A New Strategy for Thyroid Function Testing

Caldwell, Gordon; Gow, S M; Sweeting, V. M.; Kellett, H A; Beckett, G J; Seth, John; Toft, A. D.

doi:10.1097/00006254-198603000-00014

Cited by 31 publications

(43 citation statements)

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“…Before the 1990s, when the diagnosis of secondary hyperthyroidism was facilitated by modern ultrasensitive TSH methods (9,10,37), tumor size was often large at time of diagnosis (17,20). Since the introduction of the ultrasensitive TSH methods, TSH-producing adenomas are more frequently found at the stage of microadenomas (17,19,38,39,40).…”

Section: Epidemiologymentioning

confidence: 99%

“…Subsequently, the diagnostic and therapeutic management of these rare pituitary adenomas has evolved substantially. This is due to the following reasons: use of ultrasensitive TSH methods since the late 1980s (9,10); the introduction of the concept 'syndrome of inappropriate TSH secretion' (11); advances in imaging procedures, moving from computed tomography (CT) to magnetic resonance imaging (MRI) with superior visualization of the pituitary area (12); and the use of somatostatin analogs in the therapeutic management of these patients (13,14).…”

Section: Introductionmentioning

confidence: 99%

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DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

Tjörnstrand

Nyström

2017

European Journal of Endocrinology

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Thyrotropin (TSH)-secreting adenomas (TSHomas) are the rarest form of pituitary adenomas, and most endocrinologists will see few cases in a lifetime, if any. In most cases, the diagnostic approach is complicated and cases may be referred after being presented as a syndrome of inappropriate TSH secretion or as a pituitary mass. This review aims to cover the past, present and possible future diagnostic approaches to TSHomas, including different clinical presentations, laboratory assessment and imaging advances. The differential diagnoses will be discussed, as well as possible coexisting disorders. By evaluating the existing reports and reviews describing this rare condition, this review aims to present a clinically practical suggestion on the diagnosic workup for TSHomas, Major advances and scientific breakthroughs in the imaging area in recent years, facilitating diagnosis of TSHomas, support the belief that future progress within the imaging field will play an important role in providing methods for a more efficient diagnosis of this rare condition.

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Section: Epidemiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

Tjörnstrand

Nyström

2017

European Journal of Endocrinology

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“…Most of the studies of magnesium metabolism in hyperthyroidism did not concomitantly investigate cellular, plasma and urinary magnesium [7,8] The diagnosis was based on typical clinical findings, levels of serum thyroid hormones and TSH [9], and the presence of anti TSH-receptor antibodies.…”

mentioning

confidence: 99%

Magnesium Metabolism in Hyperthyroidism.

et al. 1996

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“…The diagnosis of hypothyroidism must be based on the finding of abnormal thyroid function test results. It is accepted that a TSH level greater than 10 mU/L combined with a free T4 level below the reference range indicates the presence of overt primary hypothyroidism requiring [3][4][5]. A TSH concentration above the reference range together with normal free T4 level is defined as subclinical hypothyroidism.…”

Section: Diagnosis Of Hypothyroidismmentioning

confidence: 99%

Thyroid Replacement Therapy: The Hidden Challenges

Rahim

2013

J Endocrinol Metab

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Hypothyroidism has a gradual onset and non-specific symptoms, which might be subtle, and which might therefore be ignored or misdiagnosed. Subclinical hypothyroidism is a well-established phenomenon where a patient does not have thyroid symptoms, but shows biochemical evidences of hypothyroidism. However, diagnosis and treatment of these patients may prevent development of overt hypothyroidism and cardiovascular symptoms. Replacement therapy with levothyroxine (T4) is the treatment of choice for hypothyroidism; levothyroxine is taken daily, provides stable plasma levels and is suitable for the majority of patients. Patients with certain forms of hypothyroidism -central hypothyroidism, thyroidectomy patients and patients with "low T3 syndrome" -may benefit from treatment with liothyronine (T3), which is more potent and has a shorter onset of action. The use of liothyronine in combination with levothyroxine is controversial, but there is evidence that some patients, particularly those with deiodinase 2 and thyroid hormone transporter expression polymorphisms, may benefit from combination therapy.

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A New Strategy for Thyroid Function Testing

Cited by 31 publications

References 0 publications

DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

Magnesium Metabolism in Hyperthyroidism.

Thyroid Replacement Therapy: The Hidden Challenges

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