. The study of these parameters, lacrimal thyroid is thus interesting for the diagnosis of endocrine exophthalmos and shows that only a local modification of the metabolism of T3 and T4, mainly from deiodination , process is probably implied in the pathology of these exophthalmos.

Adult↗
PubMed1984

[Free thyroxin as a determinant for thyroid function. Evaluation of direct determination of fT4 compared to the oral TRH test].

The diagnostic value of a direct assay of free thyroxine has been evaluated by comparing the concentration of free T4 with the results of an oral TRH test. 147 patients were referred to an endocrine outpatient department because of suspected thyroid dysfunction. Based on clinical investigation and on the results of an oral TRH test, 75 patients were euthyroid, 12 hyperthyroid and 12 hypothyroid. Preclinical hypothyroidism (3 h- TSH value above 35 mE/l and euthyroid peripheral thyroid hormone levels) was found in 25 patients. In 23, preclinical hyperthyroidism (3 h- TSH value after TRH below the sensitivity of the assay, i.e. less than 1 mE/l) together with euthyroid peripheral thyroid hormone values was found. Free thyroxine was assayed using the solid phase technique (Clinical Assay); intraassay coefficients of variation varied between 4.5 and 7.6% and interassay coefficients of variation between 8 and 13%. A normal range for free thyroxine was found between 8.4 and 26.4 pmol/l, the log mean being 14.9 pmol/l. In 12 hyperthyroid patients the free T4 concentration was above 49.4 pmol/l, while the mean of 12 hypothyroid patients was below 4.4 pmol/l. The mean free T4 concentrations in the syndromes of preclinical hypo- and hyperthyroidism, which by definition are only recognizable by the TSH increase in response to TRH, were within the normal range. Using the sensitive TRH test as a comparison, the present investigation thus confirms the reliability of direct assay of free T4 for the diagnosis of thyroid function in clinical practise.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1995

[Iatrogenic hyperthyroidism. Report of an outbreak].

The clinical observation of a series of 30 patients (age 29.6 +/- 9.8 years, 29 females and 1 male) who were remitted for evaluation of a thyroid dysfunction with a decrease in TSH and free thyroxin with clinical symptoms of hyperthyroidism and absence of goiter or exophthalmous is presented. Most of the patients (90%) had no family or personal history of previous thyroid disease. Anamnesis demonstrated the previous ingestion of uncommercialized prepared weight losers, dispensed in different areas off the pharmacy offices. Seventy-three percent of the patients had received the treatment from the same source (prescriber). In most of the cases (28 out of 30) normalization was observed in thyroid function tests. The demonstrated inefficacy of this medication as well as the health care importance of the problem are discussed.

Adolescent↗
PubMed1978

Triiodothyronine (T3) concentration and therapy in autistic children.

The clinical and biochemical status of thyroid function of patients with an autistic syndrome was investigated. The study consisted of 13 patients between the ages of 7 and 21 years. There was no clinical evidence for hypothyroidism in any patient, and T3, T4, and TSH concentrations were within the normal range. Two patients who had retarded bone ages were treated with triiodothyronine for 6 months. Hyperthyroidism developed when T3 levels exceeded physiologic concentrations in these patients. The concept that the clinical response to triiodothyronine in autistic patients results from correction of thyroid dysfunction is not supported by these findings.

Adolescent↗
PubMed2003

Relationship of thyroid function to post-traumatic S-100b serum levels in survivors of severe head injury: preliminary results.

OBJECTIVE: To assess thyroid function abnormalities in survivors of severe head trauma and to examine their relationship with indices of brain injury severity. DESIGN: Prospective study. SETTING: General intensive care unit (ICU) in a university hospital. PATIENTS AND PARTICIPANTS: Twenty-two (21 men) head-injured patients, with a median age of 25.5 years at the time of injury, were investigated. Severity of brain trauma was assessed by Glasgow Coma Scale (GCS) score, Marshall Computerized Tomographic Classification, intracranial pressure levels and serum S-100b concentrations measured over a 6-day period. INTERVENTIONS: Thyroid function testing was performed 1 year after ICU discharge and included the measurement of free thyroxine, triiodothyronine and thyrotropin. MEASUREMENTS AND RESULTS: On admission to the ICU, GCS ranged from 3 to 8. Peak S-100b was 1.49 microg/l (range: 0.37-5.26 microg/l). Median triiodothyronine and thyrotropin were 123 ng/dl and 1.60 microIU/ml, respectively. Free thyroxine was 1.08+/-0.22 ng/dl (range: 0.7-1.5 ng/dl). Overall, 7 of the 22 patients (32%) had thyroid dysfunction. Four patients had central hypothyroidism and three patients had subclinical hypothyroidism. Peak S-100b correlated negatively with free thyroxine (r=-0.47, p=0.02). There were no correlations between other brain injury severity indices and thyroid hormone levels. CONCLUSIONS: A significant subset of brain injury patients presents with changes in thyroid function 1 year after ICU discharge; these depend upon biochemical serum markers of head trauma severity.

Adolescent↗