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This trial compared two thyrotropin-stimulation methods and two 131I doses for postoperative ablation in patients with low-risk thyroid cancer. Rates of ablation were similar in all treatment groups. Doses lower than those currently recommended may be adequate for this condition. Radioiodine ( 131 i) is administered to patients with thyroid cancer after total thyroidectomy for three reasons 1 – 3 : first, to eradicate normal-thyroid remnants (ablation) in order to achieve an undetectable serum thyroglobulin level; second, to irradiate any neoplastic focus in order to decrease the risk of recurrence; and third, to perform 131 I total-body scanning for persistent carcinoma. Successful ablation is defined by the combination of undetectable serum thyroglobulin levels after thyrotropin stimulation and normal results on neck ultrasonography 6 to 12 months after 131 I administration. 2 , 3 When these criteria are met, approximately 1% of patients have a recurrence. 4 – 6 In . . .

In this trial, low-dose radioiodine was as effective as high-dose radioiodine in patients with differentiated thyroid tumors, and recombinant human thyrotropin (thyrotropin alfa) was as effective as thyroid hormone withdrawal. Thyroid cancer is the most frequently occurring endocrine cancer, with more than 2100 new cases each year in the United Kingdom and more than 48,000 in the United States. 1 , 2 Most cases are differentiated thyroid cancer, which is associated with a high 10-year survival rate (90 to 95%). 3 Many patients with differentiated thyroid cancer undergo radioiodine ablation to remove residual normal thyroid tissue after surgery. Some nonrandomized studies have suggested that radioiodine ablation reduces rates of death and recurrence. 4 – 7 However, there is uncertainty over the dose (administered activity) of radioiodine required for effective ablation. A systematic review of randomized . . .

Purpose While metformin is known to regulate thyroid stimulating hormone (TSH) levels, the effects of acarbose on thyroid function remain unreported. Our study was designed to evaluate the impact of acarbose and metformin on thyroid function and thyroid hormone sensitivity in type 2 diabetic patients. Methods In the MARCH study, 788 patients with type 2 diabetes were randomly assigned to treat with acarbose (300 mg) or metformin (1,500 mg) for 48 weeks. Thyroid function was assessed at baseline, 24 weeks, and 48 weeks, and the thyroid feedback quantile index (TFQI) and parameterized thyroid feedback quantile index (PTFQI) were calculated. Generalized estimating equations adjusted for confounders were used to analyze changes over time. Results Eighty-four patients with subclinical hypothyroidism (SCH) exhibited a decrease in TSH levels ( p  = 0.001) with no significant differences between the two treatment groups ( p  = 0.460). Both TFQI ( p  = 0.029) and PTFQI ( p  < 0.001) also decreased over time. Mediation analysis revealed that these change over time were not mediated by BMI (all p  < 0.05). Among the 489 euthyroid subjects, no significant changes in TSH levels were observed ( p  > 0.05). Stratification by baseline TSH levels revealed significant increases in TSH, TFQI, and PTFQI (all p  < 0.05) in the normal-low TSH group and significant decreases in PTFQI (all p  < 0.05) in the normal-high TSH group after treatment with acarbose and metformin. Conclusions Acarbose and metformin have similar buffering effects on TSH levels, the TFQI and the PTFQI. In patients with lower TSH levels, acarbose and metformin do not further decrease TSH levels. Clinical Trial Registry number ChiCTR-TRC-08000231.

To investigate the overall effect of modified Buqi Yangyin Sanjie decoction combined with levothyroxine sodium tablets on thyroid function and immune function in patients after thyroid cancer surgery. A total of 104 patients with postoperative thyroid cancer were treated in Wuhan No.1 Hospital between April 2021 and April 2022. The patients were randomly divided into two groups, with 52 patients in each group: the control group, which received levothyroxine sodium tablets, and the study group, which received modified Buqi Yangyin Sanjie decoction in combination with levothyroxine sodium tablets. The thyroid hormones, immune function, and T lymphocyte subsets of both groups were compared before and after treatment, and the efficacy and adverse reactions were analyzed. After treatment, evidently better clinical efficacy of the study group was found than that of the control group (P < .05). Before treatment, there was no statistically significant difference in the levels of FT4, TSH, and FT3 between the two groups (P > .05). After treatment, the levels of FT4 and FT3 in the study group were higher than those in the control group, while the levels of TSH were lower than those in the control group, with a statistically significant difference (P < .05). There was no significant difference in the levels of IgA, IgM, and IgG between the two groups before treatment (P > .05). However, after treatment, the study group had significantly higher levels of all three antibodies than the control group (P < .05). Before treatment, no statistically significant difference was seen in the levels of CD3+, CD4+, and CD8+ between the two groups (P > .05). After treatment, the levels of CD3+ and CD4+ in the study group were higher than those in the control group, while the levels of CD8+ were significantly lower than those in the control group (P < .05). During the treatment, 1 case of mild hyperhidrosis occurred in the study group, and the adverse reaction rate was 1/52. The control group had 2 cases of palpitations, 1 case of hand tremor, 3 cases of hyperhidrosis, and 1 case of weight loss, with an incidence of adverse reactions of 7/52. The incidence of adverse reactions in the study group was lower than that in the control group, with a statistically significant difference (χ2 = 4.875, P = .027). The present study highlighted the good outcomes of modified Buqi Yangyin Sanjie decoction combined with levothyroxine sodium tablets that effectively restored thyroid function and improved immune function in postoperative thyroid cancer patients. Hence the approach is available for clinical practice.

Background: The role of thyroid hormones in diet-induced weight loss and subsequent weight regain is largely unknown. Objectives: To examine the associations between thyroid hormones and changes in body weight and resting metabolic rate (RMR) in a diet-induced weight loss setting. Subjects/Methods: Data analysis was conducted among 569 overweight and obese participants aged 30–70 years with normal thyroid function participating in the 2-year Prevention of Obesity Using Novel Dietary Strategies (POUNDS) LOST randomized clinical trial. Changes in body weight and RMR were assessed during the 2-year intervention. Thyroid hormones (free triiodothyronine (T3), free thyroxine (T4), total T3, total T4 and thyroid-stimulating hormone (TSH)), anthropometric measurements and biochemical parameters were assessed at baseline, 6 months and 24 months. Results: Participants lost an average of 6.6 kg of body weight during the first 6 months and subsequently regained an average of 2.7 kg of body weight over the remaining period from 6 to 24 months. Baseline free T3 and total T3 were positively associated, whereas free T4 was inversely associated, with baseline body weight, body mass index and RMR. Total T4 and TSH were not associated with these parameters. Higher baseline free T3 and free T4 levels were significantly associated with a greater weight loss during the first 6 months ( P <0.05) after multivariate adjustments including dietary intervention groups and baseline body weight. Comparing extreme tertiles, the multivariate-adjusted weight loss±s.e. was −3.87±0.9 vs −5.39±0.9 kg for free T3 ( P trend =0.02) and −4.09±0.9 vs −5.88±0.9 kg for free T4 ( P trend =0.004). The thyroid hormones did not predict weight regain in 6–24 months. A similar pattern of associations was also observed between baseline thyroid hormones and changes in RMR. In addition, changes in free T3 and total T3 levels were positively associated with changes in body weight, RMR, body fat mass, blood pressure, glucose, insulin, triglycerides and leptin at 6 months and 24 months (all P <0.05). Conclusions: In this diet-induced weight loss setting, higher baseline free T3 and free T4 predicted more weight loss, but not weight regain among overweight and obese adults with normal thyroid function. These findings reveal a novel role of thyroid hormones in body weight regulation and may help identify individuals more responsive to weight loss diets.

This randomized, placebo-controlled, double-blind, multicenter trial assessed the safety and efficacy of the thyromimetic compound eprotirome in lowering the serum low-density lipoprotein cholesterol level in patients with hypercholesterolemia who were already receiving simvastatin or atorvastatin. Eprotirome was associated with decreased LDL levels in patients treated with statins. Eprotirome, a thyromimetic compound, was associated with decreased LDL levels in patients treated with statins. The association between elevated levels of circulating low-density lipoprotein (LDL) cholesterol and an increased risk of atherosclerotic cardiovascular disease is well established, 1 as are the reductions in both levels of serum cholesterol and the risk of cardiovascular disease that occur with the use of inhibitors of hepatic 3-hydroxy-3-methyl-glutaryl coenzyme A reductase. 1 However, the efficacy of statins is limited if stringent goals for serum LDL cholesterol levels are not achieved 2 in patients receiving statins alone 3 or if side effects develop that require a dose reduction or discontinuation of the agent. 4 Furthermore, statins are less effective in lowering levels of other lipoproteins, . . .

•T3 replacement therapy was safe.•T3 replacement therapy improved regional contractile dysfunction.•T3 replacement therapy has a potential cardioprotective benefit. The aim of the study was to investigate whether TH replacement therapy is safe and impact infarct size, left ventricular (LV) volumes and function in patients with acute myocardial infarction (AMI) and low T3 syndrome (LT3S). Thirty-seven AMI/LT3S patients were randomly treated or untreated with liothyronine (T3) therapy (maximum dosage 15 mcg/m2/die) in addition to standardized treatment (T3-treated group, n = 19; untreated group, n = 18). TH and thyroxine (TSH) during hospital stay and at 1-month and 6 months were evaluated. At discharge and at 6 months LV volumes, ejection fraction, wall motion score index (WMSI) and infarct extent were measured by cardiac MR. T3-treated patients had a significant increase in fT3 (p = 0.003 and p <0.001) at discharge and 1-month. These patients had no signs or symptoms of hyperthyroidism or arrhythmias. At follow-up, there was a significant reduction in WMSI in both groups (T3-treated group: Δ = −0.12, p = 0.001; untreated group: Δ = −0.04, p = 0.04) and the difference value (discharge/follow-up) was significantly higher in T3-treated group than in untreated group (mean difference between groups = 0.08, 95% confidence interval [CI]: 0.01 to 0.15, p = 0.05). Also, stroke volume increased significantly in the T3-treated group (Δ = 3.4, 95% CI: 0.8 to 6, p <0.01) at follow-up. In conclusion, this is the first pilot experience in which T3 replacement therapy resulted safe and able to improve regional dysfunction in patients with STEMI/LT3S.

To investigate whether supplementation with iodine-reduced kelp (Laminaria japonica) powder decreases body fat composition in overweight Japanese subjects, a randomized, double-blind, placebo-controlled intervention study was conducted in 50 Japanese subjects with body mass index (BMI) ≥25 and <30 kg/m2. Subjects were randomly assigned to consume thirty tablets/d (10 tablets orally, 3 times/d) containing either iodine-reduced kelp powder (test, 6 g kelp powder corresponding to 3 g alginate/d) or kelp-free powder (placebo) for 8 weeks. Anthropometric measurements, blood lipids, and serum thyroid hormone levels were obtained before and after the trial. Body fat percentage was significantly decreased in male subjects from the test group compared with the placebo group. The same tendency was observed for body weight (p = 0.065) and BMI (p = 0.072) in male subjects. No significant changes in anthropometric measurements or visceral fat area were observed in female subjects. Serum thyroid hormone concentrations did not increase after 1.03 mg/d of iodine supplementation through kelp intake. The intake of iodine-reduced kelp powder led to significant and safe reductions in body fat percentage in overweight male subjects. The consumption of kelp high in alginate may contribute to preventing obesity without influencing thyroid function in Japanese subjects with a relatively high intake of iodine from seaweed.

Iodine deficiency is one of the major causes of brain damage in childhood. However, iodine supplementation during early pregnancy and lactation can prevent the ill effects of iodine deficiency. This study evaluated maternal and infant thyroid function and infant visual information processing (VIP) in the context of maternal iodine supplementation. A community-based, randomized, supplementation trial was conducted. Mother infant dyads (n = 106) were enrolled within the first 10 days after delivery to participate in this study. Mothers were randomly assigned either to receive a potassium iodide capsule (225 μg iodine) daily for 26 weeks or iodized salt weekly for 26 weeks. Maternal thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH), thyroglobulin (Tg), urinary iodine concentration (UIC), breast milk iodine concentration (BMIC) and infant T4, TSH, UIC and VIP were measured as outcome variables. At baseline, neither mothers nor infants in the two groups were significantly different in any of the biomarkers or anthropometric measurements. Maternal TSH and goiter prevalence significantly decreased following iodine supplementation. The percentage of infants who preferentially remembered the familiar face was 26% in the capsule and 51% in the I-salt groups. Infant sex, length for age Z score, BMIC, maternal education and household food security were strong predictors of novelty quotient. In conclusion supplementation daily for six months with an iodine capsule or the use of appropriately iodized salt for an equivalent time was sufficient to reduce goiter and TSH in lactating women. Higher BMIC and LAZ as well as better household food security, maternal education, and male sex predicted higher novelty quotient scores in the VIP paradigm.

Neudesin is a newly discovered protein mainly secreted from adipose tissue and the brain. It plays a role as a neurotrophic factor in the brain and a negative regulator of energy expenditure. Neurodevelopmental delay and cognitive dysfunction are common features in cases with congenital hypothyroidism (CH) without treatment. Given the role of neudesin in brain development and its contribution to the survival of mature neurons, the relationship between neudesin and thyroid hormone was evaluated in babies diagnosed with CH. Babies aged between 2-4 weeks and diagnosed with CH and healthy controls of similar age were included. All patients were evaluated for thyroid hormones and plasma neudesin levels. The basal neudesin levels between the patient and control groups and the patients’ neudesin levels before and after l-thyroxine treatment were compared. Fifty-two babies [32 with CH, 14 (44%) female, aged 19±7 days and 20 healthy controls, 7 (35%) female, aged 22±8 days] were included. There was no significant difference in baseline neudesin between the CH and control groups (6.77±6.41 vs. 7.93±7.04 ng/mL, respectively; p=0.552). However, neudesin levels increased significantly following one month of therapy in the CH group [median: 3.93 (minimum: 0.31, maximum: 30.06) vs. median: 6.15 (minimum: 2.17, maximum: 70.05) ng/mL, p=0.019]. Although there was no difference in baseline neudesin levels between the patient and control groups, neudesin levels increased after short-term treatment. Larger prospective studies are needed to understand the pathophysiological role of neudesin in untreated and treated early CH.