Search Results (128)

Background: Patients in Intensive Care Units (ICUs) often develop non-thyroidal illness syndrome. Potentially, thyroid hormones may be removed during continuous veno-venous hemodiafiltration (CVVHDF), as their molecular size is smaller than the filter pores’ cutoff. The study’s main aim was to assess whether the serum concentration of thyroid hormones changes over time during CVVHDF. Methods: This was a prospective observational trial that included 30 patients treated in an ICU. All patients developed acute kidney injury (AKI) and had clinical indications for implementation of CVVHDF. Blood samples were collected before initiation of CVVHDF and at 1, 2, 3, 6, 9 and 12 days after. The last sample was collected three days after CVVHDF withdrawal. Thyroid function was evaluated by determining the serum concentration of TSH, thyrotropin-releasing hormone (TRH), free triiodothyronine (fT₃), free thyroxine (fT₄), total triiodothyronine (tT₃), total thyroxine (tT₄) and reverse triiodothyronine (rT₃). We additionally calculated the total activity of peripheral deiodinases (G_D) using a mathematical model. Results: TRH and TSH levels remained mostly within normal ranges. fT4 and tT4 were in normal range or slightly below. In contrast, fT3 and tT3 were undetectably low in most patients throughout. Reverse T3 levels remained within normal limits. There were no statistically significant changes in any thyroid hormone levels over the CVVHDF treatment period. The calculated peripheral G_D activity was lower than normal, but importantly, it did not change significantly over time. Conclusions: Thyroid hormones are not lost due to hemodiafiltration. Decreased deiodinases activity is responsible for alterations in serum concentrations of thyroid hormones in patients during CVVHDF. Full article

Background/Objectives: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune–metabolic–hormonal markers associated with treatment response and nutritional rehabilitation. Methods: Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. Results: Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; p < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622–0.960), chloride = 0.820 (0.690–0.950), fT4 = 0.781 (0.591–0.972), monocytes = 0.785 (0.643–0.927), MCV = 0.721 (0.549–0.892), NLR = 0.745 (0.578–0.913), MLR = 0.785 (0.643–0.927), SII = 0.736 (0.562–0.911), SIRI = 0.803 (0.671–0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. Conclusions: The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN. Full article

Background/Objectives: Frailty is a key determinant of outcomes in older adults with heart failure (HF). The free triiodothyronine/free thyroxine (FT₃/FT₄) ratio has emerged as a promising frailty biomarker that reflects metabolic and systemic resilience. This study investigates its association with frailty, nutrition, muscle strength, inflammation, and one-year mortality in very old patients with HF. Methods: In this longitudinal, single-center study, we enrolled 193 older outpatients (mean age, 86.5 ± 6.1 years; 56% women) recently discharged after acute HF. All patients underwent physical examination, blood testing, and comprehensive geriatric assessment, including handgrip strength (HGS). Participants were stratified by FT₃/FT₄ ratio (<1.7 vs. ≥1.7). Associations with the Clinical Frailty Scale (CFS) were examined using multivariable linear regression. Spearman’s correlations assessed relationships with inflammatory and nutritional biomarkers. Cox regression evaluated the association with all-cause mortality. Results: Patients with a low FT₃/FT₄ ratio (31.1%) exhibited greater frailty (CFS: median [IQR], 6 [2] vs. 4 [3]; p = 0.020), poorer nutritional status (Mini Nutritional Assessment: 10 [4] vs. 12 [3]; p = 0.008), and lower HGS (mean ± SD, 16.8 ± 3.7 kg vs. 20.3 ± 4.8 kg; p = 0.002). An inverse association was identified between the FT₃/FT₄ ratio and frailty (adjusted β = −0.09; p = 0.019). Individuals with low FT₃/FT₄ also showed elevated inflammatory markers and had more than double the one-year mortality rate compared to those with higher ratios [HR 2.32 (95% CI, 1.24–4.34; p = 0.007)]. Conclusions: In very old adults recently hospitalized for HF, a lower FT₃/FT₄ ratio was associated with frailty, malnutrition, inflammation, and increased mortality, supporting its potential role as a marker of biological vulnerability. Full article

Objective: This study evaluated the systemic bioavailability of L-thyroxine (L-T4) in healthy women following repeated cutaneous application of a new gel formulation containing L-T4 and escin. Plasma concentrations of free triiodothyronine (FT3), reverse triiodothyronine (rT3), and thyroid-stimulating hormone (TSH) were also assessed, along with local and systemic tolerability. Methods: Thirty healthy women participated in a single-group, open-label trial. L-thyroxine gel was applied at 20 g/day for the first 2 days and 10 g/day for the following 26 days (equivalent to 20 mg/day and 10 mg/day of L-T4, respectively). Blood samples were collected at Baseline, 5 and 24 h after the first application, and on Days 14, 28 (End of Treatment, EOT), and 42 (End of Study, EOS). Tolerability and safety were monitored throughout. Results: Plasma FT4 concentrations remained stable throughout the study, with no clinically significant changes from Baseline (1.13 ± 0.15 ng/dL) to EOT (1.11 ± 0.13 ng/dL). FT3 and TSH levels also remained within physiological ranges, with only a transient, non-clinically relevant decrease observed 5 h after the first application. No changes in rT3 concentrations were detected at any time point. No serious adverse events were reported. Conclusions: This study confirms that repeated application of L-thyroxine/escin gel over 28 days (total exposure of 300 g) does not affect systemic thyroid hormone levels and is well tolerated in healthy women. These findings support the hypothesis that intact skin acts as an effective barrier to transdermal L-T4 absorption. Full article

Objectives: Iodine and selenium are key elements for thyroid. There is also evidence of their immunoregulatory potential. However, the current state of knowledge of potential interactions among iodine—selenium—thyroid—immune system is not sufficient. The aim of the study was to evaluate iodine and selenium statuses and examine the relationship between them and the functioning of the thyroid and immune system in a group of women of reproductive age, without previously diagnosed disease. Methods: The study involved a group of 60 women aged 19–40 from southern Poland. The concentrations of iodine and selenium were determined in serum samples using the ICP-MS and AAS methods, respectively. Thyroid function was assessed by determining serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and anti-thyroid peroxidase antibodies (anti-TPO) by electrochemiluminescence methods. Glutathione peroxidase 3 (GPX3) and ferric ion reducing antioxidant power (FRAP) in serum were measured by spectrophotometric methods. Immune functions were evaluated by analyzing cytokine levels using ELISA tests, including interferon-γ, interleukin-4, interleukin-17, and transforming growth factor-β. Results: No significant correlations between selenium and thyroid or immunological parameters were observed. The level of iodine in serum positively correlated with free thyroxine, indicating its importance for maintaining normal thyroid function, as well as with FRAP in serum, suggesting a protective role of iodine-mediated antioxidant activity on thyroid function. Conclusions: Our results underline the complexity of the system of correlations between iodine–selenium–thyroid–immune function. Nevertheless, understanding them may turn out to be crucial for developing preventive and therapeutic strategies in the context of thyroid diseases. Full article

Background: The anti-inflammatory effects of omega-3 fatty acids and their derivatives are of considerable interest as a potential therapeutic agent in many diseases characterized by inflammation. Methods: This study aimed to measure the concentration of mediators derived from eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids. We included 33 women suffering from Hashimoto’s disease, with an average age of 37.58 ± 8.41 kg, in the study. The levels of EPA and DHA acids were examined using gas chromatography, and their derivatives were studied with liquid chromatography (HPLC). Patients were assessed after being put on a healthy and balanced diet supplemented with omega-3 fatty acids. Results: The results showed statistically significant correlations between the C-reactive protein (CRP) level and derivatives: resolvins E1 and D1 (RvE1, RvD1), 10S17R DiHDHA (Protectin DX), and 18RS HEPE (18-hydro(peroxy)-eicosapentaenoic acid) following the diet. There was also a significant correlation observed between Maresin 1 and free thyroxine (fT4). Moreover, a dependency between the RvD1 level and some anthropometric parameters was observed. Conclusions: The findings suggest that the chronic inflammatory state occurring in the course of Hashimoto’s thyroiditis (HT) is associated with increased synthesis of anti-inflammatory mediators of omega-3 fatty acids, particularly DHA derivatives. Consequently, these may affect the level of thyroid hormone synthesis, which should be considered in future research on biological drugs in Hashimoto’s therapy. Full article

Background/Objectives: This study aimed to investigate the effects of thyroxine replacement therapy (TRT) on serum Maresin 1 and nuclear factor kappa beta (NF-kB) levels in patients with Hashimoto’s thyroiditis (HT). Methods: A total of 90 patients were included in this study, 60 with HT and 30 without. Patients in the HT group were divided into two groups according to whether they received TRT. Group 1 included 30 patients who underwent TRT, and Group 2 comprised 30 patients who were newly diagnosed with HT, either euthyroid or hypothyroid. The analysis included serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroid peroxidase antibody (TPOAb), Maresin 1, and NF-kB. Results: The serum NF-kB level in the TRT group was significantly higher than that in the control and non-TRT groups. In the subgroup analysis of patients who did not receive TRT, the serum NF-kB level in euthyroid patients was significantly lower than that in hypothyroid patients. Maresin 1 levels in the control group were significantly higher than those in patients who did and did not receive TRT. The serum Maresin 1 level in the TRT group was significantly lower than that in the untreated group. Maresin 1 levels were higher in the euthyroid group than in the hypothyroid group. TPOAb levels were positively correlated with NF-kB and negatively correlated with Maresin 1. Conclusions: TRT maintains the euthyroid state in patients with HT, but may not contribute positively to the pro-anti-inflammatory balance in these patients. Full article

Background/Objectives: Hashimoto’s thyroiditis (HT) is an autoimmune disease influenced by genetic factors and environmental triggers that affect immune system function. Data suggest that vitamin D may also play a role in the etiopathogenesis of HT. Methods: This retrospective study included patients admitted to the Endocrinology and Metabolic Diseases Outpatient Clinic. Data from individuals aged 18 years and older were analyzed, including serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and vitamin D. HT was diagnosed based on the presence of anti-TPO and/or anti-TG antibodies, while individuals with negative results for both were classified as non-HT. Thyroid function was categorized as euthyroid if TSH levels were between 0.55 mU/L and 4.78 mU/L and fT4 levels were between 0.89 ng/dL and 1.76 ng/dL; hypothyroid status was defined as TSH > 4.78 mU/L. Vitamin D levels were classified as deficient (<50 nmol/L), insufficient (50–74.9 nmol/L), or sufficient (≥75 nmol/L). Results: Of the total participants, 25,018 did not have HT, while 27,800 were diagnosed with HT. Vitamin D level was significantly higher in the HT group than the non-HT group (41.43 nmol/L and 39.44 nmol/L, p < 0.001). Vitamin D deficiency was present in 65.5% of the non-HT group and 62.1% of the HT group (p < 0.001). Subgroup analyses based on thyroid function showed that vitamin D levels were highest in the euthyroid HT group and similar in the euthyroid non-HT, hypothyroid non-HT, and hypothyroid HT groups (p < 0.001). Conclusions: In conclusion, while vitamin D levels were higher in the HT group compared to the non-HT group, no clinically significant association between vitamin D levels and HT or autoantibody positivity was observed. Vitamin D deficiency was more prevalent in the hypothyroid group compared to the euthyroid group. This study suggests that although vitamin D deficiency may not be directly involved in the pathogenesis of HT, it may still play a role in modulating immune activity or influencing the disease phenotype.. Full article

Objective: This study aims to evaluate the application effect of endoscopic thyroidectomy via the gasless unilateral axillary (GUA) approach in thyroid cancer and its impact on the postoperative stress response. Methods: Ninety-four thyroid cancer patients were enrolleod and assigned into the open group (underwent conventional-open-anterior-cervical-approach thyroidectomy) and the endoscopic group (underwent GUA endoscopic thyroidectomy) (n = 47). Perioperative indicators between the two groups were compared. Thyroid function parameters [total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH)] were measured preoperatively and on postoperative day 2. Inflammatory markers [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] and stress-related hormones [norepinephrine (NE) and cortisol (Cor)] were evaluated preoperatively and on postoperative day 1. The aesthetic appearance of the incision was evaluated at 1 and 3 months postoperatively using the Vancouver Scar Scale (VSS). Postoperative complications were also compared between the two groups. Results: The endoscopic group exhibited less intraoperative blood loss, reduced postoperative drainage, a lower pain degree on 1 day postoperatively, a shorter hospitalization time, and a longer surgical time versus the open group (p < 0.05). The serum levels of TT3, TT4, FT3, and FT4 were lower, while the TSH levels were higher in both groups on postoperative day 2 compared to preoperative values. Additionally, the serum levels of IL-6, TNF-α, NE, and Cor increased on day 1 postoperatively, with the endoscopic group showing lower levels of these markers compared to the open group (p < 0.05). The VSS scores at 1 and 3 months after surgery were lower in the endoscopic group compared to the open group, indicating better cosmetic outcomes (p < 0.05). The incidence of postoperative complications was comparable between the endoscopic and open groups (p > 0.05). Conclusions: Endoscopic thyroidectomy by a GUA offers notable advantages over the conventional-open-anterior-cervical-approach thyroidectomy, including reduced intraoperative blood loss, less postoperative drainage, and a lower postoperative stress response. This approach also results in improved cosmetic outcomes, making it a promising alternative for thyroid cancer surgery. Full article

Turner syndrome (TS) is a genetic disorder caused by abnormalities in one of the X chromosomes. Individuals with TS have a higher incidence of autoimmune thyroid disorders, particularly Hashimoto’s disease, leading to thyroid dysfunction, most commonly hypothyroidism. Hormonal imbalance, growth hormone deficiency, and reduced physical activity contribute to muscle weakness in TS patients, and thyroid dysfunction can exacerbate these effects. The purpose of this study was to evaluate whether thyroid factors affect muscle strength in female patients with TS. The study included 70 women with TS and 88 age- and weight-matched controls. TS diagnoses were genetically confirmed (mosaic karyotypes: n = 20; monosomy X: n = 37; structural abnormalities: n = 7). The main criterion for exclusion from the study was unbalanced thyroid function. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and thyroid antibodies (anti-thyroid peroxidase antibodies (aTPO), anti-thyroglobulin antibodies (aTG)) were measured, and muscle strength was assessed using hand-held dynamometry. In TS patients, higher TSH levels were positively correlated, and higher fT4 levels were negatively correlated with muscle strength. No such correlations were found in controls. Thyroid compensation may impact musculoskeletal health in TS. Lower-normal TSH levels are associated with reduced muscle strength, and autoimmune thyroid changes like aTPO and aTG may contribute to muscle deterioration. Further research is needed to confirm these findings. Full article

The Cluster of Differentiation 5-like protein (CD5L) is produced by tissue-resident macrophages. It is an innate immune mediator protein with a multitude of functions, such as binding of invading microorganisms and oxidised LDL, and it is associated with clinical conditions, i.e., atherosclerosis and inflammation. The circulating CD5L level has been reported to correlate to selenium status and thyroid hormone activity. In order to test this hypothesis, we analysed CD5L in serum samples from a randomized controlled trial (RCT) with selenium and coenzyme Q₁₀ supplementation and examined associations between CD5L and thyroid hormones, health-related quality-of-life (Hr-QoL), and mortality in an elderly population low in selenium. Circulating levels of CD5L and thyroid hormones were determined in 359 elderly community-living individuals enrolled in an RCT at inclusion and after 48 months of supplementation (179 received selenium and coenzyme Q₁₀, and 180 placebo). Hr-QoL was recorded at both time-points using Short Form 36. Pre-intervention plasma selenium was low, mean 67 µg/L. CD5L correlated positively to free tri-iodothyronine (fT3) and showed an inverse relation with thyroid stimulating hormone (TSH). Low CD5L concentrations at inclusion in the placebo group were associated with increased cardiovascular mortality during 10 years of follow-up, and impaired Hr-QoL at 48 months. Selenium and coenzyme Q₁₀ supplementation significantly increased CD5L and fT3 levels, in association with a better health outcome. The data indicate that circulating CD5L positively responds to selenium and coenzyme Q₁₀ supplementation, correlates with thyroid hormone status, and associates with positive health indices. The observed effect may be due to increased selenium-dependent deiodinase isozyme expression that converts thyroxine (T4) to T3 locally and supports thyroid hormone activities. Whether the observed associations with Hr-QoL and cardiovascular mortality are a direct effect of circulating CD5L or local thyroid hormone activity is unclear and should be further investigated. Full article

Studies have shown that per- and polyfluoroalkyl substances (PFAS) may impact thyroid function in human health. While the consistency between PFAS exposure and thyroid health effects in pregnant women has been validated, the effects on men and non-pregnant women remains inconclusive. To address this, a meta-analysis was carried out in this paper, with 14 eligible studies retrieved from Embase, PubMed, and Web of Science that were published up to 2 June 2024, focusing on the relationship between PFAS exposure and its effect on thyroid hormone levels in the human body. The thyroid function indexes analyzed included thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4). The estimated value (β) and the corresponding confidence interval (95% CI) were extracted from the literature. A heterogeneity test was carried out, and the sensitivity analysis and publication bias of the studies were analyzed using Stata 18.0. The results revealed that in men and non-pregnant women, PFOA was positively correlated with FT3 (β = 0.011, 95% CI = 0.001, 0.02, I² = 13.4). However, no significant associations were found between exposure to other PFAS and thyroid hormones. A subgroup analysis further indicated that the correlations between PFAS exposure and thyroid hormone levels were more significant in adolescents, in both America and Europe. Full article

Background: In the literature, there is no study investigating the relationship between thyroid hormones in pregnancies at 41 weeks and above and the birth timing, labor duration, frequency of fetal distress, premature rupture of membranes (PROM), and maternal hemogram values. Methods: A total of 68 nulliparous pregnant women who were admitted to Basaksehir Cam and Sakura City Hospital with indications of delivery between August 2023 and January 2024, between the ages of 20 and 38 and with no comorbidities, were included in the study. Pregnant women with ≥41 weeks of gestation were classified as the late-term pregnancy group (n = 37), and those between 37 and 38 weeks were classified as the control group (n = 31). The thyrotropin (TSH), free thyroxine (FT4), and hemoglobin levels and relevant parameters were evaluated. Results: The FT4 values of pregnant women diagnosed with fetal distress in the entire population were observed to be statistically significantly lower (p < 0.05). A statistically significant negative linear relationship was detected between the FT4 values of the entire population and the weights of newborns (p < 0.05). It was determined that, as the FT4 values decreased, the newborn weights increased. There was no statistically significant difference between the two groups in terms of the TSH/FT4 values, birth types, labor duration, or postpartum Hb/Htc decrease (p > 0.05). No statistically significant relationship was found between the TSH/FT4 values of the entire population and the diagnosis of PROM, labor duration, or Hb/Htc decrease amount (p > 0.05). Conclusions: TSH/FT4 levels may be important in the mature and late–mature periods of pregnancy. There may be an association between the FT4 levels and the fetal distress risk, type of birth, and newborn weight. Full article

Graves’ disease (GD) is an autoimmune disorder that can be difficult to distinguish from other diseases due to symptom similarity. The exacerbation of GD owing to delayed diagnosis is a serious issue, and a novel accessible health screening system is needed. Therefore, this study investigated the association between GD and thyroid hormone levels in women’s hair and evaluated the prediction accuracy of this non-invasive type of sample. By optimizing pretreatment and analysis techniques using liquid chromatography–mass spectrometry (LC-MS), free triiodothyronine (FT3) and thyroxine (FT4) could be detected in only 2 mg of hair with high sensitivity. Compared with healthy controls, the thyroid hormone levels in the hair of GD patients were significantly higher in correlation with blood levels. The predictive ability of hair thyroid hormones was analyzed using a receiver operating characteristic (ROC) curve, and the optimal cut-off value was determined via the Youden index. As a result, the area under the curve (AUC) was 0.974 (95% confidence interval (CI): 0.935–1.000) for FT3 and 0.900 (95% CI: 0.807–0.993) for FT4. The cut-off value was 0.133 pg/mg (sensitivity: 91.2%; specificity: 100%; positive predictive value (PPV): 100%; negative predictive value (NPV): 76.9%) for FT3 and 0.067 pg/mg (sensitivity: 70.6%; specificity: 100%; PPV: 100%; NPV: 50.0%) for FT4. Collectively, our new approach offers the possibility of accurately and non-invasively detecting GD using hair samples. Since hair can be stored and transported at room temperature, this system facilitates large-scale screening at locations including hair salons and homes, potentially enabling the early determination of GD outside of medical facilities. Full article

Thyroid function is commonly assessed in dogs through serum measurements of free thyroxine (FT4) and thyroid-stimulating hormone (TSH). The accurate measurement of thyroid hormones is critical. In particular, the measurement of free thyroxine (FT4) is important for the diagnosis and management of thyroid disorders. Most laboratories measure FT4 using direct analog immunoassay methods. The reliability of the results obtained using these methods has often been questioned. Fifty-nine dogs for which the veterinarian had requested the evaluation of thyroid hormones were included in this study. FT4 and TSH were measured using chemiluminescence enzyme immunoassay (CLEIA). Furthermore, FT4 was also measured by liquid chromatography–tandem mass spectrometry (LC-MS/MS) preceded by ultrafiltration. Comparing FT4 with the two different methods, the results demonstrate that LC-MS/MS, preceded by ultrafiltration, provides more accurate and specific FT4 measurements, particularly in dogs with altered thyroid hormone values. Although CLEIA is cost-effective and widely used for screening, LC-MS/MS is recommended for the more precise assessment of thyroid function. Full article