Effective treatment of thyroid tests: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Thyroid function tests play a crucial role in diagnosing and monitoring thyroid disorders, which can affect individuals across various life stages. 12 highlights the importance of establishing region-specific reference intervals for thyroid hormones during pregnancy, given the variations in iodine status and other factors. 9 underscores the prevalence of thyroid dysfunction in older adults, with a significant proportion experiencing abnormal thyroid tests. This underscores the need for increased attention and screening in this population.

Research has explored various treatment options for thyroid disorders. 10 compared the effectiveness of high-intensity focused ultrasound (HIFU) and radioiodine (RAI) for treating toxic thyroid nodules, finding both methods to be effective. However, HIFU offers a potential advantage with fewer side effects and improved quality of life compared to surgery or RAI. 15 suggests that testing for antibodies to thyroid hormones can serve as a reliable marker for early thyroid damage, especially relevant in cancer patients undergoing treatment that may affect thyroid function. 21 highlights the potential for a cancer treatment drug, sunitinib, to induce severe hypothyroidism. Therefore, regular thyroid monitoring is crucial for patients taking sunitinib.

Levothyroxine (LT4) is commonly used for treating hypothyroidism. 27 demonstrates the value of ultrasound in diagnosing hypothyroidism in dogs. 25 emphasizes the need for trimester-specific reference intervals for thyroid tests in pregnant women due to variations in methodology, euthyroid definition, and iodine status. 19 found that iodine supplementation during pregnancy did not prevent the decline in FT4 levels in the second and third trimesters. 6 explores alternative routes of levothyroxine administration, such as transdermal or intranasal, as potential solutions for patients who experience challenges with oral administration. 18 highlights the effectiveness of diiodothyropropionic acid (DITPA) in treating MCT8 deficiency. DITPA, a thyroid hormone analog, can enter cells independently of MCT8 transport, offering a potential alternative treatment for individuals with this genetic condition.

Treatment Summary

Levothyroxine (LT4) is a widely used treatment for hypothyroidism. However, alternative routes of administration, such as transdermal or intranasal, may be considered for patients with challenges in oral absorption. 18 suggests the potential of DITPA for treating MCT8 deficiency.

Benefits and Risks

Benefits Summary

Early detection and appropriate treatment of thyroid dysfunction can significantly reduce the risk of various health complications. HIFU presents a potential advantage with fewer side effects and improved quality of life compared to surgery or RAI. 10

Risks Summary

Treatment of thyroid dysfunction can carry potential risks. For example, sunitinib may cause severe hypothyroidism. 21 Additionally, excessive levothyroxine dosage can lead to hyperthyroidism.

Comparison of Studies

Similarities

Many studies emphasize the importance of addressing thyroid dysfunction in specific populations, particularly pregnant women and older adults.

Differences

Treatment approaches for thyroid dysfunction vary among studies. While some studies show the effectiveness of RAI, others highlight the benefits of HIFU.

Consistency and Contradictions in Findings

Research findings on thyroid dysfunction often exhibit inconsistencies. This could stem from differences in research methodologies and participant characteristics.

Implications for Real-World Application

Thyroid dysfunction can significantly impact daily life. Early detection and treatment are crucial. However, it's important to be aware of potential treatment side effects. Consultation with a healthcare professional is essential to determine the most suitable treatment plan.

Limitations of Current Research

Research on thyroid dysfunction remains limited, especially concerning long-term effects and treatment efficacy. Further research is essential to address these gaps.

Future Research Directions

Continued research is needed to explore strategies for preventing thyroid dysfunction, developing more effective treatments, and understanding long-term implications.

Conclusion

Thyroid function tests are crucial for diagnosing and managing thyroid disorders. Early detection and appropriate treatment can significantly reduce health risks. However, treatment involves potential side effects, necessitating consultation with a healthcare professional to choose the most suitable treatment plan. Ongoing research is essential to improve understanding and treatment approaches for thyroid dysfunction.

Treatment List

RAI, HIFU, LT4, DITPA

Literature analysis of 27 papers
Positive Content
21
Neutral Content
1
Negative Content
5
Article Type
1
1
1
2
25
1.

(131)I therapy in patients with benign thyroid disease does not conclusively lead to a higher risk of subsequent malignancies.

Author: VerburgF A, LusterM, LassmannM, ReinersC

Benign thyroid disease treatment

This review of 7 studies found no increased risk of malignancies after 131I therapy for benign thyroid disease. The review considered studies published after 1990 in order to allow for sufficient long-term follow-up time.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

3.

Effect of Liothyronine Treatment on Quality of Life in Female Hypothyroid Patients With Residual Symptoms on Levothyroxine Therapy: A Randomized Crossover Study.

Author: BjerkreimBetty Ann, HammerstadSara Salehi, GulsethHanne Løvdal, BergTore Julsrud, OmdalLars Johan, Lee-ØdegårdSindre, EriksenErik Fink

Hypothyroid treatment
Hypothyroidism

This study aimed to evaluate the impact of LT3 monotherapy on quality of life (QoL) in hypothyroid patients who continued to experience symptoms despite having TSH levels within the reference range, even after LT4 monotherapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Huge follicular carcinoma originated from struma ovarii in young woman; Extremely rare case.

Author: ParkChul Min, KimBo Ram, KangHye Sim

Malignant transformation

This case report describes an extremely rare case of follicular carcinoma arising from struma ovarii, a rare ovarian mature teratoma with predominant thyroid tissue. The report highlights the importance of considering malignant transformation in struma ovarii, particularly in cases with rapid growth or suspicious features.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

5.

Amiodarone-Associated Myxedema Coma.

Author: ZagorskiEmily, JayatilakaSahani, HiraniFizza, DonatoAnthony

Early myxedema coma diagnosis

This case report describes a 71-year-old man on long-term amiodarone treatment for atrial fibrillation who presented with altered mental status, highlighting the importance of considering thyroid function tests in encephalopathic older adults on amiodarone.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Alternative routes of levothyroxine administration for hypothyroidism.

Author: RitterMegan J, GuptaSuruchi, HennesseyJames V

hypothyroidism treatment
refractory hypothyroidism

This review focuses on levothyroxine (LT4) treatment for hypothyroidism. While oral LT4 tablets are the standard, some patients experience persistent elevated thyroid-stimulating hormone (TSH) levels, indicating poor control. The review highlights alternative strategies, including liquid LT4, intravenous, intramuscular, and rectal administration, which may be effective for refractory hypothyroidism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community.

Author: DiabNermin, DayaNatalie R, JuraschekStephen P, MartinSeth S, McEvoyJohn W, SchultheißUlla T, KöttgenAnna, SelvinElizabeth

Thyroid screening
Thyroid dysfunction

This cross-sectional analysis assessed the prevalence of thyroid dysfunction in older adults (≥65) in the Atherosclerosis Risk in Communities (ARIC) study. The prevalence of thyroid dysfunction was nearly 25%, highlighting the need for increased awareness and screening in this age group.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

No Effect of Levothyroxine and Levothyroxine-Induced Subclinical Thyrotoxicosis on the Pharmacokinetics of Sorafenib in Healthy Male Subjects.

Author: HuangFunan, AjavonAntoinette, HuangErya, LettieriJohn, LiuRong, PeñaCarol, BerseMatthias

Treat cancer

This study assessed the pharmacokinetics of sorafenib in patients with differentiated thyroid carcinoma (DTC) receiving concomitant levothyroxine. The study aimed to examine whether levothyroxine interacts with sorafenib or if levothyroxine-induced subclinical thyrotoxicosis increases sorafenib exposure.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Reference Values for TSH and Free Thyroid Hormones in Healthy Pregnant Women in Poland: A Prospective, Multicenter Study.

Author: Kostecka-MatyjaMarta, FedorowiczAnna, Bar-AndziakEwa, BednarczukTomasz, Buziak-BerezaMonika, DumnickaPaulina, GórskaMaria, KrasnodębskaMałgorzata, NiedźwiedzkaBeata, PachDorota, RuchałaMarek, SiewkoKatarzyna, SolnicaBogdan, SowińskiJerzy, SzelachowskaMałgorzata, Trofimiuk-MüldnerMałgorzata, Wachowiak-OchmańskaKatarzyna, Hubalewska-DydejczykAlicja

Pregnancy thyroid treatment

This study aimed to establish trimester-specific reference intervals for TSH, fT<sub>3</sub>, and fT<sub>4</sub> in pregnant women in Poland. The study highlights the importance of establishing region-specific reference intervals for thyroid hormones in pregnant women, given variations in socioeconomic, environmental, and iodine prophylaxis conditions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Thyroid stimulating hormone (TSH) ≥2.5mU/l in early pregnancy: Prevalence and subsequent outcomes.

Author: CartyDavid M, DooganFlora, WelshPaul, DominiczakAnna F, DellesChristian

Thyroid function monitoring
Thyroid disease

This study examines the prevalence of thyroid stimulating hormone (TSH) levels ≥2.5mU/l in a large obstetric cohort, assessing the subsequent development of thyroid disease in these women.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Factitious Graves' Disease Due to Biotin Immunoassay Interference-A Case and Review of the Literature.

Author: ElstonMarianne S, SehgalShekhar, Du ToitStephen, YarndleyTania, ConaglenJohn V

MS treatment
Assay interference

Biotin (vitamin B7) plays a crucial role in various metabolic processes. While low-moderate doses are commonly found in multivitamins, high-dose biotin has shown potential benefits for multiple sclerosis patients. However, biotin supplementation can interfere with certain medical tests, especially thyroid and non-thyroid immunoassays.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Thyroid hormone testing in the 21st century.

Author: SinghRavinder J, KaurParmpreet

The study highlights the challenges in thyroid hormone testing, specifically the limitations of immunoassays and the need for more accurate and accessible methods. It suggests that LC-MS, with its superior specificity, is a promising alternative as it becomes more available and standardized.

EditorialAn article in which the editor or publisher expresses their opinion or perspective on a particular topic or issue. Its purpose is to convey a specific message or idea to the reader.
Historical ArticleA research paper that analyzes past events and developments using primary sources and examines them from a historical perspective.

Language : English

17.

Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort.

Author: LambertChristophe G, MazurieAurélien J, LauveNicolas R, HurwitzNathaniel G, YoungS Stanley, ObenchainRobert L, HengartnerNicolas W, PerkinsDouglas J, TohenMauricio, KernerBerit

Hypothyroid risk

This study compared the risk of hypothyroidism for lithium versus the anticonvulsants and second-generation antipsychotics commonly prescribed for bipolar disorder (BD). The study found that thyroid abnormalities in patients with BD have been linked to lithium treatment for decades, but other drugs have been less well studied.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

The Thyroid Hormone Analog DITPA Ameliorates Metabolic Parameters of Male Mice With Mct8 Deficiency.

Author: FerraraAlfonso Massimiliano, LiaoXiao-Hui, YeHonggang, WeissRoy E, DumitrescuAlexandra M, RefetoffSamuel

Hypermetabolism treatment
MCT8 deficiency treatment
Brain hypothyroidism

This study investigated the effects of diiodothyropropionic acid (DITPA) on thyroid tests in serum and metabolism in Mct8-deficient (Mct8KO) mice, finding that DITPA ameliorated hypermetabolism but had no effect on brain hypothyroidism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Extreme hypothyroidism associated with sunitinib treatment for metastatic renal cancer.

Author: Del FabbroEgidio, DevRony, CabanillasMaria E, BusaidyNaifa L, RodriguezEdenMae C, BrueraEduardo

Thyroid dysfunction

Sunitinib, a tyrosine kinase inhibitor used to treat metastatic renal cancer, can cause thyroid abnormalities. While most patients recover, some may experience severe hypothyroidism despite receiving thyroid hormone replacement therapy. This report highlights the complexity of managing thyroid dysfunction associated with sunitinib.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Diiodothyropropionic acid (DITPA) in the treatment of MCT8 deficiency.

Author: VergeCharles F, KonradDaniel, CohenMichal, Di CosmoCaterina, DumitrescuAlexandra M, MarcinkowskiTeresa, HameedShihab, HamiltonJill, WeissRoy E, RefetoffSamuel

Thyroid hormone alternative
Psychomotor retardation

MCT8 deficiency is a rare genetic disorder that causes severe mental and physical developmental delays. Current treatments are ineffective, but this study suggests that the thyroid hormone analog DITPA may be a potential treatment option. DITPA does not require MCT8 to enter tissues.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism.

Author: WasniewskaMalgorzata, CorriasAndrea, AversaTommaso, ValenziseMariella, MussaAlessandro, De MartinoLucia, LombardoFortunato, De LucaFilippo, SalernoMariacarolina

Normalized TSH
Hyperthyrotropinemia
TSH increase

Two-year treatment with L-thyroxine in children with subclinical hypothyroidism is unable to modify the outcome of hyperthyrotropinemia after therapy withdrawal. The risk of further TSH increase after treatment withdrawal is not prevented, and posttherapy TSH outcome is conditioned by baseline TSH.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Hypothyroidism, new nodule formation and increase in nodule size in patients who have undergone hemithyroidectomy.

Author: ErtekSibel, ErsoyReyhan Ünlü, AnılCüneyd, DemirOzgür, ErdoğanMurat Faik, GüllüSevim, BerkerDilek, GülKamile, UnlütürkUğur, ErdoğanGürbüz,

Thyroid health
Hypothyroidism
Nodule formation

This study aimed to evaluate factors related to hypothyroidism and nodular recurrences in patients who underwent hemithyroidectomy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

Trimester- and method-specific reference intervals for thyroid tests in pregnant Chinese women: methodology, euthyroid definition and iodine status can influence the setting of reference intervals.

Author: YanYu-Qin, DongZuo-Liang, DongLing, WangFeng-Rui, YangXue-Ming, JinXing-Yi, LinLai-Xiang, SunYi-Na, ChenZu-Pei

Thyroid dysfunction treatment

This study established trimester- and method-specific reference intervals for thyroid testing in pregnant women. The findings highlight the importance of accurate thyroid assessment during pregnancy and the need to consider various factors, such as methodology, euthyroid definition, and iodine status, when setting reference intervals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

[Iodine status and thyroid function of 330 pregnant women from Nice area assessed during the second part of pregnancy].

Author: HiéronimusS, Bec-RocheM, FerrariP, ChevalierN, FénichelP, Brucker-DavisF

Hypothyroidism
Iodine deficiency

Iodine deficiency is common in pregnant women, with a wide range of hypothyroxinemia and subclinical hypothyroidism prevalence.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : French

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