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Thyroxine pregnancy subclinical hypothyroidism,iodine

Lalit Narayan Chaudhary, Saroj Khatiwada, Basanta Gelal, Sharad Gautam, Madhab Lamsal, Hanoon Pokharel, Nirmal Baral
BACKGROUND: Iodine deficiency, thyroid dysfunction and development of thyroid autoimmunity during pregnancy may affect mother and the developing fetus. This study was carried out to find iodine status, thyroid dysfunction and thyroid autoimmunity among pregnant women. METHODS: Ninety two pregnant women from three districts of eastern Nepal (Sunsari, Morang and Jhapa) were enrolled for the study, and urine and blood samples were collected. Urinary iodine concentration (UIC), free thyroxine (free T4), thyroid stimulating hormone (TSH), thyroglobulin and anti-thyroid peroxidase (TPO) antibody levels were estimated...
September 8, 2017: Journal of Nepal Health Research Council
Kunling Wang, Jie Zhang, Fengao Li, Wanqi Zhang, Hao Wang, Li Ding, Yaxin Liu, Laixiang Lin, Shuang Zhang, Mei Zhu
BACKGROUND: Subclinical hypothyroidism (SH) is associated with adverse obstetric outcomes and neurodevelopment disorders. Both iodine deficiency and excess are associated with SH; however, few data regarding iodine nutrition status of pregnant women with SH are available. This study aimed to clarify whether iodine deficiency or excess is associated with SH, especially, when test results for anti-thyroid autoantibodies are negative. METHODS: A total of 115 women with SH and 104 women with euthyroidism (EH) in early pregnancy in Tianjin, China were investigated, and their serum thyroid-stimulating hormone, free thyroxine, free triiodothyronine, anti-thyroid peroxidase antibody (TPOAb), anti-thyroid globulin antibody (TGAb), urinary iodine (UIC), and urinary creatinine (UCr) concentrations were measured...
February 17, 2017: BMC Endocrine Disorders
John P Walsh
Serum thyroid-stimulating hormone (TSH) testing is the best screening tool for thyroid dysfunction. When TSH levels are in the reference range, additional tests such as free thyroxine, free triiodothyronine or thyroid antibodies rarely add value, except in patients with pituitary disease, when TSH is unreliable. Overt hypothyroidism and subclinical hypothyroidism with TSH levels > 10 mU/L can be treated without further investigation. The health impact of subclinical hypothyroidism with mildly elevated levels of TSH (4-10 mU/L) remains uncertain, particularly in older people; treatment or observation are reasonable options...
August 15, 2016: Medical Journal of Australia
Alan R McNeil, Phoebe E Stanford
While there is agreement that overt maternal hypothyroidism (serum thyroid stimulating hormone (TSH) >10 mIU/L) should be treated immediately, the evidence is mixed regarding the harm associated with subclinical hypothyroidism and the benefits of thyroxine replacement. The diagnosis of subclinical hypothyroidism rests on the recognition of an increased serum concentration of TSH which may be affected by many factors including gestational age, analytical method, the antibody status of the mother, ethnicity, iodine nutrition and even the time of day when the blood is collected...
November 2015: Clinical Biochemist. Reviews
Hui Min, Jing Dong, Yi Wang, Yuan Wang, Weiping Teng, Qi Xi, Jie Chen
Maternal hypothyroxinemia can induce neurodevelopmental impairments in the developing fetus. We here review recent studies on the epidemiology and molecular mechanisms associated with this important public health issue. In 2011, the American Thyroid Association defined maternal hypothyroxinemia as low serum free thyroxine (FT4) levels (<5th or <10th percentile) existing in conjunction with normal serum free triiodothyronine (FT3) or thyroid stimulating hormone (TSH) levels during pregnancy. Compared to clinical or subclinical hypothyroidism, hypothyroxinemia is more commonly found in pregnant women...
April 2016: Molecular Neurobiology
Xiaoguang Shi, Cheng Han, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Chenyang Li, Bin Xu, Tao Meng, Jianling Du, Shaowei Zhang, Zhengnan Gao, Xiaomei Zhang, Chenling Fan, Zhongyan Shan, Weiping Teng
CONTEXT: The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak. OBJECTIVE: We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China. METHOD: Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured...
April 2015: Journal of Clinical Endocrinology and Metabolism
Wen Chen, Zhongna Sang, Long Tan, Shufen Zhang, Feng Dong, Zanjun Chu, Wei Wei, Na Zhao, Guiqin Zhang, Zhaixiao Yao, Jun Shen, Wanqi Zhang
OBJECTIVE: The effects of long-term excessive maternal iodine intake on neonatal thyroid function are less known. This study aimed to assess the effects of maternal excessive iodine intake from drinking water on thyroid functions of both mothers and their neonates. DESIGN AND METHODS: This observational study was performed in high iodine (HI) areas and adequate iodine (AI) intake areas, including 384 healthy pregnant women in late gestation (mean week 39·3 ± 1·6 weeks) and their newborns...
September 2015: Clinical Endocrinology
John Lazarus, Rosalind S Brown, Chantal Daumerie, Alicja Hubalewska-Dydejczyk, Roberto Negro, Bijay Vaidya
This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency...
June 2014: European Thyroid Journal
Tomasz Skweres, Dariusz Wójcik, Rafał Ciepłuch, Wojciech Sliwiński, Robert Czech, Wojciech Gruszczyński, Maciej Rogacki
Thyroid disorders, both in women who wish to conceive and in gravidas, has become a topic of much interest to numerous researchers. Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening condition among women undergoing controlled ovarian hyperstimulation (COH). We present a case of thyroid dysfunction in severe OHSS in a patient diagnosed with subclinical hypothyroidism before COH. The dose of L-thyroxine (L-T4) was increased before the procedure in order to reach TSH levels below 2.5 mU/L, and from day 1 of the stimulation the dose of L-T4 was increased by 33%...
June 2014: Ginekologia Polska
Alex Stagnaro-Green, Elizabeth Pearce
The thyroid gland is substantially challenged during pregnancy. Total T(3) and T(4) levels increase by 50% during pregnancy owing to a 50% increase in thyroxine-binding globulin levels. Serum TSH levels decrease in the first trimester and increase in the second and third trimesters; however, not to prepregnancy levels. Hypothyroidism is present in up to 3% of all pregnant women. Subclinical hypothyroidism during pregnancy is associated with an increased rate of miscarriage and preterm delivery, and a decrease in the IQ of the child...
November 2012: Nature Reviews. Endocrinology
Lluís Vila, Inés Velasco, Stella González, Francisco Morales, Emilia Sánchez, José Maria Lailla, Txanton Martinez-Astorquiza, Manel Puig-Domingo
There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far...
November 3, 2012: Medicina Clínica
Inés Seoane Cruz, Manuel Penín Álvarez, Reyes Luna Cano, Ricardo Víctor García-Mayor
BACKGROUND: Hypothyroidism is usually treated with thyroxine doses on patient weight. In some cases, however, fixed doses have proved to useful to normalize TSH levels, which is especially important during pregnancy. PATIENTS AND METHODS: Sixty-eight women diagnosed with subclinical hypothyroidism, autoimmune or not, during pregnancy were given a fixed dose of thyroxine 50 mcg/day. TSH measurements were performed to assess the need to change the dose, which was increased or decreased by 25 mcg/day when necessary...
May 2012: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
A Kut, A Gursoy, S Senbayram, N Bayraktar, I Irem Budakoğlu, H S Akgün
BACKGROUND: A recent study showed first sign of reduction in goiter prevalence and elimination of iodine deficiency state among school-age children in Turkey after a decade of mandatory iodination of table salt. However, iodine status among pregnant women is a still debated issue in our country. AIM: To investigate iodine status, iodized salt consumption rate, and goiter prevalence in 1st trimester pregnant women 8 yr after the mandatory iodination. MATERIAL/ SUBJECTS AND METHODS: One hundred and forty-one 1sttrimester pregnant women who had been followed-up between January and October 2006 in the obstetric outpatient clinics in Turkey were included...
July 2010: Journal of Endocrinological Investigation
Juan Carlos Galofré Ferrater, Juan José Corrales Hernández, Begoña Pérez Corral, Ana Cantón Blanco, Núria Alonso Pedrol, Antonio Pérez Pérez, Teresa Lajo Morales, Frederic Tortosa Henzi
Subclinical thyroid disease is a biochemical diagnosis and is common during pregnancy. Because of the physiological hormonal changes that take place during pregnancy and the absence of normal ranges for thyroid hormones during this period, subclinical thyroid disease is difficult to interpret during pregnancy. Subclinical hyperthyroidism during pregnancy has few clinical consequences and no treatment is required. In contrast, subclinical hypothyroidism seems to improve with thyroxine treatment. Iodine supplements during pregnancy and lactation, even in iodine-sufficient areas, are also indicated...
February 2009: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
S Hiéronimus, M Bec-Roche, P Ferrari, N Chevalier, P Fénichel, F Brucker-Davis
BACKGROUND: Iodine deficiency (ID) is still common in Western Europe and its prevention remains a challenge, particularly during pregnancy. METHODS: We studied 330 pregnant women in the third trimester of pregnancy for ioduria (UIE) and thyroid tests (TSH, fT4). We collected information on personal history of thyroid disease and treatment with thyroid hormones or iodinated pregnancy tablets. RESULTS AND DISCUSSION: Median UIE was 64 microg/l, reflecting inadequate iodine intake in our population...
September 2009: Annales D'endocrinologie
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