Endocrine Abstracts

Objective: Hypothyroidism is common and predominantly managed in primary care. Symptoms are non-specific, with thyroid function tests (TFT) required for diagnosis. We sought to investigate current practice in levothyroxine prescribing in primary care.Methods: We studied the initiation of levothyroxine using the General Practice Research Database (GPRD), the world’s largest database of anonymised medical records. Individuals with i) thyroid cancer ii...

Introduction: Peptide immunotherapy has been shown to be a simple and effective method of restoring tolerance and reversing disease in animal models of type 1 diabetes. It is highly important to administer the peptide interadermally into an environment in which antigen presenting cells such as dendritic cells are maintained in a tolerogenic state.Objective: Our aim was to determine whether topical pre-treatment of the skin has the potential to enhance to...

Expansion of the orbital contents, by adipogenesis and hyaluronan (HA) overproduction, causes Graves orbitopathy (GO). Orbital HA is generated predominantly by hyaluronan synthase 2 (HAS2) whose transcription is positively regulated by pAkt in cell lines. GO is most frequently associated with Graves’ disease (GD) in which thyroid stimulating antibodies bind the TSH receptor (TSHR) increasing cAMP. Previous studies highlight a role for TSAB and ‘neutral’ TSHR ant...

Objective: The hypothalamus–pituitary–thyroid axis profoundly influences skeletal development. Whilst the adverse effects of thyroid dysfunction on bone are well established; the effects of variation within the normal range is less clear.Design: In a subset of the Avon Longitudinal Study of Parents and Children we performed full thyroid function tests from stored samples taken at age 7. 668 children had thyroid hormone parameters within the ref...

Background: Single-nucleotide polymorphisms (SNPs) allow us to study effects of genetic variation on thyroid hormone levels. Phosphodiesterase 8B (PDE8B) is a protein responsible for cAMP generation, found in thyroid and brain tissue, but not normal pituitary tissue. Variation at this locus has been reported to influence TSH levels, but its effect on T3 and T4 had not been studied in the general population. Deiodinase 1 (DIO1) is known to influence T...

Introduction: It is standard teaching that thyroid function is associated with mood, in particular hypothyroidism with depression. Recent studies however have provided conflicting data, with community based studies suggesting no relationship, but a study in patients on thyroxine showing an association. There may be biases involved in these studies as in communities with good health care, symptomatic people with mildly abnormal thyroid function are often put on thyroxine and ex...

Background: CMA showed price paid for liothyronine tablets rose from £15.15 in 2009 to £258.19 in 2017; a £100 million fine against suppliers was made public December 2021. BTA published guidance on use of liothyronine for appropriate patients in May 2023 suggesting daily dose 5-10mg at possible split twice day. This report investigated link between amounts and costs of T3 prescribing for different dose levels over the last 6 years.<p class=...

Background: An association between breast cancer (BC) and thyroid autoimmunity has been frequently observed, and several small-scale studies correlated the presence of autoantibodies to thyroid peroxidase (TPOAb) with an improved BC outcome. We aimed to clarify in a large cohort of patients whether circulating TPOAb are prognostic for BC recurrence.Materials and methods: Available plasma samples for patients with node-positive or high-risk node-negative ...

Context: Approximately 15% of people with hypothyroidism remain symptomatic despite treatment. The Thr92Ala substitution in DIO2, may influence T3 tissue levels.Methods: We assessed HADS anxiety and depression scores in HUNT2 in 50,901 individuals (6,687 homozygous for Thr92Ala) of whom 1,480 had a history of levothyroxine use (180 homozygous for Thr92Ala). Anxiety and depression caseness (score>=8) by levothyroxine and Thr92Ala status was a...

Context: Up to 15% of people with hypothyroidism remain symptomatic despite treatment with levothyroxine. A proportion of these utilise combination thyroid hormone replacement, T3 monotherapy and desiccated thyroid extract (DTE). We sought to explore thyroid hormone profiles in these patients.Methods: We performed hourly blood tests (8.30am-4.30pm) to assess TSH, T3 and T4 levels in 49 individuals (n =14 combination thyroid hormone replacement, ...