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Nature Reviews. Endocrinology Mar 2022Thyroid disorders are prevalent in pregnant women. Furthermore, thyroid hormone has a critical role in fetal development and thyroid dysfunction can adversely affect... (Review)
Review
Thyroid disorders are prevalent in pregnant women. Furthermore, thyroid hormone has a critical role in fetal development and thyroid dysfunction can adversely affect obstetric outcomes. Thus, the appropriate management of hyperthyroidism, most commonly caused by Graves disease, and hypothyroidism, which in iodine sufficient regions is most commonly caused by Hashimoto thyroiditis, in pregnancy is important for the health of both pregnant women and their offspring. Gestational transient thyrotoxicosis can also occur during pregnancy and should be differentiated from Graves disease. Effects of thyroid autoimmunity and subclinical hypothyroidism in pregnancy remain controversial. Iodine deficiency is the leading cause of hypothyroidism worldwide. Despite global efforts to eradicate iodine deficiency disorders, pregnant women remain at risk of iodine deficiency due to increased iodine requirements during gestation. The incidence of thyroid cancer is increasing worldwide, including in young adults. As such, the diagnosis of thyroid nodules or thyroid cancer during pregnancy is becoming more frequent. The evaluation and management of thyroid nodules and thyroid cancer in pregnancy pose a particular challenge. Postpartum thyroiditis can occur up to 1 year after delivery and must be differentiated from other forms of thyroid dysfunction, as treatment differs. This Review provides current evidence and recommendations for the evaluation and management of thyroid disorders in pregnancy and in the postpartum period.
Topics: Female; Humans; Hyperthyroidism; Postpartum Period; Pregnancy; Pregnancy Complications; Thyroid Diseases; Thyroid Nodule
PubMed: 34983968
DOI: 10.1038/s41574-021-00604-z -
Cells Mar 2023The most common cause of acquired thyroid dysfunction is autoimmune thyroid disease, which is an organ-specific autoimmune disease with two presentation phenotypes:... (Review)
Review
The most common cause of acquired thyroid dysfunction is autoimmune thyroid disease, which is an organ-specific autoimmune disease with two presentation phenotypes: hyperthyroidism (Graves-Basedow disease) and hypothyroidism (Hashimoto's thyroiditis). Hashimoto's thyroiditis is distinguished by the presence of autoantibodies against thyroid peroxidase and thyroglobulin. Meanwhile, autoantibodies against the TSH receptor have been found in Graves-Basedow disease. Numerous susceptibility genes, as well as epigenetic and environmental factors, contribute to the pathogenesis of both diseases. This review summarizes the most common genetic, epigenetic, and environmental mechanisms involved in autoimmune thyroid disease.
Topics: Humans; Hashimoto Disease; Graves Disease; Autoimmune Diseases; Thyroid Diseases; Autoantibodies
PubMed: 36980259
DOI: 10.3390/cells12060918 -
Frontiers in Endocrinology 2023Selenium, a non-metallic element, is a micronutrient essential for the biosynthesis of selenoproteins containing selenocysteine. In adults, the thyroid contains the... (Review)
Review
Selenium, a non-metallic element, is a micronutrient essential for the biosynthesis of selenoproteins containing selenocysteine. In adults, the thyroid contains the highest amount of selenium per gram of tissue. Most known selenoproteins, such as glutathione peroxidase, are expressed in the thyroid and are involved in thyroid hormone metabolism, redox state regulation, and maintenance of cellular homeostasis. Some clinical studies have shown that lack of selenium will increase the prevalence of several kinds of thyroid diseases. Selenium treatment in patients with Graves' orbitopathy has been shown to delay disease progression and improve the quality of life. Selenium supplementation in Hashimoto's thyroiditis was associated with the decreased levels of anti-thyroid peroxidase antibody and improved thyroid ultrasound structure. In thyroid cancer, various selenium supplements have shown variable anticancer activity. However, published results remain the conflicting and more clinical evidence is still needed to determine the clinical significance of selenium. This article reviews the strong association between selenium and thyroid disease and provides new ideas for the clinical management of selenium in thyroid disease.
Topics: Humans; Selenium; Quality of Life; Graves Ophthalmopathy; Thyroid Diseases; Selenoproteins
PubMed: 37033262
DOI: 10.3389/fendo.2023.1133000 -
Frontiers in Endocrinology 2021Thyroid disorders and sleep disorders are common problems in the general population that can affect people of all ages, backgrounds, and sexes, but little is known about... (Review)
Review
Thyroid disorders and sleep disorders are common problems in the general population that can affect people of all ages, backgrounds, and sexes, but little is known about their clinical associations. We reviewed the literature assessing the associations between thyroid disease and sleep disorders and noted that hyperthyroidism and hypothyroidism have clinical overlap with sleep conditions such as insomnia, restless legs syndrome, and obstructive sleep apnea. These findings highlight the importance of identifying and managing thyroid dysfunction for patients with these common sleep disorders. Additional research is needed to further understand how thyroid dysfunction affects sleep physiology.
Topics: Animals; Humans; Sleep Wake Disorders; Thyroid Diseases; Thyroid Gland
PubMed: 34504473
DOI: 10.3389/fendo.2021.725829 -
Obstetrics and Gynecology Jun 2020Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal...
Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid gland. This document reviews the thyroid-related pathophysiologic changes that occur during pregnancy and the effects of overt and subclinical maternal thyroid disease on maternal and fetal outcomes. This Practice Bulletin has been updated with information on the diagnosis and the management of thyroid disease in pregnant women and includes a new clinical algorithm on management of thyroid disease in pregnancy.
Topics: Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Care; Puerperal Disorders; Societies, Medical; Thyroid Diseases; Thyroid Function Tests; United States
PubMed: 32443080
DOI: 10.1097/AOG.0000000000003893 -
Radiologic Clinics of North America Nov 2020Thyroid ultrasound with gray-scale and color Doppler is the most helpful imaging modality to differentiate normal thyroid parenchyma from diffuse or nodular thyroid... (Review)
Review
Thyroid ultrasound with gray-scale and color Doppler is the most helpful imaging modality to differentiate normal thyroid parenchyma from diffuse or nodular thyroid disease by evaluating glandular size, echogenicity, echotexture, margins, and vascularity. The various causes of diffuse thyroid disease often have overlapping sonographic imaging features. Thyroid nodules may be hyperplastic or neoplastic, with most due to benign hyperplastic changes in architecture and benign follicular adenomas; only a small percentage are malignant. A systematic approach to nodule morphology that includes evaluation of composition, echogenicity, margin, shape, and any echogenic foci can guide decision to biopsy or follow nodules.
Topics: Biopsy, Fine-Needle; Diagnosis, Differential; Female; Humans; Male; Risk Assessment; Thyroid Diseases; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule; Ultrasonography, Doppler; Ultrasonography, Doppler, Color
PubMed: 33040847
DOI: 10.1016/j.rcl.2020.07.003 -
Physiological Research Sep 2020Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate... (Review)
Review
Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate indicator of iodine intake is the concentration of iodine in urine, but the indicator of iodine intake in the longer term of several months is thyroglobulin (Tg). Tg negatively correlated with increasing intake of iodine in population that do not suffer from thyroid disease, while a more than adequate to excessive iodine intake leads to an increase in Tg. The dependence of Tg on iodine can be described by a U-shaped curve. Thyroglobulin in serum is elevated in thyroid disease mainly in hyperthyroidism (diagnosis E05 of WHO ICD-10 codes) and in goiter (diagnosis E04 of WHO ICD-10 codes). Tg values decrease below 20 microg/l after effective treatment of patients with thyroid disease. Thyroglobulin may thus be an indicator of thyroid stabilization and the success of the thyroid gland treatment.
Topics: Animals; Humans; Iodine; Thyroglobulin; Thyroid Diseases; Thyroid Gland
PubMed: 33094621
DOI: 10.33549/physiolres.934514 -
Endocrine, Metabolic & Immune Disorders... 2022Thyroid hormones play a vital role in regulating our body's metabolism. Two important thyroid hormones released from the thyroid gland are tri-iodothyronine (T3) and... (Review)
Review
BACKGROUND
Thyroid hormones play a vital role in regulating our body's metabolism. Two important thyroid hormones released from the thyroid gland are tri-iodothyronine (T3) and tetra-iodothyronine (T4). Thyroid-stimulating hormone and thyroid regulating hormone control the T3 and T4 levels in our body. Increased TSH levels indicate hypothyroidism and decreased TSH levels indicate hyperthyroidism. Iodine is a crucial nutrient for the synthesis of thyroid hormones and is mostly obtained from our diet. Other essential nutrients for the thyroid hormones formation include selenium, iron, vitamin D, vitamin B12, etc. Dietary changes in these nutrients can result in alterations in thyroid function and structure. Although normally, the hormonal diseases cannot be cured, but we can improve their signs and symptoms using suitable dietary supplements.
OBJECTIVE
The aim of the study was to thoroughly analyze the various benefits and risks associated with the use of dietary supplements for the prevention and treatment of various thyroid disorders, like hypothyroidism, as seen in Hashimoto's thyroiditis; hyperthyroidism, as seen in Graves' disease; sick euthyroidism and subclinical hypothyroidism.
METHODS
Literature was searched using the search terms "dietary supplements+thyroid diseases" on Pubmed, Google Scholar, Scopus, Cochrane Library, and other search engines, and data were collected from 1967 to November, 2021, including research inputs from the authors. The literature was thoroughly searched, and deep knowledge was acquired on this topic, which was then sequentially organized and summarized using suitable tables and figures.
CONCLUSION
After analyzing various studies on this topic, we arrived at the conclusion that although there are various claimed and observed health benefits of dietary supplements in the prevention and treatment of various thyroid disorders, still several studies have shown too many risks to be associated with the use of dietary supplements, and people using these products should be aware of these risks in order to use them very judiciously for the improvement of their thyroid status.
Topics: Dietary Supplements; Graves Disease; Humans; Hyperthyroidism; Hypothyroidism; Thyroid Diseases; Thyroid Hormones; Thyrotropin; Thyroxine
PubMed: 35440339
DOI: 10.2174/1871530322666220419125131 -
Clinical Medicine (London, England) Mar 2023Pregnancy is accompanied by metabolic changes associated with the thyroid gland. It is therefore important to understand the underlying physiological alterations and the... (Review)
Review
Pregnancy is accompanied by metabolic changes associated with the thyroid gland. It is therefore important to understand the underlying physiological alterations and the management of patients with thyroid disorders in pregnancy. This review focuses on the physiology and the management of hyperthyroidism, hypothyroidism and thyroid nodules in the context of pregnancy.
Topics: Pregnancy; Female; Humans; Pregnancy Complications; Thyroid Diseases; Hyperthyroidism; Hypothyroidism
PubMed: 36958843
DOI: 10.7861/clinmed.2023-0018 -
Best Practice & Research. Clinical... Jul 2020Thyroid autoimmunity (TAI) and/or thyroid dysfunction are prevalent in women of reproductive age and have independently been associated with adverse fertility and... (Review)
Review
Thyroid autoimmunity (TAI) and/or thyroid dysfunction are prevalent in women of reproductive age and have independently been associated with adverse fertility and pregnancy outcomes, in the case of spontaneous conception or after assisted reproductive technology (ART). Thus, it seems reasonable to screen for thyrotropin (TSH) and thyroid peroxidase autoantibodies (TPO-abs) in infertile women attempting pregnancy. However, even if the relationship between fertility and thyroid dysfunction and/or TAI persists when properly controlled for other variables, it remains challenging to claim causation. Several studies with different designs (cross sectional, case -control, prospective and retrospective cohort studies) have looked at the association between thyroid autoimmunity, thyroid function and fertility. Heterogeneity among study results are related to small numbers of included patients, poor study design, selection of causes of infertility and different assays used to measure TAI, thyroid hormones and TSH reference values. Indeed, there is no consensus regarding the upper limit of normal for TSH to define thyroid dysfunction and the cut-off levels for intervention. Furthermore, data from interventional trials looking at the impact of levothyroxine treatment on fertility outcome in randomised controlled studies are scarce. Despite the recent update of the guidelines by the American Thyroid Association (ATA) for the Diagnosis and Management of Thyroid Disease during Pregnancy and the postpartum, many questions remain unsettled in ART.
Topics: Adult; Female; Fertility; Humans; Infertility, Female; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis; Reproductive Techniques, Assisted; Thyroid Diseases; Thyroid Function Tests; Treatment Outcome
PubMed: 32037280
DOI: 10.1016/j.beem.2020.101378