Endocrine Abstracts

Subclinical hypothyroidism (SCH) is a relatively common endocrine condition characterised by raised serum thyrotropin (TSH) levels in the presence of normal circulating thyroid hormones. It is generally recognised that SCH – especially if it is sustained - is a mild form of hypothyroidism but whether it should be treated or not is a matter of a long-standing debate amongst both paediatric as well as adult endocrinologists. In adults, there are conflicting data on the long...

Background: Both overt hypothyroidism as well as subclinical hypothyroidism is frequently encountered in older individuals. It is increasingly being recognised that treatment of subclinical hypothyroidism may not be beneficial, particularly in an older person. These findings are particularly relevant at a time when treatment with thyroid hormones is increasing and more than 10–15% of people aged over 80 years are prescribed levothyroxine therapy.Mai...

Context: Serum TSH reference range increases with age but target TSH is similar in younger and older hypothyroid patients on treatment. It is unknown if quality of life (QoL), hypothyroid symptoms and cardiovascular (CV) risk factors change in older patients in whom a higher serum TSH is aimed for.Objective: To assess if a higher target serum TSH of 4.01–8.0 mU/l is feasible in and acceptable to older treated hypothyroid patients.<p class="abste...

Background: Graves disease is an autonomous condition characterised by interaction of the TSH receptor with autoantibody(TRAb). It is well recognised that atrial fibrillation (AF) is a consequence of hyperthyroidism but the prevalence, predictors and outcomes of AF in patients with Graves hyperthyroidism is not completely known.Method: We analysed a prospective database of Graves disease patients over a 16 year period fr...

Background: Graves’ disease is an autoimmune condition leading to hyperthyroidism and characteristically elevated TSH receptor antibody (TRAb). TRAb levels typically fall post-treatment with anti-thyroid drugs (ATDs) and are used in identifying risk of relapse. Tobacco smoking is a risk factor for reduced treatment efficacy of ATDs. We intended to evaluate the effect of smoking on changes in TRAb levels in patients treated for Graves’ disease.<p ...

Background: Thyroid function is affected by critical illness – termed as non-thyroidal illness – and usually presents with low serum TSH and FT3 levels but normal FT3 concentrations. Critically ill patients may also have impaired immune function that could contribute to increased susceptibility to acquired infections and mortality. Thyroid hormones influence neutrophil levels and function but the effect of non-thyroidal illness on neutrophil fun...

Background: Graves’ hyperthyroidism is treated with anti-thyroid drugs (ATD) for 12–18 months, after which ~50% of patients remain euthyroid. Risk factors predicting relapse are: male gender, younger age, orbitopathy, large goitres, severe hyperthyroidism at diagnosis and smoking. Recent reports suggest measurement of TBII at ATD cessation is useful in predicting risk of relapse. Aim: To prospectively investigate whether TBII levels at cessation of ATD therapy are us...

Background: Thyroid function within the normal range has been shown to influence body weight in a population. Even slightly elevated serum TSH levels are associated with an increase in the occurrence of obesity. It is unclear whether significant weight loss has the reverse effect on thyroid function, and studies to date have yielded inconsistent results.Aims: Our aim was to describe changes in TSH and fT4 in relation to durable and significant...

Background: Environmental factors play a role in the pathogenesis of autoimmune conditions. The incidence of type 1 diabetes is higher in winter. It is unclear whether autoimmune thyroid disease is similarly affected by seasonal variation. We aimed to study the variation in anti thyroid peroxidase (TPO) antibodies in relation to calendar month of sampling.Methods: We obtained TPO-antibody results for the 12 months (October 2009 till September 2010). Indi...

There are discrepancies between different studies with regards to the association of subclinical hypothyroidism (SCH), dyslipidaemia and cardiovascular (CV) disease. Therefore, we have conducted a systematic search and meta-analysis of population-based studies of CV disease in which thyroid status was examined and randomised controlled trials (RCTs) of treatment.The PubMed and Embase databases were searched for relevant studies published between 1976 and...