Total T4 rise in pregnancy: a relook?
ConclusionRise in total T4 in second trimester pregnancy is only around 25% as compared to first trimester value and 35% than the non-pregnant value. Hence multiplying non-pregnant T4 value by 1.5 may actually over-diagnose maternal hypothroxinemia and lead to inappropriate diagnosis and treatment of isolated maternal hypothyroxinemia in a significant proportion of subjects. (Source: Thyroid Research)
Source: Thyroid Research - July 30, 2020 Category: Endocrinology Source Type: research
Kinetic analysis of the growth rate of sporadic and hereditary medullary thyroid carcinoma: comparing the postoperative calcitonin-doubling rate with the hypothetical preoperative tumor volume-doubling rate
ConclusionsIn this series of MTC patients, the pre-surgery calculated hypothetical TV-DRs were significantly higher than the Ct-DRs observed post-surgery, suggesting that there were rapid growth periods before surgery in the vast majority of these MTC patients. (Source: Thyroid Research)
Source: Thyroid Research - July 20, 2020 Category: Endocrinology Source Type: research
Teprotumumab: a disease modifying treatment for graves ’ orbitopathy
ConclusionsThe results from these two large clinical trials have shown teprotumumab to have remarkable effects on multiple clinical outcomes in GO, particularly in its ability to reverse proptosis. It may herald a new era in the treatment of thyroid eye disease and could offer an alternative to surgery and its associated complications. Additional studies will continue to shape the treatment of GO and define the role of teprotumumab within the treatment paradigm. (Source: Thyroid Research)
Source: Thyroid Research - July 3, 2020 Category: Endocrinology Source Type: research
Antithyroid drugs and birth defects
AbstractAntithyroid drugs (ATDs) are preferred for the treatment of hyperthyroidism caused by Graves ’ disease in pregnant women. The drugs have been a recognized treatment for decades, and a general risk of side effects is known. For the use of ATDs in pregnancy, a concern about teratogenic side effects has been brought forward since the 1970s. In more recent years, a number of large observation al studies have added new evidence and quantified the risk of birth defects associated with different types of ATDs. The findings that both Methimazole (MMI) and Propylthiouracil (PTU) are associated with birth defects have chal...
Source: Thyroid Research - June 26, 2020 Category: Endocrinology Source Type: research
Elevated serum TSH concentrations are associated with higher BMI Z-scores in southern Iranian children and adolescents
ConclusionBMI Z-score and elevated TSH levels are positively correlated however studies should be performed on establishing the causality. (Source: Thyroid Research)
Source: Thyroid Research - June 12, 2020 Category: Endocrinology Source Type: research
Macrofollicular variant of papillary thyroid carcinoma with metastasis to femur
ConclusionsOur case supports the view that, on rare ocassions, MFV-PTC may show a more aggressive biological behavior than expected. The synchronous or asynchronous presence of one or more bone lesions, should raise the suspicion of metastasis. Given the suspicion, it is necessary to take a biopsy to confirm histologically. Only a careful analysis of the architectural and cytological characteristics of goiter or hyperplastic nodules will allow to recognize this rare variety of carcinoma. (Source: Thyroid Research)
Source: Thyroid Research - June 12, 2020 Category: Endocrinology Source Type: research
Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic
ConclusionThyroid cancer has a higher prevalence in Yemen than in other middle eastern countries. Our study also reports a higher rate of follicular thyroid cancer than that in other published data, which has to be confirmed by further studies. The malignancy and premalignant diagnosis rate was ~ 50% in our patients who underwent surgery. Many centers in Yemen still do not perform FNA before thyroid surgery. It is important that other centers in the country start emphasizing the need for FNA before surgery. This will decrease the number of unnecessary surgeries and associated complications. (Source: Thyroid Research)
Source: Thyroid Research - June 5, 2020 Category: Endocrinology Source Type: research
Nice guideline on thyroid disease: where does it take us with liothyronine?
AbstractThe new NICE guidelines on thyroid disease and its management do not recommend the routine use of liothyronine, but do not completely rule it out either. Guidelines from the British and European Thyroid Associations are open to a “trial of liothyronine” on an individual basis.Some patients do not feel well on L-thyroxine despite a serum TSH in the reference range. Key issues to consider in such patients include establishing whether the patient had established hypothyroidism initially, and whether the L-thyroxine has been titrated carefully enough, possibly using small increments, to achieve a careful balance be...
Source: Thyroid Research - May 22, 2020 Category: Endocrinology Source Type: research
The effectiveness of cognitive- behavioral therapy on quality of life in women with hypothyroidism in the reproductive age: a randomized controlled trial
ConclusionCounseling using CBT can improve some aspects of quality of life, including emotional health, emotional health problems, energy and general health in patients with hypothyroidism.Trial registration numberIranian Registry for Clinical Trials: 20190323043101 N1.https://www.irct.ir/ (Source: Thyroid Research)
Source: Thyroid Research - May 19, 2020 Category: Endocrinology Source Type: research
Adequate timing and constant supervision are the keys for successful implementation of levothyroxine or levothyroxine/paracetamol absorption test
ConclusionsAdequate patient supervision and frequent sampling (e.g. every 30 min for 210 min) is the key for successful implementation of LT4 absorption test. Paracetamol coadministration appears superfluous in such cases. (Source: Thyroid Research)
Source: Thyroid Research - May 17, 2020 Category: Endocrinology Source Type: research
Time-dependent changes in FT4 and FT3 levels measured using mass spectrometry after an acute ingestion of excess levothyroxine in a case with hypothyroidism
ConclusionIt was helpful to clarify the time dependent changes in free thyroid hormone levels by ultrafiltration LC-MS/MS in discussing the clinical course in this case. Though mass spectrometry has a disadvantage in speed for routine laboratory use, its accurate measurement, particularly of levels exceeding the measurable range of the immunoassay, provides valuable information for more appropriate management of extreme thyrotoxicosis. (Source: Thyroid Research)
Source: Thyroid Research - April 30, 2020 Category: Endocrinology Source Type: research
Should radioiodine now be first line treatment for Graves ’ disease?
ConclusionsEarly radioiodine treatment will potentially reduce mortality and should be offered to patients with severe disease. However, thionamides are still suitable for patients with milder disease, contraindications to radioiodine, or individuals who choose to avoid permanent hypothyroidism. Ultimately, a patient individualised approach that prioritises early and sustained control of hyperthyroidism will improve long-term outcomes regardless of the therapy modality used. (Source: Thyroid Research)
Source: Thyroid Research - March 8, 2020 Category: Endocrinology Source Type: research
Falsely undetectable TSH in a euthyroid patient
ConclusionIf the result of TSH level revealed very low or undetectable through one specific method, it should not be considered necessarily as a symptom of hyperthyroidism. It is to be requested to measure by the other methods with other devices too. (Source: Thyroid Research)
Source: Thyroid Research - January 29, 2020 Category: Endocrinology Source Type: research
Cross-sectional and prospective study on anti-M üllerian hormone changes in a cohort of pre-menopausal women with a history of differentiated thyroid cancer
ConclusionsAMH can be considered a reliable index of ovarian reserve in women with DTC. Chronological age is the main factor influencing AMH levels in both DTC patients and controls. After age-related stratification, AMH levels are similar in women with DTC treated with RAI and those treated with surgery alone. (Source: Thyroid Research)
Source: Thyroid Research - January 9, 2020 Category: Endocrinology Source Type: research
Life-threatening complications of high doses of intravenous methylprednisolone for treatment of Graves ’ orbitopathy
ConclusionsAn individualized safe and effective dose of intravenous methylprednisolone should be established for each patient with GO based on the vascular risk factors, comorbidities, and concomitant drugs. According to the European Group on Graves ’ Orbitopathy (EUGOGO) guidelines, cumulative doses of intravenous methylprednisolone should not exceed 8 g. (Source: Thyroid Research)
Source: Thyroid Research - December 22, 2019 Category: Endocrinology Source Type: research
