Symptoms of thyrotoxicosis, bone metabolism and occult atrial fibrillation in older women with mild endogenous subclinical hyperthyroidism

Rosário, Pedro Weslley; Carvalho, Marcos Alberto de; Calsolari, Maria Regina

doi:10.1111/cen.12979

Cited by 17 publications

(15 citation statements)

References 43 publications

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“…TSH in the lower two quartiles were independently related to osteoporosis and osteopenia 53 . The effects of endogenous SH especially on sites of cortical bone, the duration and the degree of TSH suppression were also confirmed by other recent studies [54][55][56] .…”

Section: Endogenous Subclinical Hyperthyroidism and Bone Diseasesupporting

confidence: 83%

Impact of subclinical hyperthyroidism on bone

Koutroumpi¹,

Stratigou²,

Vlassopoulou³

2019

JRPMS

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Normal balance of thyroid hormones plays a key role on skeletal growth and integrity. Overt hyperthyroidism is an established risk factor for osteoporosis and fractures. However, recent studies report that even subclinical hyperthyroidism has a negative impact on bone health. Screening of subjects at risk and consequent treatment to prevent or recover secondary bone loss depends on age, gender, menopausal status, severity and duration of thyroid dysfunction.

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Section: Endogenous Subclinical Hyperthyroidism and Bone Diseasesupporting

confidence: 83%

Impact of subclinical hyperthyroidism on bone

Koutroumpi¹,

Stratigou²,

Vlassopoulou³

2019

JRPMS

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“…Osteoclasts and osteoblasts have been reported to play a vital role in maintaining normal bone mass in bony remodeling [3]. The destruction of osteoblasts causes reduced bone formation and imbalanced bone metabolism.…”

Section: ------------------------------------------------------------mentioning

confidence: 99%

Calycosin regulates glucocorticoid-induced apoptosis via Nrf2/ARE signaling in MC3T3-E1 cells

Liu¹,

Wu²,

Zhu³

et al. 2018

Trop. J. Pharm Res

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“…Bu sebeple İki-üç ay aralıklarla TSH ölçümleri tekrarlanmalıdır. 28 Subklinik tedavi algoritması Şekil 1'de görülmektedir.…”

Section: Subkli̇ni̇k Ti̇rotoksi̇koz Nasil Tedavi̇ Edi̇li̇r ?unclassified

Subclinical Thyrotoxicosis

Şimşir¹,

ALTINER²,

Kabalak³

2017

Turkiye Klinikleri J Intern Med

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Ö ÖZ ZE ET T Subklinik tirotoksikoz, düşük tiroid stimülan hormon (TSH) varlığında normal serum serbest tiroksin (sT4) ve serbest triiyodotironin (sT3) düzeylerinin olması durumudur. Aşikar tirotoksikozda ise sT4, sT3 veya her ikisinin seviyelerinde yükselme ve TSH değerinde süpresyon izlenmektedir. TSH alt normal sınırı çeşitli ölçüm kitelerinde 0,2-0,4 µU/mL arasında verilmektedir. Subklinik tirotoksikoz insidansı yayınlarda oldukça farklı olarak verilmiştir. Farklılık, kabul edilen TSH kesme noktası değeriyle ilişkilidir. Subklinik tirotoksikozda hipertiroidi semptomları nonspesifik olduğundan subklinik tirotoksikoz sadece biyokimyasal bir tanımlamadır. Ancak, subklinik olsa bile tirotoksik semptom ve bulgular bulunabilmektedir. Subklinik hipertiroidi tanısı konulmadan önce laboratuvar hataları, TSH'nin sirkadiyan salgı özelliği olması ve günün farklı saatlerinde alınan kandaki ölçümlerde ufak farklılıklar olabileceği, özellikle sınıra yakın değerle-rin yanıltıcı olabileceği akıldan uzak tutulmamalıdır. Gereken durumlarda TSH ölçümü tekrarlanmalıdır. Subklinik hipertiroidi, ülkemiz gibi iyot yetersizliği bulunan bölgelerde daha sık görülmektedir. Tirotoksikoz tedavisinde semptomatik anlamda beta bloker kullanımı temel yaklaşımdır. Klasik hipertiroidi tedavi araçları; antitiroid ilaçlar (propiltiourasil veya metimazol), radyo iyot veya cerrahi tedavi, sebebe ve vakaya göre değerlendirilmektedir. Bu konuda önemli bir nokta da 80 yaş üstü hastalardır. Seksen yaş üstünde yaşam süresi TSH düzeyi ile doğru, sT4 dü-zeyi ile ters orantılıdır. Hastanın klinik olarak doğru değerlendirilmesi, tedavi ve izlemi için nüans yaratmaktadır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Tirotoksikoz; TSH; tiroksin, triiyodotironin A AB BS S T TR RA AC CT T Subclinical thyrotoxicosis is the presence of normal serum free thyroxine (fT4) and free triiodothyronine (fT3) levels in the presence of low thyroid stimulating hormone (TSH). In the case of obvious thyrotoxicosis, elevation in levels of fT4, fT3, or both, and suppression of TSH levels are observed. The lower normal limit of TSH subtype is given between 0.2-0.4 μU/mL in various measurement kits. The incidence of subclinical thyrotoxicosis is quite different in the literature. The difference is related to the accepted TSH cut-off point value. Since symptoms of hyperthyroidism are nonspecific, subclinical thyrotoxicosis is only a biochemical definition. However, even if the condition is subclinical, thyrotoxic symptoms and signs may be present. Before being diagnosed with subclinical hyperthyroidism, it should not be kept in mind that laboratory errors, that TSH has a circadian secretory feature, and that there may be slight differences in the measurements taken at different times of the day, especially near-transitory values may be misleading. TSH measurement should be repeated when necessary. Subclinical hyperthyroidism is more common in regions with iodine deficiency such as our country. The use of beta-blocker in symptomatic sense is the basic approach in the tr...

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Symptoms of thyrotoxicosis, bone metabolism and occult atrial fibrillation in older women with mild endogenous subclinical hyperthyroidism

Abstract: Mild endogenous SCH (TSH between 0·1 and 0·4 mIU/l) was not associated with symptoms of thyrotoxicosis, altered bone metabolism or a higher prevalence of occult AF in women ≥65 years.

Cited by 17 publications

References 43 publications

Impact of subclinical hyperthyroidism on bone

Impact of subclinical hyperthyroidism on bone

Calycosin regulates glucocorticoid-induced apoptosis via Nrf2/ARE signaling in MC3T3-E1 cells

Subclinical Thyrotoxicosis

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