Endocrine Abstracts

Objective: Thyroid hormones are essential for maintaining metabolic balance and particularly influence lipid synthesis and degradation. Metabolomics and in-depth lipid profiling may enable us to assess for differential effects of thyroid hormones and provide insight into tissue thyroid status, that cannot be captured by levels of serum free thyroid hormones alone.Methods: 4,347 children from the Avon Longitudinal Study of Parents and Children who had thy...

Introduction: Around 15% of people diagnosed with primary hypothyroidism remain significantly symptomatic despite TSH normalisation with levothyroxine (LT4). The Thr92Ala substitution (rs225014) in a key deiodinase that activates T4 to T3, DIO2 may influence tissue levels of T3 but previous studies have been inconsistent regarding symptoms on LT4 and the presence of this polymorphism.Methods: We assessed HADS anxiety and depression scores in the HUNT2 st...

Introduction: Thionamides are the mainstay of management of thyrotoxicosis but can be associated with adverse effects like agranulocystosis, hepatitis and vasculitis. While radioactive iodine and thyroidectomy can be utilized in such scenarios, they were not timely available during the COVID pandemic. We present our experience of using cholestyramine as monotherapy.Case Series: Our series consists of four females. Graves’ disease was the underlying ...

A 67-year-old lady was admitted through her General Practitioner with a history of reduced oral intake & unresponsiveness. She was diagnosed to have an insulinoma in 2012 and has been on diazoxide 75 mg thrice daily as she was deemed to be unfit for any surgical intervention. On clinical examination, she was pyrexial, tachycardic, hypoxic and had an initial GCS of 3. She was noted to have shingles on her chest & right basal coarse crackles.On adm...

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...

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...

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: The Controlled Antenatal Thyroid Screening II (CATS) study, a large randomised trial of thyroxine supplementation for suboptimal gestational thyroid function (SGTF), reported a higher prevalence of elevated attention deficit hyperactivity disorder (ADHD) scores in 9 year-old children exposed to higher thyroid hormone (TH) in utero. Here we investigated if this was accompanied by altered neurodevelopment.Methods: 85 children aged 11-1...

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 ...