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Thyroid diseases are more prevalent in women, particularly between puberty and menopause. It is wellknown that estrogen (E) has indirect effects on the thyroid economy. Direct effects of this steroid hormone on thyroid cells have been described more recently; so, the aim of the present paper was to review the evidences of these effects on thyroid function and growth regulation, and its mechanisms. The expression and ratios of the two E receptors, α and β, that mediate the genomic effects of E on normal and abnormal thyroid tissue were also reviewed, as well as nongenomic, distinct molecular pathways. Several evidences support the hypothesis that E has a direct role in thyroid follicular cells; understanding its influence on the growth and function of the thyroid in normal and abnormal conditions can potentially provide new targets for the treatment of thyroid diseases.

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Our findings suggest that TE are associated with significantly increased prevalence of alcohol and anxiety comorbidity as well as lower BDNF levels in bipolar patients. It is possible that a decrease in BDNF levels may account for increased comorbidity, but further prospective studies are required to confirm this.

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Objective:To assess the impact of anxiety comorbidity on the quality of life of patients with bipolar disorder (BD). Methods:We undertook a cross-Sectional survey of 162 BD outpatients interviewed with the Structured Clinical Interview for DSM-IV. The primary outcome measure was quality of life, assessed with the 26-item WHO Quality of Life Instrument (WHOQOL-BREF).Results: Anxiety comorbidity in BD patients was associated with lower scores in all domains of quality of life. The impact of anxiety comorbidity on the psychological domain of the WHOQOL-BREF was kept, even when the current level of depression was added to the model as a confounding factor. Current anxiety comorbidity was also associated with lifetime alcohol abuse and dependence, rapid cycling, lifetime psychosis, number of suicide attempts, and a lower score in the Global Assessment of Functioning measure. Conclusion:Our findings suggest that anxiety comorbidity in BD patients is related to lower quality of life, particularly on the psychological domain. BD-anxiety comorbidity may be associated with such markers of illness severity as number of suicide attempts, rapid cycling, lifetime alcohol abuse, and psychosis. The recognition and treatment of anxiety comorbidity may help patients with BD to relieve their psychological pain and improve their overall quality of life. Clinical Implications· Anxiety comorbidity is highly prevalent among BD patients, with a great impact on quality of life, and warrants routine clinical assessment and better specific management.· The comprehension of a relation between BD-anxiety comorbidity and quality of life suggests the importance of routine screening for other associated factors, such as suicide risk, rapid cycling, and alcohol abuse. · Quality of life has increasingly become an outcome measure for treatment trials. Multiple factors, such as anxiety comorbidity, may affect quality of life and can be more specifically targeted in treatment interventions. Limitations· This study had a cross-Sectional design, so no causative evidence could be taken. · The anxiety disorders have been combined here, although they are not all alike. · Investigation of a broad concept such as quality of life may be affected by other possible confounders not considered here.