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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Serum TSH level is used to screen for primary hypothyroidism. In overt hypothyroidism, TSH levels are raised with low levels of free T4. Levels of anti-thyroid antibodies such as the thyroid peroxidase antibodies should also be evaluated.
Paper 2
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Start treatment with thyroxine 25 micrograms/day.Check thyroid peroxidase antibodies.Start carbimazole treatment.Start treatment with thyroxine 50 micrograms/day.Repeat thyroid function tests in 3 months’ time.
Micronutrients and Nutraceuticals: Effects on Exercise Performance
Published in Peter M. Tiidus, Rebecca E. K. MacPherson, Paul J. LeBlanc, Andrea R. Josse, The Routledge Handbook on Biochemistry of Exercise, 2020
Stella L. Volpe, Quentin Nichols
Iron is also involved in thyroid hormone production. Thyroid hormones are involved in nearly every process in the body, including energy metabolism and thermoregulation. Specifically, iron-deficiency anaemia can negatively affect thyroid peroxidase (TPO) activity. Thyroid peroxidase is a haem-containing enzyme. If TPO activity is impaired, thyroid-stimulating hormone (TSH) activity will be increased and thyroxine (T4) and triiodothyronine (T3) activity will be decreased (37). Therefore, iron-deficiency anaemia may lead to a decreased resting metabolic rate (RMR) and impaired thermoregulation, especially under cold conditions (9, 53).
Premature ovarian insufficiency: an International Menopause Society White Paper
Published in Climacteric, 2020
N. Panay, R. A. Anderson, R. E. Nappi, A. J. Vincent, S. Vujovic, L. Webber, W. Wolfman
In view of the increased incidence of autoimmune disorders in POI, autoantibody testing should be performed. To a certain extent, the tests performed will depend on personal and family history. The most clinically significant autoimmune association of POI is with adrenal insufficiency; 2.5–20% of women with POI have evidence of adrenal autoimmunity with histological evidence of autoimmune oophoritis, and 10–20% of patients with Addison’s disease have POI51. Testing for adrenal cortex or 21-hydroxylase antibodies in peripheral blood is the most sensitive test and should be screened for in all POI patients. If positive, adrenal function tests should then be performed. Thyroid peroxidase autoantibodies and thyroid function should also be tested for due to the frequent co-existence of autoimmune thyroid disorders. Ovarian antibody testing is not recommended due to poor correlation with clinical symptoms and hormone biomarkers and the high rate of false-positive results51.
An assay for screening xenobiotics for inhibition of rat thyroid gland peroxidase activity
Published in Xenobiotica, 2020
Roger J. Price, Rachel Burch, Lynsey R. Chatham, Larry G. Higgins, Richard A. Currie, Brian G. Lake
The thyroid gland produces the hormones L-thyroxine (3,3′,5,5′-tetraiodo-L-thyronine; T4) and triiodo-L-thyronine (3,3′,5-triodo-L-thyronine; T3). Thyroid hormones are involved in important physiological processes including regulation of energy metabolism, growth and differentiation, and development and maintenance of brain function (DeVito et al., 1999; Miller et al., 2009). Chemicals may disrupt thyroid gland function by a number of modes of action including interference with thyroid hormone synthesis or secretion, increased thyroid hormone catabolism and excretion, and disruption of the conversion of T4 to T3 (Capen, 2001; DeVito et al., 1999; Miller et al., 2009). In terms of inhibition of thyroid hormone synthesis, a number of chemicals have been shown to inhibit thyroid peroxidase (TPO) activity (EC 1.11.1.8). TPO catalyses the iodination of tyrosyl residues in thyroglobulin (forming mono- and di-iodinated forms) followed by coupling of the iodotyrosyl residues to form the thyroid hormones (Capen, 2001; Taurog et al., 1996). Known inhibitors of TPO include the antihyperthyroid drugs 6-propyl-2-thiouracil (PTU) and methimazole (MMI), anti-bacterial agents, flavonoids, isoflavones, industrial chemicals and some pesticides (Capen, 2001; Divi & Doerge, 1996; Divi et al., 1997; Doerge & Decker, 1994; Freyberger & Ahr, 2006; Paul et al., 2013, 2014).
Assessment of thyroid functions and thyroid volume in normal pregnant Egyptian females
Published in Gynecological Endocrinology, 2020
Ibrahim Elebrashy, Hebat-Allah Kamal Eldein, Hoda Abd-Elstar, Nashwa Ghanem, Shrook Mousa, Maha Assem, Laila Rashed, Mohamed Salit, Maged Abd-Elraoof, Ahmed Dorgham, Ahmed Mansour, Mohamed Mahmoud, Aasem Saif
Approximately 2–3% of pregnant women will have an elevated serum TSH level at the time of routine screening. Of the screened women, 0.3–0.5% will have overt hypothyroidism (OH) and 2–2.5% will have subclinical hypothyroidism (SCH) [5]. The prevalence of both OH and SCH increases with patient age and is also likely to be higher in iodine-deficient regions. Hyperthyroidism is less common, occurring in approximately 0.1–0.4% of pregnant women [6]. Moreover, about 10–20% of all euthyroid pregnant females are positive for thyroid antibodies [7]. Thyroid size is influenced by different factors, including iodine supply, genetics, gender, age, TSH, anthropometric parameters and pregnancy [8]. About 11–20% of women with a thyroid nodule detected in the first trimester of pregnancy developed a second nodule through the course of pregnancy [9]. Pregnancy was considered a risk factor for growth of thyroid nodules; however, it is still unclear if thyroid nodules are more commonly diagnosed in pregnant than in non-pregnant women [10]. The aim of this study was to assess the thyroid functions in normal pregnant Egyptian females in order to establish a population-specific reference range. Thyroid peroxidase antibodies (TPO Abs) and thyroid volume (by ultrasonography) were also assessed.