Research Studies
The following links may be of interest.
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Articles
Thyrotropin and thyroid antibodies as predictors of hypothyroidism: a 13-year, longitudinal study of a community-based cohort using current immunoassay techniques. Walsh JP1, Bremner AP, Feddema P, Leedman PJ, Brown SJ, O'Leary P.
CONCLUSIONS: The use of TSH cutoffs of 2.5 and 4.0 mU/liter, combined with thyroid antibodies, provides a clinically useful estimate of the long-term risk of hypothyroidism.
To view full article http://www.ncbi.nlm.nih.gov/pubmed/20097710
Clinical Strategies in the Testing of Thyroid Function Jim Stockigt, M.D., FRACP, FRCPA Monash University and Alfred and Epworth Hospitals Melbourne, Australia Last Update: June 1, 2011.
To view full article http://www.ncbi.nlm.nih.gov/books/NBK285558/
Antithyroid peroxidase antibodies in women with polycystic ovary syndrome
Comment - High prevalence of thyroid autoimmunity in PCOS women of reproductive age brings this question in our mind that is it necessary to screen these patients for hypothyroidism?
To view full article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941407/
Ignored adult primary hypothyroidism presenting chiefly with persistent ovarian cysts: a need for increased awareness
Summary: It is necessary to consider hypothyroidism and other endocrine disorders in the differential diagnosis of adult patients with ovarian multiple cyst formation in order to prevent inadvertent ovarian surgery.
To view full article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184057/?report=classic
Is Neuropsychological Development Related to Maternal Hypothyroidism or to Maternal Hypothyroxinemia?
To view article http://press.endocrine.org/doi/full/10.1210/jcem.85.11.6961
Neonatal Effects of Maternal Hypothyroxinemia During Early Pregnancy
This study confirms that maternal hypothyroxinemia constitutes a serious risk factor for neurodevelopmental difficulties that can be identified in neonates as young as 3 weeks of age.
Effect of vitamin C on the absorption of levothyroxine in patients with hypothyroidism and gastritis
Published online 6 March 2014 in the JCEM http://press.endocrine.org/doi/abs/10.1210/jc.2013-4360
Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease
Published Feb 2014. To view full article visit http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937134/
Low levels of serum vitamin D3 are associated with autoimmune thyroid disease in pre-menopausal women
Conclusion :The levels of serum vitamin D were significantly lower in pre-menopausal women with AITD. Vitamin D deficiency and insufficiency were significantly associated with AITD in pre-menopausal women.
Published April 2014. To view full article visit http://www.ncbi.nlm.nih.gov/pubmed/24320141
Current Thyroid Cancer Trends in the United States published Feb 20 2014 in the Journal of American Medical Association
According to the MJA* - News in Brief
US researchers have called for action to reduce overdiagnosis and overtreatment of thyroid cancer after an analysis revealed the incidence of the cancer had nearly tripled from 4.9 to 14.3 per 100 000 people over 3 decades. The analysis, published in JAMA Otolaryngology–Head & Neck Surgery, looked at secular trends in patients diagnosed with thyroid cancer from 1975 to 2009. The researchers wrote that almost the entire increase in cancer diagnosis was attributable to papillary thyroid cancer, from 3.4 to 12.5 cases per 100 000 population over the time period. In women, the absolute increase in thyroid cancer diagnosis was almost four times that of men. The mortality rate of 0.5 deaths per 100 000 cases had been stable. The researchers wrote that the US seemed to have an “epidemic of diagnosis” of thyroid cancer. “A simple way that physicians could begin today [to approach this problem] would be to openly share with patients the uncertainty surrounding small thyroid cancers — explaining that many will never grow and cause harm to a patient — but it is not possible to know with certainty which ones fall into that category”, they wrote.
*The Medical Journal of Australia is Australia's premier journal of medical practice and clinical research, published by the Australasian Medical Publishing Company Proprietary Limited (AMPCo) for the Australian Medical Association.
January 2014 - Paradigm shifts in thyroid hormone replacement therapies for hypothyroidism http://www.nature.com/nrendo/journal/vaop/ncurrent/full/nrendo.2013.258.html#access
Abstract : Impaired psychological well-being, depression or anxiety are observed in 5–10% of hypothyroid patients receiving levothyroxine, despite normal TSH levels. Such complaints might hypothetically be related to increased free T4 and decreased free T3 serum concentrations, which result in the abnormally low free T4:free T3 ratios observed in 30% of patients on levothyroxine. Evidence is mounting that levothyroxine monotherapy cannot assure a euthyroid state in all tissues simultaneously, and that normal serum TSH levels in patients receiving levothyroxine reflect pituitary euthyroidism alone. Levothyroxine plus liothyronine combination therapy is gaining in popularity; although the evidence suggests it is generally not superior to levothyroxine monotherapy, in some of the 14 published trials this combination was definitely preferred by patients and associated with improved metabolic profiles. Disappointing results with combination therapy could be related to use of inappropriate levothyroxine and liothyronine doses, resulting in abnormal serum free T4:free T3 ratios. Alternatively, its potential benefit might be confined to patients with specific genetic polymorphisms in thyroid hormone transporters and deiodinases that affect the intracellular levels of T3 available for binding to T3 receptors. Levothyroxine monotherapy remains the standard treatment for hypothyroidism. However, in selected patients, new guidelines suggest that experimental combination therapy might be considered.
Nov 2013 - Vitamin d deficiency and its association with thyroid disease http://www.ncbi.nlm.nih.gov/pubmed/24533019
OBJECTIVES: Vitamin D deficiency is a global health problem, its role as an immune modulator has been recently emphasized. The evidence is increasingly pointing towards vitamin D significant role in reducing the incidence of autoimmune diseases. However, at this time the research on its role in autoimmune and thyroid disease is not conclusive. We aimed to examine the relationship between hypothyroidism and vitamin D deficiency and to clarify the relation between serum calcium levels with hypothyroid disease
CONCLUSION: Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
May 2013 - Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study. http://www.ncbi.nlm.nih.gov/pubmed/23539727
CONCLUSION:DTE therapy did not result in a significant improvement in quality of life; however, DTE caused modest weight loss and nearly half (48.6%) of the study patients expressed preference for DTE over L-T₄. DTE therapy may be relevant for some hypothyroid patients.
Aust Prescriber 2011;34:12-5 -Thyroid function tests Robin H Mortimer, Professor, Department of Endocrinology, Royal Brisbane and Women's Hospital, and the University of Queensland, Brisbane http://www.australianprescriber.com/magazine/34/1/12/5
Thyroid disorders can be difficult to detect clinically, but thyroid function tests can assist in making a diagnosis. Measuring thyroid stimulating hormone is the first step. If it is abnormal, free thyroxine should be measured. A raised concentration of thyroid stimulating hormone with a low concentration of free thyroxine suggests hypothyroidism. A low concentration of thyroid stimulating hormone with a high concentration of free thyroxine suggests hyperthyroidism. Measuring thyroid autoantibodies may help establish the cause of the dysfunction. Different assays can give different results, and tests of thyroid function may be affected by drugs and intercurrent illness.
Dec 2011 - The Link between Thyroid Function and Depression http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246784/
Abstract : The relation between thyroid function and depression has long been recognized. Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities. Traditionally, the most commonly documented abnormalities are elevated T4 levels, low T3, elevated rT3, a blunted TSH response to TRH, positive antithyroid antibodies, and elevated CSF TRH concentrations. In addition, thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressant drugs. However, the mechanisms underlying the interaction between thyroid function and depression remain to be further clarified. Recently, advances in biochemical, genetic, and neuroimaging fields have provided new insights into the thyroid-depression relationship.
Hashimoto's thyroiditis and insulin-dependent diabetes mellitus: differences among individuals with and without abnormal thyroid function.
PubMed article http://www.ncbi.nlm.nih.gov/pubmed/9589653
Effects of prophylactic thyroid hormone replacement in euthyroid Hashimoto's thyroiditis. Hashimoto's thyroiditis is the most frequent autoimmune thyroid disease. L-thyroxine therapy can reduce the incidence and alleviate the symptoms of this disease. PubMed article http://www.ncbi.nlm.nih.gov/pubmed/1600672