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Background: Brain natriuretic peptide (BNP) is released from the ventricular myocardium as a reaction to volume expansion and pressure overload. Since the thyroid hormones stimulate the release of BNP, it can be used as an indicator of thyroid failure and guiding in thyroid control. This study was THUS designed to assess the value of measuring serum BNP as a marker for diagnosis and follow up of patients with subclinical and overt hyperthyroidism. Patients and Methods: This is a prospective cohort study for patients with hyperthyroidism. Patients have been enrolled from Endocrinology Outpatient Clinic at Zagazig University Hospitals in the period from December 2018 to October 2020. Results: Patients were divided into two major groups; overt hyperthyroidism (group 1) and subclinical hyperthyroidism (group 2). In all cases BNP level over 100 ng/l. Median for BNP in group (1) 671.89 and the median BNP in group (2 ) 318.19. We noticed a significant elevation of BNP levels in group (1) than group (2) (p = <0.001), Hyperthyroid patients with major clinical symptoms had showed higher BNP levels (656.9) than those with minor clinical complaint (314 .6) (p =<0.001). Positive correlations between BNP, F.T4 (p= <0.001) and F.T3 (p= <0.001) were documented. But there was no correlation between BNP and TSH or BMI (p= 0.595, p 0.104 respectively). Conclusions: BNP levels were significantly elevated in all patients of the study, especially in overt hyperthyroid than subclinical hyperthyroid patients. [ABSTRACT FROM AUTHOR]

Hypokalemic Periodic Paralysis (HPP) is a neurological manifestation of hypokalemia, with a prevalence of 1 in 100,000. HPP is recognized by the sudden onset of muscle paralysis and low serum potassium. Due to its various causes, it may be misdiagnosed and neglected. We present a case of 42-year-old Asian female with weakness of both legs and cramps. The weakness was felt upon awakening from sleep. She also complained of palpitation, tiredness, sweating, heat intolerance, and hand tremors. In the recent weeks, her appetite increased. Periodic paralysis (PP) is characterized by bursts of painless muscle weakening. A possible cause of periodic paralysis is hypokalemia which was found in our case. Hyperthyroid is classified into potassium depletion by extra renal route which was found in this case. Management When managing a patient with sudden onset weakness or paralysis, it is crucial to consider the possibility of periodic paralysis. HPP is a rare but serious medical emergency. This should be suspected in any patient presenting with sudden muscle weakness. Prompt correction of any abnormalities in potassium levels can lead to rapid and complete symptom resolution. To avoid persistent or recurrent paralysis, any underlying causes should be effectively managed wherever possible. [ABSTRACT FROM AUTHOR]

Cardiac dysfunction in thyrotoxicosis is believed to arise from changes in preload, afterload, heart rate, and contractility. Cardiomyopathy is a less frequent cardiac complication linked to thyrotoxicosis. Here, we present a rare case of thyrotoxicosis induced cardiomyopathy in a 30-year-old male, where dilated cardiomyopathy manifested as the initial sign of thyrotoxicosis. The patient was treated with antithyroid drugs, diuretics and beta blockers. General surgery opinion obtained and planned to do thyroidectomy after euthyroid status. Patient was followed up and after 6 weeks was symptomatically better and was found to be euthyroid and repeat 2D ECHO showed an improvement in systolic function with EF of 55% and the patient was planned for thyroidectomy. In the management of thyrotoxicosis induced cardiomyopathy, pharmacological interventions involve the use of specific thyroid therapies such as thionamides (methimazole, carbimazole, propylthiouracil) and beta-blockers, coupled with heart failure management. [ABSTRACT FROM AUTHOR]

Objective: To compare the demographic and clinical phenotypes of thyroid-associated ophthalmopathy (TAO) with euthyroidism (Eu-TAO), hyperthyroidism (Hr-TAO), and hypothyroidism (Ho-TAO). Methods: We enrolled 2158 TAO patients in this retrospective study and assessed their demographics, clinical manifestations, activity, and severity. Results: Among the enrolled patients, 526 (24.37%) had Eu-TAO, 1544 (71.55%) had Hr-TAO, and 88 (4.08%) had Ho-TAO. Compared to Hr-TAO (2.02) and Ho-TAO (2.52) patients, Eu-TAO (1.57) patients had the lowest female-to-male ratio (p = 0.026). The mean ages of Eu-TAO, Hr-TAO, and Ho-TAO patients were 43.11 ± 12.05, 42.23 ± 13.63, and 47.39 ± 13.28 years, respectively (p = 0.001). Patients with Eu-TAO had more unilateral involvement (50% vs. 14.38% vs. 21.59%, p < 0.001) than Hr-TAO or Ho-TAO patients. Clinically active TAO patients presented 8.56% in euthyroid vs. 13.86% in hyperthyroid vs. 11.36% in hypothyroid (p = 0.006). Regarding the severity of the European Group on Graves' Orbitopathy (EUGOGO) classification among euthyroid, hyperthyroid, and hypothyroid patients, mild TAO was present in 67.68, 54.27, and 72.72% of participants, moderate-to-severe TAO in 31.18, 42.49, and 26.14%, and sight-threatening TAO in 1.14, 3.24, and 1.14%, respectively. Eu-TAO was positively correlated with unilateral involvement (OR = 5.671, p < 0.001) and age (OR = 1.013, p = 0.003) and negatively correlated with the female-to-male ratio (OR = 0.656, p < 0.001) and TAO severity (OR = 0.742, p < 0.01). Conclusions: Eu-TAO patients are older and less likely to be female, and show more unilateral and milder clinical phenotypes than hyper/hypothyroid TAO patients. [ABSTRACT FROM AUTHOR]

Introduction: Hypothyroid or Hyperthyroid state affects all the physiological systems including cardiovascular system, central nervous system, digestive system, blood, etc. Despite increasing knowledge of thyroid physiology and better means for investigation of thyroid functions, we still are at preliminary stage of understanding the pathophysiology of these disorders Objectives: The present study was carried out to compare body T3, T4 and TSH levels in newly diagnosed patients of hypothyroidism, hyperthyroidism and age and gender matched euthyroid subjects Materials and methods: The present study was carried out in 90 female subjects in the age group of 30 to 45. Diagnosis of hypothyroidism and hyperthyroidism was based on both clinical and biochemical criteria. Subjects were divided in euthyroid, hypothyroid and hyperthyroid groups with each group containing 30 subjects. T3, T4 & TSH levels were measured in all the groups. Results: Hyperthyroid group had significantly higher T3 and T4 levels as compared to euthyroid and hypothyroid groups. Hypothyroid group had significantly higher TSH as compared to euthyroid and hyperthyroid groups. Conclusion: T3 and T4 levels are significantly higher in hyperthyroidism and they are significantly lower in Hypothyroidism as compared to euthyroid premenopausal women. TSH levels are significantly higher in hypothyroid subjects, while TSH levels are significantly lower in hyperthyroid subjects. Regular monitoring of T3, T4 and TSH especially in women is recommended. [ABSTRACT FROM AUTHOR]

Background: Patients with hyperthyroidism present a morbid life. The quality of life is low. Under this setting, understanding the clinical profile of these patients helps to improve their quality of life by the physician. Objectives: To study various cardiac manifestations in overt hyperthyroidism and subclinical hyperthyroidism. Methods: A total of 46 consecutive unselected patients with overt and subclinical hyperthyroidism were recruited. Institutional Ethics Committee permission was obtained and informed consent was taken from each and every patient. All had a structured cardiovascular history and examination, including measurements of blood pressure (BP) and pulse rate. All had resting 12-lead electrocardiogram and 2D-ECHO. Data was entered and analyzed. Results: In Hyperthyroidism out of 46. In patients population female preponderance was seen with male to female ratio being 4.5:5. Palpitation was the most common cardiovascular symptom, present in thirty two (70%) cases followed by Dyspnea and Chest pain. Atrial fibrillation was the predominant ECG finding in the present study, 19 patients out of 46 patients of hyperthyroidism followed by Sinus Tachycardia (35%), RAD (15%), RVHi (17%) and ST Changes (13%) 2D-Echocardiographic analysis showed Pulmonary Hypertension in 10 (22%) cases and Chamber Enlargement in 12 (26%) cases followed by Systolic Dysfunction (21.7%), Diastolic Dysfunction and Regurgitant Lesion chiefly MR & TR in a isolate case. Conclusion: In conclusion, thyroid disorder is a frequent disease, affecting more women than men. Thyroid hormones have essential effects on the cardiovascular system. Imbalance of their levels leads to disturbance in the homeostasis of the cardiovascular system. Serious cardiac complications such as congestive heart failure, atrial fibrillation, and angina pectoris may arise in thyroid disorder patients importantly, most of these deleterious hormone-mediated cardiovascular effects can be reversed or managed with the proper regulation or blockade of these hormones. Therefore, it is important for both endocrinologists and cardiologists to apply a global approach in the assessment of such patients and to improve the prognosis of severe cardiac complications in overt / subclinical hyper-thyroid dysfunction. [ABSTRACT FROM AUTHOR]

Thyroid hormone exerts effects across all organ systems. Hence, patients with thyroid dysfunction are at a risk of numerous complications. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation, and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to optimize the status of thyrotoxic and hypothyroid patients. This article describes the adverse effects of thyroid dysfunction in patients undergoing nonthyroid surgery and recommends treatment approaches aimed at appropriate build‑up to decrease perioperative risk. [ABSTRACT FROM AUTHOR]

Objective: To see the impact of abnormal secretion of thyroid hormones on red cell indices in patients of thyroid disorders. Study Design: Descriptive Cross Sectional study. Setting: Department of Pathology, Sahiwal Teaching Hospital, Sahiwal. Period: September 2020 to March 2021. Material & Methods: Two hundred and thirty four (234) patients of thyroid disorders were enrolled in total, out of which 44 were hyperthyroid, 102 were euthyroid and 88 were hypothyroid. Patients of both genders with age limit of 20-60 years were included. Blood samples for CBC and serum TSH were analysed. SPSS 20 was used to analyse data. To analyze significance among various groups of thyroid dysfunction, we applied an independent t-test. Results: The comparison of hyperthyroid and euthyroid groups, showed a statistically significant difference in the RBC count (p=0.043) and hematocrit (p=0.032). Between hyperthyroid and hypothyroid groups a statistically significant difference was also noted in the mean hemoglobin (p=0.036) and hematocrit (p=0.022). Comparison of hypothyroid and euthyroid groups remained statistically non-significant for any of the hematological parameters. Conclusion: A fluctuation in hematological indices is seen due to interrelation between erythropoiesis and thyroid dysfunction, therefore in patients with thyroid disorders, monitoring of hematological parameters should be done. [ABSTRACT FROM AUTHOR]

Synopsis: Hyperthyroid‐induced pulmonary hypertension in pregnancy is reversible with aggressive treatment together with close monitoring of cardiac function. [ABSTRACT FROM AUTHOR]

Objective: To find out the frequency of anemia, agranulocytosis and thrombocytopenia in hyperthyroid patients after the use of propylthiouracil. Study Design: Cross sectional study. Place and Duration of Study: Out Door Patients Department and Pathology Laboratory in Liaquat University Medical & Health Sciences, Hospital Hyderabad/Jamshoro, from May 2016 to Apr 2017. Methodology: Two hundred cases, comprising of adult patients were categorized into five groups, age group 15-30 years 79 (39.5%) patients presenting the highest out of total, age group 31-45 years 68 (34%) patients, age group 46-60 years 36 (18%), age group 61-75 years 14 (7%) patients, age group >75 years 3 (1.5) patients. Complete blood count was analyzed on Sysmex Kx21 and thyroid profiles were analyzed on Elecysis 2010 from the Pathology Department. SPSS version 22 was used for data analysis. Result: Out of total patients, 32 (16%) were males and 168 (84%) were females with mean age of 37.44 ± 14.82 years. Majority of patients 68 (34%) were anemic, while 4 (2%) had agranulocytosis and 11 (5.5%) had thrombocytopenia. Headache was reported in 111 (55.5%), exophthalmos in 106 (53%), sore throat in 172 (86%), fever in 136 (68%) and weight loss in 95 (47.5%) patients. Conclusion: Propylthiouracil causes defective hematopoiesis in hyperthyroid patients because propylthiouracil has adverse suppressive effects on bone marrow. [ABSTRACT FROM AUTHOR]

Background: Liver‐type fatty acid‐binding protein (L‐FABP) and neutrophil gelatinase‐associated lipocalin (NGAL) are candidate biomarkers for the detection of early chronic kidney disease (CKD) in cats. Objective: To evaluate urinary and serum L‐FABP and NGAL concentrations in CKD cats and in hyperthyroid cats before and after radioiodine (131I) treatment. Animals Nine CKD cats, 45 healthy cats and hyperthyroid cats at 3 time points including before (T0, n = 49), 1 month (T1, n = 49), and 11 to 29 months after (T2, n = 26) 131I treatment. Methods: Cross‐sectional and longitudinal study. Serum L‐FABP (sL‐FABP), serum NGAL (sNGAL), urinary L‐FABP (uL‐FABP), and urinary NGAL (uNGAL) were compared between the 3 groups and between hyperthyroid cats before and after treatment. Data are reported as median (min‐max). Results: CKD cats had significantly higher sL‐FABP (13.50 [3.40‐75.60] ng/ml) and uL‐FABP/Cr (4.90 [0.97‐2139.44] µg/g) than healthy cats (4.25 [1.34‐23.25] ng/ml; P =.01 and 0.46 [0.18‐9.13] µg/g; P <.001, respectively). Hyperthyroid cats at T0 had significantly higher uL‐FABP/Cr (0.94 [0.15‐896.00] µg/g) than healthy cats (P <.001), thereafter uL‐FABP/Cr significantly decreased at T2 (0.54 [0.10‐76.41] µg/g, P =.002). For the detection of CKD, uL‐FABP/Cr had 100% (95% confidence interval [CI], 66.4‐100.0) sensitivity and 93.2% (95% CI, 81.3‐98.6) specificity. There were no significant differences in sNGAL and uNGAL/Cr between the 3 groups. Conclusions and Clinical Importance: L‐FABP, but not NGAL, is a potential biomarker for the detection of early CKD in cats. Utility of uL‐FABP to predict azotemia after treatment in hyperthyroid cats remains unknown. [ABSTRACT FROM AUTHOR]

Thyroid dysfunction is an abnormality on thyroid gland that influences lipid metabolism and possibly has a role in lipid-related disease pathophysiology. This study evaluates the value of lipid profile on patients with hyperthyroid and hypothyroid. A cross-sectional study was conducted from January to February 2019. Lipid profile data from medical records were obtained and analyzed using statistical test. Most subjects with hyperthyroid or hypothyroid were females and at productive age. Hypothyroid had the highest mean value of triglyceride (260.18±39.39) and total cholesterol (31.09±26.95). Statistically, significant mean differences among three groups were only found in LDL-C (p <0.001), triglyceride (p <0.001), total cholesterol (p <0.001), and fT4 (p <0.001). On correlation test, we found that LDL-C, triglyceride, and total cholesterol were significantly correlated and had strong positive correlation (CC >0.400) with TSHs and strong negative correlation (CC <0.400) with fT4. Thyroid dysfunction is associated with lipid profile changes. Hyperthyroid causes decrease LDL-C, triglyceride, and total cholesterol levels, while hypothyroid causes an increase in LDL-C, triglyceride, and total cholesterol levels. [ABSTRACT FROM AUTHOR]

Thyroid hormones (THs) are vital for normal reproductive function and dysregulation of TH impairs follicular development. Although the functions of THs on female reproduction are of great interest, the mechanisms still remain unclear. Many studies have shown that NO plays important roles in female reproduction. In the present study, we investigate the effects of TH dysregulation on nitric oxide synthase types (NOS) expression in rats. Propylthiouracil (PTU) and L-thyroxine were administered to rats to induce hypo- and hyperthyroidism, respectively. Ovarian histology was detected by immunohistochemistry (IHC) and protein or mRNA content was analyzed by Western blotting or RT-PCR, respectively. The results showed that NOS1, NOS2 and NOS3 expressions were detected in the oocyte, granulosa cell and theca cell in all follicular stages, which were up-regulated by eCG treatment. NOS1 protein content was increased in both PTU and L-thyroxine treatments. There were no significant differences in NOS2 levels between the treatment and the control group. However, NOS3 was only increased in the hyperthyroid group. These results were consistent with the IHC staining. The present study provides evidence that TH dysregulation alters NOSs profiles, which suggests that NOSs/nitric oxide (NO) is possibly involved in the regulation of female reproduction. [ABSTRACT FROM AUTHOR]

Analysis of many clinically important analytes is dependent on antibody-based assays. However, depending on the design, these assays are vulnerable to interference from endogenous molecules including circulating antibodies and free biotin. In this case report, we describe a patient whose laboratory findings from immunoassay based methodologies, are inconsistent with the clinical presentation. A 14-year-old male was referred to Pediatric Endocrinology for suspected hyperthyroidism based on critically elevated free thyroxine (fT4) levels although clinical assessment was inconsistent with hyperthyroidism. Because repeat testing was discrepant, Endocrinology questioned the validity of the results prompting consultation with the laboratory to investigate the source of the inconsistent findings. Review of discordant results revealed that fT4 levels measured in laboratories utilizing Roche instrumentation were critically high, while results from laboratories using alternative platforms (i.e. Siemens Centaur) were within normal limits. After a comprehensive evaluation which included testing of paired specimens on multiple platforms, measurement of serially diluted specimens and a formal evaluation for the presence of heterophile antibodies, it was determined that a heterophile antibody interference was the most likely cause of the aberrant results in this patient. [ABSTRACT FROM AUTHOR]

Acute myocarditis and hyperthyroidism are common diseases that often present in young, otherwise healthy patients. Autoimmunity is central to the pathogenesis of both. Patients presenting with acute myocarditis should be screened for symptoms of hyperthyroidism, and physicians should consider screening for myocarditis in patients with hyperthyroidism and persistent cardiac symptoms. [ABSTRACT FROM AUTHOR]

Case of co-existence of twin pregnancy of complete hydatidiform molar with viable intrauterine pregnancy is extremely rare with low incidence of 1 case for 20,000 - 100,000. It is associated with high risk of spontaneous abortion, preterm delivery, intrauterine death, bleeding, pre-eclampsia, and persistence trophoblastic disease (PTD). It may associate with biochemical derangement that may induce symptomatic manifestation to the mother. There are few cases reported in Asia population with significant clinical dilemma and management to the maternal and foetus. Here, we report a case of a young woman with previous bad obstetric history who presented with antepartum per-vaginal bleeding and was noted to have a twin pregnancy with complete hydatidiform molar and viable foetus. It was complicated with markedly elevated human chorionic gonadotropin (hCG) and hyperthyroidism. Postpartumly, her hCG level was persistently high and her condition progressed into gestational trophoblastic neoplasm. [ABSTRACT FROM AUTHOR]

Background: Radioiodine is the treatment of choice for hyperthyroidism in cats. The ideal method of dose determination of radioiodine remains controversial. Objective: To compare a method of radioiodine dose determination that utilized thyroid scintigraphy with a standard fixed dose for treatment of hyperthyroidism. Animals Fifty‐seven and 23 client‐owned hyperthyroid cats in the variable and fixed dose groups, respectively. Methods: Cats with a percent dose uptake using 99mTc‐pertechnetate uptake on thyroid scintigraphy <5%, 5%‐10%, and >10% were to receive 3, 3.5, or 4.5 millicuries (mCi) of radioiodine, respectively, administered SC. Radioiodine dose was adjusted according to thyroid gland size as determined by the thyroid:salivary size ratio and categorized as <5:1, 5‐10:1, and >10:1. If the thyroid size fell into a higher dosing category than the percent dose uptake, the dose was increased accordingly. Cats in the fixed dose group received 4.5 mCi. Six months after treatment, cats were determined to be euthyroid, hypothyroid, or hyperthyroid based on serum thyroxine and thyroid stimulating hormone concentrations. Results: No difference in outcome was found between the variable and fixed dose treatment groups. Euthyroidism, hypothyroidism, and persistent hyperthyroidism developed in 61, 30, and 9% of cats in the fixed dose group compared to 58, 26, and 16%, respectively, in the variable dose group. Conclusions: A variable dosing method of radioiodine based on percent dose uptake primarily and thyroid gland size secondarily did not improve outcome compared to a standard fixed dose method. [ABSTRACT FROM AUTHOR]

Background: Our studies over recent years have focused on some new ideas concerning the pathogenesis for the orbital reaction that characterizes Graves’ ophthalmopathy namely, that there are antigens expressed by thyroid tissue and orbital tissue where they are targeted by autoantibodies and/or sensitized T cells, leading to orbital inflammation. While this has been well studied for the thyroid stimulating hormone-receptor, the possible role of another major thyroid antigen, Thyroglobulin (TG), has been largely ignored. Methods: We identified novel variant 1623 A/G single nucleotide polymorphism (SNP) (rs180195) in the promoter of TG gene associated with autoimmune thyroid disorders. We genotyped the TG SNPs rs2069566, rs2076739, rs121912646, rs121912647, rs121912648, rs121912649, rs121912650, rs137854433, rs137854434, and rs180195 by MassARRAY SNP analysis using iPLEX technology in a cohort of 529 patients with thyroid autoimmunity with and without ophthalmopathy, and controls. Results: We showed that variant 1623 A/G SNP (rs180195) in the promoter of TG gene is a marker for thyroid autoimmunity, but not for ophthalmopathy. We showed that there was a significant difference in the distribution of the major allele (G) vs minor allele (A) in patients with Hashimoto’s thyroiditis (HT). In HT the wild-type (GG) genotype was less common. We showed that the genotypes homozygous AA and heterozygous GA rs180195 SNP in the promoter of TG gene were more closely associated with thyroid autoimmunity than the wild-type (GG) polymorphism, and are thus, markers of autoimmunity. Conclusion: rs180195 SNP was previously identified by Stefan et al independently of us, who showed that this TG SNP predisposed to autoimmune thyroid diseases. However, this is the first study to explore the association between TG SNPs and HT. Our findings support the notion that the thyroid and orbital disorders are not part of the same disease, ie, “Graves’ disease” or “Hashimoto’s disease”, but separate autoimmune disorders. [ABSTRACT FROM AUTHOR]

Background: Maternal hyperthyroidism causes developmental defects on the nervous system of fetuses. Objectives: The present study was designed to study the effects of maternal hyperthyroidism on the development of the parietal lobe in the brain of rat embryos. Methods: In this experimental study, thirty Sprague-Dawley rats were randomly divided into three groups. The control group received no injections, the sham group received intraperitoneal injections of distilled water solution containing salt and polysorbate (solvent of levothyroxine) and the experimental group received once-daily, intraperitoneal injections of 0.5 mg/kg levothyroxine for a 10-day period to become hyperthyroid rats. The hyperthyroid rats were then mated and all pregnant rats were killed on the 20th day of gestation. Fetuses were removed, fixed, and processed for histological procedures. The fetuses were sagitally sectioned at 5 μ thickness and stained with hematoxylin-eosin (H and E) technique. The sections were examined using a light microscope and Motic software. Results: The results showed no significant difference in the studied variables between the sham and control groups. A significantly increase in body weight and a significant decrease in crown-rump length of embryos was observed in the experimental group when compared to the control group. The mean total thickness of the parietal cortex, ventricular layer and intermediate layer of embryos showed a significant decrease in the experimental group compared to the control and sham groups. The mean number of cells also showed a significant decrease in the intermediate and ventricular layers in the experimental group compared to the control and sham groups. Conclusions: This study showed that maternal hyperthyroidism leads to a reduction in development of the parietal cortex in embryos. Maternal hyperthyroidism can disturb the growth and development of embryos. [ABSTRACT FROM AUTHOR]

[Display omitted] • Hyperthyroidism decreased Grin2b expression level at young adult male rats. • Hyperthyroidism decreased learning and memory function at young adult male rats. • In hyperthyroidism, decreased memory function is possibly modulated by a mechanism involving Grin2b gene expression alteration. • In hyperthyroidism cdk5 did not affect hippocampal dependent spatial memory related genes. The hippocampus as an important structure for learning and memory functions contains a high level of thyroid hormone receptors. Although there are numerous studies investigating the effects of thyroid hormones on cognitive dysfunction and psychiatric symptoms, the underlying molecular processes of these disorders have not yet been fully elucidated. In the present study, 24 male adult rats (4 months) were divided into 3 groups: control group, sham group and hyperthyroid group. Hyperthyroid group and sham group were treated with l -thyroxine or saline for 21 days. Each group was exposed to Morris water maze testing (MWMT), measuring their performance in a hidden-platform spatial task. After learning and memory tests, intracardiac blood was taken from the rats for serum thyroxine levels. Following blood collection, the rats were decapitated to isolate hippocampal tissue. GRIN2A, GRIN2B, BDNF, cFOS, Cdk5, cdk5r1 (p35), and cdk5r2 (p39) gene expression were evaluated using quantitative reverse transcriptase-PCR. Serum thyroxine level was found to be higher in hyperthyroid rats than in the control and sham groups. According to our MWMT findings, the memory performance of the hyperthyroid group was significantly impaired compared to the control and sham groups (p < 0.05). In the hippocampus, the GRIN2A gene expression level was decreased in the sham group, and the GRIN2B gene expression level was decreased in the sham and hyperthyroid groups compared to the control group (p < 0.05). There was no significant difference in other genes (p > 0.05). Hyperthyroidism impaired hippocampus-dependent spatial memory. Hyperthyroidism caused decreased level of GRIN2B gene expression in the hippocampus. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effects of thyroid dysfunction on markers of oxidative stress in rat pancreas. Hypothyroidism and hyperthyroidism were, respectively, induced in rats via administration of propylthiouracil (PTU) and L-thyroxine sodium salt in drinking water for 45 days. The activities of superoxide dismutase (SOD), catalase (CAT), glutathioen peroxidase (GPx), glutathione reductase (GR), glucose-6-phosphate dehydrogenase (G6PD), xanthine oxidase (XO), and nonenzymatic markers of oxidative stress including malondialdehyde (MDA), protein carbonyl (PC), reduced glutathione (GSH), and total thiols (T-SH) were determined in the rat pancreas. In hyperthyroid rats, pancreatic CAT, SOD, GPx, GR, XO, G6PD activities were increased compared with those in hypothyroid and control groups. There were no differences in activities of antioxidant enzymes between hypothyroid and control rats. Pancreatic MDA and PC in hyperthyroid rats increased compared with hypothyroid and the control animals. Whereas, hyperthyroid rats had decreased levels of tissue GSH and T-SH compared with hypothyroid and the control groups. The findings showed that only GSH level has decreased significantly in the hypothyroid group compared with control groups. In conclusion, our results showed that experimental hyperthyroidism induces oxidative stress in pancreas of rats, but hypothyroidism has no major impact on oxidative stress markers. [ABSTRACT FROM AUTHOR]

Background In humans, measurement of serum thyroid-stimulating hormone ( TSH) concentration is commonly used as a first-line discriminatory test of thyroid function. Recent reports indicate that canine TSH ( cTSH) assays can be used to measure feline TSH and results can help diagnose or exclude hyperthyroidism. Objectives To investigate the usefulness of cTSH measurements as a diagnostic test for cats with hyperthyroidism. Animals Nine hundred and seventeen cats with untreated hyperthyroidism, 32 euthyroid cats suspected of having hyperthyroidism, and 131 clinically normal cats. Methods Prospective study. Cats referred to the Animal Endocrine Clinic for suspected hyperthyroidism were evaluated with serum T4, T3, free T4 ( fT4), and TSH concentrations. Thyroid scintigraphy was used as the gold standard to confirm or exclude hyperthyroidism. Results Median serum TSH concentration in the hyperthyroid cats (<0.03 ng/ mL) was significantly ( P < .001) lower than concentrations in clinically normal cats (0.05 ng/ mL) or euthyroid cats with suspected thyroid disease (0.06 ng/ mL). Only 18 (2.0%) hyperthyroid cats had measurable TSH concentrations (≥0.03 ng/ mL), whereas 114 (69.9%) of the 163 euthyroid cats had detectable concentrations. Combining serum TSH with T4 or fT4 concentrations lowered the test sensitivity of TSH from 98.0 to 97.0%, but markedly increased overall test specificity (from 69.9 to 98.8%). Conclusions and Clinical Importance Serum TSH concentrations are suppressed in 98% of hyperthyroid cats, but concentrations are measurable in a few cats with mild-to-moderate hyperthyroidism. Measurement of serum TSH represents a highly sensitive but poorly specific test for diagnosis of hyperthyroidism and is best measured in combination with T4 and fT4. [ABSTRACT FROM AUTHOR]

The article describes the case of a 37-year-old Filipino male presented to a community emergency department with acute bilateral flaccid leg paralysis.

The objective of the present study was to investigate the effect of melatonin and L-thyroxine (T4) on the expression of various receptors, and some metabolic, reproductive, and gonadotropic hormones in letrozole-induced polycystic ovary syndrome (PCOS) in rats. Assessment of gravimetric, hormonal profile and thyroid histology and relative expression of melatonin receptors (MT1, MT2) and estrogen receptor α (Erα) in thyroid and ovary, and type II iodothyronine deiodinase (Dio2) and thyroid hormone receptor α (TRα) in the ovary were performed using standard protocols. A significant increase in thyroid follicles numbers was noted in the hyperthyroid rat. T4 treatment to PCOS showed the expected increment in the circulating level of triiodothyronine (T 3) and T 4. Melatonin and T4 treatment of PCOS rats resulted in a significant decrease in the circulating level of T 3 and T 4. Hyperthyroid rats showed a decrement in plasma melatonin levels. However, T4 treatment to PCOS rats showed increased circulating melatonin levels, and a decrease in the circulating level of gonadotropins (LH and FSH), and testosterone. Melatonin treatment to PCOS-hyperthyroid rats resulted in the normal expression of ovarian and thyroid MT1 and ERα, receptors, which had been altered in PCOS and hyperthyroid rats, without any significant change in the MT2 receptor. The present findings suggest a fine interplay and cross-talk via melatonin and its two receptors with ERα, TRα, and Dio 2 in thyroid and ovarian tissue during PCOS and hyperthyroidism pathogenicity. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this study is to assess for differences in incidence of gestational diabetes mellitus (GDM) for patients with thyroid hypofunction versus patients with thyroid hyperfunction. Methods: A retrospective chart review of all women with clinical thyroid disease delivering at Johns Hopkins Hospital from January 2005 to December 2008 was performed. Clinical parameters were abstracted and appropriate statistical tests were performed. Results: GDM occurred in 12.3% of women in the study cohort. Of the women with hypothyroidism, 14.3% developed GDM compared to 5.8% of hyperthyroid women. Cesarean delivery was significantly higher in women with hypothyroidism versus women with hyperthyroidism ( p = 0.002). There were no differences between groups with respect to preterm delivery, postpartum hemorrhage or hypertensive disorders of pregnancy. Conclusions: If larger studies confirm the trends observed in our study, consideration should be given to including women with known thyroid disease in the subset of women who should be offered screening for diabetes early in pregnancy and appropriate clinical surveillance. [ABSTRACT FROM AUTHOR]

Purpose: It is well known that thyroid hormone disorders can influence homeostasis of trace elements in the body, such as zinc (Zn). The aim of this study was to evaluate saliva Zn levels in patients with thyroid diseases. Material and Method: The study was performed on 126 patients (21 male, 105 female) with thyroid diseases (31 hyperthyroid, 30 hypothyroid, 31 subclinical hyperthyroid and 34 subclinical hypothyroid) and 38 healthy control subjects (7 male, 31female). Saliva was collected from all participants and Zn levels were determined on an atomic absorption spectrophotometer. Results: Our results demonstrated that saliva Zn (p=0.007 for hypothyroid patients and p=0.023 for subclinical hypothyroid patients) levels were significantly lower in hypothyroid and subclinical hypothyroid patients than in control subjects. Discussion: This is the first study investigating saliva Zn levels in patients with thyroid diseases. Our results show that saliva Zn levels are affected by hypothyroid disease. Turk Jem 2013; 17: 1-4 [ABSTRACT FROM AUTHOR]

Disrupted thyroid hormone function evokes severe physiological consequences in the immature brain. In adulthood, although clinical reports document an effect of thyroid hormone status on mood and cognition, the molecular and cellular changes underlying these behavioural effects are poorly understood. More recently, the subtle effects of thyroid hormone on structural plasticity in the mature brain, in particular on adult hippocampal neurogenesis, have come to be appreciated. However, the specific stages of adult hippocampal progenitor development that are sensitive to thyroid hormone are not defined. Using nestin-green fluorescent protein reporter mice, we demonstrate that thyroid hormone mediates its effects on hippocampal neurogenesis by influencing Type 2b and Type 3 progenitors, although it does not alter proliferation of either the Type 1 quiescent progenitor or the Type 2a amplifying neural progenitor. Thyroid hormone increases the number of doublecortin (DCX)-positive Type 3 progenitors, and accelerates neuronal differentiation into both DCX-positive immature neurones and neuronal nuclei-positive granule cell neurones. Furthermore, we show that this increase in neuronal differentiation is accompanied by a significant induction of specific transcription factors involved in hippocampal progenitor differentiation. In vitro studies using the neurosphere assay support a direct effect of thyroid hormone on progenitor development because neurospheres treated with thyroid hormone are shifted to a more differentiated state. Taken together, our results indicate that thyroid hormone mediates its neurogenic effects via targeting Type 2b and Type 3 hippocampal progenitors, and suggests a role for proneural transcription factors in contributing to the effects of thyroid hormone on neuronal differentiation of adult hippocampal progenitors. [ABSTRACT FROM AUTHOR]

Abstract: Background: Previous studies reported that RAS inhibitors prevented atrial fibrillation by improving atrial electrical and structural remodeling. However, the effect of RAS inhibitors on the substrates of atrial fibrillation (AF) underlying hyperthyroid is unclear. Methods: Forty rabbits were assigned to four groups: sham group, thyroxine group, benazepril group and irbesartan group (10 per group). The atrial effective refractory period (AERP) was measured. The physiologic rate adaptation and the AF vulnerability were evaluated. The real-time PCR, Western blot or fluorescent immunohistochemistry was performed to detect the expression of AF related Ca+, K+ channel and gap junction. Results: No significant difference was found in AERP among the thyroxine group, benazepril group and irbesartan group (75.13±5.41ms vs. 76.63±4.44ms, 79±4.95ms, P =0.28). However, benazepril or irbesartan could reduce AF vulnerability underlying hyperthyroid (75% vs. 37%, 44%, for thyroxine group, benazepril group and irbesartan group, respectively), and significantly improved physiologic rate adaptation of the AERP. Furthermore, both drugs significantly reduced L-Ca2+ channel related subunits (α1C or α1D) and interstitial fibrosis (17.1±2.2% vs. 12.3±1.8, 11.7±1.2%, P <0.01, for thyroxine group, benazepril group and irbesartan group, respectively), increased lateral/polar connection of Cx43 (1.04±0.16 vs. 1.33±0.29,1.28±0.25, P <0.01, for thyroxine group, benazepril group and irbesartan group, respectively) and improved the abnormal distribution of gap junctions (Cx40, Cx43) underlying hyperthyroid. Conclusion: Blockade of angiotensin II could improve abnormal atrial electrophysiological properties and further reduce AF vulnerability by extenuating ion channel, gap junction and structural remodeling in experimental thyrotoxic rabbits. [Copyright &y& Elsevier]

Abstract: Excessive thyroid hormone induces cardiac hypertrophy and promotes heart failure in patients with hyperthyroidism, but the mechanism remains elusive. Rats were orally administered with levothyroxine (100μg/kg, T4) for 4 weeks to induce hyperthyroidism. The calculated stroke volume decreased and the shortening amplitude–frequency relationship in unloaded contraction of isolated cardiomyocytes was negative in T4-treated rats. Apoptotic rates increased and DNA laddering was also detectable in T4-treated rat hearts. By contrast, in primary cultured cardiomyocytes, T3 induced dose-dependent hypertrophy but did not affect the apoptotic rate. Angiotensin II further increased the apoptotic rate of T3-induced hypertrophied cardiomyocytes. The apoptotic rate was dependent on the extent of cardiomyocyte hypertrophy. These results suggest that cardiac contractility is enhanced during the early stage of hyperthyroidism, but decreased during the late stage of hyperthyroidism. The hypertrophied cardiomyocytes were also susceptible to apoptotic stimulation by angiotensin II. Depressed cardiac contractility and enhanced apoptosis may lead to heart failure in hypertrophied myocardium. [Copyright &y& Elsevier]

To understand the mechanism of cardiovascular dysfunction in the hyperthyroid condition, the role of oxidative stress was examined in rats treated with 3,5,3′-triiodo-l-thyronine (T3). Treatment of rats daily with T3 (8 μg/100 g BW) for 15 days resulted in an increase in heart weight to body weight ratio, which was ameliorated by antioxidants, melatonin (2 mg/100 g BW) or vitamin E (4 mg/100 g BW). Both melatonin and vitamin E also inhibited rises of lipid peroxidation and hydroxyl radical generation and prevented the inhibition of Cu,Zn-superoxide dismutase in the hypertrophic heart. The expression of the glucose transporter, GLUT4, was reduced in response to T3, which was completely restored by melatonin and partially by vitamin E. However, neither antioxidant prevented down regulation of peroxisome proliferator-activated receptor- α in the hyperthyroid heart. Furthermore, the reduced level of myocyte enhancer factor-2, a regulator of GLUT4 transcription was restored completely by melatonin and partially by vitamin E treatment. Glucose uptake in hypertrophic left ventricular cells was also restored by these antioxidants. The expression of B-type natriuretic peptide, a marker of heart failure, was significantly increased by T3 and ameliorated by melatonin or vitamin E treatments. In general, the beneficial effects of melatonin given as a co-treatment with T3 were better than those induced by vitamin E. These data show that melatonin ameliorates hypertrophic growth of the myocardium induced by hyperthyroidism and provide an insight into the mechanism of reactive oxygen species-mediated down regulation of metabolically important genes such as GLUT4 in the heart. [ABSTRACT FROM AUTHOR]

Thyroid dysfunction is associated with attention deficit and impairment of the motor system (muscle weakness and fatigue). This paper investigates possible motor function deficit in thyroid patients, compared to the controls. Functional MRI studies (fMRI) were carried out in five hypo and five hyperthyroid patients and six healthy volunteers. Whole brain imaging was performed using echo planar imaging (EPI) technique, on a 1.5T whole body MR system (Siemens Magnetom Vision). The task paradigm consisted of 8 cycles of active and reference phases of 6 measurements each, with right index finger tapping at a rate of 120 taps/min. Post-processing was performed using statistical parametric mapping on a voxel-by-voxel basis using SPM99. Clusters of activation were found in the contralateral hemisphere in primary somatomotor area (M1), supplementary motor area (SMA), somatosensory, auditory receptive and integration areas, inferior temporal lobe, thalamus and cerebellum. Increased clusters of activation were observed in M1 in thyroid subjects as compared to controls and with bilateral activation of the primary motor cortex in two hyperthyroid patients. The results are explained in terms of increased functional demands in thyroid patients compared to volunteers for the execution of the same task. [ABSTRACT FROM AUTHOR]

Abstract: Thyroid hormones (THs) have critical roles in brain development and normal brain function in vertebrates. Clinical evidence suggests that some human nervous disorders involving GABA(γ-aminobutyric acid)-ergic systems are related to thyroid dysfunction (i.e. hyperthyroidism or hypothyroidism). There is experimental evidence from in vivo and in vitro studies on rats and mice indicating that THs have effects on multiple components of the GABA system. These include effects on enzyme activities responsible for synthesis and degradation of GABA, levels of glutamate and GABA, GABA release and reuptake, and GABAA receptor expression and function. In developing brain, hypothyroidism generally decreases enzyme activities and GABA levels whereas in adult brain, hypothyroidism generally increases enzyme activities and GABA levels. Hyperthyroidism does not always have the opposite effect. In vitro studies on adult brain have shown that THs enhance GABA release and inhibit GABA-reuptake by rapid, extranuclear actions, suggesting that presence of THs in the synapse could prolong the action of GABA after release. There are conflicting results on effects of long term changes in TH levels on GABA reuptake. Increasing and decreasing circulating TH levels experimentally in vivo alter density of GABAA receptor-binding sites for GABA and benzodiazepines in brain, but results vary from study to study, which may reflect important regional differences in the brain. There is substantial evidence that THs also have an extranuclear effect to inhibit GABA-stimulated Cl− currents by a non-competitive mechanism in vitro. The thyroid gland exhibits GABA transport mechanisms as well as enzyme activities for GABA synthesis and degradation, all of which are sensitive to thyroidal state. In rats and humans, GABA inhibits thyroid stimulating hormone (TSH) release from the pituitary, possibly by action directly on the pituitary or on hypothalamic thyrotropin-releasing hormone neurons. In mice, GABA inhibits TSH-stimulated TH release from the thyroid gland. Taken together, these studies provide strong support for the hypothesis that there is reciprocal regulation of the thyroid and GABA systems in vertebrates. [Copyright &y& Elsevier]

Abstract: This study explored the effect of hyperthyroid state on humoral immune response and NF-κB signaling in lymphocytes. Male Wistar rats were treated with l-thyroxin for four weeks. Animals were immunized with sheep red blood cells (SRBC) after three weeks of l-thyroxin treatment. After one week of immunization, serum anti-SRBC titer was measured and NF-κB signaling was studied in lymphocytes by Western blot analysis of p-IKB-α, IKB-α, and p65. These results were compared with that of control rats. Antibody response and density of p-IKB-α and p65 were significantly higher in l-thyroxin treated rats in comparison to controls. The antibody response was found to have significant correlation with density of p-IKB-α and p65. Our results indicate that NF-κB signaling pathway in lymphocytes is activated in hyperthyroid state which might play a role in potentiation of antibody response. [Copyright &y& Elsevier]

Objective: To investigate endothelin-1 (ET-1) and several other endothelial function parameters in hyper and hypo-thyroidism. Patients and methods: Thirty-five hyperthyroid, 11 hypothyroid and 35 euthyroid patients were evaluated for von Willebrand factor activity (vWf), plasma fibronectin and ET-1. Non-parametric tests were used for statistical analysis. Results: Significantly elevated plasma levels of endothelin-1 and fibronectin (30.08 ± 11.21 pmol/L; 37.9 ± 6.5 mg/dl) were measured in hyperthyroid patients compared to controls (22.91 ± 7.51 pmol/L; 32 ± 7.5 mg/dl), (p = 0.011; p = 0.001, respectively) but only fibronectin compared to hypothyroids (25.55 ± 12.65 pmol/L; 29.28 ± 9.9 mg/dl) (p = 0.271; p = 0.006, respectively). Positive correlations were found between ET-1 and free-triiodothyronine (r = 0.320; p = 0.009) and free-thyroxine (r = 0.271; p = 0.029); and between ET-1 and heart rate (r = 0.278, p = 0.027) in the whole sample. Positive correlation was also observed between vWf and free-triiodothyronine (r = 0.283; p = 0.017). Conclusion: The role of shear stress and/or direct effects of thyroid hormones were thought to be the possible causes of elevated levels of ET-1 and fibronectin in hyperthyroidism. Ann Med Sci 2003;12:79-84. [ABSTRACT FROM AUTHOR]

To determine the responsiveness of cat hindlimb muscles to thyroid manipulation, adult female cats were made hypothyroid (thyroidectomy plus tapazole treatment), hyperthyroid (synthroid pellets), or maintained euthyroid. After 4 months, the hypothyroid soleus had slower time-to-peak (TPT, 80%) and half-relaxation (HRT) times, whereas the hyperthyroid soleus had faster TPT (20%) and HRT than euthyroid cats. The tension at low stimulation frequencies (5–15 Hz) was higher in hypothyroid and lower in hyperthyroid cats compared to euthyroid cats. Muscle weight, maximum twitch and tetanic (Po) tensions, and maximum rates of shortening (Vmax) were similar across groups. The soleus of hypothyroid cats was more fatigable than normal. The myosin heavy chain (MHC) composition, based on gel electrophoresis, was unaffected by thyroid hormone manipulation. Based on the reaction of monoclonal antibodies for specific MHCs, some fast fibers in the hypothyroid cats coexpressed developmental MHC. These data indicate that 4 months of an altered thyroid state result in changes in the isometric twitch speed properties of the cat soleus, but not the tension-related or isotonic properties. Further, a chronic decrease in thyroid hormone had a greater impact than a chronic increase in thyroid hormone on the mechanical properties of the adult cat soleus.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: The need for thyroid screening of patients presenting with panic disorder (PD), social phobia (SP) or generalized anxiety disorder (GAD) remains uncertain. Methods: We examined thyroid histories and serum testing in 169 patients, 92 with PD, 48 with SP, and 29 with GAD. Combined prevalence rates of hyperthyroidism and hypothyroidism were compared with expected rates (2.7%) derived from the population based Whickham Survey. Data from previously published studies were also compared with these expected rates. Results: In our sample, only 2/169 patients had thyroid dysfunction detected by serum testing, but 5/169 [1/92 (1%) with PD, 1/48 (2%) with SP, and 3/29 (10%) with GAD], all currently euthyroid, reported a history of thyroid disease. The rates were statistically significant only for GAD (10.4%; z=2.56, p=0.01). However, combining prior PD studies that examined both thyroid history and test results with our data also suggests significantly elevated rates of thyroid dysfunction (6.5%; z=4.69, p<0.0001). Limitations: As with previous data, the 95% confidence interval for our findings is broad, reflecting the instability of low rates of illness in relatively small samples. Further, methods for obtaining thyroid histories and tests were not uniform. Conclusions: Despite relatively low yields on serum testing, lifetime prevalence of thyroid dysfunction does appear elevated for GAD and PD, with minimal data addressing this issue for SP. The data support the need to query GAD and PD patients regarding thyroid history and perform serum testing in those without prior testing. [Copyright &y& Elsevier]

Objective To establish the extent to which individuals with thyroid dysfunction consider weight as a problem and the relevance of psychological factors. Design Cross-sectional study of individuals with thyroid dysfunction. Participants Members of the British Thyroid Foundation. Main outcome measures Two self-administered questionnaires, tailored for hypothyroid and hyperthyroid patients, respectively, and circulated to all members of the British Thyroid Foundation. These questionnaires specifically targeted views on weight and the experiencing of psychological symptoms. Results Twenty-five per cent of hypothyroid individuals regained normal body weight on adequate treatment with Thyroxine but 75% did not. Only 19% of subjects had received dietary advice from their doctor. Eighty-seven per cent of hypothyroid individuals felt depressed prediagnosis and 80% remained so on adequate treatment. Thirty-nine per cent felt weight was a contributing factor. Fifty-five per cent of thyrotoxic subjects reported a weight problem on or after treatment, 69% exceeding their pretoxic weight. Only 28% had received dietary advice from their doctor. Seventy-eight per cent of thyrotoxic individuals reported mood problems when the thyroid was over active and of these 77% improved with therapy. Twenty-three per cent did not. In excess of 60% of individuals had persistent symptoms after treatment. Thirty-four per cent of these blamed a weight problem. Conclusion Weight is a major concern to the majority of patients with thyroid dysfunction, sometimes contributing to significant mood disturbance. All patients with thyroid dysfunction, particularly if over weight, should receive dietary advice. This must emphasize that thyroid hormone manipulation does not always solve the problem. Furthermore, the associated psychological problems of thyroid disease do not always settle with treatment to euthyroidism and may require therapy in their own right. [ABSTRACT FROM AUTHOR]

Euthyroid Graves' Disease (EGD) is a challenging pathology, due to its atypical clinical manifestations and the absence of abnormal thyroid function. Typically, thyroid ophthalmopathy is associated with elevated thyroid hormone levels and with the presence of thyrotropin receptor antibodies (TRAb) but a low percentage of patients remain euthyroid without developing hyperthyroidism during long-term follow-up periods. Although it is considered a different pathology, it shares a lot of similarities with Graves' disease, rendering the diagnosis more difficult. It is also important to note that ophthalmopathy may be the first clinical manifestation of Graves' disease and that thyroid function examinations do not present abnormalities over a long period. Treatment choices for euthyroid disease do not differ from those described in Graves' ophthalmopathy. However, it is considered that since euthyroid patients develop milder ophthalmic symptoms and their clinical activity score is lower, they tend to have better responses to treatment. Moreover, atypical sight-threatening cases such as exposure keratopathy and dysthyroid optic neuropathy with variable responses to therapy also exist. Disease management consists of a favorable collaboration between ophthalmologists and endocrinologists because patients with EGD can develop thyroid abnormalities over time. In conclusion, the diagnosis of EGD is difficult, clinical manifestations and evolution are variables depending on several factors, including the heterogeneity of TRAb. This review aimed to identify the characteristics of this disease by reviewing the clinical studies and case reports published in previous years. [ABSTRACT FROM AUTHOR]

The metabolic syndrome and thyroid dysfunction are commonly associated with type 2 diabetes mellitus and cardiovascular diseases. AIMS: 1. To find out the status of metabolic syndrome in females being investigated for thyroid dysfunction. 2. To find out the association of metabolic syndrome and its components with thyroid dysfunction. METHODOLOGY: Study was conducted at the Thyroid Clinical Laboratory at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. It was a hospital-based, cross-sectional study. One hundred females subjected to thyroid function tests (fT3, fT4 and TSH) were included in this study with their consent. A detailed history was taken and clinical examination done, followed by anthropometric measurement of height, weight, waist circumference and blood pressure. Fasting blood glucose, triglycerides and HDL-C were estimated in all subjects. STATISTICAL ANALYSIS: Data was expressed as mean ± standard deviation and analyzed by using one-way ANOVA followed by Student's 't' test. RESULTS: The prevalence of metabolic syndrome was 32%, more in euthyroid group (21/48) than hyperthyroid group (5/24) and hypothyroid group (6/28). Age-specific metabolic syndrome was statistically significant (P < 0.01). Diastolic blood pressure, waist circumference, triglycerides and HDL-C were statistically significant within and between the metabolic syndrome and thyroid dysfunction groups. CONCLUSION: The thyroid dysfunction may be protective for the development of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases (n = 64, hyperthyroid; n = 53 euthyroid; n = 18, hypothyroid) and healthy controls (n = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm2). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD. [ABSTRACT FROM AUTHOR]

Background: The 2016 American Thyroid Association guidelines indicate that patients with Graves' disease who undergo a thyroidectomy should be rendered euthyroid through the use of antithyroid drugs (ATD) prior to surgery to avoid complications such as a thyroid storm. At times, the use of ATDs can have limited efficacy and therefore some patients will inevitably remain biochemically hyperthyroid at the time of surgery. The aim of this study is to assess if hyperthyroid patients undergoing a thyroidectomy are at an increased risk of developing a thyroid storm in comparison to euthyroid patients. Furthermore, this study seeks to establish a correlation between thyroid storm identified by the levels of thyroid hormones (T3 and T4) and the level of thyroid stimulating hormone (TSH). Methods: A retrospective cohort study was conducted at two Canadian centers, one in Montreal and the other in Nova Scotia. Sixty-seven patients undergoing thyroidectomy for Graves' disease from January 2006 to December 2016 were evaluated. Results: The study comprised 67 participants with a mean age of 46 years (range16–78 years). A total of 78% of patients were on methimazole, 34% on beta-blockers, 27% on potassium iodine solution, 10% on propylthiouracil and 7% on steroids. At the time of surgery 21% were in an overt hyperthyroid state and 33% were in a subclinical hyperthyroid state. The average TSH level of 0.03 mIUL/L (range 0.01–0.23 mIUL/L). Sixteen percent of patients had a TSH level less than 0.01 mIUL/L. The average free T4 level was 29.58 pmol/L (range 11.5–95.2 pmol/L). The average total T3 level was 11.52 nmol/L (range 4.5–29.1 nmol/L) and free T3 level was 6.35 pmol/L (range 6.1–6.6 pmol/L). No patient developed thyroid storm. Conclusions: In our study, biochemically hyperthyroid patients undergoing thyroidectomy did not develop thyroid storm. Additional studies with larger sample sizes are needed to better understand the risk of thyroid storm in hyperthyroid patients. [ABSTRACT FROM AUTHOR]