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Hypothyroid rct

Salman Razvi, Lorna Ingoe, Vicky Ryan, Simon H S Pearce, Scott Wilkes
BACKGROUND: Hypothyroidism is a common condition, particularly in the older population. Thyroid hormone requirements change with age and serum TSH levels also alter, especially in older patients. However, in practice laboratory reference ranges for thyroid function are not age-specific and treatment in older patients aims to achieve a similar target thyroid function level as younger age groups. METHODS: A dual centre, single blind, randomised controlled trial was conducted to determine the feasibility of a future definitive RCT in hypothyroid individuals aged 80 years or older who were treated with levothyroxine...
2016: Thyroid Research
Xue Li, Zhaowei Meng, Qiang Jia, Xiaojun Ren
Sub-clinical hypothyroidism is a common disease and whether L-thyroxine replacement treatment improves serum lipid levels in affected patients remains controversial. Thus, the aim of the present meta-analysis was to assess the effect of L-thyroxine therapy on serum lipid levels in sub-clinical hyperthyroidism. Relevant randomized controlled trials (RCTs) containing continuous data, published until July 2015 were retrieved from the Cochrane Library, PubMed, Medline, Google Scholar and Embase databases and subjected to meta-analysis using Review Manager software version 5...
October 2016: Biomedical Reports
Hai Wang, Libo Man, Guizhong Li, Guanglin Huang, Jianwei Wang
OBJECTIVE: This study was performed to evaluate the comparative efficacy and safety of axitinib and sorafenib in the therapy of metastatic renal cell carcinoma. MATERIALS AND METHODS: Eligible studies were searched from PubMed, Embase, and Future Medicine databases. The pooled hazard ratios and relative risk ratios (RRs) were calculated by using Stata 12.0 software. RESULTS: A total of 1,011 patients qualified to participate in this Phase III study that included randomized controlled trials...
2016: OncoTargets and Therapy
Meng Zhao, Lu Liu, Fei Wang, Zhongshang Yuan, Xu Zhang, Chao Xu, Yongfeng Song, Qingbo Guan, Ling Gao, Zhongyan Shan, Haiqing Zhang, Jiajun Zhao
BACKGROUND: Mild subclinical hypothyroidism (SCH) affects a large number of people and is known to be a risk factor for dyslipidemia. However, whether mild SCH patients should be treated with L-thyroxine to improve lipid profiles remains controversial. In addition, it is also unclear whether all mild SCH patients can benefit from L-thyroxine treatment, regardless of basal thyrotropin or lipid levels. This study aimed to assess the effects of L-thyroxine replacement therapy on the lipid profiles of mild SCH patients...
August 2016: Thyroid: Official Journal of the American Thyroid Association
Junqi Wang, Lan Qin
OBJECTIVE: This meta-analysis was performed to compare radioiodine therapy with antithyroid drugs in terms of clinical outcomes, including development or worsening of ophthalmopathy, hyperthyroid cure rate, hypothyroidism, relapse rate and adverse events. METHODS: Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, SinoMed and National Knowledge Infrastructure, China, were systematically reviewed to compare the effects of radioiodine therapy with antithyroid drugs in patients with Graves' disease...
June 27, 2016: British Journal of Radiology
Özgür Bilgin Topçuoğlu, Özlem Oruç, Gülgün Çetintaş Afşar, Sema Saraç, Kayıhan Uluç
PURPOSE: Obstructive sleep apnea (OSA) is a highly prevalent disease. For diagnostic and therapeutic purposes, OSA has been divided into several subgroups. Positional OSA (POSA), the most frequent subgroup (56 %), is described as overall apnea hypopnea index (AHI) ≥5 and supine AHI at least twice as high when compared to non-supine AHI. We aimed to investigate the frequency of ulnar nerve entrapment neuropathy at the elbow (UNEE) in OSA patients without clinical signs and symptoms of ulnar neuropathy and intended to find if sleeping position in OSA had an impact on UNEE development...
May 23, 2016: Sleep & Breathing, Schlaf & Atmung
Tiantian Zhang, Lingyan Zhou, Cong Cong Li, Hong Shi, Xinli Zhou
Epidemiological evidence suggests that thyrotropin (TSH) levels are closely correlated with the severity of hypercholesterolemia. Reverse cholesterol transfer (RCT) plays an important role in regulating bloodcholesterol. However, the molecular mechanism of hypercholesterolemia in subclinical hypothyroidism (SCH) has not been fully clarified. The SCH mouse model, which is characterized by elevated serum TSH but not thyroid hormone levels, demonstrated a significant increase in plasma cholesterol compared with controls...
May 11, 2016: Biochemical and Biophysical Research Communications
Torie C Plowden, Enrique F Schisterman, Lindsey A Sjaarda, Shvetha M Zarek, Neil J Perkins, Robert Silver, Noya Galai, Alan H DeCherney, Sunni L Mumford
CONTEXT: Prior studies examining associations between subclinical hypothyroidism and antithyroid antibodies with early pregnancy loss and live birth suggest mixed results and time to pregnancy (TTP) has not been studied in this patient population. OBJECTIVE: This study sought to examine associations of prepregnancy TSH concentrations and thyroid autoimmunity with TTP, pregnancy loss, and live birth among women with proven fecundity and a history of pregnancy loss...
June 2016: Journal of Clinical Endocrinology and Metabolism
David Taïeb, Claire Bournaud, Marie-Claude Eberle, Bogdan Catargi, Claire Schvartz, Marie-Béatrice Cavarec, Isabelle Faugeron, Marie-Elisabeth Toubert, Danielle Benisvy, Cendrine Archange, Olivier Mundler, Philippe Caron, Ahmad Esmaeel Abdullah, Karine Baumstarck
OBJECTIVE: While radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon. METHODS: A multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4 treatment) or the control group (n=48) (group B: standard follow-up)...
April 2016: European Journal of Endocrinology
Margaret M Peel, Marie Cooke, Helen J Lewis-Peel, Rodney A Lea, Wendy Moyle
OBJECTIVE: To determine if coenzyme Q(10) alleviates fatigue in the late-onset sequelae of poliomyelitis. DESIGN: Parallel-group, randomized, placebo-controlled trial. BACKGROUND SETTING: Coenzyme Q(10) has been shown to boost muscle energy metabolism in post-polio subjects but it does not promote muscle strength, endurance or function in polio survivors with post-poliomyelitis syndrome. However, the collective increased energy metabolism might contribute to a reduction in post-polio fatigue...
December 2015: Complementary Therapies in Medicine
Luba Freja Michaelsson, Bjarke Borregaard Medici, Jeppe Lerche la Cour, Christian Selmer, Michael Røder, Hans Perrild, Nils Knudsen, Jens Faber, Birte Nygaard
BACKGROUND: Five to ten percent of patients with hypothyroidism describe persistent symptoms despite being biochemically well regulated on levothyroxine (L-T4). Thyroxine (T4)/triiodothyronine (T3) combination therapy [L-T4/liothyronine (L-T3) or desiccated thyroid] are still regarded as experimental with no evidence of superior effect on persistent symptoms according to meta-analyses. However, some randomized controlled trials have demonstrated patients' preference for T4/T3 combination therapy as compared to L-T4 monotherapy...
September 2015: European Thyroid Journal
Seo Young Sohn, Hye Won Jang, Yoon Young Cho, Sun Wook Kim, Jae Hoon Chung
BACKGROUND: Previous studies have suggested that recombinant human thyroid stimulating hormone (rhTSH) stimulation is an acceptable alternative to thyroid hormone withdrawal (THW) when radioiodine remnant ablation is planned for thyroid cancer treatment, based on superior short-term quality of life with non-inferior remnant ablation efficacy. This study evaluated the cost-effectiveness of radioiodine remnant ablation using rhTSH, compared with the traditional preparation method which renders patients hypothyroid by THW, in Korean perspective...
December 2015: Endocrinology and Metabolism
Laura Spencer, Tanya Bubner, Emily Bain, Philippa Middleton
BACKGROUND: Thyroid dysfunction pre-pregnancy and during pregnancy (both hyper- and hypothyroidism) is associated with increased risk of adverse outcomes for mothers and infants in the short- and long-term. Managing the thyroid dysfunction (e.g. thyroxine for hypothyroidism, or antithyroid medication for hyperthyroidism) may improve outcomes. The best method of screening to identify and subsequently manage thyroid dysfunction pre-pregnancy and during pregnancy is unknown. OBJECTIVES: To assess the effects of different screening methods (and subsequent management) for thyroid dysfunction pre-pregnancy and during pregnancy on maternal and infant outcomes...
2015: Cochrane Database of Systematic Reviews
Ihsan Ates, Fatma Meric Yilmaz, Mustafa Altay, Nisbet Yilmaz, Dilek Berker, Serdar Güler
OBJECTIVE: We have aimed to study the relation between Hashimoto's thyroiditis (HT) and thyroid autoantibodies and oxidative stress parameters in euthyroid, subclinical and overt hypothyroid stages. DESIGN AND METHODS: A total of 124 patients were included in the study; 93 of whom were newly diagnosed with HT (31 patients in each of the euthyroid, subclinical hypothyroid and overt hypothyroid subgroups), aged over 18 and had not received any prior treatment and 31 of whom were healthy volunteers...
December 2015: European Journal of Endocrinology
Sofie Bliddal, Malene Boas, Linda Hilsted, Lennart Friis-Hansen, Ann Tabor, Ulla Feldt-Rasmussen
OBJECTIVE: Aberrations in maternal thyroid function and autoimmunity during pregnancy have been associated with negative obstetric outcome. In Denmark, a national iodine fortification program was implemented in the year 2000 with the aim to alleviate the mild-moderate iodine deficiency. Following the iodine implementation, there has been an increase in thyroid autoimmunity in the background population. This study investigates the thyroid status of pregnant Danish women following the iodine fortification program, and a possible association with preterm delivery...
December 2015: European Journal of Endocrinology
Benjamin T Brown, Petra L Graham, Rod Bonello, Henry Pollard
BACKGROUND: Hypothyroidism is a common endocrine condition. There is evidence to suggest that, for a proportion of sufferers, the standard medical treatment does not completely reverse the constitutional and neuropsychiatric symptoms brought about by this condition. The management of hypothyroidism follows a biomedical model with little consideration given to alternative management approaches. There exists anecdotal evidence and case reports supporting the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population...
2015: Chiropractic & Manual Therapies
Helmuth G Dörr, Markus Bettendorf, Gerhard Binder, Beate Karges, Carolin Kneppo, Heinrich Schmidt, Egbert Voss, Martin Wabitsch, Jörg Dötsch
BACKGROUND: Levothyroxine (L-T4) treatment of euthyroid children with Hashimoto thyroiditis (HT) is a controversial issue. PATIENTS AND METHODS: We conducted a prospective, randomized, controlled clinical trial. Out of 79 identified euthyroid patients, 59 started the study; 25 patients (21 female, 4 male; age: 11.8 ± 2.3 years) received L-T4 at a mean dose of 1.6 µg/kg (SD, 0.8) daily, and 34 (27 female, 7 male; age: 12.6 ± 1.2 years) were not treated. Patients developing subclinical hypothyroidism during follow-up (n = 13) were treated with L-T4 and removed from the observation group...
2015: Hormone Research in Pædiatrics
Isabelle Herter-Aeberli, Mohamed Cherkaoui, Nawal El Ansari, Riccarda Rohner, Sara Stinca, Laila Chabaa, Arnold von Eckardstein, Abdelmounaim Aboussad, Michael B Zimmermann
BACKGROUND: In iodine deficiency, thyrotropin (TSH) may increase to stimulate thyroidal iodine uptake. In iodine-sufficient populations, higher TSH predicts higher total cholesterol. Whether higher TSH caused by iodine deficiency affects serum lipids is uncertain. OBJECTIVE: Our aim was to determine if iodine repletion decreases serum TSH and improves the lipid profile. METHODS: In this randomized controlled intervention, iodine-deficient, overweight or obese Moroccan women (n = 163) received 200 μg oral iodine or a placebo daily for 6 mo...
September 2015: Journal of Nutrition
Josephine H Li, Zhiheng H He, Vivek Bansal, James V Hennessey
Radioactive iodine (RAI) ablation is a beneficial, adjuvant therapy for the management of differentiated thyroid cancer (DTC) after thyroidectomy. The goal of RAI is to destroy remnant thyroid and microscopic cancerous tissue. Radioactive iodine uptake is enhanced by elevating TSH levels and initiating a low iodine diet (LID) prior to ablation. An ideal LID should preferably not exceed 50 mcg/day of dietary iodine for 1-2 weeks, although the duration may be shortened to a week with a structured patient education programme...
January 2016: Clinical Endocrinology
I Hollan, P H Dessein, N Ronda, M C Wasko, E Svenungsson, S Agewall, J W Cohen-Tervaert, K Maki-Petaja, M Grundtvig, G A Karpouzas, P L Meroni
The increased risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been recognized for many years. However, although the characteristics of CVD and its burden resemble those in diabetes, the focus on cardiovascular (CV) prevention in RA has lagged behind, both in the clinical and research settings. Similar to diabetes, the clinical picture of CVD in RA may be atypical, even asymptomatic. Therefore, a proactive screening for subclinical CVD in RA is warranted. Because of the lack of clinical trials, the ideal CVD prevention (CVP) in RA has not yet been defined...
October 2015: Autoimmunity Reviews
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