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Simple Summary: Neutering, which includes orchiectomy for males and ovariohysterectomy for females, is a common practice in dogs to control populations and prevent health issues. Despite its benefits, neutering can lead to hormonal changes that may contribute to a tendency toward obesity over time. Our study investigated how neutering in both female and male dogs affects hormones involved in metabolism and appetite regulation, specifically nesfatin-1, serotonin, dopamine, TSH, and T4. We observed that neutering decreased levels of nesfatin-1, serotonin, and T4, and increased TSH levels in both genders. These hormonal changes could be part of a mechanism contributing to the higher risk of obesity observed in neutered dogs in the long term. Neutering of dogs, whether male or female, provides various benefits such as contraception, population control, and the prevention of reproductive disorders and undesirable sexual behaviors. However, it is also associated with an increased risk of obesity, which may be directly linked to post-neutering hormonal changes. Our study aims to determine the effects of neutering on plasma levels of nesfatin-1, serotonin, dopamine, TSH, and T4—hormones implicated in obesity and metabolic regulation. Fourteen dogs (seven males and seven females), aged between 1 and 3 years, were included in this study. Male dogs underwent orchiectomy and females underwent ovariohysterectomy. Blood samples were collected before surgery and on days 7 and 14 post-operatively to measure the plasma levels of these hormones using ELISA. The results showed a significant decrease in nesfatin-1, serotonin, and T4 levels, along with a significant increase in TSH levels in both male and female dogs post-neutering. While these hormonal changes are likely part of the body's adaptive response to neutering, they may represent a potential mechanism that contributes to the long-term tendency toward obesity in neutered dogs. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is a significant endocrine malignancy with varying effects on thyroid hormone profiles. The interaction between thyroid hormone levels and thyroid cancer remains poorly understood, prompting the need for detailed studies. Objectives: To assess the levels of Thyroid-Stimulating Hormone (TSH), Triiodothyronine (T3), and Thyroxine (T4) in patients diagnosed with thyroid cancer. Methods: A cross-sectional study was conducted involving 200 patients diagnosed with thyroid cancer. Serum levels of TSH, T3, and T4 were measured using immunoassays. Statistical analyses included descriptive statistics and inferential techniques to evaluate the relationship between hormone levels and cancer severity. Results: The study is expected to provide insights into the thyroid hormone profiles of thyroid cancer patients and their potential deviations from normal levels. Conclusion: This study aims to enhance the understanding of thyroid hormone dynamics in thyroid cancer patients, potentially aiding in better management and prognostic strategies. [ABSTRACT FROM AUTHOR]

Objective: Thyroid function tests are common biochemical analyses, and agreement between the routinely used immunoassays is important for diagnosis and monitoring of thyroid disease. Efforts are continuously made to align the biochemical assays, and we aimed to evaluate the agreement between immunoassays used in a clinical laboratory setting among non‐pregnant and pregnant adults. Design: Cross‐sectional study. Participants: Serum samples were obtained from 192 blood donors (non‐pregnant adults) and from 86 pregnant women in the North Denmark Region with no known thyroid disease. Measurements: Each sample was used for measurement of thyroid‐stimulating hormone (TSH) with the routinely used automatic immunoassays in the regional Departments of Clinical Biochemistry (Alinity, Abbott Laboratories, Cobas, Roche Diagnostics, and Atellica, Siemens Healthineers) and reported as the median with 95% confidence interval (95% CI). Results: In nonpregnant adults, the level of TSH was higher with Cobas and Atellica than with Alinity as reflected by median (Alinity: 1.39 mIU/L (95% CI: 1.30–1.51 mIU/L); Cobas: 1.57 mIU/L (95% CI: 1.48–1.75 mIU/L); Atellica: 1.74 mIU/L (95% CI: 1.61–1.83 mIU/L)). Similarly, a trend was seen towards higher median TSH with Cobas than with Alinity among pregnant women (Alinity: 1.90 mIU/L (95% CI: 1.37–2.82 mIU/L); Cobas: 2.33 mIU/L (95% CI: 1.69–3.62 mIU/L)). Conclusion: Results of thyroid function tests obtained with different immunoassays were not interchangeable when evaluated among pregnant and non‐pregnant adults. The distinct differences are relevant for clinical decision making and emphasize the necessity of clinical laboratory information when different assays are used for diagnosis and monitoring of patients with thyroid disease. [ABSTRACT FROM AUTHOR]

Background: Function of thyroid gland is regulated by the axis hypothalamic- pituitarythyroid through these hormones: Thyrotrophin releasing hormone (TRH), thyroid stimulating hormone (TSH), tetraiodothyronine hormone (T4) and triiodothyronine hormone (T3). Thyroid disorders(hyperthyroidism or hypothyroidism) are common around the world and are common diseases in Iraq. Thyroid disorders are states that initially affect on amount of hormones that produced by the thyroid, and affects on all physiological systems including central nervous system, cardiovascular system, blood, and others. Afamin (AFM) is an 87 Kilodalton (kDa) glycoprotein that shares 55% of the amino acid sequence of albumin and contains 15% of carbohydrates. Vimentin (VIM) is a protein among 70 types of intermediate filaments, including Vimentin, Keratin, Desmin and Lamin. Vimentin is a cytoskeleton is an intermediate filament protein that makes up the nucleus and muscle cells. Aimes of study: We aimed to evaluate levels of Afamin, Vimentin and number of biochemical variables (TRH,TSH,T3 and T4) with Body mass index (BMI) in females patients with thyroid disorders. Methods: The study groups include 30 women with hyperthyroidism, 30 women with hypothyroidism and a control group of 30 healthy women with ages between(18-45) years, From September 2023 until March 2024. Protein assays include Afamin, Vimentin levels and number of biochemical variables( TRH,TSH,T3 and T4) in females patients with thyroid disorders . Results: The results of current study showed a significant increase at (P≤ 0.05) in AFM (227.67 ± 32.31), VIM(40.00 ± 4.39) levels with TRH(225.04± 57.08), TSH (11.71 ± 2.77) and BMI (29.70 ± 2.86) in patients with hypothyroidism group compared to (hyperthyroidism and healthy) groups. Levels of T3 (0.76 ± 0.14) and T4 (3.33 ± 0.79) showed a significant decrease at (P≤0.05) in hypothyroidism group compared to hyperthyroidism and healthy groups, While TSH (0.25 ± 0.08) levels showed a significant decrease at (P≤ 0.05) in hyperthyroidism group compared to hypothyroidism group and healthy group. Concentrations of T4 (13.42 ± 1.36) with T3 (2.16 ± 0.42) showed a significant increase at (P≤ 0.05) in hyperthyroidism group compared to hypothyroidism and healthy groups. Conclusions: We conclude from results of current study that high levels of AFM and VIM are associated with high levels of TRH,TSH and BMI in hypothyroidism group . Serum levels of AFM and VIM may be a new biomarkers for detecting and monitoring thyroid disorders, and may be an important useful clinical tools for detecting and monitoring thyroid disturbances. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic–pituitary–thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease. Aim: To evaluate the relationship between stress and primary hypothyroidism. Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5–5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument. Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score. Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients.

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic--pituitary--thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease. Aim: To evaluate the relationship between stress and primary hypothyroidism. Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5--5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument. Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score. Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients. [ABSTRACT FROM AUTHOR]

Alcoholic Liver Disease (ALD) is among one of the ten most common causes of deaths worldwide. Liver the largest gland in the body is a major site of thyroid hormones peripheral metabolism and is involved in its conjugation, biliary excretion, oxidative deamination and extrathyroidal deiodination of T4 to T3. In most chronic hepatic illnesses defects arise in thyroid hormone metabolism resulting in sick euthyroid syndrome. The above functions of liver are impaired in chronic liver diseases leading to decrease in T3, T4 and altered TSH levels. Some patients with chronic liver diseases may have thyroiditis, hyperthyroidism or hypothyroidism through autoimmune mechanisms. The exact mechanisms behind this is not well understood and hence the present study. Methods In the present study about 100 males subjects were selected randomly from Medicine OPD of GMCH, Nagpur in the age group of 40 - 60 years (50 normal healthy controls and 50 alcoholics) during May 2020 to May 2022. IEC approval was sought and informed consent was obtained from each subjects. Height, Weight of each subjects were measured by standing against a wall with a measuring scale on it and Body Mass Index (BMI) was calculated and recorded. After satisfying all inclusion and exclusion criterias about 5 ml of venous blood was withdrawn from each subjects ante-cubital vein using disposable sterile syringe and needle under strict aseptic precautions. The samples were immediately processed in ADVIA Centaur XP using chemiluminescence immunoassay technique for T3, T4 and TSH levels. Using appropriate statistical methods (Student's paired-t-test, Pearson's correlation coefficient) data was analysed. Results It was observed that BMI in ALD (20.21 ± 2.2) was highly significantly decreased as compared to controls (23.06 ± 2.4) with p -- value of < 0.005 [Chart 1.]. In ALD patients there was a highly significant decrease in T3 (0.48 ± 0.08) and T4 (6.4 ± 1.55) levels when compared to controls [T3 (0.98 ± 0.33), T4 (8.85 ± 1.79)] with p -- value of < 0.005. While TSH levels (4.77 ± 0.7) in ALD was observed to be highly significantly raised when compared to controls (2.46 ± 0.8) with p -- value of < 0.005 [Chart 2.]. Conclusions In ALD patients a highly significant decrease in T3 levels was seen due to decrease peripheral conversion of T4 to T3 may be due to decrease in activity of hepatic iodothyronine -- 5'-deiodinase. Moreover, upon withdrawal of ethanol the already decreased TBG reverts back to normal. Acetaldehyde a thyrotoxic agent may cause a blunting TSH response to TRH resulting in altered thyroid hormone levels in ALD patients which may stress a need in better ALD patient management since patients are clinically euthyroid and Propylthiouracil remains the mainstay of treatment in hypothyroidism. [ABSTRACT FROM AUTHOR]

We present a comprehensive overview of changes in thyroxine (T4) and thyroid stimulating hormone (TSH) serum concentrations after pre-gestational, gestational and/or lactation exposures of rodents to various chemicals that affect the thyroid hormone system. We show that T4 and TSH changes consistent with the idealized view of the hypothalamic-pituitary-thyroid (HPT) feedback loop (T4 decrements accompanied by TSH increases) are observed with only a relatively small set of chemicals. Most substances affect concentrations of various thyroid hormones without increasing TSH. Studies of altered T4 concentrations after gestational exposures are limited to a relatively small set of chemicals in which pesticides, pharmaceuticals and industrial chemicals are under-represented. Our risk-of-bias analysis exposed deficits in T4/TSH analytics as a problem area. By relating patterns of T4 - TSH changes to mode-of-action (MOA) information, we found that chemicals capable of disrupting the HPT feedback frequently affected thyroid hormone synthesis, while substances that produced T4 serum decrements without accompanying TSH increases lacked this ability, but often induced liver enzyme systems responsible for the elimination of TH by glucuronidation. Importantly, a multitude of MOA leads to decrements of serum T4. The current EU approaches for identifying thyroid hormone system-disrupting chemicals, with their reliance on altered TH serum levels as indicators of a hormonal mode of action and thyroid histopathological changes as indicators of adversity, will miss chemicals that produce T4/T3 serum decreases without accompanying TSH increases. This is of concern as it may lead to a disregard for chemicals that produce developmental neurotoxicity by disrupting adequate T4/T3 supply to the brain, but without increasing TSH. [ABSTRACT FROM AUTHOR]

Thyrotropin-releasing hormone (TRH) stimulation can be used as a test of thyroid function and pituitary thyrotropin (thyroid-stimulating hormone, TSH) reserve, but optimal stimulation testing protocols in cats are unreported. We randomly divided 6 healthy young adult cats into 3 groups of 2 and administered 3 different intravenous doses of TRH (0.01, 0.05, 0.1 mg/kg) at weekly intervals in our crossover study. Serum TSH and thyroxine (T4) concentrations were measured using chemiluminescent immunoassay before, and at 30 and 60 min after, TRH administration. All cats were monitored for 4 h post-TRH administration for side effects. All 3 TRH doses induced significant TSH (0.01 mg/kg, p = 0.001; 0.05 mg/kg, p = 0.002; 0.1 mg/kg, p = 0.006) and total T4 (0.01 mg/kg, p = 0.008; 0.05 mg/kg, p = 0.006; 0.1 mg/kg, p = 0.001) responses. Lower TRH doses (0.01 and 0.05 mg/kg) caused fewer side effects (1 of 6 cats) than did the highest dose (3 of 6 cats), and may be safer in cats than the previously reported higher dose (0.1 mg/kg) of TRH. Our results do not support the use of maropitant to prevent side effects of a TRH stimulation test in cats. [ABSTRACT FROM AUTHOR]

Purpose: The growing rate of obesity led to an increased number of bariatric surgeries (BS) as a treatment option for obesity. The gastrointestinal tract (GIT) changes following BS can impact many drugs' absorption. Levothyroxine (LT4) is a synthetic thyroxine (T4) replacement used commonly as tablets to manage hypothyroidism disorder, which is more prevalent among patients with obesity. This study aims to examine the LT4 oral tablet form therapy after sleeve gastrectomy. Materials and Methods: A retrospective cohort study was conducted in multi-center. The LT4 doses and TSH and T4 levels were compared before and after BS. The post-surgery readings were categorized into three periods: (one to three months), (four to six months), and (> six) months after surgery. ANOVA test was used for analysis. Results: A total of 14374 patients who underwent BS from (1/2019 to 3/2022) were screened for eligibility, and n = 101 participants matched the inclusion criteria. The TSH and T4 were not statistically significant differences before and after surgery (P-values of 0.4864 and 0.5970, respectively). However, the doses significantly differed before and after surgery in all the follow-up time point periods (P < 0.002). Conclusion: The LT4 required doses significantly reduced after sleeve gastrectomy, which can be related to the improved endogenous thyroid production in patients with obesity. However, the abnormality of the GIT induced by the sleeve gastrectomy may affect the exogenous LT4 absorption. Using liquid forms of LT4 while monitoring the thyroid function parameters can optimize the treatment after the procedure. [ABSTRACT FROM AUTHOR]

BackgroundAntithyroid drugs, such as methimazole (MMI), are standard therapies for the medical management of thyrotoxicosis. Agranulocytosis is a rare but lethal adverse effect of antithyroid medications. We have reported 2 cases of MMI-induced agranulocytosis with similar risk factors that likely predisposed them to this adverse reaction.Case reportCase 1 involved a 71-year-old woman, with a history of Graves disease, who presented with an altered mental status. She was recently discharged on 40 mg of MMI twice daily, and she continued this dose for 2 months. She was readmitted and found to have neutropenic fever in the setting of MMI-induced agranulocytosis. MMI was discontinued, and she was started on filgrastim. Her cell counts gradually improved, and she was subsequently discharged.Case 2 involved a 68-year-old woman, with a history of Graves disease, who presented with severe back pain, nausea, and vomiting. She was recently discharged on 10 mg of MMI twice daily, which was increased to 10 mg 3 times a day. She was readmitted to the hospital because of a septic shock in the setting of pneumonia, colitis, bacteremia, and MMI-induced agranulocytosis. A bone marrow biopsy showed a polyclonal infiltrate with up to 85% plasma cells. Despite treatment with antibiotics, filgrastim, and continuous renal replacement therapy, she ultimately passed away.DiscussionAlthough these cases had differing outcomes, they shared similar features and risk factors, including older age, female sex, and relatively higher doses of MMI.ConclusionClose follow up and awareness of risk factors, such as age, female sex, and higher doses of MMI, may decrease the risk of MMI-induced agranulocytosis and fatal outcomes.

We present a comprehensive overview of changes in thyroxine (T4) and thyroid stimulating hormone (TSH) serum concentrations after pre-gestational, gestational and/or lactation exposures of rodents to various chemicals that affect the thyroid hormone system. We show that T4 and TSH changes consistent with the idealized view of the hypothalamic-pituitary-thyroid (HPT) feedback loop (T4 decrements accompanied by TSH increases) are observed with only a relatively small set of chemicals. Most substances affect concentrations of various thyroid hormones without increasing TSH. Studies of altered T4 concentrations after gestational exposures are limited to a relatively small set of chemicals in which pesticides, pharmaceuticals and industrial chemicals are under-represented. Our risk-of-bias analysis exposed deficits in T4/TSH analytics as a problem area. By relating patterns of T4 – TSH changes to mode-of-action (MOA) information, we found that chemicals capable of disrupting the HPT feedback frequently affected thyroid hormone synthesis, while substances that produced T4 serum decrements without accompanying TSH increases lacked this ability, but often induced liver enzyme systems responsible for the elimination of TH by glucuronidation. Importantly, a multitude of MOA leads to decrements of serum T4. The current EU approaches for identifying thyroid hormone system-disrupting chemicals, with their reliance on altered TH serum levels as indicators of a hormonal mode of action and thyroid histopathological changes as indicators of adversity, will miss chemicals that produce T4/T3 serum decreases without accompanying TSH increases. This is of concern as it may lead to a disregard for chemicals that produce developmental neurotoxicity by disrupting adequate T4/T3 supply to the brain, but without increasing TSH.

Background:- Thyroid dysfunction is the most common endocrine disorder. Both hypothyroidism and hyperthyroidism cases changes in serum urea and serum cholesterol. Objectives: To determine the influence of thyroid hormone profile in the serum cholesterol and serum urea. Material & method:-Serum T3, T4 & TSH, serum urea, serum cholesterol were estimated. Result and conclusion: Both hypothyroidism and hyperthyroidism raised serum urea level. No significant difference was found in serum cholesterol levels of cases and controls. [ABSTRACT FROM AUTHOR]

Thyroid and gonadotropin hormones play an essential role in the regulation of regulating various physiological functions. The effects of melatonin and zinc (Zn) on these hormones have already been investigated. The aim of the present study was to investigate the effect of melatonin with and without zinc on the levels of gonadotropin hormones and thyroid hormones (triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH)) in female rats. In general, 35 sexually mature female rats were randomly divided into five treatment groups, with each group comprising 7 rats, in a completely randomized design (CRD) during the research. The rats were treated daily with Zn and melatonin via gavage as follows: T1 (control 1, basal diet), T2 (control 2, treatment with normal saline) and the other experimental groups, including T3, T4 and T5, were treated with Zn (40 ppm), melatonin (5 mg/kg) or a combination of Zn and melatonin at the same dose. The administration of the drugs was continued for 20 days (daily) . Plasma samples were then taken for the determination of LH, FFH, LH/FSH, estrogen, progesterone, T3, T4 and TSH levels. The results showed no significant differences in FSH and LH levels between treatments. Estrogen, progesterone and TSH levels were higher in the rats receiving 5 mg melatonin per day than in the other groups, but not statistically significant (P>0.05). However, T3 levels decreased significantly in the group receiving 40 mg/kg Zn compared to the other experiments. (P<0.05). The results showed no significant difference between the treatments in terms of T4 levels (P>0.05). In conclusion, no remarkable changes in other variables were observed in female rats receiving melatonin, Zn or a combination of melatonin and Zn, with the exception of T3. [ABSTRACT FROM AUTHOR]

Background: Glycolipid metabolism disorders (dysglycolipidemia) are characterized by elevated levels of glycolipid profile components and fasting blood glucose. Dysglycolipidemia are major threats to human health and life. Therefore, the aim of this cross-sectional study is to estimate the prevalence of dysglycolipidemia and the existence of association of TSH and T4 and glycolipid profiles. Methods: Cross-sectional data were obtained from the medical laboratory of Ma'an Governmental Hospital. A total of 141 patients' results were collected (18-60 years). Differences in the glycolipidemic profiles according to age and sex and TSH and T4 were compared. Different statistical analyses were used to analyze the prevalence of dysglycolipidemia and the correlation with the levels of TSH and T4. Results: The study involved results of 141 patients (54.7% males and 45.3% females) in Ma'an Province (Jordan), who visited the internal medicine clinic at Ma'an Governmental Hospital. Patients have overweight and BMI of more than 25 kg/m2. The overall results of the prevalence of dyslipidemia indicated that patients have 42.5% of hypercholesterolemia, 48.2% of high LDL-C, 34.1% of hypertriglyceridemia, and 41.8% of low HDL-C. The prevalence of isolated lipid profiles showed that 10 patients have mixed dyslipidemia. The association of dyslipidemia with age indicated a positive significance between triglyceride and older people (=40 years), while HDL levels have a significance with gender (p=0.025). The overall ANOVA model yielded non-statistical significant results between levels of any components of lipid profile and levels of TSH and T4 hormones. Welch test (p=0.036) showed positive significance between levels of fasting blood glucose and triglyceride levels. Conclusions: Our results showed and confirmed the presence of a high percentage of hyperlipidemia in Ma'an province and there was no relationship with levels of TSH and T4. A relationship exists between levels of triglycerides and blood glucose concentrations. [ABSTRACT FROM AUTHOR]

Given the expansion of life expectancy, the aging of the population, and the anticipated rise in the number of stroke survivors in Europe with severe neurological consequences in the coming decades, stroke is becoming the most prevalent cause of functional disability. Therefore, the prognosis for a stroke must be timely and precise. Two databases (MEDLINE and Scopus) were searched to identify all relevant studies published between 1 January 2005 and 31 December 2022 that investigated the relationship between thyroid hormone levels and acute stroke severity, mortality, and post-hospital prognosis. Only full-text English-language articles were included. This review includes Thirty articles that were traced and incorporated into the present review. Emerging data regarding the potential predictive value of thyroid hormone levels suggests there may be a correlation between low T3 syndrome, subclinical hypothyroidism, and poor stroke outcome, especially in certain age groups. These findings may prove useful for rehabilitation and therapy planning in clinical practice. Serum thyroid hormone concentration measurement is a non-invasive, relatively harmless, and secure screening test that may be useful for this purpose. [ABSTRACT FROM AUTHOR]

Background and objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease-19 (COVID-19). The effects of COVID-19 on the thyroid axis remain uncertain. This study aimed to determine the occurrence of thyroid dysfunction, as previously demonstrated for SARS-CoV-1 infection, and to analyze electrolytes (sodium, potassium, and chloride) to determine the severity of the disease. Methods: Blood samples were taken from patients who were admitted to Erbil hospitals from July to October 2021. Infection was detected by polymerase chain reaction (PCR). The 306 cases were labeled as moderate or severe. The samples were assessed for doing C-reactive protein (CRP), as a marker of systemic inflammation, thyroid-stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4), and (sodium, potassium, and chloride) electrolytes. Results: Patients comprised of 157 (51.3%) males and 149 (48.7%) females. The result revealed that 274 (89.5%), 278 (90.8%), 292 (95.4%) of patients had normal TSH, T3, T4 level respectively, 22 (7.2%), 23 (7.5%), 9 (2.9%) of patients had low TSH, T3, T4 level respectively, and 10 (3.3%), 5 (1.6%), 5 (1.6%), had high TSH, T3, T4 level respectively. There was no significant difference between moderate and severe cases in alterations of TSH, T3, T4 level. There was a significant difference between moderate and severe cases in sodium, potassium, and chloride electrolyte abnormality. Conclusion: The occurrence of thyroid dysfunction in moderate and severe cases. The severity of the COVID-19 infection is associated with abnormalities in sodium, calcium, and chloride electrolytes.

Background: Thyroid hormones are key determinants of health and well-being. Normal thyroid function is defined according to the standard 95% confidence interval of the disease-free population. Such standard laboratory reference intervals are widely applied in research and clinical practice, irrespective of age. However, thyroid hormones vary with age and current reference intervals may not be appropriate across all age groups. In this review, we summarize the recent literature on age-related variation in thyroid function and discuss important implications of such variation for research and clinical practice. Main text: There is now substantial evidence that normal thyroid status changes with age throughout the course of life. Thyroid stimulating hormone (TSH) concentrations are higher at the extremes of life and show a U-shaped longitudinal trend in iodine sufficient Caucasian populations. Free triiodothyronine (FT3) levels fall with age and appear to play a role in pubertal development, during which it shows a strong relationship with fat mass. Furthermore, the aging process exerts differential effects on the health consequences of thyroid hormone variations. Older individuals with declining thyroid function appear to have survival advantages compared to individuals with normal or high-normal thyroid function. In contrast younger or middle-aged individuals with low-normal thyroid function suffer an increased risk of adverse cardiovascular and metabolic outcomes while those with high-normal function have adverse bone outcomes including osteoporosis and fractures. Conclusion: Thyroid hormone reference intervals have differential effects across age groups. Current reference ranges could potentially lead to inappropriate treatment in older individuals but on the other hand could result in missed opportunities for risk factor modification in the younger and middle-aged groups. Further studies are now needed to determine the validity of age-appropriate reference intervals and to understand the impact of thyroid hormone variations in younger individuals. [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]

This study aims to investigate the relationship between thyroid peroxidase antibody (TPO) and thyroid function tests (TSH, T3 and T4) in patients with type 2 diabetes mellitus (T2DM). Ninety women and men, with ages ranging between 35- 65 years and weighing 60-80 kgs, were selected for this study. They were classified into three groups: G1 included 15 healthy control group, G2 had15 patients with T2DM and G3 had 60 patients with T2DM and hypothyroidism. Blood samples were collected from each individual via vein puncture to assess thyroid hormone and TPO-Ab. The results showed highly significant (p < 0.01) increase in TSH level in the diabetic group with hypothyroidism when compared to the other groups. There was no significant difference between diabetic and control groups. T4 and T3 levels showed highly significant (p<0.01) decrease in the diabetic group with hypothyroidism when compared to the diabetic and healthy control groups. On the other hand, there was no significant difference between the diabetic and healthy control groups. The results showed highly significant (p < 0.01) increase in the TPO-AB level in diabetic group with hypothyroidism when compared with the diabetic and healthy control groups. [ABSTRACT FROM AUTHOR]

Background: Adolescence is the phase of life between childhood and adulthood, from ages of 10 -19 years, during which thyroid disorders peak and mostly goes undetected. Hence, there is a need for evaluation of thyroid functions in this age group. Objective: To assess the thyroid status of adolescents aged 10-19 years coming to a tertiary care Centre. Material and Methods: This cross sectional analytical study was conducted among adolescents between the age of 10-19 years who attended the Department of Paediatrics at JSS Hospital, a tertiary care centre in Mysuru, Karnataka, India. Duration of study was 18 Month. Consecutive Sampling technique was used. Results: Family history of hypothyroidism was seen in 2% of study subjects. Subclinical hypothyroidism(14%) was the most common thyroid abnormality followed by subclinical hyperthyroidism (3.3%). Conclusion: In our study, subclinical hypothyroidism is the most common presentation of thyroid abnormalities in adolescents. Hence, thyroid function test is strongly recommended to identify the thyroid abnormalities & early initiation of treatment. [ABSTRACT FROM AUTHOR]

Objectives: Ultrasonography and fine-needle aspiration biopsy (FNAB) are the gold standard methods in the prediction of benign and malignant thyroid nodules. However, despite being easily applicable, FNAB is an invasive procedure. Less invasive biomarkers should be utilized in the diagnosis of thyroid malignancies. In this study, we aimed to determine the parameters that can be used in the diagnosis of differentiated thyroid cancer (DTC) based on the serum thyroid and thyroglobulin (TG) levels which are routinely checked in patients followed up for thyroid nodules. Methods: In the study, we evaluated patients who underwent thyroid surgery for nodular diseases between January 2015 and June 2022. Of the 1444 patients evaluated, 919 patients who met the inclusion criteria (normothyroid benign nodular disease or normothyroid DTC) were included in the study. Patients were divided into two groups as benign group (BG) and DTC group (DTCG). We compared patients' pre-operative serum thyroid and TG values and the diagnostic properties of their ratios. Results: Of the 919 patients included, 517 (56.3%) were in BG and 402 (43.7%) were in DTCG. In DTCG, 318 patients were female and 84 patients were male. The mean age in the DTCG was 47.8 years. Comparison of DTCG and BG revealed a significant difference between T3/T4 ratio (p=0.002), T3/TSH ratio (p=0.001), T4/TSH ratio (p=0.001), TG/TSH ratio (p=0.001), and TSH/TG ratio (p=0.001). However, evaluation of the specified values by ROC analysis showed that the T3/T4 ratio did not make a significant difference between the two groups (p=0.1), whereas the other values displayed a significant difference (p=0.001 for T3/TSH, p=0.001 for T4/TSH, p=0.001 for TG/TSH, and p<0.001 for TSH/TG). Conclusion: T3/TSH (cutoff =2.183), T4/TSH (cutoff=0.6), and TG/TSH (cutoff=29.67) values were found to be significant tumor markers for the prediction of malignancy in thyroid nodules, and low values were found to be associated with malignancy. TSH/TG (cutoff=0.031) value was also significant in predicting malignancy while high values were found to be associated with malignancy. Thyroid hormone and TG ratios may alter the preferred treatment method for thyroid nodules. [ABSTRACT FROM AUTHOR]

Tribulus terrestris (Tt) is a herb distributed worldwide due to its beneficial claims on many diseases. This study aimed to study the role of Tt against Cadmium (Cd)-induced toxicity on thyroid gland of adult male albino rats. Twenty-four rats were subdivided into four groups; (Control group) without any treatment, (Tt + Cd group) with a daily oral dose of Tt (5 mg/ kg b. wt.) for eight weeks, from the beginning of the ninth week, they injected i.p. with 2 mg/kg of CdCl4 for 8 days, (Cd group) injected i.p. with 2 mg/kg of CdCl4 for 8 days, (Cd + Tt group) injected i.p. with 2 mg/kg of CdCl4 for eight days, from the ninth day they were given a daily oral dose of Tt (5 mg/ kg b. wt.) for eight weeks. Results revealed that levels of T4 and TAC decreased while levels of TSH and MDA increased in Cd group resulted in follicular cells degeneration, increasing the amount of collagen fibers, and increased positive immunoreactivity of PCNA. Administration of Tt before Cd injection increased levels of T4 and TAC while decreased levels of TSH and MDA. administration of Tt after Cd injection didn't affect T4, TSH, MDA and TAC levels. The pre-treatment with Tt protects the thyroid tissue from those destructive changes by Cd while the post-treatment did not treat them. In conclusion, Tribulus terrestris is highly effective in shielding the thyroid gland from further damaging effects of Cd -induced oxidative stress when utilized as prophylactic antioxidant rather than treatment therapy. [ABSTRACT FROM AUTHOR]

Background and purpose: Melasma is a common skin pigmentation disorder that manifests as hyperpigmented macules and patches. Genetic predisposition, sun exposure, and pregnancy are known risk factors for melasma. Previous studies have suggested that thyroid disorders may be associated with melasma. Given the fact that vitamin D affects and stimulates the production of melanin by melanocytes, this study aimed to investigate the relationship between thyroid disorders and serum level of vitamin D with melasma in female patients attending Qaemshahr Razi Hospital and Sari Bouali-Sina Hospital. Materials and methods: In this study, 80 people were divided into melasma group (n=40) and control group (n=40). They were matched for sex and age. Serum levels of TSH, Anti-TPO, T3, T4, and Vit D were measured in both groups. The standard mMASI score was used to measure the clinical severity of pigmentation in patients with melasma. Results: The prevalence of thyroid abnormalities and serum levels of vitamin D were seen in 50% and 47.5% of patients with melasma and 27.5% and 40% of the control group, respectively. Examination of thyroid hormone and vitamin D levels showed that T3 level was significantly higher in case group (P

Abstract—. Thyroid disorders are the second biggest endocrine problem in society after diabetes. Environmental and genetic factors lead to the development of thyroid disorders. So this study designed to determine the prevalence of thyroid disorders in Nasiriya city . One hundred-twenty subjects for both genders involved in this study , 80 of whom were patients, and 40 of healthy people. A blood sample and personal information was collected from all . The levels of thyroid hormones was estimate by Cobas e411 Electeo Chemiluminescence Immunoassay (ECLI). The study found that the incidence of female was more than male (77.5% , 22.5%) and the ratio was 3.4:1. The results showed hypothyroidism disorder more prevalence than hyperthyroidism , and (83.64%) of hypothyroidism were female, and only (16.36%) were male, also (64%) of hyperthyroidism were female while male represented only (36%) of them. The majority of patients were in ages between 35-46 years. The results indicated that (43.75%) of patients had a family history, (26.25%) diagnosed with hypothyroidism and (17.5%) diagnosed with hyperthyroidism . It was concluded that thyroid disorders, especially hypothyroidism, constitute a serious concern for public health, and middle-aged people and females were the category most susceptible to thyroid disorders.

The aim of this study was to evaluate the correlation between triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) hormones and thyroid gland volume with volumetric analysis performed by using computed tomography (CT) images. In this retrospective study, IV contrasted thoracic CT images taken for different indications between 2019 January and 2020 January were scanned from the archive system of the hospital. 67 (31F, 36M) individuals chosen randomly among patients whose CT results were reported as normal and who had taken thyroid hormone tests within the past week were included in the study. Images in Digital Imaging and Communications in Medicine format were transferred to the personal work station program (Horos Medical Image Viewer). By using the Region of Interest (ROI) console in the current program, a three dimensional model was obtained by drawing the border of the thyroid gland in sections varying between 15 and 25. Volume values of this three-dimensional model and TSH, T3, T4 values of the individuals were compared. While no correlation was found between thyroid gland volume and T3 and T4 hormones, a negative significant correlation was found with TSH. In terms of gender, thyroid gland volume, T3, T4 values were found to be statistically significantly higher in women when compared with men (p≤0.05). TSH value was found to be higher in women when compared with men (p=0.005). No statistically significant difference was found in T4 value (p=0.057). Radio-anatomical volumetric data of the thyroid gland presented in this study and its correlation with thyroid functions will be beneficial to clinicians working in the field in both internal and surgical medicine branches and will also guide future studies. [Med-Science 2022; 11(2.000): 810-3]

Background & aim: Lead is a heavy metal that enters the body as an environmental contaminant through the gastrointestinal tract or respiratory tract. Therefore, the aim of the present study was to determine the effect of aqueous alcoholic extract of Parsley leaf (Petroselinum crispum) on pituitary-thyroid hormones in adult male rats following lead acetate poisoning. Methods: The present experimental study was conducted in 2020 at the Islamic Azad University, Kazeron Branch. Forty-eight adult male Wistar rats were included in the study, which were divided into 6 groups of 8, including control and control groups (solvent treatment). Four experimental groups were treated with 200 mg / kg lead acetate, 200 mg / kg parsley leaf extract and simultaneously treated with lead acetate and 100 and 200 mg / kg parsley leaves. All prescriptions were performed by gavage for 21 days. Finally, after anesthesia of mice and blood sampling from animal hearts, serum levels of T4, T3 and TSH hormones were measured by ELISA method. The collected data were analyzed using analysis of variance and Tukey test. Results: The results indicated that serum levels of lead acetate T4 and T3 increased in animals receiving lead acetate and TSH showed a significant decrease at the level of p

This systematic review and meta-analysis was conducted to evaluate the effect of COVID-19 on thyroid function and the role of thyroid hormones alterations in predicting the severity of COVID-19. Online databases, including Scopus, Medline/PubMed, EMBASE, Google Scholar, and Cochrane were searched up to August 2, 2022. After screening titles, abstracts, and full manuscripts, respectively, 30 reports were enrolled. The risk of bias (ROB) was evaluated using the QUADAS-2 tool. In addition, odds ratio (OR) and hazard ratio (HR) analysis for assessing the OR of abnormal thyroid function tests (TFT) in predicting the COVID-19 severity and poor outcomes. Among 30 enrolled studies, ROB of the current study is estimated low to moderate. The average number of patients in each study was 325 (range: 40-3,703), with an overall mean age of 57.6, and the female proportion of 40.4%. Overall, the pooled analysis showed that the prevalence of thyroid dysfunction among 9,707 COVID-19 cases was 15%. Among mild to moderate COVID-19 patients, 6.2% had abnormal TFT, and among patients who experienced severe to critical COVID-19, 20.8% had abnormal TFT. The pooled OR for abnormal TFT and the severity of COVID-19 obtained from 3,865 COVID-19 patients was 3.77 (2.03, 6.99). The pooled HR of TSH level of COVID-19 mortality was 1.57 (0.91, 2.72). Our results demonstrate a high prevalence of thyroid dysfunction in COVID-19, and that among patients severe cases had a 3.77-fold higher risk of abnormal TFT compared to mild to moderate COVID-19. Further studies are required to evaluate the longer-term prognostic role of thyroid dysfunction in severe COVID-19, and investigate potential therapeutic strategies. [ABSTRACT FROM AUTHOR]

Based on genetic factors, trace minerals are essential for thyroid function and hormone metabolism. For this purpose, serum levels of thyroid hormones and some blood micronutrient concentrations in lambs were determined, compared and their relationships were investigated. A 176 lambs including 70 males under 2 months old and 106 females aged over 2 months were selected from Ghezel and Makui breeds. The 5 ml Jugular blood was prepared and the sera were evaluated for the concentrations of T3, T4, TSH, copper, iron and zinc. Thyroid hormones were determined by ELISA and trace minerals by autoanalyzer method. Mean T3 and TSH in males were higher than females and T4 in females were higher than in males but only TSH was significant. The mean serum concentrations of copper, iron and zinc in males were less than females in that only copper and zinc were significant and iron was not different. TSH in males was 36.3% higher than in females, copper and zinc in females were 12.6% and 7.3% higher than in males, respectively. The T3/T4 ratio was higher in males than in females and overall the T3/T4 ratio was low. Significant negative relationships were found between T3/TSH (r=-0.36) and T4/copper (r=-0.24) in males but not in females. Significant negative relationship was also found between TSH/T3 (r=-0.16) for all lambs. Significant positive relationships were presented between copper/zinc (r=0.38) and iron/zinc (r=0.44) in males, females and overall (P<0.01). In conclusion, the thyroid hormones and micronutrient concentrations in lambs’ blood were about the standard level. The amount of thyroid hormones and trace minerals with the exception of T3, were higher in females than in males. The T3/T4 ratio was higher in males than in females. Thyroid hormones were not correlated with trace minerals in males and females except between TSH/Zn and T4/copper which were negative. There were positive and significant relationships between copper/zinc and iron/zinc in males, females and overall samples but copper/iron was not correlated. Finally, mares are predisposing to trace minerals and thyroid hormones sufficiency than females. [ABSTRACT FROM AUTHOR]

Abstract Background High normal levels of thyroid-stimulating hormone (TSH) have been reported to be associated with chronic kidney disease (CKD) among euthyroid individuals. However, there has been only limited research on the association between TSH and proteinuria, a major risk factor for the progression of renal disease. Methods A cross-sectional study of 1595 euthyroid individuals was conducted. All participants were within the normal range for free triiodothyronine (T3), free thyroxine (T4), and TSH. Analyses were stratified by thyroid cyst status to test the hypothesis that the absence of thyroid cysts, an indicator of latent thyroid damage, is associated with declining ability to synthesis thyroid hormone. Results For participants with thyroid cysts, a significant inverse association between TSH and proteinuria was observed (adjusted odds ratio (95% confidence intervals) of log-transformed TSH for proteinuria 0.40 (0.18, 0.89)). In participants without thyroid cysts, a significant positive association between those two factors was observed (2.06 (1.09, 3.90)). Conclusions Among euthyroid individuals in the general population, being in the normal range of TSH was found to have an ambivalent association with proteinuria. Thyroid cyst status could be an effect modifier for those associations.

This systematic review and meta-analysis was conducted to evaluate the effect of COVID-19 on thyroid function and the role of thyroid hormones alterations in predicting the severity of COVID-19. Online databases, including Scopus, Medline/PubMed, EMBASE, Google Scholar, and Cochrane were searched up to August 2, 2022. After screening titles, abstracts, and full manuscripts, respectively, 30 reports were enrolled. The risk of bias (ROB) was evaluated using the QUADAS-2 tool. In addition, odds ratio (OR) and hazard ratio (HR) analysis for assessing the OR of abnormal thyroid function tests (TFT) in predicting the COVID-19 severity and poor outcomes. Among 30 enrolled studies, ROB of the current study is estimated low to moderate. The average number of patients in each study was 325 (range: 40-3,703), with an overall mean age of 57.6, and the female proportion of 40.4%. Overall, the pooled analysis showed that the prevalence of thyroid dysfunction among 9,707 COVID-19 cases was 15%. Among mild to moderate COVID-19 patients, 6.2% had abnormal TFT, and among patients who experienced severe to critical COVID-19, 20.8% had abnormal TFT. The pooled OR for abnormal TFT and the severity of COVID-19 obtained from 3,865 COVID-19 patients was 3.77 (2.03, 6.99). The pooled HR of TSH level of COVID-19 mortality was 1.57 (0.91, 2.72). Our results demonstrate a high prevalence of thyroid dysfunction in COVID-19, and that among patients severe cases had a 3.77-fold higher risk of abnormal TFT compared to mild to moderate COVID-19. Further studies are required to evaluate the longer-term prognostic role of thyroid dysfunction in severe COVID-19, and investigate potential therapeutic strategies.

Summary: Background: During illness, adaptations of the hypothalamic–pituitary‐thyroid axis reduce energy expenditure, protein catabolism and modulate immune responses to promote survival. Lower serum free triiodothyronine‐to‐thyroxine (fT3/fT4) ratio has been linked to non‐response to treatment in a range of diseases, including in biologic‐treated patients with inflammatory bowel disease. Aim: To assess whether baseline serum fT3/fT4 ratio predicted primary non‐response (PNR) and non‐remission to infliximab and adalimumab in patients with Crohn's disease Methods: Thyroid function tests were undertaken in stored serum from biologic‐naïve adult patients with active luminal Crohn's disease immediately prior to treatment with infliximab (427 originator; 122 biosimilar) or adalimumab (448) in the Personalised Anti‐TNF Therapy in Crohn's Disease study (PANTS). Results: Baseline median [IQR] fT3/fT4 ratios were lower in women than men (0.30 [0.27–0.34] vs 0.32 [0.28–0.36], p < 0.001), in patients with more severe inflammatory disease, and in patients receiving corticosteroids (0.28 [0.25–0.33] vs. 0.32 [0.29–0.36], p < 0.001). Multivariable logistic regression analysis demonstrated that fT3/fT4 ratio was independently associated with PNR at week 14 (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.31–0.85, p = 0.009), but not non‐remission or changes in faecal calprotectin concentrations at week 54. The optimal threshold to determine PNR was 0.31 (area under the curve 0.57 [95% CI 0.54–0.61], sensitivity 0.62 [95% CI 0.41–0.74], and specificity 0.53 [95% CI 0.42–0.73]). Conclusions: Lower baseline serum fT3/fT4 ratio was associated with female sex, corticosteroid use and disease activity. It predicted PNR to anti‐TNF treatment at week 14, but not non‐remission at week 54. [ABSTRACT FROM AUTHOR]

Background and Objectives: Conditions such as trauma, burns, sepsis, or acute intoxications have considerable consequences on the endocrine status, causing "sick euthyroid syndrome". Organophosphate exposure may induce an increase in acetylcholine levels, thus altering the thyroid's hormonal status. The present study aims to identify the effects of acetylcholinesterase inhibition on thyroid hormones. Material and methods: A prospective experimental study was conducted on twenty Wistar rats. Blood samples were drawn to set baseline values for thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). Chlorpyrifos 0.1 mg/kg was administered by oral gavage to induce acetyl-cholinesterase inhibition. After exhibiting cholinergic symptoms, blood samples were collected to assess levels of cholinesterase and thyroid hormones using ELISA. Results: Butyrylcholinesterase levels confirmed major inhibition immediately after intoxication compared to the baseline, certifying the intoxication. A significant increase in T4 levels was noted (p = 0.01) both at 2 h and 48 h after administration of organophosphate in sample rats. Similarly, T3 almost doubled its value 2 h after poisoning (4.2 ng/mL versus 2.5 ng/mL at baseline). Surprisingly, TSH displayed acute elevation with an afterward slow descending trend at 48 h (p = 0.1), reaching baseline value. Conclusions: This study demonstrated that cholinesterase inhibition caused major alterations in thyroid hormone levels, which may be characterized by a transient hypothyroidism status with an impact on survival prognosis. [ABSTRACT FROM AUTHOR]

Lead (Pb) is a prevalent environmental toxic metal that may harmfully affect the function of the thyroid gland. Our information about the effects of lead on thyroid function in lead poisoning is limited. The present study aimed to evaluate thyroid function in lead-poisoned patients compared with the healthy group. In this study, two groups of lead poisoning subjects (lead concentrations ≥ 25 μg/dL) (n = 56) (HBLC group) and randomly selected age and gender-matched healthy individuals with lower blood lead concentrations (BLC < 10 μg/dL) (n = 58) (LBLC group) were included. Thyroid function tests, including thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) concentration, were measured for each patient in both groups (for the HBLC group, it was taken on admission). The linear regression model was used to investigate the effects of lead poisoning on thyroid function tests. A p-value of less than 0.05 was considered significant. Our study showed no significant difference between the two groups in terms of age and gender. The mean concentration of T3 and TSH in the HBLC group was significantly lower than the LBLC group, but the mean levels of T4 were significantly higher in the HBLC group (p < 0.05). Based on the linear regression model results, the T3 and TSH levels in the LBLC group were significantly higher by 13.86 and 0.43 units than the HBLC group, respectively. The current study results showed that lead poisoning affects thyroid function, reduces TSH, and increases T4. [ABSTRACT FROM AUTHOR]

Background and Objectives: The virus SARS-CoV2, which causes COVID-19, affects the endocrine system. This study investigated serum concentrations of the thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) in 53 outpatients infected with SARS-CoV2 and 53 non-infected matched participants in Khuzestan Province, Iran. We also examined the possible association of clinical symptoms progression and disease severity with serum concentrations of TSH, T3, and T4. Materials and Methods: A checklist was applied to collect demographic and clinical data. Blood samples were taken for biochemical analysis of serum concentrations of TSH, T3, and T4. Clinical symptoms of the infected outpatients were monitored weekly for 28 days. Results: Our results indicated that, as the severity of the disease increased, the respiratory and pulse rates raised significantly. Additionally, disease severity was significantly different between genders. Specifically, 79.5% of the asymptomatic/mild, and 38.5% of moderate outpatients were men. We also found significantly lower serum T3 but higher T4 in infected outpatients, compared with controls. However, serum TSH did not significantly differ between the two groups. The generalized estimating equation (GEE) analysis revealed no relationship between clinical symptoms progression and disease severity with serum concentrations of TSH, T3, and T4 in our study population. Additionally, GEE analysis showed that the odds ratio of neurological symptoms among women was 2.5 times that of men, the odds ratio of neurological symptoms in illiterates was 10 times higher than that of those without a high-school diploma, and the chance of developing pulmonary symptoms in those without high-school diploma was about 21 times higher than illiterates. Conclusion: In conclusion, this study showed that infected outpatients had significantly lower serum T3 but higher T4 than non-infected participants. There was no relation between symptom progression and disease severity with serum concentrations of TSH, T3, and T4, but educational status and sex significantly affected the chance of neurological and pulmonary symptoms occurring over 28 days. Our results may be used to develop potential therapies to treat COVID-19 disease. [ABSTRACT FROM AUTHOR]

Objective: The present study was conducted to explore the different clinical presentations of thyroid disorders among the patients presenting at the Endocrinology Clinic at Medical Teaching Institution (MTI) Lady Reading Hospital. Study type, settings & duration: A cross-sectional study was conducted at the Department of Diabetes & Endocrinology, Medical Teaching Institution (MTI), Lady Reading Hospital, Peshawar from January to July 2021. Methodology: The sample of 66 subjects to screen for thyroid disorders. Patients’ demographic data, clinical, biochemical and thyroid symptomatology profile was collected using a pre-structured questionnaire. Results: Most of the patients were found to have hyperthyroidism (72.7%), followed by hypothyroidism (12.1%), subclinical hypothyroidism (9.1%) and subclinical hyperthyroidism (6.1%). The most common symptoms observed among hypothyroid patients were weight gain and cold intolerance (87.5% each), while weight loss and heat intolerance were prominent among hyperthyroid patients, i.e. 97.9% and 93.8%, respectively. Anxiety was most common among the neuropsychiatric symptoms (81.8% overall), reported by all patients with hyperthyroidism and subclinical hyperthyroidism, while 12.5% and 16.7% of patients with hypo and subclinical hypothyroidism reported so. Thyroid swelling was detected among all patients (98.5%), irrespective of under or overactive thyroid. Based on the diagnostic test, anti-thyroid peroxidase (TPO) was present among 4.54% of patients, while thyroid receptor antibody (TRAb) results were positive for 6.06% of patients, indicating the presence of autoimmune thyroid disorders. Conclusion: High prevalence of thyroid disorders was observed among middle-aged females of northern Pakistan. The clinical, biochemical and symptomatology were extensively studied, and we found substantial variations among patients ..........

Bacterial infection is one of the most common causes of systemic inflammatory syndrome known as sepsis. Previous studies have been shown that sever sepsis was often complicated with secondary multiple organs dysfunction. This syndrome may greatly affect thyroid gland function leading to thyroid gland dysfunction. The objective of this study was to elucidate the effect of bacterial endotoxin (lipopolysaccharide, LPS) on thyroid gland function. The study extended to investigate the role of L-arginine (L-Arg) as immunomodulator in LPS-induced systemic inflammation. Eighty adults, male Wistar rats were randomly divided into four equal groups: The control group was intraperitoneally (IP) injected with physiological sterile saline (0.9% NaCl at dose 1 ml/kg body weight (BW)); LPS-treated group was injected with a single dose of LPS (1 mg/kg BW, IP); L-Argtreated group was injected with L-Arg (10 mg/kg BW, IP) once per day for 7 consecutive days; and L-Arg + LPS treated group was injected with L-Arg (10 mg/kg BW, IP) once per day for 7 consecutive days followed by a single dose of LPS (1 mg/kg BW, IP). Histopathological changes of thyroid gland, serum triiodothyronine (T3), thyroxine(T4), and thyroid stimulating hormone (TSH) levels were examined at 6, 12, 24 and 72 hours (h) after the last injection. Treatment of rats with a single dose of LPS alone resulted in thyroiditis which manifested by decreased serum T3 and T4 levels and severe necrosis of the thyroid follicles. However, in L-Arg-treated endotoxemic rats, pretreatment with L-Arg attenuated the LPS-induced acute thyroid gland injury.

The aim of this study was to evaluate the correlation between triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) hormones and thyroid gland volume with volumetric analysis performed by using computed tomography (CT) images. In this retrospective study, IV contrasted thoracic CT images taken for different indications between 2019 January and 2020 January were scanned from the archive system of the hospital. 67 (31F, 36M) individuals chosen randomly among patients whose CT results were reported as normal and who had taken thyroid hormone tests within the past week were included in the study. Images in Digital Imaging and Communications in Medicine format were transferred to the personal work station program (Horos Medical Image Viewer). By using the Region of Interest (ROI) console in the current program, a three dimensional model was obtained by drawing the border of the thyroid gland in sections varying between 15 and 25. Volume values of this three-dimensional model and TSH, T3, T4 values of the individuals were compared. While no correlation was found between thyroid gland volume and T3 and T4 hormones, a negative significant correlation was found with TSH. In terms of gender, thyroid gland volume, T3, T4 values were found to be statistically significantly higher in women when compared with men (p≤0.05). TSH value was found to be higher in women when compared with men (p=0.005). No statistically significant difference was found in T4 value (p=0.057). Radio-anatomical volumetric data of the thyroid gland presented in this study and its correlation with thyroid functions will be beneficial to clinicians working in the field in both internal and surgical medicine branches and will also guide future studies. [ABSTRACT FROM AUTHOR]

Objective: The present study was conducted to explore the different clinical presentations of thyroid disorders among the patients presenting at the Endocrinology Clinic at Medical Teaching Institution (MTI) Lady Reading Hospital. Study type, settings & duration: A cross-sectional study was conducted at the Department of Diabetes & Endocrinology, Medical Teaching Institution (MTI), Lady Reading Hospital, Peshawar from January to July 2021. Methodology: The sample of 66 subjects to screen for thyroid disorders. Patients' demographic data, clinical, biochemical and thyroid symptomatology profile was collected using a pre-structured questionnaire. Results: Most of the patients were found to have hyperthyroidism (72.7%), followed by hypothyroidism (12.1%), subclinical hypothyroidism (9.1%) and subclinical hyperthyroidism (6.1%). The most common symptoms observed among hypothyroid patients were weight gain and cold intolerance (87.5% each), while weight loss and heat intolerance were prominent among hyperthyroid patients, i.e. 97.9% and 93.8%, respectively. Anxiety was most common among the neuropsychiatric symptoms (81.8% overall), reported by all patients with hyperthyroidism and subclinical hyperthyroidism, while 12.5% and 16.7% of patients with hypo and subclinical hypothyroidism reported so. Thyroid swelling was detected among all patients (98.5%), irrespective of under or overactive thyroid. Based on the diagnostic test, anti-thyroid peroxidase (TPO) was present among 4.54% of patients, while thyroid receptor antibody (TRAb) results were positive for 6.06% of patients, indicating the presence of autoimmune thyroid disorders. Conclusion: High prevalence of thyroid disorders was observed among middle-aged females of northern Pakistan. The clinical, biochemical and symptomatology were extensively studied, and we found substantial variations among patients with hypothyroidism, hyperthyroidism and their sub-clinical forms. [ABSTRACT FROM AUTHOR]

Objective: To determine the percentage of Hypothyroidism in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: Nutrition Rehabilitation Center, Children's Hospital and Institute of Child Health Multan. Period: January 2019 to December 2019. Material & Methods: A total of 255 malnourished patients (as per inclusion criteria) were included in current study. A written Performa was designed to collect history, anthropometric measurements and systemic examination. Taking aseptic measures venous blood was sent for baseline tests as well as for T3, T4 and TSH, total serum protein albumin and total ferritin levels to hospital laboratory. Correlation between serum thyroid concentrations and total protein, albumin, hemoglobin and serum ferritin were estimated by using t-test and p-vlaue less than 0.05 was considered as significant. Total collected data was entered and analyzed in SPSS version 21.0. Results: A total of 255 malnourished children were included in this study. Majority of studied subjects were male (52.5%) with 83.92%, 3-5 years of age. Amongst the 255 children mean values of T3 in MAM and SAM patients were 105.4 ng/dl and 89.7 ng/dl respectively. There was a statistically significant (p <0.001) association between decreased T3 and type of malnutrition. Similarly, mean values of T4 in MAM and SAM patients were 6.3 ug/dl and 5.7 ug/dl respectively that was statistically significant (p <0.05). Lower values of T4 were higher among SAM children in 1 to 3 years age group compared to respective MAM children with p value .0.05 and high T4 value in 3-5 years age group of MAM children were both statistically insignificant. Higher mean Values of TSH was found in SAM compared to MAM children both age groups. Conclusion: Severe acute malnutrition (SAM) is associated with reduction in T3 and T4 levels and higher levels of TSH in SAM children as compared to MAM. The altered thyroid hormone status in children with PEM is perhaps a protective phenomenon to limit protein catabolism and lower energy requirements. [ABSTRACT FROM AUTHOR]

The evaluation of the thyroid can be a very involved process. A misinterpretation of the results of a thyroid function test can lead to serious complexities in a patient's management and outcome. The nuances in diagnostic approaches necessitates that standardized protocols for assessing thyroid function are established. A number of factors may impact how the thyroid functions and these factors must be considered when interpreting the results of a thyroid function test. Unfortunately, many clinicians only observe a cursory analysis of thyroid function. Primary care physicians, in particular, must be aware of these practice deficiencies and hopefully increase the detection of thyroid anomalies with greater accuracy at this first level of clinical contact.

Background: High normal levels of thyroid-stimulating hormone (TSH) have been reported to be associated with chronic kidney disease (CKD) among euthyroid individuals. However, there has been only limited research on the association between TSH and proteinuria, a major risk factor for the progression of renal disease. Methods: A cross-sectional study of 1595 euthyroid individuals was conducted. All participants were within the normal range for free triiodothyronine (T3), free thyroxine (T4), and TSH. Analyses were stratified by thyroid cyst status to test the hypothesis that the absence of thyroid cysts, an indicator of latent thyroid damage, is associated with declining ability to synthesis thyroid hormone. Results: For participants with thyroid cysts, a significant inverse association between TSH and proteinuria was observed (adjusted odds ratio (95% confidence intervals) of log-transformed TSH for proteinuria 0.40 (0.18, 0.89)). In participants without thyroid cysts, a significant positive association between those two factors was observed (2.06 (1.09, 3.90)). Conclusions: Among euthyroid individuals in the general population, being in the normal range of TSH was found to have an ambivalent association with proteinuria. Thyroid cyst status could be an effect modifier for those associations. [ABSTRACT FROM AUTHOR]

Background: Thyroid disorders are commonly encountered endocrine ailments in clinical practice. Objective: To determine the trends and frequency of thyroid disorders in patients presented for thyroid dysfunction at the department of Pathology Benazir Bhutto hospital Rawalpindi Study Design: Cross-sectional retrospective study. Materials and Methods: Patients who underwent thyroid function tests were enrolled in the study Thyroid function tests were performed on a fully automated Chemistry Analyzer. Graph Pad Prism version 7 and SPSS version 25 were used for statistical analysis of the data. Results: Out of 2856 patients, 81.9% were females and 18.1% were males. The mean age of the participants was 38.12 ± 14.51 years and the median was 35(13-96). Overall, 1951 (68.3%) of the subjects were euthyroid, 343(12.0%) had subclinical hyperthyroidism, 200 (7.0%) had subclinical hypothyroidism, 192(6.7%) had overt hyperthyroidism and 168 (5.9%) had overt hypothyroidism. Females have a significantly high percentage of thyroid disorders as compared to males(χ2 =0.976 p =0.027). The major age group 798(27.9 %) tested for thyroid dysfunction suspicion was 24 to 33 years followed by 34-43 (22.9%). Conclusions: The thyroid dysfunction prevalence was higher in females than males. An upward trend in the frequency of thyroid dysfunction was observed with increasing age. Subclinical hyperthyroidism was the commonest abnormality observed. A steep rise in subclinical hyperthyroidism may be attributed to the high intake of iodized salt. [ABSTRACT FROM AUTHOR]

Dichlorodiphenyltrichloroethane (DDT) and its metabolites accumulate in adipose tissue through dietary exposure, and have been proposed to contribute to the development of abdominal obesity, insulin resistance and dyslipidemia. Toxicity may also result when DDT and its metabolites are released from adipose tissue into the bloodstream as a result of rapid weight loss. We hypothesized that DDT-exposed rats fed a high fat diet (HFD) followed by 60% calorie restriction would have an adverse metabolic response to rapid weight loss. To test this, we exposed obese Sprague-Dawley (SD) rats to DDT and a HFD over one month followed by 60% calorie restricted diet for two weeks, and examined metabolic parameters throughout the study. During the HFD feeding period, DDT-exposed rats had significantly elevated postprandial non-esterified fatty acids (NEFAs) and decreased body temperature compared with control rats. During calorie restriction, DDT-exposed rats had lowered food efficiency (weight gained/calories consumed), body temperature, and circulating TSH. Our findings suggest that exposure to DDT may impairs metabolic substrate utilization in rats during dynamic periods of weight gain and weight loss.

Objective: Toxoplasma gondii is an important agent responsible for many hormonal and behavioral disorders in humans. The main objective of this study was to evaluate the hypothesis that 'T. gondii infection interferes with thyroid hormones secretion or thyroid drug treatment'. Methods: This is a cross-sectional study that involved 249 patients suffering from thyroid dysfunctions, divided into 3 groups: hypothyroidism (n=107), hyperthyroidism (n=96), and drug-controlled thyroid disorders (n=91), referred to Seyedoshohada Kerman private clinic. Serum samples were tested for thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) along with Toxoplasma anti-IgG using ELISA technique. Demographic information was collected using a demographic sheet. Results: The seroprevalence of Toxoplasma gondii IgG antibodies among patients with hypothyroidism, hyperthyroidism, and drug-controlled thyroid disorders was 22.4%, 19.8%, and 22% respectively. The mean value of thyroid hormones of positive T. gondii samples in hypothyroidism, hyperthyroidism, and drug-controlled thyroid disorders was TSH=7.95, T3=1.12, T4=2.36; TSH=0.14, T3=1.42, T4=7.85; and TSH=2.75, T3=1.12, T4=1.45 respectively. The seropositivity of Toxoplasma gondii infection was 40.4% among individuals with a history of contact with pets and 26.3% among the rural dwellers. Conclusion: There was no significant difference between T. gondii infection among the three study groups. A comparison of serum levels of thyroid hormones between infected and non-infected individuals in the above-mentioned groups illustrated that latent toxoplasmosis wasn't significantly associated with thyroid hormones secretion. Also, contact with pets and the rural lifestyle has a positive association with T. gondii seroprevalence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of vitamin D deficiency in postmenopausal women in light of restrictions imposed by the Covid-19 pandemic. Methods: This was a single-center cross-sectional study with total of 167 women patients (post-menopausal :133, pre-menopausal: 24) who were divided into two groups according to age. Result: There were significant negative links between serum T4 hormone levels and each of serum calcium values (r=-0.049, p <0.001) in post-menopausal. Serum T4 hormone levels are negatively correlated to TSH hormone levels (r=-0.032, p < 0.001) but T3 hormone levels shows significantly negative correlation (r=-0.277p<0.001). The correlation between serum T4 hormone levels vs Glucose in patients was significantly negative (r= -0.017, p <0.001),The results show that significant decrease(p<0.01) in serum levels T4, T3 hormone, vit. D in post-menopausal women compared as compared to pre-menopausal, correlation of vitamin D with serum calcium (0.23 and T4, hormone (0.137) was significantly positive, and high fasting glucose in post-menopausal as compared to pre-menopausal . Conclusion: Baseline serum vitamin D levels are inversely related with thyroid hormone in post-menopausal women. [ABSTRACT FROM AUTHOR]