Effect of Heparin on Serum Free Thyroxine Linked to Post‐heparin Lipolytic Activity

Bayer, Monika

doi:10.1111/j.1365-2265.1983.tb00035.x

Cited by 21 publications

(11 citation statements)

References 15 publications

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“…In chronically ill geriatric patients, we were able to demonstrate an increased THBI activity of the serum and its correlation to the clinical state but not to age. The well known effect of heparin on FT4 is also said to be mediated by a heparin‐induced excess of NEFA 14–17 . Interestingly, in hospitalized chronic geriatric patients, this heparin effect could be found even at small doses.…”

Section: Discussionmentioning

confidence: 99%

“…(2) Nonthyroidal illness in geriatric patients may lead to changes in serum T4, FT4, T3, and TSH levels 9–11 . (3) The hormonal parameters of thyroid activity may be influenced, both in vitro and in vivo, by several drugs without thyroid hormone activity; for example, glucocorticoids 12 and dopamine 13 suppress TSH secretion, and the heparin‐induced excess of serum non‐esterified fatty acids (NEFA), 14–17 or furosemide, 18–19 competes for T4 binding in serum.…”

mentioning

confidence: 99%

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Factors Affecting the Serum Free Thyroxine Levels in Hospitalized Chronic Geriatric Patients

Szabolcs¹,

Ploenes

Beyer

et al. 1993

J American Geriatrics Society

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Factors Affecting the Serum Free Thyroxine Levels in Hospitalized Chronic Geriatric Patients

Szabolcs¹,

Ploenes

Beyer

et al. 1993

J American Geriatrics Society

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“…Although free and total T4 can be normal or slightly reduced, it can sometimes be increased due to the effect of heparin used in anticoagulant therapy during HD. Lipolytic activity of heparin leads to lipolysis of triglycerides in non-esterified free fatty acids which in high concentrations compete with T4 for proteins carriers (13). TSH levels according to several study results in patients with CKD are not uniform.…”

Section: Introductionmentioning

confidence: 97%

Role of Renal Anemia in the Functional, Morphological and Autoimmune Thyroid Disorders in patients on Chronic Hemodialysis

Jusufović¹,

Hodžić²,

Halilcevic³

2011

Med Arh

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t hyroid disorders are common in chronic kidney disease. The aim of this study was to examine the role of renal anemia on thyroid function, morphology and autoimmunity in clinically euthyroid patients on chronic hemodialysis (HD). Prospective study during 12 months period included 40 stable patients on chronic HD treatment. Patients were divided into two groups according to the serum hemoglobin level (group A Hgb > 125 g / L and group B Hgb <125 g / L). Blood samples were taken for determination total and free thyroid hormones, thyroid antibodies and standard biochemical tests. Thyroid ultrasonography was performed with a 7.5 MHz transducer, 50 mm linear transducer. Thyroid wolume was calculated, echostructure assessed and presence of nodular changes. In group A, was found significantly lower levels of total T3 (1.29 ± 0469 vs. 1.55 ± 0352, p <0.1); higher prevalence of low T3 syndrome (17.24% (n = 5) vs. 0.00 (n = 0), p <0.05); ultrasound findings suggestive for Hashimoto thyroiditis (13.79 (n = 4) vs. 0.00% (n = 0), p <0.05) and multinodular goiter (13.79% (n = 4) vs. 0.00% (n = 0) , p <0.05). We found no statistically significant difference in the mean values of of thyroid antibodies levels, as well as in their percentage representation among groups. Morphological, functional and autoimmune disorders of thyroid gland are more common in patients on HD with Hgb level <125 g / L. These findings suggest a role of renal anemia in the pathogenesis of these, and need for periodical screening of thyroid function, morphology, and titer of thyroid antibodies in patients HD, as well as more effective diagnosis and more aggressive treatment of renal anemia.

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“…Chu et al [5] could demonstrate only a 50% decrease of T3; free T3 and reverse T3 were not evaluated in their study. The normal fT4 concentrations during CPB are most likely mediated by the large amounts of heparin dur ing CPB [13,14]. Gotzsche et al [7] even found elevated fT4 concentrations during CPB.…”

Section: Influence O F Iodine Contamination On Thyroid Functionmentioning

confidence: 99%

Influence of Coronary Artery Bypass Surgery on Thyroid Hormone Parameters

Reinhardt¹,

Mocker²,

Jockenhövel³

et al. 1997

Horm Res

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The postoperative period after cardiac surgery with cardiopulmonary bypass (CPB) is associated with a low T3 syndrome, i.e. low T3 and fT3 concentrations in the presence of normal T4 and TSH concentrations. So far, results from studies evaluating thyroid function during and after CPB are rather conflicting. We therefore evaluated prospectively thyroid function in 28 patients before, during and up to 3 days after coronary artery bypass surgery. We could demonstrate the most significant changes in thyroid hormone concentrations on day 1 after CPB (low T3 and fT3 concentrations, elevated rT3 concentrations in the presence of a significant fall of TSH). T3 fell from 1.93 to 0.6 nmol/l and fT3 from 5.5 to 1.42 pmol/l. Those patients with low cardiac output syndrome after surgery had significantly lower T3 concentrations than patients without this complication. Moreover, those patients, who already had significant lower T3 values prior to CPB, also demonstrated low T3 concentrations on day 1 after CPB. Cortisol usually has a suppressive effect on TSH secretion. However, the effect of cortisol on TSH in patients undergoing CPB seems to be not that important: those patients with high endogenous cortisol concentrations on day 1 after CPB had similar TSH values to those patients with only slightly elevated cortisol concentrations. Also, the application of high doses of catecholamines seems to have only minor effects on TSH secretion, because those patients requiring high doses of dopamine over a prolonged time period had essentially the same TSH values after CPB. Patients who had been exposed preoperatively to high doses of iodine did not demonstrate significantly different thyroid hormone concentrations. In conclusion: We could demonstrate that CPB induces a low T3 syndrome up to 3 days after surgery. Those patients with low T3 concentrations prior to surgery demonstrate postoperatively a more severe degree of nonthyroidal illness (NTI).Catecholamines and cortisol seem to have only minor effects on the TSH secretion after CPB. The influence of a previous iodine contamination is negligible.

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Effect of Heparin on Serum Free Thyroxine Linked to Post‐heparin Lipolytic Activity

Cited by 21 publications

References 15 publications

Factors Affecting the Serum Free Thyroxine Levels in Hospitalized Chronic Geriatric Patients

Factors Affecting the Serum Free Thyroxine Levels in Hospitalized Chronic Geriatric Patients

Role of Renal Anemia in the Functional, Morphological and Autoimmune Thyroid Disorders in patients on Chronic Hemodialysis

Influence of Coronary Artery Bypass Surgery on Thyroid Hormone Parameters

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