Reference ranges of serum <scp>TSH</scp>,<scp> FT</scp>4 and thyroid autoantibodies in the Thai population: the national health examination survey

Sriphrapradang, Chutintorn; Pavarangkoon, Supatra; Jongjaroenprasert, Wallaya; Chailurkit, La‐or; Ongphiphadhanakul, Boonsong; Aekplakorn, Wichai

doi:10.1111/cen.12371

Cited by 36 publications

(32 citation statements)

References 31 publications

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“…We speculated with caution that apparently thyroid healthy individuals were likely to be recruited without rigorous exclusion criteria and iodine nutritional status was also not considered when the manufactures established the RIs of thyroid hormones. Table 4 shows the RIs of thyroid hormones reported by the investigators in various countries and regions during the past decade [11][12][13][16][17][18][19][20][21][22]. Our upper-limit of serum TSH level was marginally higher than Guan's results but similar with Li's results [11,13].…”

Section: Discussionsupporting

confidence: 83%

“…Our results showed that significant differences among all the age groups were observed in FT 3 , but neither in TSH nor in FT 4 . The findings were in accord with substantial previous studies [12,21,22,24,25], but were inconsistent with several other studies [13,17,20]. The possible explanations might be associated with the differences of race and iodine nutritional status [17,24,26,27].…”

Section: The Effects Of Age and Gender On Tsh And Other Thyroid Hormocontrasting

confidence: 57%

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Reference intervals of thyroid hormones in a previously iodine-deficient but presently more than adequate area of Western China: a population-based survey

et al. 2016

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Section: Discussionsupporting

confidence: 83%

Section: The Effects Of Age and Gender On Tsh And Other Thyroid Hormocontrasting

confidence: 57%

Reference intervals of thyroid hormones in a previously iodine-deficient but presently more than adequate area of Western China: a population-based survey

et al. 2016

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“…That debate is related to the heterogeneity in TSH reference ranges established in previous studies (6,7,8,9,10,11,12,13) with differences of the upper TSH limit between 2.12 mIU/l (12) and 5.30 mIU/l (13). These discrepancies can be explained by different study populations, age ranges (4), laboratory methods (14), and iodine supplies of populations (15,16).…”

Section: Introductionmentioning

confidence: 99%

“…These discrepancies can be explained by different study populations, age ranges (4), laboratory methods (14), and iodine supplies of populations (15,16). In regions with iodine deficiency, reference intervals for serum TSH levels tend to be lower than that in regions with sufficient iodine supply, leading to higher reference intervals in North America (6) and East Asia (8,10,13) than that in large parts of Europe (7,9,12), where most countries are inherently iodine deficient (17).…”

Section: Introductionmentioning

confidence: 99%

Shift of the TSH reference range with improved iodine supply in Northeast Germany

Ittermann

Khattak

Nauck

et al. 2015

European Journal of Endocrinology

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Objective: Germany was iodine deficient until the mid-1990s when a nationwide iodine fortification program became effective. It is expected that after a longer period of sufficient iodine supply, median TSH values in the general population will shift to the right. Hence, the previous TSH reference range does not reflect the current TSH distribution in the general population of Germany. Thus, we aimed to establish a new reference range for serum TSH levels. Design and methods: We used data from the Study of Health in Pomerania TREND, a population-based study including 4420 individuals. The reference population consisted of 1596 individuals without diagnosed thyroid diseases or thyroid-related findings in ultrasound and serum analysis. Serum TSH levels were measured by an immunochemiluminescent procedure on a Siemens Dimension Vista. Results: The overall reference range for TSH was 0.49 mIU/l (95% CIZ0.44; 0.53)-3.29 mIU/l (95% CIZ3.08; 3.50). The lower reference limit differed significantly by sex, whereas the upper reference limit showed no significant difference between males and females. Age was significantly associated with the 2.5th TSH percentile in males but not in females, whereas age was significantly associated in males and females for the 97.5th TSH percentile. Conclusions: We demonstrate a shift toward the right of the TSH reference range in comparison with data from the same study region 10 years earlier, which is likely due to the improved iodine supply of the study region. Our study indicates that TSH reference limits are dependent on past and current iodine supply of populations.

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“…Thyroid autoantibodies might probably be markers of some other autoimmune disorder affecting the brain 4. The presence of antithyroperoxidase can be found in nearly 9% of the general Thai population,16 therefore, presence of high titres are necessary for the diagnosis of HE, but not specific. A recent report showed that serum autoantibodies against the N-terminal of α-enolase are a useful diagnostic biomarker for HE 17…”

Section: Discussionmentioning

confidence: 99%

Steroid-responsive encephalopathy: an under recognised aspect of Hashimoto's thyroiditis

2015

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SUMMARYWe present a case of a patient who was diagnosed with Hashimoto's encephalopathy based on the presence of subacute behavioural changes, negative work up for infection and immunological serology except for high serum titres of thyroid autoantibodies. Thyroid function tests (TFTs) and MRI of the brain were normal. EEG showed low amplitude, slow waves and θ waves at both frontal areas. His condition improved dramatically after treated with high-dose glucocorticoid. After 2 years of a relapsing-remitting course, a new episode occurred. There was an abrupt change of TFTs within 5 days: free thyroxine (fT4) from 1.52 to 1.53 ng/mL, free triiodothyronine (fT3) from 3.25 to >30 pg/mL and thyroid-stimulating hormone (TSH) from 5.08 to 0.78 mIU/L. On the following day found fT4 2.58, fT3 14.67 and TSH 0.042. The patient was diagnosed with Hashitoxicosis. High-dose glucocorticoid and β-blockers were initiated. The symptoms gradually improved and TFTs normalised within 2 weeks. BACKGROUND

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Reference ranges of serum TSH, FT4 and thyroid autoantibodies in the Thai population: the national health examination survey

Abstract: The reference interval for TSH needs to be derived from each specific population. Slightly elevated TSH concentrations in the elderly could be considered acceptable, with no need for thyroxine treatment.

Cited by 36 publications

References 31 publications

Reference intervals of thyroid hormones in a previously iodine-deficient but presently more than adequate area of Western China: a population-based survey

Reference intervals of thyroid hormones in a previously iodine-deficient but presently more than adequate area of Western China: a population-based survey

Shift of the TSH reference range with improved iodine supply in Northeast Germany

Steroid-responsive encephalopathy: an under recognised aspect of Hashimoto's thyroiditis

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