Soy protein improves cardiovascular risk in subclinical hypothyroidism : a randomized double-blinded crossover study

© 2017 Endocrine Society. Background: Soy protein with isoflavones appears to have an adverse effect on thyroid function, but it is not known whether it is the protein or isoflavone component that is deleterious. The effect of isoflavone-free soy on thyroid function was determined in patients with subclinical hypothyroidism, with a secondary aim of assessing its effect on cardiovascular risk indices. Methods: This was a randomized, double-blind, crossover study involving 80 patients with subclinical (compensated) hypothyroidism. Patients were randomly assigned to either isolated soy (isoflavone-free) protein (SP) or casein protein (CP) supplementation for 8 weeks, washed out for 8 weeks, and then crossed over for a further 8-week period. Results: Thyroid function was unaffected by either a SP or CP. There were significant decreases in fasting glucose (4.760.6 vs 5.561.4, P < 0.01), insulin resistance (3.3±3.0 vs 3.8±3.4, P = 0.05), total cholesterol (4.4 ± 0.9 vs 5.3 ± 1.2, P < 0.01), triglycerides (0.9 ± 0.5 vs 1.7 ± 0.9, P < 0.1), and highly sensitive C-reactive protein (hsCRP; 0.8 ± 0.7 vs 2.6 ± 2.8, P < 0.01) in the SP group compared with the CP group. Blood pressure, low-density lipoprotein, and high-density lipoprotein remained unchanged in both groups. Conclusion: SP alone had no effect on thyroid function in patients with subclinical hypothyroidism and resulted in a significant reduction in fasting glucose, insulin resistance, total cholesterol, triglycerides, and hsCRP compared with CP

A hidden cause of infertility in hypothyroid patients

Methylene tetrahydrofolate reductase (MTHFR) gene mutations could be the cause of infertility in hypothyroid patients. Hence, it is worthy to screen for MTHFR gene mutations in infertile hypothyroid females and their partners if infertility persists after optimizing thyroid function

Thyroxine treatment in patients with symptoms of hypothyroidism but thyroid function tests within the reference range: randomised double blind placebo controlled crossover trial

OBJECTIVES: To determine whether thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. DESIGN: Randomised double blind placebo controlled crossover trial. SETTING: Outpatient clinic in a general hospital. Participants: 25 patients with symptoms of hypothyroidism who had thyroid function tests within the reference range, and 19 controls. Methods: Participants were given thyroxine 100 microgram or placebo to take once a day for 12 weeks. Washout period was six weeks. They were then given the other to take once a day for 12 weeks. All participants were assessed physiologically and psychologically at baseline and on completion of each phase. MAIN OUTCOME MEASURES: Thyroid function tests, measures of cognitive function and of psychological and physical wellbeing. RESULTS: 22 patients and 19 healthy controls completed the study. At baseline, patients' scores on 9 out of 15 psychological measures were impaired when compared with controls. Patients showed a significantly greater response to placebo than controls in 3 out of 15 psychological measures. Healthy participants had significantly lower scores for vitality when taking thyroxine compared to placebo (mean (SD) 60 (17) v 73 (16), P&#60;0.01). However, patients' scores from psychological tests when taking thyroxine were no different from those when taking placebo except for a poorer performance on one visual reproduction test when taking thyroxine. Serum concentrations of free thyroxine increased and those of thyroid stimulating hormone decreased in patients and controls while they were taking thyroxine, confirming compliance with treatment. Although serum concentrations of free triiodothyronine increased in patients and controls taking thyroxine, the difference between the response to placebo and to thyroxine was significant only in the controls. CONCLUSIONS: Thyroxine was no more effective than placebo in improving cognitive function and psychological wellbeing in patients with symptoms of hypothyroidism but thyroid function tests within the reference range. Thyroxine did not improve cognitive function and psychological wellbeing in healthy participants

Monitoring thyroid function status in elderly patients on amiodarone

Objectives: To evaluate whether elderly patients on amiodarone were having their thyroid function status monitored as recommended in the literature and to identify the frequency and type of thyroid function test abnormalities noted. Methods: Patients on amiodarone were identified by examining the prescription charts and medical files of consecutive admissions into Zammit Clapp Hospital (ZCH) and residents at St Vincent de Paul Residence (SVPR). Data was obtained on whether thyroid function tests had been checked at the start of the medication and every six months; the results of such tests carried out over the previous year; the clinical indication to prescribe the medication; and the course of action followed when results were abnormal. Results: 1334 prescription charts were examined. 69 patients (5.2%) were on amiodarone. The most common clinical indication for the medication was atrial fibrillation (68.1%). As regards thyroid status, 39.1% of subjects had blood tests checked at the start of the medication but only 2.9% every 6 months. Although 75.4% had had their thyroid status checked over the previous year, 8.7% never had any thyroid function tests carried out whilst they were on the medication. In all 27.5% of subjects had thyroid gland dysfunction of which 13% had subclinical hypothyroidism, 11.6% clinical hypothyroidism and 2.9% clinical hyperthyroidism. All patients with abnormal results had been kept on amiodarone even when the arrhythmia had abated. Conclusions: Thyroid dysfunction is a common side effect of amiodarone medication. The regular measurement of thyroid function tests, as recommended, should be adhered to in a stricter manner.peer-reviewe

Goiter frequency is more strongly associated with gastric adenocarcinoma than urine iodine level

Purpose: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. Materials and Methods: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonograph-ic examination, and thyroid function tests. Results: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). Conclusions: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goi-ter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma com-pared to the existing iodine deficiency itself. © 2013 by The Korean Gastric Cancer Association

Thyroid function tests

Thyroid disorders can be difficult to detect clinically, but thyroid function tests can assist in making a diagnosis. Measuring thyroid stimulating hormone is the first step. If it is abnormal, free thyroxine should be measured. A raised concentration of thyroid stimulating hormone with a low concentration of free thyroxine suggests hypothyroidism. A low concentration of thyroid stimulating hormone with a high concentration of free thyroxine suggests hyperthyroidism. Measuring thyroid autoantibodies may help establish the cause of the dysfunction. Different assays can give different results, and tests of thyroid function may be affected by drugs and intercurrent illness

HUBUNGAN FUNGSITIROID DENGAN GANGGUAN PENDENGARAN PADA ANAK SINDROM DOWN

Background: Children with Down syndrome have increased risk of health problems. Two common health problems in children with Down syndrome are thyroid dysfunction and hearing disorder. These health problems could inhibit the growth and development of children with Down syndrome. Aim: To find out the correlation of thyroid function and hearing disorder in children with Down syndrome. Methods: This retrospective observational study was done by taking data from medical records of Down syndrome patients in RSUP dr. Kariadi, Semarang. The subjects is Down syndrome children who underwent medical checkup in RSUP dr. Kariadi, Semarang. Data are subject’s characteristic, thyroid test result, and hearing test result for both ears by tympanometri, OAE and, BERA. Chi-square test and Spearman test were used for statistical analysis. Result: 32 subjects met the inclusion criteria in this study. 62.5% of them had hypothyroidism. 21 children had hearing loss with two children suffered a unilateral hearing loss so that there are 40 ears (62,5%) had hearing loss by 35% suffered from type CHL and 65% suffered from type SNHL. The Spearman test showed a weak degree correlation between thyroid function and hearing disorder (r = 0.267; p = 0.033). The Chi-square test showed an association between thyroid function with type of hearing disorder (p = 0.007). Conclusion: There is a weak degree correlation between thyroid function and hearing disorder in children with Down syndrome. Keywords: Down syndrome, thyroid, Hearing, CHL, SNH

Maternal thyroid function and child educational attainment: prospective cohort study

Objective: To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Design: Prospective cohort study. Setting: Avon Longitudinal Study of Parents and Children cohort in the UK. Participants: 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Exposures: Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Main outcome measures: Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. Results: No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Conclusions: Maternal thyroid dysfunction in early pregnancy does not have a clinically important association with impaired child performance at school or educational achievement