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hypothyroidism subclinical treatment

Rebecca S Usadi, Kathryn S Merriam
The incidence of subclinical hypothyroidism (SCH) in pregnancy was classically thought to be low; however, with new definition of normal TSH range in pregnancy, there has been an increase in the percentage of women who meet classification for SCH. The diagnosis of SCH is important not only for monitoring for maternal conversion to overt hypothyroidism, but also for identifying obstetric and neonatal outcomes related to SCH. Although there have been proven associations between maternal overt hypothyroidism and adverse obstetric and neonatal outcomes, there has been conflicting data on the correlation between SCH and these outcomes...
October 17, 2016: Seminars in Reproductive Medicine
Aimee Seungdamrong
Subclinical hypothyroidism has been found to be associated with adverse reproductive outcomes, such as infertility, miscarriage, preterm birth, and complications of pregnancy. Multiple studies have investigated the relationships between thyroid function, thyroid antibodies, fertility, and pregnancy. Thyroid autoimmunity is the most common cause of hypothyroidism in iodine-sufficient locations. Thyroid antibodies have been associated with adverse reproductive outcomes such as miscarriage and infertility. Debate exists regarding the method of identification of thyroid dysfunction in pregnancy, which can be conducted by targeted screening or by universal screening...
October 14, 2016: Seminars in Reproductive Medicine
Jeffrey M Kroopnick, Caroline S Kim
Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear...
October 14, 2016: Seminars in Reproductive Medicine
Zdeňka Límanová, Jan Jiskra
Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial. Large meta-analyses within last 10 years have shown that subclinical hyperthyroidism is associated with higher cardiovascular risk than subclinical hypothyroidism...
2016: Vnitr̆ní Lékar̆ství
Stephen R James, Lopamudra Ray, Kandasamy Ravichandran, Sunil Kumar Nanda
BACKGROUND: A controversy exists regarding the association between subclinical hypothyroidism (SH) and dyslipidemia. Moreover, studies on lipid ratios and atherogenic index of plasma (AIP) in SH are rare, particularly in the Indian scenario. AIM: This study aimed to investigate abnormalities in conventional lipid profile, lipid ratios, and AIP in SH and attempted to correlate thyroid stimulating hormone (TSH) and AIP in SH. MATERIALS AND METHODS: In this retrospective analysis of patient records of SH subjects and euthyroid subjects, age, free triiodothyronine, free thyroxine, TSH, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, lipid ratios, and AIP were compared between the two groups...
September 2016: Indian Journal of Endocrinology and Metabolism
Albino Petrone, Flaminio Mormile, Giacomo Bruni, Michela Quartieri, Maria R Bonsignore, Oreste Marrone
OBJECTIVE: In obstructive sleep apnea (OSA), while both hypothyroidism and hyperthyroidism have been studied, the occurrence of non-thyroidal illness syndrome (NTIS) (normal thyroid stimulating hormone [TSH] with low triiodotironine) has not been investigated. We explored the occurrence of NTIS in patients with moderate to severe OSA and its relationship to the severity of nocturnal respiratory disorders. We also studied the occurrence of subclinical hypothyroidism (SH, ie, high TSH with normal thyroxine) in OSA and changes in circulating TSH, free triiodotironine (fT3) and free thyroxine (fT4) after CPAP treatment...
July 2016: Sleep Medicine
Layal Chaker, Symen Ligthart, Tim I M Korevaar, Albert Hofman, Oscar H Franco, Robin P Peeters, Abbas Dehghan
BACKGROUND: The association of thyroid function with risk of type 2 diabetes remains elusive. We aimed to investigate the association of thyroid function with incident diabetes and progression from prediabetes to diabetes in a population-based prospective cohort study. METHODS: We included 8452 participants (mean age 65 years) with thyroid function measurement, defined by thyroid-stimulating hormone (TSH) and free thyroxine (FT4), and longitudinal assessment of diabetes incidence...
September 30, 2016: BMC Medicine
Jesper Roed Sorensen, Kristian Hillert Winther, Steen Joop Bonnema, Christian Godballe, Laszlo Hegedus
BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. METHODS: PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations...
September 27, 2016: Thyroid: Official Journal of the American Thyroid Association
Abhilash Chandra
BACKGROUND: There is an increased prevalence of hypothyroidism in chronic kidney disease (CKD) patients as the glomerular filtration rate falls. However, there is a paucity of Indian data in this respect. METHODS: A cross-sectional analysis was performed based on the database of the information system of a tertiary care hospital in northern India to retrieve results of nephrology CKD outpatients (> 18 years of age) from September 2013 to October 2015 to determine the prevalence of hypothyroidism in the non-dialysis-dependent CKD population...
September 2016: Kidney Research and Clinical Practice
Maria Adamarczuk-Janczyszyn, Aleksandra Zdrojowy-Wełna, Natalia Rogala, Katarzyna Zatońska, Grażyna Bednarek-Tupikowska
BACKGROUND: Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. OBJECTIVES: The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
BACKGROUND: Metformin was found to reduce elevated serum thyrotropin levels. No previous study has compared the effect of this drug on serum levels of thyrotropin and thyroid hormones between men and women. METHODS: The study included 23 women and 12 men with subclinical hypothyroidism, who because of coexisting diabetes or impaired fasting glucose were treated with metformin (1.7-3.0g daily). Fasting plasma glucose levels, the homeostatic model assessment 1 of insulin resistance ratio (HOMA1-IR), glycated hemoglobin, serum levels of thyrotropin, free and total thyroid hormones and prolactin, as well as thyroid peroxidase and thyroglobulin antibodies were assessed at baseline and after 4 months of metformin treatment...
July 16, 2016: Pharmacological Reports: PR
Won Sang Yoo, Hyun Kyung Chung
Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus...
September 2016: Endocrinology and Metabolism
Mette Nygaard Andersen, Anne-Marie Schjerning Olsen, Jesper Clausager Madsen, Søren Lund Kristensen, Jens Faber, Christian Torp-Pedersen, Gunnar H Gislason, Christian Selmer
CONTEXT: Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. OBJECTIVE: To examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. DESIGN: Register-based historical cohort study. SETTING AND PARTICIPANTS: Danish primary care patients and hospital outpatients aged 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997 - 2011...
August 29, 2016: Journal of Clinical Endocrinology and Metabolism
Sirshak Dutta, Kaustuv Das Biswas, Soumya Ghatak, Dibakar Haldar, Indranil Sen, Ramanuj Sinha
Primary laryngeal carcinoma is a common cancer, predominantly affecting males. Hypothyroidism is an undesirable sequela of both surgery and radiotherapy, the two most commonly used modalities of treatment. For advanced cases, standard treatment protocol includes total laryngectomy and neck dissection along with pre- or postoperative radiotherapy. Hemithyroidectomy is also routinely performed as an integral part of total laryngectomy. In the present study, assessment of the function of the remaining half of the thyroid gland has been done in cases of total laryngectomies in combination with uni- or bilateral neck dissection and pre- or postoperative radiotherapy...
August 2016: Ear, Nose, & Throat Journal
Chang Hoon Yim
Thyroid dysfunction during pregnancy can result in serious complications for both the mother and infant; however, these complications can be prevented by optimal treatment of maternal overt thyroid dysfunction. Although several studies have demonstrated that maternal subclinical hypothyroidism is associated with obstetric complications and neurocognitive impairments in offspring, there is limited evidence that levothyroxine treatment can improve these complications. Therefore, most professional societies do not recommend universal screening for thyroid dysfunction during pregnancy, and instead recommend a case-finding approach in which only high-risk women are tested...
September 2016: Endocrinology and Metabolism
Kamila Such, Aneta Gawlik, Aleksandra Dejner, Malgorzata Wasniewska, Agnieszka Zachurzok, Aleksandra Antosz, Tomasz Gawlik, Ewa Malecka-Tendera
The main purpose of our retrospective study was to evaluate the medical care of the patients with subclinical hypothyroidism (sHT) and to investigate the rationale for administering L-thyroxine (LT-4) to young sHT patients. Patients and Methods. Based on a retrospective review of the charts of 261 patients referred to the Endocrinology Outpatient Clinic between 2009 and 2014 with suspicion of sHT, 55 patients were enrolled for further analysis. Data collected was baseline age, anthropometric measurements, serum TSH, fT4, fT3, anti-thyroid autoantibodies, positive family history, absence/presence of clinical symptoms, length of follow-up, and data concerning LT-4 therapy (therapy: T1; no therapy: T0)...
2016: International Journal of Endocrinology
Connie M Rhee, Vanessa A Ravel, Elani Streja, Rajnish Mehrotra, Steven Kim, Jiaxi Wang, Danh V Nguyen, Csaba P Kovesdy, Gregory A Brent, Kamyar Kalantar-Zadeh
CONTEXT AND OBJECTIVE: End-stage renal disease patients have a higher risk of thyroid disease compared to those without kidney disease. While thyroid dysfunction is associated with higher death risk in the general population and those undergoing hemodialysis, little is known about the impact of thyroid disease upon mortality in peritoneal dialysis (PD) patients. Design, Setting, Participants, and Main Outcome: We examined the association of thyroid status, assessed by serum TSH, with all-cause mortality among PD patients from a large national dialysis organization who underwent one or more TSH measurements over five years (1/2007-12/2011)...
August 15, 2016: Journal of Clinical Endocrinology and Metabolism
Pedro W Rosario, Maria R Calsolari
No abstract text is available yet for this article.
November 2016: Clinical Endocrinology
Paolo Cavarzere, Marta Camilot, Florina Ion Popa, Silvana Lauriola, Francesca Teofoli, Rossella Gaudino, Monica Vincenzi, Franco Antoniazzi
OBJECTIVE: To evaluate the incidence of congenital hypothyroidism (CH) with delayed TSH elevation among low-birth-weight (LBW) newborns in North-Eastern Italy and to verify if they need a second or third screening. DESIGN: Analysis of clinical and biochemical data of newborns affected by CH with delayed TSH elevation identified by neonatal screening. METHODS: Data of all newborns with birth weight (BW) <2500 g and evidence of delayed TSH elevation at newborn screening were collected between 2011 and 2014...
November 2016: European Journal of Endocrinology
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