Common symptoms of overt hypothyroidism are non-specific and include fatigue, lethargy, and dry skin. Although the diagnosis is considered to be straightforward, no single symptom can be used to identify patients with overt hypothyroidism, while many patients with subclinical hypothyroidism are asymptomatic. A large population-based study on the spectrum of symptoms in subclinical hypothyroidism showed similar rates of thyroid disease-related symptoms compared with euthyroid subjects, while the TSH concentration had no impact on symptom score. Together, these findings make it challenging to attribute symptoms to their underlying cause. This is also true in the case of unexplained persistent symptoms in levothyroxine-treated patients. Although generally considered a life-long replacement therapy, successful thyroid hormone discontinuation resulting in euthyroidism has been reported in approximately one third of patients. Thus, we overtreat patients with (subclinical) hypothyroidism, highlighting the importance of reliable diagnostic criteria. The diagnostic process, including the implementation of robust TSH and FT4 reference intervals, is especially challenging in specific situations including aging, pregnancy, non-thyroidal illness, and central hypothyroidism. There is a clear need for improved adherence to current guidelines from scientific societies and for willingness to manage symptoms without a clear pathological correlate, especially in the case of mild TSH elevations. This review will highlight recent literature on this topic and offers some practice points.
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http://dx.doi.org/10.3389/fendo.2023.1130661 | DOI Listing |
Thyroid
January 2025
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
The longest reported follow-up for thermal ablation of papillary thyroid microcarcinoma (PTMC) is 5 years. We evaluated the long-term efficacy and safety of radiofrequency ablation (RFA) in patients with low-risk PTMC with clinical follow-up of more than 10 years. In this retrospective cohort study, we included patients with low-risk PTMC who had more than 10 years of follow-up after ultrasound (US)-guided RFA (performed between May 2008 and December 2013).
View Article and Find Full Text PDFCureus
December 2024
General and Internal Medicine, Pakistan Ordinance Factories (POF) Hospital, Rawalpindi, PAK.
Introduction: Thyroid hormone imbalances are known to significantly affect cardiovascular health, contributing to conditions such as arrhythmias, dyslipidemia, and hypertension. Given the increasing prevalence of thyroid dysfunction and its potential impact on cardiovascular outcomes, early diagnosis and intervention are crucial, particularly within specific regional populations.
Objective: This study aimed to evaluate the impact of thyroid hormone imbalance on cardiovascular health outcomes in patients at Lady Reading Hospital, Peshawar, over a 24-month period.
Front Cardiovasc Med
January 2025
Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Norrkoping, Sweden.
Introduction: Known risk factors for new-onset atrial fibrillation/flutter (NOAF) include thyrotoxicosis and subclinical hypothyroidism. While prior research has predominantly explored the link between thyrotoxicosis and NOAF, the presence of subclinical hypothyroidism among patients presenting with acute NOAF in the emergency department (ED) remains an underexplored area of inquiry. This study aimed to assess the prevalence of undiagnosed thyrotoxicosis and subclinical hypothyroidism in patients with acute NOAF diagnosed in the ED.
View Article and Find Full Text PDFAME Case Rep
January 2025
Ushakov Thyroid Clinic, Moscow, Russia.
Background: It is known that subclinical hypothyroidism (SCH) often converts to euthyroidism. However, the mechanism of such changes is unclear and can only be speculated. This difficulty is likely due to limitations in diagnostic guidelines and their interpretation.
View Article and Find Full Text PDFEcotoxicol Environ Saf
January 2025
NHC Key Laboratory of Public Nutrition and Health, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China. Electronic address:
In 2023, European Food Safety Authority (EFSA) published a re-evaluation of the safety of bisphenol A (BPA), establishing the new tolerable daily intake (TDI) as 0.2 ng/kg·bw/day with a 20,000-fold reduction compared to 2015, which regained public concern about the impact of bisphenols (BPs) on human health. In order to explore the health risk to thyroid function of BPs, in this study, we assessed the internal exposure levels of BPs and the relationships between urinary BPs and thyroid function in general adults.
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