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BMC Research Notes Feb 2022Abnormal thyroid function may disrupt sleep architecture. We aimed to determine the frequency of various chronotypes in women with hypothyroidism. We performed a...
OBJECTIVE
Abnormal thyroid function may disrupt sleep architecture. We aimed to determine the frequency of various chronotypes in women with hypothyroidism. We performed a single-center retrospective study at an ambulatory clinic from January 2013-December 2015. Participants were women with hypothyroidism. Chronotype was determined from the Munich ChronoType Questionnaire. The χ test was used to compare differences in clinical characteristics and sleep patterns in early and intermediate/late chronotypes. The t test was used to compare differences between means.
RESULTS
We evaluated 99 patients (mean [SD], 56 [7] years): calculated chronotype revealed: 56% early, 38% intermediate and 6% late. Analysis with the χ test showed significant differences between early and intermediate/late calculated chronotypes for sleep latency (P = 0.01), light exposure (P = 0.009), and no alcohol intake (P = 0.001). t test showed the following differences in mean (SD) between chronotypes: sleep duration, 7.30 (1.39) hours (early chronotype) and 7.04 (2.06) hours (intermediate/late); body mass index (BMI), 29.4 (7.3) (early) and 31.1 (6.8) (intermediate/late); and TSH level, 2.89 (3.69) mIU/L (early) and 1.69 (1.41) mIU/L (intermediate/late). Early chronotypes were frequent in women with hypothyroidism. Light exposure and BMI may influence chronotypes in patients with hypothyroidism; findings are consistent with healthier behaviors in patients who tend toward morningness.
Topics: Adult; Circadian Rhythm; Female; Humans; Hypothyroidism; Retrospective Studies; Sleep; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 35164850
DOI: 10.1186/s13104-022-05934-3 -
Cellular and Molecular Neurobiology Oct 2023Hypothyroidism (HPT) HPT could be a risk factor for the development and progression of Alzheimer's disease (AD). In addition, progressive neurodegeneration in AD may... (Review)
Review
Hypothyroidism (HPT) HPT could be a risk factor for the development and progression of Alzheimer's disease (AD). In addition, progressive neurodegeneration in AD may affect the metabolism of thyroid hormones (THs) in the brain causing local brain HPT. Hence, the present review aimed to clarify the potential association between HPT and AD. HPT promotes the progression of AD by inducing the production of amyloid beta (Aβ) and tau protein phosphorylation with the development of synaptic plasticity and memory dysfunction. Besides, the metabolism of THs is dysregulated in AD due to the accumulation of Aβ and tau protein phosphorylation leading to local brain HPT. Additionally, HPT can affect AD neuropathology through various mechanistic pathways including dysregulation of transthyretin, oxidative stress, ER stress, autophagy dysfunction mitochondrial dysfunction, and inhibition of brain-derived neurotrophic factor. Taken together there is a potential link between HPT and AD, as HPT adversely impacts AD neuropathology and the reverse is also true.
Topics: Humans; Alzheimer Disease; tau Proteins; Amyloid beta-Peptides; Brain; Hypothyroidism
PubMed: 37540395
DOI: 10.1007/s10571-023-01392-y -
Journal of Midwifery & Women's Health May 2022Hypothyroidism affects up to 5% of the global population. Incidence increases with age and is more common in women and individuals with prolonged estrogen exposure when...
Hypothyroidism affects up to 5% of the global population. Incidence increases with age and is more common in women and individuals with prolonged estrogen exposure when compared with people who have not been exposed to estrogen. Symptoms can develop slowly and often mimic symptoms of other disorders, including menstrual cycle abnormalities. Understanding risk factors and common presenting symptoms is important in providing high-quality primary and reproductive care. Diagnosis relies on simple-to-obtain, fairly inexpensive testing of thyroid-stimulating hormone (TSH) levels and confirmation with levels of thyroxine. Management of hypothyroidism usually involves monotherapy with levothyroxine taken on an empty stomach. There are 2 methods for beginning levothyroxine treatment, and outpatient primary care clinicians can use shared decision-making to determine the best initiation method for each individual. Follow-up involves regular assessment of levels of TSH and symptom relief. Although some patients may need referral for specialist treatment, the majority of individuals with hypothyroidism can be diagnosed and treated by their outpatient primary care providers.
Topics: Estrogens; Female; Humans; Hypothyroidism; Risk Factors; Thyrotropin; Thyroxine
PubMed: 35384263
DOI: 10.1111/jmwh.13358 -
Journal of Integrative Medicine Nov 2019Hypothyroidism (Qillat-e-Ifraz-e-Darqiyya) is a condition where the thyroid gland is underactive and unable to produce enough thyroid hormone. The description of... (Review)
Review
Hypothyroidism (Qillat-e-Ifraz-e-Darqiyya) is a condition where the thyroid gland is underactive and unable to produce enough thyroid hormone. The description of hypothyroidism as a disease is not directly found in Unani texts. However, the signs and symptom of hypothyroidism resemble the clinical manifestation associated with Su-e-Mizaj Barid Maddi (derangement in cold temperament), such as plethora (Imtila), excessive salivation (Kasrat-e-Luabe-e-Dahan), tiredness (Aa'yan), loss of appetite (Zoaf-e-Ishteha), excessive sleeping (Kasrat-e-Naum) and cold skin (Baroodat-e-Jildia). These signs and symptoms are the result of an excess in abnormal phlegm (Ghair Tabayi Balgham) in the body. This review article identifies the observations from Unani literature that describe derangement in cold temperament and relate them to the clinical presentation of primary hypothyroidism in conventional medicine. We also discuss management of these symptoms in Unani medicine.
Topics: Humans; Hypothyroidism; Medicine, Unani
PubMed: 31164280
DOI: 10.1016/j.joim.2019.05.006 -
MMW Fortschritte Der Medizin Oct 2021
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Frontiers in Endocrinology 2024Cardiovascular disease (CVD) remains the leading cause of death worldwide, representing a major health issue of social and economic relevance. Both hyperthyroidism and... (Review)
Review
Cardiovascular disease (CVD) remains the leading cause of death worldwide, representing a major health issue of social and economic relevance. Both hyperthyroidism and hypothyroidism are very common in the adult population, and both disorders may contribute to the onset and progression of CVD. After a brief description of the role of thyroid hormones (THs) on the physiology of the cardiovascular system and the potential mechanism that links THs alterations with changes in cardiac function, blood pressure, endothelial function, and lipid levels, we review updated data about the clinical impact of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) on CV risk, CVD, and mortality. Furthermore, we summarize the current evidence for treating SCH with levothyroxine (L-T4). Several guidelines of distinguished endocrine societies recommend treatment for SCH with TSH higher than 10 mIU/L, where the benefit of L-T4 therapy is more evident for younger people, but still controversial in those aged over 65 years. Based on current knowledge, more research efforts are needed to better address the clinical management of CV risk and CVD in the elderly affected by SCH.
Topics: Humans; Hypothyroidism; Cardiovascular Diseases; Thyroid Hormones; Thyroxine; Risk Factors
PubMed: 38887272
DOI: 10.3389/fendo.2024.1408684 -
The Journal of Clinical Endocrinology... Mar 2023Systemic lupus erythematosus (SLE) and hypothyroidism often coexist in observational studies; however, the causal relationship between them remains controversial.
INTRODUCTION
Systemic lupus erythematosus (SLE) and hypothyroidism often coexist in observational studies; however, the causal relationship between them remains controversial.
METHODS
Complementary genetic approaches, including genetic correlation, Mendelian randomization (MR), and colocalization analysis, were conducted to assess the potential causal association between SLE and primary hypothyroidism using summary statistics from large-scale genome-wide association studies. The association between SLE and thyroid-stimulating hormone (TSH) was further analyzed to help interpret the findings. In addition, findings were verified using a validation data set, as well as through different MR methods with different model assumptions.
RESULTS
The linkage disequilibrium score regression revealed a shared genetic structure between SLE and primary hypothyroidism, with the significant genetic correlation estimated to be 0.2488 (P = 6.00 × 10-4). MR analysis with the inverse variance weighted method demonstrated a bidirectional causal relationship between SLE and primary hypothyroidism. The odds ratio (OR) of SLE on primary hypothyroidism was 1.037 (95% CI, 1.013-1.061; P = 2.00 × 10-3) and that of primary hypothyroidism on SLE was 1.359 (95% CI, 1.217-1.520; P < 0.001). The OR of SLE on TSH was 1.007 (95% CI, 1.001-1.013; P = 0.032). However, TSH was not causally associated with SLE (P = 0.152). Similar results were found using different MR methods. In addition, colocalization analysis suggested that shared causal variants existed between SLE and primary hypothyroidism. The results of the validation analysis indicated a bidirectional causal relationship between SLE and primary hypothyroidism, as well as shared loci.
CONCLUSION
In summary, a bidirectional causal relationship between SLE and primary hypothyroidism was observed with complementary genetic approaches.
Topics: Humans; Genome-Wide Association Study; Polymorphism, Single Nucleotide; Hypothyroidism; Thyrotropin; Lupus Erythematosus, Systemic; Mendelian Randomization Analysis
PubMed: 36263677
DOI: 10.1210/clinem/dgac614 -
FP Essentials Mar 2022Hypothyroidism is caused by deficient thyroid hormone production secondary to autoimmune disease or insufficient iodine consumption or as a complication of...
Hypothyroidism is caused by deficient thyroid hormone production secondary to autoimmune disease or insufficient iodine consumption or as a complication of hyperthyroidism management. Signs and symptoms include fatigue, weight gain, dry skin, constipation, and cold intolerance. The U.S. Preventive Services Task Force found insufficient evidence to recommend for or against screening for hypothyroidism, but some organizations support screening in special populations. If hypothyroidism is suspected, initial laboratory evaluation consists of a serum thyrotropin (TSH) measurement with reflex testing of free thyroxine (T). Thyroid function tests must be interpreted carefully because acute illness, diet, and drugs may alter values. Overt hypothyroidism occurs when a patient has an elevated TSH level and a low free T level with symptoms of hypothyroidism. Management includes thyroid hormone replacement, ideally levothyroxine. Subclinical hypothyroidism is characterized by an elevated TSH level with a normal T value. The decision to treat subclinical hypothyroidism should be based on patient characteristics and shared decision-making discussions. Special consideration should be taken in treating patients with high-risk conditions, including heart disease, pregnancy, and myxedema coma, and in patients requiring high-dose levothyroxine. Thyroid hormone should be titrated based on goal TSH values, symptoms, and potential treatment adverse effects.
Topics: Female; Humans; Hypothyroidism; Pregnancy; Thyroid Function Tests; Thyrotropin; Thyroxine
PubMed: 35235282
DOI: No ID Found -
European Thyroid Journal Aug 2023The clinical consequences of primary hypothyroidism include cardiovascular morbidity, increased mortality, and poor quality of life; therefore guidelines endorsed by... (Review)
Review
The clinical consequences of primary hypothyroidism include cardiovascular morbidity, increased mortality, and poor quality of life; therefore guidelines endorsed by several Scientific Societies recommend measuring circulating thyroid-stimulating hormone (TSH) in patients at risk. The assessment of serum TSH levels is also deemed to be the most robust and accurate biomarker during the management of replacement therapy in patients with a previous diagnosis of primary hypothyroidism. In line with a reflex TSH laboratory strategy, free thyroxine is measured only if the TSH falls outside specific cutoffs, in order to streamline investigations and save unjustified costs. This serum TSH-based approach to both diagnosis and monitoring has been widely accepted by several national and local health services; nevertheless, false-negative or -positive testing may occur, leading to inappropriate management or treatment. This review aims to describe several infrequent causes of increased circulating TSH, including analytical interferences, resistance to TSH, consumptive hypothyroidism, and refractoriness to levothyroxine replacement treatment. We propose a clinical flowchart to aid correct recognition of these various conditions, which represent important potential pitfalls in the diagnosis and treatment of primary hypothyroidism.
Topics: Humans; Diagnosis, Differential; Quality of Life; Software Design; Hypothyroidism; Thyrotropin
PubMed: 37067253
DOI: 10.1530/ETJ-23-0012 -
British Medical Bulletin Sep 2022Thyroid dysfunction in pregnancy is associated with adverse offspring outcomes and recent birth-cohort studies suggest that even mild degrees of thyroid dysfunction may... (Review)
Review
BACKGROUND
Thyroid dysfunction in pregnancy is associated with adverse offspring outcomes and recent birth-cohort studies suggest that even mild degrees of thyroid dysfunction may be linked with a range of late cognitive and behavioural effects in childhood and adolescence.
SOURCES OF DATA
This review summarizes recent literature of observational studies and critically appraises randomized controlled trials (RCTs) of antenatal thyroid screening and Levothyroxine intervention.
AREAS OF AGREEMENT
Overt hypothyroidism and hyperthyroidism carry significant risks for unfavourable offspring outcomes and should be appropriately corrected in pregnancy.
AREAS OF CONTROVERSY
The significance of subclinical hypothyroidism and hypothyroxinaemia is still unclear. Meta-analyses of birth-cohort studies show associations of maternal subclinical hypothyroidism and hypothyroxinaemia with intellectual deficits, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders, while hyperthyroidism and high-normal FT4 were linked with ADHD. RCTs have shown no benefits of screening on neurodevelopmental outcomes although Levothyroxine could have been initiated too late in pregnancy in these trials.
GROWING POINTS
A small number of studies have shown inconsistent associations of maternal thyroid dysfunction with offspring cardiometabolic indices including blood pressure and body weight. Correction of maternal thyroid dysfunction was, however, associated with favourable long-term metabolic profiles in mothers, including lipid profiles, fat mass and body mass index. Antenatal thyroid screening may therefore present opportunities for optimizing a wider range of outcomes than envisaged.
AREAS FOR DEVELOPING RESEARCH
Future trials with early antenatal thyroid screening and intervention are necessary to clarify the impact of screening on late offspring and maternal effects.
Topics: Female; Humans; Hyperthyroidism; Hypothyroidism; Lipids; Pregnancy; Thyroxine
PubMed: 35868487
DOI: 10.1093/bmb/ldac018