• 제목/요약/키워드: subclinical hypothyroidism

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준임상적 갑상선기능저하증;논란이 되는 주제들 (Subclinical Hypothyroidism;Controversial Subjects and Therapeutic Regimen)

  • 박지훈;김호준;이명종
    • 한방비만학회지
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    • 제6권2호
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    • pp.29-41
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    • 2006
  • Subclinical hypothyroidism is defined as a normal serum free thyroxine level combined with an elevated thyroid stimulating hormone level. The causes of subclinical hypothyroidism are the same as those of overt hypothyroidism. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. The management of subclinical hypothyroidism is remains controversial. Patients with a serum thyroid stimulating hormone level greater than 10 mU/L have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that hormone treatment of subclinical hypothyroidism is beneficial. The use of thyroid stimulating hormone level lone as a diagnostic and assessment tool for hypothyroidism is inadequate because this test cannot identify numerous conditions this sentence is unclear in its meaning. Using an expanded list of clinical signs and symptoms associated with dysfunction of the Hypothalamus-Pituitary-Thyroid axis, it is possible to hypothesize that subclinical hypothyroidism may be more common in a population of patients with early signs of age-related diseases than most practitioners realize. To improve thyroid function in subclinical hypothyroidism patients, practitioners should become familiar with foods and nutrients that can hinder or support thyroid function.

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준임상적 갑상선 기능저하증과 혈청 지질 및 비만도의 상관관계 (Correlations of Subclinical Hypothyroidism with Serum Lipid Profiles and Obesity Index)

  • 김호준;박정현;이명종;박지훈;송미영
    • 대한한의학회지
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    • 제29권3호
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    • pp.38-49
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    • 2008
  • Objectives: Though overt thyroid dysfunction is well recognized to affect serum lipid profiles and obesity, there are conflicting reports on the effect of subclinical hypothyroidism on serum lipid profiles and obesity. In most reports, the definition of the upper normal limit of serum thyroid stimulation hormone (TSH) of 4.0${\sim}$5.0mU/L has been used to diagnose. However, recent studies have suggested a much lower TSH cut off with an upper limit of 2.5mU/L, because >95% of rigorously screened normal euthyroid volunteers had serum TSH values between 0.4 and 2.5mU/L. Therefore we defined subclinical hypothyroidism as a TSH level greater than 2.5mU/L. We sought to evaluate the correlations of subclinical hypothyroidism with obesity index and serum lipid profiles Methods: TSH levels were measured in 6190 men and 4223 women that participated in health examination and free T4, lipid profiles (total-cholesterol, triglyceride, LDL-C), and obesity index (body mass index, body fat, waist circumference, C-reactive protein) were also measured. Results: There were significant differences of triglyceride between subclinical hypothyroidism men and normal control subjects. In women, there were also significant differences of triglyceride and LDL-C between subclinical hypothyroidism and normal control subjects. Subclinical hypothyroidism women showed significant correlations of TSH with total cholesterol, LDL-C, triglyceride, and C-reactive protein. Subclinical hypothyroidism men and women with a TSH level 2.5${\sim}$4.0mU/L had significant differences of triglyceride and body fat. In men, there were significant differences of waist circumference andC-reactive protein. In women, there were significant differences of LDL-C. Conclusions: We have demonstrated correlations of subclinical hypothyroidism with serum lipid profiles and obesity index. These findings suggested that subclinical hypothyroidism people had an increased risk of dyslipidemia and obesity. Subclinical hypothyroidism people with a TSH level 2.5${\sim}$4.0mU/L may be also considered suspect since it may signal a case of evolving thyroid underactivity eligible to be prevented.

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불현성 갑상선 기능저하증과 혈청 총 콜레스테롤, 저밀도 콜레스테롤 농도와의 상관성 (Interreationship between the Subclinical Hypothyroidism and Serum Total Cholesterol, LDL-Cholesterol)

  • 석성자;유왕근
    • 대한예방한의학회지
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    • 제12권1호
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    • pp.127-134
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    • 2008
  • This study was carried out in 14,443 subjects(8,706 men, 5,737 women, mean age $41.8{\pm}9.16$) who visited the health promotion center of one university hospital. Serum $T_3$, $T_4$ and TSH concentrations were measured with CIA using commercial kits on ADVIA Centaur Assay and Serum total cholesterol, triglyceride, and HDL-cholesterol were measured by auto-analyzer Hitach 7600 in enzyme method. 1. The prevalence of subclinical hypothyroidism was 12.6/1,000 population(men 6.0/1,000, women 22.7/1,000) and as high as about 4 times in women than in men. 2. In subclinical hypothyroidism, the values of total cholesterol and LDL-cholesterol were significantly high by 5.5 mg/dL, 4.6 mg/dL compared with normal group(p<0.05). 3. In all the tested hypercholesterolemia and hyperLDL-cholesterolemia, were correlated with TSH. There is higher correlation in women group than men group. These results indicate that the subclinical hypothyroidism and dyslipemia significantly correlated. Especially, it is very important to find that the hypercholesterolemia and hyperLDL-cholesterolemia are the high risk factors of atherosclerosis. Therefore, it is essential for the group of subclinical hypothyroidism to take the cholesterol, LDL-cholesterol and serum lipid test as well as thyroid function test.

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불현성 갑상선기능저하증에 대한 이선탕 가미 처방 투여 경과 : 증례보고 (Subclinical Hypothyroidism Treated by Means of Modified Er-Xian Decoction)

  • 정창운;조희근;김보민
    • 대한한방내과학회지
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    • 제39권6호
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    • pp.1281-1289
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    • 2018
  • Objectives: This study is the first report on a case of subclinical hypothyroidism treated with Modified Er-Xian Decoction, which is rarely used in Korea. Methods: Patients were treated for 3 months with Modified Er-Xian Decoction and their therapeutic effects were evaluated through thyroid function tests and Spleen-Kidney deficiency Questionnaire. Results: Initial improvement was apparent after the administration of Modified Er-Xian Decoction. After 3 months of treatment, the patient 's Spleen-Kidney deficiency index improved significantly, and thyroid hormone levels returned to normal. Conclusions: In this case report, symptoms and biochemical improvement were confirmed based on a single herbal medicine prescription for subclinical hypothyroidism. It is necessary to verify the effect of this prescription through well - established clinical trials.

Quetiapine 치료 중 발생한 무증상 갑상선 기능저하증 1례 (Subclinical Hypothyroidism during Quetiapine Treatment : A Case Report)

  • 나경세;김용구
    • 생물정신의학
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    • 제14권1호
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    • pp.68-71
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    • 2007
  • Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

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전현성 갑상선 기능저하증의 임상적 고찰 (The Clinical Study on 39 Cases of Subclinical Hypothyroidism)

  • 유철재;안원전;이헌영;노흥규
    • 대한핵의학회지
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    • 제20권1호
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    • pp.67-73
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    • 1986
  • Subclinical hypothyroidism can be defined as an asymptomatic state in which a reduction in thyroid activity has been compensated by an increased TSH output to maintain a euthyroid state. We analysed clinical features, laboratory data, and pathologic findings in 3g cases of subclinical hypothyroidism who were diagnosed at the Dept. of Internal Medicine, Chungnam National University Hospital from Aug. 1984 to June, 1985. 1) The age distribution was from sixteen to sixty-nine and mean a9e was 34.8. Peak incidence was in the 4th decade and 3rd, 5th, 6th decade in order. 2) The sex distribution showed female preponderance with a ratio of 18.5 to 1. 3) The major presenting manifestations were nonspecific ones such as fatigue, indigestion, and anorexia. 4) Physical examination revealed diffuse goiter in 47.6%. Major abnormalities were no gross abnormality (30.9%), nodular goiter and facial edema. 5) There was no significant difference of the basal serum $T_3\;and\;T_4$ concentrations between subclinical hypothyroidism and normal controls (p>0.05). 6) The basal serum TSH concentration of subclinical hypothyroidism $(32.61{\pm}14.95{\mu}U/ml)$ was significantly higher than that of normal controls $(3.92{\pm}1.05{\mu}U/ml)$ (p<0.005). 7) Microsomal antibody was detected in 80.6% and thyroglobulin antibody was detected in 30%. 8) The pathologic findings in 26 cases revealed Hashimoto's thyroiditis in 76.9% (lymphocytic type, 34.6%; oxyphilic type, 26.9%; fibrotic type, 15.4%). The others were adenomatous goiter(15.4%), adenomatous carcinoma (3.8%) and subacute thyroiditis(3.8%).

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한방치료로 호전된 불현성 갑상선 기능저하증 환자 1례 (A clinical report of Herbal treatment effect on a subclinical hypothyroidism patient)

  • 이종빈;박상우;정호영;김철중;조충식
    • 혜화의학회지
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    • 제21권1호
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    • pp.97-101
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    • 2012
  • We treated a 18 year-old female patient. The main symptoms were Low back pain, Dyspepsia, Anorexia. She want to check blood test spontaneously and we diagnosed her as subclinical hypothyroidism and prescribe herbal medicine three times a day. We observed clinical symptoms and Free T4, T3, TSH levels. After the treatment, The main symptom were improved and TSH levels fell. This case shows that herbal medicine has an effect on subclinical hypothyroidism.

두경부암 치료후 발생하는 갑상선기능저하증 (Hypothyroidism after Treatment for Head and Neck Cancer)

  • 조재식;이상철;임상철;김종식;박종부;심우진
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.101-108
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    • 1997
  • 최근 5년간 전남대학교 병원에서 두경부암으로 치료받은 52명의 환자를 대상으로 시행한 갑상선기능 검사를 분석하여 다음과 같은 결과를 얻었다. 1. 두경부암 환자에서 방사선 치료와 수술을 병행하여 치료한 경우에서 갑상선기능저하증 발생빈도가 높았고, 특히 후두적출술을 시행한 경우는 위험성이 증가되었다. 2. 종양의 임상병기가 높을수록, 원발병소가 설골 하부인 경우에서 병합요법을 시행할수록 갑상선기능저하증 발생빈도가 높았다. 3. 연령, 성, 방사선 조사량, 치료후 갑상선 검사까지의 기간 사이에는 갑상선기능저하증 발생에 통계학적으로 의의 있는 인자는 없었다. 따라서, 위험군에서는 추적관찰 도중 갑상선기능 저하증의 임상적 증후를 주의 깊게 관찰하고, 정기적인 갑상선 기능 검사를 통해 조기 발견해서 levothyroxine 보충치료로 임상적 갑상선기능저하증으로의 진행을 예방하여야 한다.

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불현성 갑상선기능저하증이 병발한 고령의 뇌졸중 환자의 호전 1례 (A Case Report of Cerebral Infarction in an Elderly Patient with Subclinical Hypothyroidism)

  • 우성호;김병철;심효주;나유진;강래엽;김진원;서호석;김정욱;김용호
    • 대한한방내과학회지
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    • 제28권3호
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    • pp.624-631
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    • 2007
  • Hypothyroidism is a common disease of the endocrinal system, characterized by fatigue, cold intolerance, bradycardia, and so on. Subclinical hypothyroidism is a common biochemical abnormality which can be found in routine screening tests of thyroid function. It is defined as an asymptomatic state which characterized by normal free thyroxine(FT4) and elevated thyroid stimulating hormone(TSH) levels. The purpose of this study was to evaluate the effect of treatment with palmijihwang-tang and to observe the changes in triiodothyronine(T3), free thyroxine(FT4), thyroid stimulating hormone(TSH) level and VAS of cold intolerance, hoarseness, dry skin. After the treatment, triiodothyronine(T3) increased from 57.12ng/dl to 120.53ng/dl. Free thyroxine(FT4) increased from 12.59pg/ml to 14.21pg/ml. Thyroid stimulating hormone(TSH) decreased from 10.61mU/L to 1.57mU/L. Cold intolerance, hoarseness and dry skin changed for the better. These results support a role for oriental medical therapy in treating subclinical hypothyroidism. Further case studies of herbal treatment of this ailment are needed.

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The Relationship Between Night Shift Work and the Risk of Abnormal Thyroid-Stimulating Hormone: A Hospital-Based Nine-Year Follow-up Retrospective Cohort Study in Taiwan

  • Chen, Hsin-Hao;Chiu, Hsiao-Hui;Yeh, Tzu-Lin;Lin, Chi-Min;Huang, Hsin-Yi;Wu, Shang-Liang
    • Safety and Health at Work
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    • 제12권3호
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    • pp.390-395
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    • 2021
  • Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33-1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19-1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion: In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.