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Kerry J Welsh, Steven J Soldin
Hypothyroidism is a very common disorder worldwide, for which the usual treatment is monotherapy with levothyroxine (L-T4). However, a number of patients treated with L-T4 continue to report symptoms of hypothyroidism despite seemingly normal levels of thyroid-stimulating hormone (TSH), free-T3 (FT3) and free-T4 (FT4) measured by immunoassay. This review summarizes the limitations of the immunoassays commonly used to measure thyroid hormone levels and emphasizes the advantages of the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS)...
December 2016: European Journal of Endocrinology
Ulrike Gottwald-Hostalek, Wolfgang Uhl, Peter Wolna, George J Kahaly
OBJECTIVE: Small levothyroxine (L-T4) dose changes can lead to significant clinical effects. To ensure thyroid hormone levels are safely maintained, authorities are increasingly adopting stricter potency specifications for L-T4, the most stringent of these being 95-105% of the labeled dose over the whole shelf-life. Levothyroxine sodium (Euthyrox®, Eutirox®, Lévothyrox®) has been reformulated, and two studies performed to ensure bioequivalence to the currently marketed formulation and dosage form proportionality of the new formulation...
October 8, 2016: Current Medical Research and Opinion
Sahreh Shabani, Alireza Sarkaki, Seyyed Ali Mard, Akram Ahangarpour, Layasadat Khorsandi, Yaghoob Farbood
Alzheimer's disease (AD) is associated with cognitive impairments and a decline in the spontaneous neuronal discharge. In the current study, we evaluated the effect of subcutaneous (S.C.) and intrahippocampal (I.H.) administrations of levothyroxine (LT-4) on the passive avoidance and spatial memory, as well as electrophysiological activity in an animal model of AD. One hundred-sixty male Wistar rats were divided into two main groups. The S.C. group included two Sham and four AD (vehicle or L-T4 25, 50 & 100μg/kg); and the I...
October 2016: Neuropeptides
Y Sertbas, Y Akcan, M Yazici
Objectives: The aim of this study is to evaluate the variation of cardiovascular risks of subclinical hypothyroid patients with thyroid hormone replacement therapy by using Framingham Risk Scoring system. Materials and methods: In this study 21 subclinical hypothyroid and 22 healthy volunteers, between the ages 37 to 68 were taken as cases and control groups. Subclinical hypothyroid patients were given L-T4 replacement therapy for one-year to keep the thyroid hormone (TSH) values in normal ranges...
October 16, 2015: West Indian Medical Journal
Sunanda Panda, Anand Kar
The hitherto unknown role of saponin in the regulation of thyrotoxicosis has been revealed in chemically-induced thyrotoxic rats. l-T4 (l-thyroxine) administration at pre-standardized dose of 500-μg/kg body weight for 12days increased the levels of thyroid hormones, enhanced the activity of hepatic 5'-monodeiodinase I (5'DI) and glucose-6-phosphatase (G-6Pase) as well as lipid peroxidation (LPO) with a parallel decrease in the levels of antioxidative enzymes. However, administration of the isolated saponin for 15days ameliorated the T4-induced alterations in serum thyroid hormones, hepatic LPO, G-6-Pase and 5'DI activity, and improved the cellular antioxidant status, indicating its antithyroidal and antioxidative potential...
October 1, 2016: Bioorganic & Medicinal Chemistry Letters
Poupak Fallahi, Silvia Martina Ferrari, Ilaria Ruffilli, Francesca Ragusa, Marco Biricotti, Gabriele Materazzi, Paolo Miccoli, Alessandro Antonelli
INTRODUCTION: The most recent advance concerning levothyroxine (L-T4) therapy is the development of novel oral formulations: the liquid preparation, and the soft gel capsule. AREAS COVERED: This review evaluates the most recent clinical studies about these new formulations. The liquid formulation has been shown to overcome: the food and beverages intereference with L-T4 tablets absorption, caused by food or coffee at breakfast; malabsorption induced by the increased gastric pH, resulting from atrophic gastritis, or due to proton-pump inhibitors; and malabsorption after bariatric surgery...
August 23, 2016: Expert Opinion on Drug Delivery
Pedro W Rosario, Maria R Calsolari
No abstract text is available yet for this article.
November 2016: Clinical Endocrinology
Jacoba J Bongers-Schokking, Wilma C M Resing, Wilma Oostdijk, Yolanda B de Rijke, Sabine M P F de Muinck Keizer-Schrama
BACKGROUND: In congenital hypothyroidism (CH) age-specific reference ranges for fT4 and TSH (asRR) are usually used to signal over/under-treatment. We compared the consequences of individual fT4 steady state concentrations (SSC's) and asRR regarding over-treatment signalling and intelligence quotient at 11 years (IQ11) and the effect of early over-treatment with high L-T4 dosages on IQ11. METHODS: 61 patients (27 severe, 34 mild CH) were psychologically tested at 1...
August 5, 2016: Pediatric Research
B Biondi, L Bartalena, L Chiovato, A Lenzi, S Mariotti, F Pacini, A Pontecorvi, P Vitti, F Trimarchi
Levothyroxine (L-T4) is recommended as lifelong replacement therapy for hypothyroidism. Recent clinical and experimental data support the addition of levotriiodothyronine (L-T3) treatment in some selected hypothyroid patients when their symptoms persist and their quality of life remains impaired despite adequate L-T4 monotherapy. An increase in L-T3 prescriptions has been recently observed in Italy due to availability of different L-T3 formulations, making it possible to clinicians to prescribe L-T3 alone or in combination with L-T4...
July 29, 2016: Journal of Endocrinological Investigation
Xuejie Dong, Zhi Yao, Yanjin Hu, Ning Yang, Xia Gao, Yuan Xu, Guang Wang
OBJECTIVE: Hypothyroidism (HO) can induce metabolic dysfunctions related to insulin resistance and dyslipidemia. Our previous studies showed that homocysteine (Hcy) impaired the coronary endothelial function and that Hcy can promote chemokine expression and insulin resistance (IR) by inducing endoplasmic reticulum stress in human adipose tissue and hypothyroid patients. The aim of this study was to investigate the potential harmful correlation between plasma Hcy and low-density lipoprotein cholesterol (LDL-C) in patients with HO...
July 2016: Medicine (Baltimore)
Lara Vera, Stefano Gay, Claudia Campomenosi, Sabrina Paolino, Giorgia Pera, Eleonora Monti, Lorenzo Mortara, Bruno Seriolo, Massimo Giusti
INTRODUCTION: After thyroidectomy and radioiodine therapy, patients with differentiated thyroid cancer (DTC) are indefinitely treated with levothyroxine (L-T4). Osteoporosis is a debated consequence of hypothyroxinaemia. The aim of this study was to evaluate bone mineral density (BMD) and fracture risk assessed by FRAX in a cohort of DTC women. MATERIAL AND METHODS: Seventy-four women with DTC (aged 56.5 ± 9.9 years) treated at the mean age of 51.9 ± 12.0 years were studied...
2016: Endokrynologia Polska
Mehdi Rajabi, Thangirala Sudha, Noureldien H E Darwish, Paul J Davis, Shaker A Mousa
The tyrosine-based hormones 3,3',5-triiodo-l-thyronine (l-T3) and l-thyroxine (l-T4) that are produced by the thyroid gland control metabolic functions. Iodothyronine deiodinase enzymes convert l-T4 to l-T3, the form of thyroid hormone critical to genomic actions within cells and regulation of metabolism, and to reverse-l-T3, a hormone isoform that is largely inactive. We used tertiary amines in a study of deiodination based on derivatives of tetraiodothyroacetic acid (tetrac)-a naturally occurring derivative of l-T4-to mimic the action of the iodothyronine deiodinases and deiodination of the outer ring iodines...
August 15, 2016: Bioorganic & Medicinal Chemistry Letters
Johannes W Dietrich, Gabi Landgrafe-Mende, Evelin Wiora, Apostolos Chatzitomaris, Harald H Klein, John E M Midgley, Rudolf Hoermann
Although technical problems of thyroid testing have largely been resolved by modern assay technology, biological variation remains a challenge. This applies to subclinical thyroid disease, non-thyroidal illness syndrome, and those 10% of hypothyroid patients, who report impaired quality of life, despite normal thyrotropin (TSH) concentrations under levothyroxine (L-T4) replacement. Among multiple explanations for this condition, inadequate treatment dosage and monotherapy with L-T4 in subjects with impaired deiodination have received major attention...
2016: Frontiers in Endocrinology
Debmalya Sanyal, Moutusi Raychaudhuri
According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH) could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity...
July 2016: Indian Journal of Endocrinology and Metabolism
Christophe Hommel, Etienne Delgrange
We report the case of a 49-year-old female patient with hypothyroidism who underwent bariatric surgery and developed severe hypothyroidism despite high doses of oral levothyroxine (L-T4) tablets. Initially, a high-dose L-T4 tablets absorption test was performed to exclude pseudo-malabsorption. In view of a modest increase in serum T4 levels, L-T4 liquid formulation absorption test was performed, and showed faster and more efficient absorption of thyroid hormones. We discuss the issue of distinguishing malabsorption from pseudo-malabsorption, review the literature concerning the benefits of liquid L-T4 in cases of impaired absorption such as bariatric surgery and consider the socio-economic implications of different liquid formulations...
June 16, 2016: Acta Clinica Belgica
Mary H Samuels, Irina Kolobova, Anne Smeraglio, Meike Niederhausen, Jeri S Janowsky, Kathryn G Schuff
BACKGROUND: There has been recent debate within the thyroid field regarding whether current upper limits of the thyrotropin (TSH) reference range should be lowered. This debate can be better informed by investigation of whether variations in thyroid function within the reference range have clinical effects. One important target organ for thyroid hormone is the brain, but little is known about variations in neurocognitive measures within the reference range for thyroid function. METHODS: This was a cross-sectional study of 132 otherwise healthy hypothyroid subjects receiving chronic replacement therapy with levothyroxine (LT4) who had TSH levels across the full span of the laboratory reference range (0...
September 2016: Thyroid: Official Journal of the American Thyroid Association
Carlo Cappelli, Ilenia Pirola, Elena Gandossi, Alessandra Cristiano, Linda Daffini, Barbara Agosti, Claudio Casella, Maurizio Castellano
Background. Recently, it has been shown that liquid L-T4 formulation can be ingested with breakfast. This study looked to extend these findings by investigating whether a soft gel capsule formulation of L-T4 could also be ingested at breakfast time. Methods. 60 patients (18-65 yrs), previously submitted to thyroidectomy for proven benign goitre in stable euthyroidism receiving liquid L-T4 therapy ingested with breakfast, were enrolled. TSH, fT4, and fT3 levels were assessed in all the patients who were switched from liquid L-T4 to a soft gel capsule formulation at the same dosage of L-T4...
2016: International Journal of Endocrinology
Poupak Fallahi, Silvia Martina Ferrari, Stefania Camastra, Ugo Politti, Ilaria Ruffilli, Roberto Vita, Giuseppe Navarra, Salvatore Benvenga, Alessandro Antonelli
OBJECTIVE: Drug malabsorption is one of the potential troubles after bariatric surgery. Evidence for diminished levothyroxine (L-T4) absorption has been reported in patients after bariatric surgery. METHODS: This study reports 17 cases of hypothyroid patients [who were well replaced with thyroxine tablets (for >1 year) to euthyroid thyrotropin (TSH) levels before surgery (13 Roux-en-Y gastric bypasses (RYGB); 4 biliary pancreatic diversions (BPD))]. From 3 to 8 months after surgery, these patients had elevated TSH levels...
June 7, 2016: Obesity Surgery
Grigorios Panagiotou, Kalliopi Pazaitou-Panayiotou, Stavroula A Paschou, Despina Komninou, Nikolaos Kalogeris, Andromachi Vryonidou, Christos S Mantzoros
BACKGROUND: Both thyroid hormones and irisin increase energy expenditure and induce browning of adipose tissue. However, irisin physiology and regulation remain largely unknown, and existing data are mainly derived from observational studies. In this study, we aimed to elucidate whether changes in thyroid-axis hormones alter circulating irisin levels in humans, thereby exerting a direct downstream effect on serum irisin. SUBJECTS AND METHODS: Samples from a cross-sectional evaluation and two interventions were utilized, including patients who had previously undergone thyroidectomy...
August 2016: Thyroid: Official Journal of the American Thyroid Association
Chunyun Fu, Shiyu Luo, Shujie Zhang, Jin Wang, Haiyang Zheng, Qi Yang, Bobo Xie, Xuyun Hu, Xin Fan, Jingsi Luo, Rongyu Chen, Jiasun Su, Yiping Shen, Xuefan Gu, Shaoke Chen
BACKGROUND: Defects in the human dual oxidase 2 (DUOX2) gene are reported to be one of the major causes of congenital hypothyroidism (CH). This study was set to examine the DUOX2 mutation spectrum and prevalence among Chinese CH and subclinical congenital hypothyroidism (SCH) patients and to define the relationships between DUOX2 genotypes and clinical phenotypes. METHODS: Peripheral venous blood samples were collected from 192 CH/SCH patients in Guangxi Zhuang Autonomous Region of China...
July 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
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