Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
Volume 11 Issue 1
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Clinical Thyroidology for the Public Volume 11 Issue 1 (PDF file, 6.3 MB)
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HYPERTHYROIDISM Subclinical hyperthyroidism with a suppressed TSH is associated with increased dementia risk in older adults
Severe thyroid disease is associated with cognitive deficits that could be misdiagnosed as dementia. The association of milder forms of these thyroid conditions and cognitive deficits is less well understood. It is also unclear of the association between dementia and thyroid disease. The purpose of this study was to determine whether subclinical thyroid disease is associated with dementia.
Aubert CE et al. The association between subclinical thyroid dysfunction and dementia: the Health, Aging and Body Composition (Health ABC) study. Clin Endocrinol (Oxf). August 29, 2017 [Epub ahead of print].
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THYROID IN THE ELDERLY The risk of dying may be higher in older patients whose levels of TSH and free T4 are more variable
While there may be minor changes in TSH levels during the course of the day, in general, both TSH and thyroid hormone levels are stable over time. However, in some individuals, TSH levels are more variable and it is known that TSH levels are generally higher in older adults than in younger people. This study aimed to determine changing thyroid function with aging and examine the association of these changes with survival, by analyzing thyroid function over time.
Mammen JS et al. Unstable thyroid function in older adults is caused by alterations in both thyroid and pituitary physiology and associated with increased mortality. Thyroid, 2017 Nov;27(11):1370-1377.
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HYPERTHYROIDISM Risk factors for liver abnormalities with hyperthyroidism
Both hyperthyroidism as well as the medications used to treat it can affect the function of the liver, causing increases in blood levels of markers of liver function know as liver function tests. If the increase in liver function tests is due to the antithyroid medications, the medication needs to be stopped to avoid damage to the liver. This study examined the risk factors for abnormal liver tests in patients with hyperthyroidism.
Lin TY et al. Incidence of abnormal liver biochemical tests in hyperthyroidism. Clin Endocrinol (Oxf ) 2017;86:755-9. Epub March 9, 2017.
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THYROID NODULES Parathyroid lesions can be diagnosed by biopsy, but will need additional testing
Parathyroid glands can sometimes look like thyroid nodules on ultrasound and other imaging, especially when they are found in unusual locations such as inside the thyroid gland. Biopsy of a parathyroid gland usually is indeterminate, as parathyroid identification requires special stains. The goal of this study was to determine if other, less involved methods such as simple pattern recognition on cytology, could be used to accurately distinguish parathyroid from thyroid lesions with a thyroid biopsy specimen.
Cho M et al. Distinguishing parathyroid and thyroid lesions on ultrasound-guided fine-needle aspiration: a correlation of clinical data, ancillary studies, and molecular analysis. Cancer. June 16, 2017 [Epub ahead of print].
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THYROID CANCER The time it takes for lung metastases in thyroid cancer may allow more appropriate selection of patients for aggressive chemotherapy
Patients with thyroid cancer that spreads to the lungs (metastasis) tend to have shorter survival. Some patients have faster growing lung metastases and will require oral chemotherapy drugs to try to stop the cancer growth. The authors of this study try to predict which patients will have better survival based on the amount of cancer and by measuring the rate of growth of the metastases, also referred to as cancer volume doubling times.
Sabra MM et al Tumor volume doubling time of pulmonary metastases predicts overall survival and can guide the initiation of multikinase inhibitor therapy in patients with metastatic, follicular cell-derived thyroid carcinoma. Cancer 2017;123:2955–64. Epub April 3, 207.
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