ABSTRACT Congenital hypothyroidism (CH) is the most frequent endocrine-metabolic disease in infancy, with an incidence of about 1/2500 newborns [1, 2]. In the last 20-30 years the incidence of congenital hypothyroidism in newborns has increased from 1:4000 to 1:2000 [3, 4]. This phenomenon could be explained by using a lower b-TSH cutoff, that allowed […]
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ABSTRACT The thyroid-stimulating hormone (TSH) receptor (TSHR) is a member of the glycoprotein hormone receptors (GPHRs), a sub-group of class A G protein-coupled receptors (GPCRs). TSHR and its ligand thyrotropin are of essential importance for growth and function of the thyroid gland. The TSHR activates different G-protein subtypes and signaling pathways, of which Gs and […]
This chapter is, in part, based on the previous version written by Prof. Rosalind Brown. ABSTRACT Thyroid disorders in infancy, childhood and adolescence represent common and usually treatable endocrine disorders. Thyroid hormones are essential for normal development and growth of many target tissues, including the brain and the skeleton. Thyroid hormone action on critical genes […]
ABSTRACT Thyroid hormone is indispensable for normal development and metabolism of most cells and tissues. Thyroid hormones are metabolized by different pathways: glucuronidation, sulfation, and deiodination, the latter being the most important. Three enzymes catalyzing deiodination have been identified, called type 1 (D1), type 2 (D2) and type 3 (D3) iodothyronine deiodinases. D1 […]
ABSTRACT The sensitive and tightly regulated feedback control system, thyroid gland autoregulation, and the large intrathyroidal and extrathyroidal storage pools of thyroid hormone serve to provide a constant supply of thyroid hormone to peripheral tissues in the face of perturbations imposed by the external environment, chemicals and drugs, and a variety of diseases processes. The […]
ABSTRACT Multinodular goiter (MNG) is the most common of all the disorders of the thyroid gland. MNG is the result of the genetic heterogeneity of follicular cells and apparent acquisition of new cellular qualities that become inheritable. Nodular goiter is most often detected simply as a mass in the neck, but sometimes an enlarging gland […]
ABSTRACT Thyroid disease in pregnancy is a common clinical problem. During the past 2 years significant clinical and scientific advances have occurred in the field. This chapter reviews the physiology of thyroid and pregnancy focusing on iodine requirements and advances in placental function. There follows discussion on thyroid function tests in pregnancy and their interpretation […]
ABSTRACT The biological activity of thyroid hormone (TH) is regulated at the target tissue level by two important processes, i.e. deiodination and plasma membrane transport. The first process involves the expression of the deiodinase D2, which converts the prohormone T4 to bioactive T3, and/or of the deiodinase D3 which converts both T4 and T3 to […]
ABSTRACT This discussion stresses the normal occurrence of immune self-reactivity, the genetic and environmental forces that may amplify such responses, the role of the antigen-driven immune attack, secondary disease-enhancing factors, and the important contributory role of antigen-independent immune reactivity. Research on thyroid autoimmunity has benefited greatly by knowledge of the specific target antigens and easy […]
ABSTRACT The main function of the thyroid gland is to make hormones, T4 and T3, which are essential for the regulation of metabolic processes throughout the body. As at any factory, effective production depends on three key components – adequate raw material, efficient machinery, and appropriate controls. Iodine is the critical raw material, because 65% […]
ABSTRACT This chapter presents an analysis and a summarized synthesis of our present knowledge of the biology of the thyroid gland, phylogeny ,ontogeny ,anatomy ,structure ,general metabolism ,regulatory factors and hormones , signalling cascades and their regulations , ( eg TSH ), functions including iodine metabolism and thyroid hormones synthesis , control of gene expression ,differentiation […]
ABSTRACT NTIS refers to a syndrome found in seriously ill or starving patients with low fT3, usually elevated RT3, normal or low TSH, and if prolonged, low fT4. It is found in a high proportion of patients in the ICU setting, and correlates with a poor prognosis if TT4 is <4ug/dl. The patho-physiology includes […]
9.1 HISTORICAL The full-blown expression of hypothyroidism is known as myxedema. Adult myxedema escaped serious attention until Gull described it in 1874 1 . That it was a state resembling the familiar endemic cretinism, but coming on in adult life, was what chiefly impressed Gull. Ord 2 invented the term myxedema in 1873. The disorder […]
POSTPARTUM DISEASE Q My name is xxxx and I stumbled across your webpage while doing a google search. I don’t know if you are able to answer any questions or give any advice but I am in desperate need of direction. A little over a year ago, I had a child. Eight days after his […]
Mitchell CS , Savage DB , Dufour S , Schoenmakers N , Murgatroyd P , Befroy D , Halsall D , Northcott S , Raymond-Barker P , Curran S , Henning E , Keogh J , Owen P , Lazarus J , Rothman DL , Farooqi IS , Shulman GI , Chatterjee K , Petersen […]
INTRODUCTION Thyrotoxicosis is defined as the clinical syndrome of hypermetabolism resulting from increased free thyroxine (T4) and/or free triiodothyronine (T3) serum levels (1). The term thyrotoxicosis is not synonymous with hyperthyroidism, the elevation in thyroid hormone levels caused by an increase in their biosynthesis and secretion by the thyroid gland (Table 1) (2). For example, […]
Any physician may submit a question regarding a thyroid patient to ldegroot@earthlink.net and one of our panel of expert thyroidologists will attempt to provide an answer as soon as possible by return Email. Physicians should provide adequate clinical information about the problem, and provide their name, office address, and telephone number. We will send an […]
Question About 3 years ago, I asked this thyroid manager whether it thought that hypothyroid women with autoimmune thyroid disease receiving levothyroxine (in treatment during pregnancy with increased doses of levothyroxine from the very beginning of pregnancy) should receive iodine supplements or not. At the time I was worried about the risk of a prolonged […]
TOPIC: TSH reference range increases with aging Title: Extreme longevity is associated with increased serum thyrotropin. Authors: Atzmon G, Barzilai N, Hollowell JG, Surks MI, & Gabriely I. Reference: Journal of Clinical Endocrinology & Metabolism 94: 1251-1254, 2009 Summary Context The TSH reference range, specifically the setting of the upper reference limit, is currently controversial. […]
Question My husband and I are trying to conceive and I have Hypothyroidism-I was diagnosed shortly after birth (at 29 weeks) and have been on a regimine of eltroxin ever since (ranging from 0.1 to 0.137 at present-Synthroid didn’t agree with me and made me retain more water). There have been several changes with my […]
Dear Andrea, Thank you for your email. You have Graves’ disease with some eye problems which occur with Graves’ disease. It is not clear whether you are still hyperthyroid (over active) but you certainly need your T3 and T4 checked carefully. Propanolol can sometimes interfere with the thyroid function test to a small degree. If […]
Questions answered by Dr John Lazarus 1 Antithyroid drugs, Carbimazole I would like to ask a question for the thryoid disease manager web site. I am 58 and have Graves disease being controlled by carmbimazole 10mg daily. I am feeling very well and able to live a full and active life. Last test results l.4 […]
TOPIC: Genetics of hypothalamic-pituitary axis Title: Heritability of serum TSH, free T4 and free T2 concentrations: a study of a large UK twin cohort. Authors: Panicker V, Wilson SG, Spector TD, Brown SJ, Falchi M, Richards JB, Surdulescu GL, Lim EM, Flectcher SJ, & Walsh JP. Reference: Clinical Endocrinology 68: 652-659, 2008 Summary Objective Thyroid […]
TOPIC: Thyroid hormone metabolism & action Title: Type 2 deiodinase deficiency results in functional abnormalities at multiple levels of the thyroid axis. Authors: Hernandez A, Martinez ME, Liao XH, Van Sande J, Refetoff S, Galton VA, & St Germain DL. Reference: Endocrinology 148: 5680-5687, 2007 Summary Background The type 3 deiodinase (D3) is a selenoenzyme […]
TREATING HYPERTHYROIDISM12/1/2007 Question My mother had been diagnosed as Hyperthyroidism and she is now having her medication to controlling her thyroid hormone for 3 months which will be continue for a year if her thyroid level still in high risk, what I want to ask are : 1.how to gain her weight since she is […]