Ovarian Ultrasound and Ovarian and Adrenal Hormones before and after Treatment for Hyperthyroidism

Abstract

Objective: To relate thyroid, steroid and pituitary hormones to ovarian ultrasonographic findings in hyperthyroid patients before and during treatment. Study Design: Ultrasonography of the ovaries and serum hormone determination by immunoassay were performed before and during thiamazole therapy in 18 women of fertile age treated for hyperthyroidism at the Danderyd Hospital from 1996 to 1998. Results: When hyperthyreotic, the patients had elevated serum levels of sex hormone-binding globulin (SHBG) and subnormal values of cortisol, free testosterone (fT) and dehydroepiandrosterone (DHEA). In the euthyreotic state following treatment, endocrine variables were normalized. Patients with a short duration of the disease had higher pretreatment levels of free thyroxine (fT4), SHBG and testosterone and lower corticosteroid binding globulin (CBG) and cortisol levels compared to patients with a long duration of the disease. The pretreatment ultrasonographic picture was abnormal in 16 of 18 patients. Of the 8 patients who were examined by ultrasonography after 3 months of treatment, all but 1 showed a normal picture. Samples from patients showing an abnormal ultrasonographic picture had significantly higher fT4 and lower free testosterone (fT) values than samples from patients with a normal ultrasonographic picture. Conclusion: Ultrasonographic findings showing a multicystic/multifollicular picture, resembling polycystic ovaries (PCO), in hyperthyroidism may be related to direct effects of thyroid hormones on the ovaries and/or altered intraovarian androgen environment due to elevated SHBG levels. It is highly recommended to assess the thyroid status in patients with multicystic/multifollicular ovaries/PCO.

Increased Sex Hormone-Binding Globulin Levels in Children and Adolescents with Thyrotoxicosis

“…Our present findings of elevated SHBG levels in hyperthyroid children and adolescents with a normalization during ATT are in accordance with previous reports in adults [2,3,12]. In vitro studies have examined the stimulatory effect of thyroid hormones on SHBG concentrations and found a marked increase in the secretion of SHBG preceded by a similar increase in the concentration of SHBG mRNA when human hepatoblastoma cells are treated with thyroid hormones [13].…”

Positive Correlation between Serum Osteocalcin and Testosterone in Male Hyperthyroidism Patients with High Bone Turnover

“…Some indicated that the reason was the increased gonadotropin concentration like LH and FSH, for the unreduced function of hypothalamic-pituitary-gonadal axis in patients with hyperthyroidism [23], which was not consistent with our study. In addition, some demonstrated that the reason was the enhanced degradation rate of cholesterol to steroid hormone, which was promoted by thyroid hormone, since steroids could convert into testosterone in adrenal [24]. Lastly, other studies considered the reason was that the thyroid hormone directly acted on the ovary, which increased the secretion of testosterone by ovaries.…”

Graves’ disease as a driver of depression: a mechanistic insight

“…Subsequent abnormalities of various endocrine hormones are developed as a result of hyperthyroidism. Studies have confirmed that thyroid function will affect HPA axis activity, insulin sensitivity of glucose, lipid metabolism, and ovarian secretion function, resulting in hypercortisolism, insulin resistance, and sexual dysfunction (78,(98)(99)(100)(101)(102). On the other hand, patients with depression have manifested abnormalities of numerous hormones, including thyroid hormones, insulin, and sex hormones.…”