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Thyroxine, pregnancy, iodine

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
Hye Jeong Kim, Yoon Young Cho, Sun Wook Kim, Tae Hyuk Kim, Hye Won Jang, Soo-Youn Lee, Suk-Joo Choi, Cheong-Rae Roh, Jong-Hwa Kim, Jae Hoon Chung, Soo-Young Oh
Background/Aims: Maternal thyroid dysfunction has been associated with adverse pregnancy outcomes. The purpose of our study was to establish trimester-specific reference intervals for thyroid hormones in pregnant women in Korea, where iodine intake is more than adequate and to examine pregnancy and perinatal outcomes in their offspring. Methods: Among 459 healthy pregnant women who were screened, we enrolled 417 subjects who had negative results for thyroid autoantibodies...
February 8, 2017: Korean Journal of Internal Medicine
Jinyan Fu, Anqiang Yang, Jun Zhao, Yunlong Zhu, Ying Gu, Yaohui Xu, Daozhen Chen
Our objective was to evaluate the relationship between iron level and thyroid function during the first trimester of pregnancy in Eastern China. This was a hospital-based, cross-sectional observational study. A total of 1764 pregnant women were enrolled during their first trimester of gestation in Wuxi city. Serum ferritin (SF), hemoglobin (Hb), urinary iodine concentrations (UIC), thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured and evaluated in pregnant women...
January 22, 2017: Journal of Trace Elements in Medicine and Biology
Rajesh Rajput, Bhagat Singh, Vasudha Goel, Amit Verma, Shashi Seth, Smiti Nanda
BACKGROUND: Reference intervals for thyroid hormone during pregnancy need to be gestational age, method, and population specific and there is need to establish trimester-specific thyroid levels for the different population across the world. The aim of this study was to establish trimester-specific reference range for thyroid hormone during pregnancy in a tertiary care center in Haryana. MATERIALS AND METHODS: A total of 1430 pregnant women were recruited for the study...
November 2016: Indian Journal of Endocrinology and Metabolism
A Lumen, N I George
Previously, a deterministic biologically-based dose-response (BBDR) pregnancy model was developed to evaluate moderate thyroid axis disturbances with and without thyroid-active chemical exposure in a near-term pregnant woman and fetus. In the current study, the existing BBDR model was adapted to include a wider functional range of iodine nutrition, including more severe iodine deficiency conditions, and to incorporate empirically the effects of homeostatic mechanisms. The extended model was further developed into a population-based model and was constructed using a Monte Carlo-based probabilistic framework...
January 1, 2017: Toxicology and Applied Pharmacology
Xiaomei Zhang, Baoting Yao, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Xiaochun Teng, Cheng Han, Weiwei Zhou, Chenyang Li, Bin Xu, Lihua Bi, Tao Meng, Jianling Du, Shaowei Zhang, Zhengnan Gao, Liu Yang, Chenling Fan, Weiping Teng, Zhongyan Shan
BACKGROUND: A self-sequential longitudinal reference interval may be expected to minimize the inter-individual variation of thyroid function. Comparison between the self-sequential longitudinal reference interval (SLRI) and cross-sectional reference interval (CSRI) in pregnancy has not been well investigated. The objectives of this study were to establish a stringent SLRI of thyroid function in pregnant women and to compare it with the conventional CSRI. METHODS: Three cohorts were enrolled: group 1, pregnant women for an SLRI (n = 99); group 2, pregnant women for a CSRI (n = 1318); group 3, non-pregnant control women (NC) as a control group (n = 301) according to the criteria of the National Academy of Clinical Biochemistry...
December 2016: Thyroid: Official Journal of the American Thyroid Association
Fiona L R Williams, Jennifer Watson, Chris Day, Aung Soe, Sateesh K Somisetty, Lesley Jackson, Elena Velten, Anita Boelen
BACKGROUND: Infants <32 weeks' gestation should not be exposed to topical iodine and its avoidance is recommended during pregnancy and breast feeding. Exposure to contrast media and topical iodine is frequently used in many preterm neonates. AIM: To determine whether thyrotropin levels in preterm infants are affected by exposure to intrapartum/neonatal topical iodine and/or the use of iodinated contrast media. DESIGN: Infants <32 weeks' gestation were recruited...
January 1, 2017: Journal of Perinatal Medicine
Xiaowen Zhang, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Shiqiao Peng, Zhaojun Wang, Cheng Han, Xiaomei Zhang, Danyang Wang, Chenling Fan, Zhongyan Shan, Weiping Teng
OBJECTIVES: To describe the changes in thyroglobulin (Tg) based upon gestational and postpartum concentrations in healthy pregnant women from an iodine-sufficient region in China, and to evaluate the use of Tg as a biomarker for iodine-sufficient pregnant women. DESIGN: A longitudinal study of Tg change in normal pregnant women from an iodine-sufficient region. PATIENTS AND MEASUREMENTS: Blood and urine samples were obtained from 133 pregnant women...
February 2017: Clinical Endocrinology
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
Eftychia Koukkou, Ioannis Ilias, Irene Mamalis, Georgios G Adonakis, Kostas B Markou
OBJECTIVE: To assess the reliability of thyroglobulin (Tg) as a marker of iodine status during pregnancy. DESIGN: 299 women aged 30.5 ± 4.8 years (mean ± SD) were studied. METHODS: In every subject, we measured urinary iodine concentration (UIC), serum thyrotropin (TSH), Tg, free thyroxine (fT4), Tg autoantibodies (TgAbs) and human chorionic gonadotropin (hCG) levels. We excluded samples with increased TgAbs from the analysis. RESULTS: According to WHO criteria, the study population was iodine deficient in every trimester...
July 2016: European Thyroid Journal
Helena Jastrzębska, Magdalena Kochman, Zbigniew Bartoszewicz, Mariusz Ołtarzewski, Romuald Dębski, Wojciech Zgliczyński
INTRODUCTION: Pregnant women require about 250 μg of iodine daily. Hypothyroid women treated with L-thyroxine do not utilise iodine, and metabolism of L-thyroxine tablets is an additional source of iodine for their foetuses. The aim of the study was to evaluate the influence of iodine supplementation in hypothyroid pregnant women treated with L-thyroxine on neonate TSH concentration and maternal thyroid parameters. MATERIAL AND METHODS: Ninety-two pregnant women with primary hypothyroidism on adequate thyroid hormone replacement were voluntarily divided into two groups: "thyroxine" (n = 38) treated with L-thyroxine only, and "thyroxine + iodine" (n = 54) treated additionally with 150 μg/day of iodine since 10th gestational week...
2016: Endokrynologia Polska
Mary E Mortensen, Rebecca Birch, Lee-Yang Wong, Liza Valentin-Blasini, Elizabeth B Boyle, Kathleen L Caldwell, Lori S Merrill, John Moye, Benjamin C Blount
The sodium iodide-symporter (NIS) mediates uptake of iodide into thyroid follicular cells. This key step in thyroid hormone synthesis is inhibited by perchlorate, thiocyanate (SCN) and nitrate (NO3) anions. When these exposures occur during pregnancy the resulting decreases in thyroid hormones may adversely affect neurodevelopment of the human fetus. Our objectives were to describe and examine the relationship of these anions to the serum thyroid indicators, thyroid stimulating hormone (TSH) and free thyroxine (FT4), in third trimester women from the initial Vanguard Study of the National Children's Study (NCS); and to compare urine perchlorate results with those in pregnant women from the National Health and Nutritional Examination Survey (NHANES)...
August 2016: Environmental Research
Tarun Sekhri, Juhi Agarwal Juhi, Reena Wilfred, Ratnesh S Kanwar, Jyoti Sethi, Kuntal Bhadra, Sirimavo Nair, Satveer Singh
CONTEXT: Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. AIMS: We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. SETTINGS AND DESIGN: 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals...
January 2016: Indian Journal of Endocrinology and Metabolism
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
Yang Zhang, Fang Liu, Weijie Sun, Youyuan Huang, Wei Zhang, Baojing Wang, Shiping Su, Ying Gao, Yanming Gao, Huixia Yang, Xiaohui Guo
OBJECTIVE: To establish the gestational age-specific reference ranges for thyroid-related indicators of pregnant women in our hospital, especially for serum thyroid stimulating hormone (TSH) in the first trimester. METHODS: A total of 548 pregnant women in the first trimester were collected in Peking University First Hospital from June 2013 to April 2014. Among them, 254 pregnant women with single fetus who conformed to the National Academy of Clinical Biochemistry criteria, without adverse pregnancy outcomes and obstetric complications, were enrolled in the current study...
February 2, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Hui Min, Jing Dong, Yi Wang, Yuan Wang, Ye Yu, Zhongyan Shan, Qi Xi, Weiping Teng, Jie Chen
Iodine deficiency (ID)-induced thyroid hormone (TH) insufficient during development leads to impairments of brain function, such as learning and memory. Marginal ID has been defined as subtle insufficiency of TH, characterized as low thyroxine (T4) levels, whether marginal ID potentially had adverse effects on the development of hippocampus and the underlying mechanisms remain unclear. Thus, in the present study, we established Wistar rat models with ID diet during pregnancy and lactation. The effects of marginal ID on long-term potentiation (LTP) were investigated in the hippocampal CA1 region...
January 2017: Molecular Neurobiology
Thirunavukkarasu Yoganathan, Manjula Hettiarachchi, Vasanthy Arasaratnam, Chandrani Liyanage
INTRODUCTION: Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate. METHODS: Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroglobulin (Tg), urinary iodine levels, and the neonatal thyrotrophin (nTSH) level were assessed...
November 2015: Indian Journal of Endocrinology and Metabolism
Mariacarla Moleti, Francesco Trimarchi, Gaetano Tortorella, Alice Candia Longo, Grazia Giorgianni, Giacomo Sturniolo, Angela Alibrandi, Francesco Vermiglio
BACKGROUND AND OBJECTIVE: Maternal iodine nutrition and thyroid status may influence neurocognitive development in offspring. This study investigated the effects on the intelligence quotient (IQ) of children born to mothers with different levels of iodine supplementation, with or without the administration of levothyroxine (LT4), prior to and during pregnancy. PATIENTS AND METHODS: This pilot, prospective, observational study included four study groups, each comprising 15 mother-child pairs, identified on the basis of maternal histories of iodized salt consumption and LT4 treatment prior to and during pregnancy...
February 2016: Thyroid: Official Journal of the American Thyroid Association
Firoozeh Nili, Sedigheh Hantoushzadeh, Afsaneh Alimohamadi, Mamak Shariat, Golnaz Rezaeizadeh
BACKGROUND: Iodine-containing disinfectants are widely used for skin preparation before caesarean section. Current evidence suggests that maternal exposure to these disinfectants results in thyroid dysfunction in the newborns, but its extent is not known. OBJECTIVES: The purpose of this study was to explain the quality of the effect of these disinfectants on the thyroid function of newborns. METHODS: This cohort study was performed on all the healthy mothers with a term pregnancy who underwent caesarean section in the obstetrics emergency department of an educational hospital affiliated with Tehran University of Medical Sciences from December 2013 to December 2014...
December 2015: Postgraduate Medical Journal
Megan K Horton, Benjamin C Blount, Liza Valentin-Blasini, Ronald Wapner, Robin Whyatt, Chris Gennings, Pam Factor-Litvak
BACKGROUND: Adequate maternal thyroid function during pregnancy is necessary for normal fetal brain development, making pregnancy a critical window of vulnerability to thyroid disrupting insults. Sodium/iodide symporter (NIS) inhibitors, namely perchlorate, nitrate, and thiocyanate, have been shown individually to competitively inhibit uptake of iodine by the thyroid. Several epidemiologic studies examined the association between these individual exposures and thyroid function. Few studies have examined the effect of this chemical mixture on thyroid function during pregnancy OBJECTIVES: We examined the cross sectional association between urinary perchlorate, thiocyanate and nitrate concentrations and thyroid function among healthy pregnant women living in New York City using weighted quantile sum (WQS) regression...
November 2015: Environmental Research
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