The Relationship of Serum Thyrotropin (TSH) to the Thyroid Hormones after Oral TSH-Releasing Hormone in Patients with Preclinical Hypothyroidism*

Jj, Staub; Noelpp, B.; Gräni, R; Gemsenjäger, E; Hauenstein, M; Girard, J

doi:10.1210/jcem-56-3-449

Cited by 25 publications

(21 citation statements)

References 15 publications

(19 reference statements)

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“…In fact, significant lowering of both FT4 and FT3 occurs in each of the three different grades of hypothyroid patients as classified according to Evered et al (1973), and is accompanied by a simultaneous significant in¬ crease in TSH secretion. These findings confirm and extend previous studies showing a gradual fall in T4 and a rise in TSH in similar groups of hypothyroids (Evered et al 1973;Sawin et al 1979;Bastenie et al 1980;Tunbridge et al 1981;Staub et al 1983). Significantly reduced FT3 levels in subclinical hypothyroidism were found in the present study as well as in that by Franklyn et al (1984a) despite normal T3 levels, as previously reported by others (Evered et al 1973;Sawin et al 1979;Bastenie et al 1980;Tunbridge et al 1981;Staub et al 1983).…”

Section: Discussionsupporting

confidence: 93%

“…Patients are usually classified as overt hypothyroid in the presence of typical symptoms and signs, low T4 and high TSH levels, mild hypothyroid when elevated TSH and low or normal T4 are associated with some clinical evi¬ dence of thyroid failure, and subclinically hypo¬ thyroid when TSH, basal and/or after TRH, is increased, T4 is in the normal range, and clinical manifestations of hypothyroidism are lacking (Evered et al 1973;Hall & Scanion 1979). Despite individual T4 levels in the normal range, patients with subclinical hypothyroidism have significantly lower mean serum T4 levels than healthy controls and subjects with asymptomatic autoimmune thy¬ roiditis and normal TSH secretion (Evered et al 1973;Sawin et al 1979;Bastenie et al 1980;Tunbridge et al 1981;Staub et al 1983). How¬ ever, serum free thyroid hormones (FT4, FT3) in hypothyroid patients have been evaluated in only a few investigations.…”

mentioning

confidence: 99%

“…How¬ ever, serum free thyroid hormones (FT4, FT3) in hypothyroid patients have been evaluated in only a few investigations. In the study by Staub et al (1983), FT4 levels were measured together with total T4 in 46 subjects with subclinical hypothy¬ roidism, and significantly lower mean values were reported. FT4 and FT3 concentrations have been determined in another study (Franklyn et al 1984a) in 17 patients with subclinical hypothy¬ roidism, and subnormal values were found in 9 for FT4 and in 7 also for FT3.…”

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confidence: 99%

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Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis

Ferrari

Paracchi

Parisio

et al. 1987

Acta Endocrinologica

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Serum total and free T4 and T3, thyroxinebinding globulin (TBG) and TSH, basal and 20, 30 and 60 min after TRH (200 \g=m\g iv), were evaluated in 125 hypothyroid patients (38 with severe, 23 with mild, and 64 with subclinical hypothyroidism), in 35 euthyroid subjects with autoimmune thyroiditis, and in 51 healthy controls. T4/TBG and T3/TBG ratios were also calculated. A significant decrease in all indices of thyroid function except for T3 occurred simultaneously with a significant increase in basal and TRH-stimulated TSH levels from healthy subjects to subclinical hypothyroids, from subclinical to mild and from mild to severe hypo-

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

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confidence: 99%

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Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis

Ferrari

Paracchi

Parisio

et al. 1987

Acta Endocrinologica

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“…Some of these abnormalities appear to reflect what has become known as the "euthyroid sick syndrome" (21). A number of CTD patients had thyroid test values consistent with incipient or true biochemical primary hypothyroidism ( 3 1,32). However, a large number of the CTD patients had thyroid test values consistent with hyperthyroxinemid hypertriiodothyronemia (6).…”

Section: Prevalence Of Abnormal Thyroid Function Tests In Connective mentioning

confidence: 99%

Prevalence of Abnormal Thyroid Function Tests in Connective Tissue Disease

Arnaout

Nasrallah

El‐Khateeb

1994

Scandinavian Journal of Rheumatology

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The prevalence of thyroid function tests' abnormalities in 170 patients with various connective tissue diseases (CTD) was examined and compared to a group of 100 age- and sex-matched controls. The overall prevalence of diagnosed thyroid disease was 3.5%. Categorizing the patients into 5 "functional groups" by the concurrent thyroid function test/results showed normal thyroid function tests in 14%, isolated elevated TSH levels with normal T4 and T3 levels in 4% and findings consistent with the laboratory diagnosis of primary hypothyroidism in 3%. The "euthyroid sick syndrome" was evidenced in 54% and elevated T4 levels and/or increased or normal T3 values with normal TSH in 25%. Antimicrosomal antibodies were noted in 12 patients (7%), with the highest incidence in systemic lupus erythromatosus patients (10%). patients with mixed connective tissue disease had significantly (p < 0.0005) higher frequency of hypothyroidism, whereas patients with systemic vasculities had higher frequency of hyperthyroxinemia. In conclusion, CTD patients frequently have abnormal results of one or more of thyroid function tests. Hypothyroidism and hyperthyroidism should be considered when evaluating symptoms and signs in CTD and a significant subset of CTD patients appears to be predisposed to the development of hyperthyroidism.

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“…Furthermore, human patients with preclinical hypothyroidism (serum T 4 normal, TSH normal or high, and exaggerated TRH response) often have low normal baseline T 4 concentrations but normal T 3 concentrations and therefore an increased T 3 :T 4 ratio. 32 The diagnostic applications of thyroid hormone levels in neonatal llamas are potentially significant. Congenital hypothyroidism has been reported in many species, 2,4,6,7,11,16,18,[21][22][23]29,34 and hypothyroidism in young llamas has also been reported.…”

Section: Discussionmentioning

confidence: 99%

Serum Triiodothyronine and Thyroxine Concentrations in Neonatal Llamas

McLaughlin

Evans²,

Colton³

1993

J VET Diagn Invest

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Abstract. Total serum triiodothyronine (T 3 ) and thyroxine (T,) concentrations were assayed in neonatal llamas from birth to 90 days of age. T 3 concentrations were high at birth and increased from birth to approximately 6 days, then gradually decreased. T 4 concentrations were highest at time of birth and decreased gradually over the 90-day period.Knowledge of baseline serum thyroid hormone concentrations is necessary for the diagnosis and investigation of thyroid-related diseases. Basal serum triiodothyronine (T 3 ) and thyroxine (T 4 ) concentrations for llamas (Llama glama) in North America have only recently been established. 13,30 One study determined serum T 3 and T 4 concentrations in males, females, and pregnant females, ranging in age from 6 months to 10 years. 30 The other study divided test subjects into several age and sex categories, including 1 group with animals less than 1 month old. 13 Research in other species, however, has shown that serum T 3 and T 4 concentrations are highest shortly after birth and decline thereafter for a variable period of time. 9,12,16,17,24 The extremely high hormone concentrations of neonatal animals could cause errors in interpretation if compared with normal values from older animals. An erroneous diagnosis of hyperthyroidism could result from comparing normal neonatal hormone concentrations to lower yet normal concentrations of older animals. Conversely, an animal with congenital hypothyroidism could have low thyroid hormone concentrations that fall within the range of normal values from older animals. Thus, a knowledge of serum T 3 and T 4 concentrations in the immediate perinatal period could be useful information for the investigation of congenital hypothyroidism in the neonatal llama.The objective of this study was to determine basal serum T 3 and T 4 concentrations and T 3 :T 4 ratios in neonatal llamas (crias) and to compare these values with those from older animals. Received for publication July 15, 1992. 208Serum T 3 concentrations were high in the 0-2-day age group (X = 5.13 ng/ml) and increased slightly in the 3-4-day and 5-6-day age groups before decreasing steadily in each age group thereafter (Table 1). Peak mean serum T 3 concentrations of 5.47 ng/ml occurred in the 3-4-day age group. Mean serum T 3 concentrations in the 11-30-day age group (3.27 ng/ml) were only approximately 60% of those in the 3-4-day age Materials and methodsSpecimen collection. Blood samples were collected from 66 crias of both sexes that appeared vigorous and exhibited normal behavior after birth. Venous blood samples were allowed to clot at 4 C, the samples were centrifuged, and the serum was removed and stored at -20 C until analyzed. The samples were allotted to groups based on the animal's age: 0-2 days, 3-4 days, 5-6 days, 7-8 days, 9-10 days, 11-30 days, 31-90 days.Hormone assays. Total serum T 4 concentrations were determined by use of a radioimmunoassay diagnostic kit. a Total serum T 3 concentrations were determined by use of a microparticle enzyme immunoassay. b The ...

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The Relationship of Serum Thyrotropin (TSH) to the Thyroid Hormones after Oral TSH-Releasing Hormone in Patients with Preclinical Hypothyroidism*

Cited by 25 publications

References 15 publications

Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis

Serum free thyroid hormones in different degrees of hypothyroidism and in euthyroid autoimmune thyroiditis

Prevalence of Abnormal Thyroid Function Tests in Connective Tissue Disease

Serum Triiodothyronine and Thyroxine Concentrations in Neonatal Llamas

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