Hypothyroidism has various cardiovascular manifestation and exhibits electrocardiographic change. The QT dispersion on surface ECG reflects regional variations in myocardial repolarization. The effect of L-thyroxine treatment on ECG parameters, such as QT dispersion, in patients with primary hypothyroidism were investigated. This study involved 18 patients (3 men, 15 women, ages: 48+/-18 yr) with primary hypothyroidism. All patients were checked with a standard 12-lead ECG before and after L-thyroxine treatment. Various ECG parameters were then measured twice. The mean L-thyroxine treatment duration was 22+/-2.7 months. The mean thyroid-stimulating hormone levels of patients before and after therapy were 40.2+/-29.8 microU/mL, 3.6+/-4.6 microU/mL (p<0.001) and free-T4 levels were 0.44+/-0.38 ng/dL, 1.51+/-0.39 ng/dL (p<0.001). After L-thyroxine treatment, QT interval (395+/-42 vs. 380+/-24 msec, p<0.05), QTc interval (434+/-32 vs. 417+/-23 msec, p<0.05), QT dispersion (45+/-23 vs. 30+/-13 msec, p=0.008), QTc dispersion (49+/-23 vs. 32+/-14 msec, p=0.005) significantly decreased. There were no significant changes in the PR and RR intervals, as well as the QRS duration. Our findings suggest that the thyroid hormone affects ventricular inhomogenicity, and that L-thyroxine replacement therapy may reduce malignant ventricular arrhythmia and sudden cardiac death in primary hypothyroidism.
Thyroxine/*therapeutic use ; Middle Aged ; Male ; Hypothyroidism/*drug therapy/physiopathology ; Humans ; Female ; Electrocardiography/*drug effects ; Adult

OBJECTIVETo compare differences in the intelligence and physical developmental levels of children with congenital hypothyroidism (CH) who received initial treatment at different times.

METHODSForty-nine children with CH diagnosed by neonatal screening between September 2008 and September 2011 were enrolled in this study. According to the timing of initial treatment with thyroid hormone, they were classified into two groups: <1 month and 1 to 3 months of life. At 6 months old, 1 year and 2 years old, their intelligence levels were evaluated by Gessell test. Their physical developmental levels were also measured. Their thyroid functions were examined with fluorescence immunoassay.

RESULTSWith treatment, there were no significant differences in thyroid hormones (FT3, FT4 and TSH) between the two groups (P>0.05) at 6 months old, 1 year and 2 years old. However, heights and weights in the <1 month treatment group were significantly higher than in the 1 to 3 months treatment group at all time points (P<0.05). At 6 months old, intelligence developmental levels in the <1 month treatment group were better than the 1 to 3 months treatment group (P<0.05) but significant differences were not noted at 1 and 2 years old (P>0.05).

CONCLUSIONSThe timing of initial treatment with thyroid hormone appears to be associated with the intelligence and physical development in children with CH. Treatment starting at less than 1 month of life contributes to improved physical and intelligence development compared with treatment starting at 1 to 3 months of life.

Body Height ; Body Weight ; Child Development ; drug effects ; Child, Preschool ; Congenital Hypothyroidism ; drug therapy ; physiopathology ; psychology ; Female ; Humans ; Infant ; Intelligence ; drug effects ; Male ; Thyroxine ; therapeutic use

OBJECTIVETo observe the clinical effects of Prunellae Oral Liquid (POL) on the size of thyroid with different states of thyroid function in patients of goiter.

METHODSFifty-six patients with hyperthyroidism, 24 with hypothyroidism and 18 with simple goiter were randomized into two groups. Group A treated by classical therapy, Group B by POL based on classical therapy. Size of thyroid of patients before and after treatment was measured by color ultrasonic Doppler and compared with the data obtained from 20 healthy subjects as control.

RESULTSSize of thyroid in all patients before treatment were obviously larger than that of normal control (P<0.01), but it reduced after treatment in both groups, especially in group B, in which it differed insignificantly to that in the normal control (P > 0.05).

CONCLUSIONCombined treatment of Chinese medicine (using POL) and Western medicine is superior to Western medicine alone in treating goiter with different states of thyroid function.

Adult ; Antithyroid Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Goiter ; drug therapy ; physiopathology ; Humans ; Hyperthyroidism ; drug therapy ; physiopathology ; Hypothyroidism ; drug therapy ; physiopathology ; Male ; Middle Aged ; Phytotherapy ; Plant Extracts ; therapeutic use ; Prunella ; chemistry ; Thyroid Gland ; drug effects ; physiopathology ; Treatment Outcome

OBJECTIVETo observe the effects of initial doses and treatment timing of levothyroxine (L-T4) on the clinical efficacy in children with congenital hypothyroidism (CH).

METHODSThis study included 98 children who had an abnormal level of thyroid stimulating hormone (TSH) in neonatal screening in four regions of Yunnan Province and who finally had a confirmed diagnosis of CH. They received treatment with L-T4 and were divided into standard dose group (10-15 μg/kg per day) and low dose group (<10 μg/kg per day) by the therapeutic dose of L-T4. Meanwhile, these patients were also classified into two treatment groups based on the starting time of L-T4 treatment, namely under 2 months old group and more than 2 months old group. The thyroid function and physical and neural development were examined before and after treatment.

RESULTSCompared with the low dose group, the standard dose group had a significantly lower TSH level and a significantly higher free thyroxine (FT4) level at 2 weeks after treatment (P<0.05). There were no significant differences in TSH and FT4 levels at other time points after treatment between the standard and low dose groups (P>0.05). The physical and neural development were not significantly different between the two dose groups before and at all time points after treatment (P>0.05). At all time points after treatment, the levels of TSH and FT4 and physical development were not significantly different between the different starting time groups (P>0.05). However, the Gesell score was significantly higher in the under 2 months old group than in the more than 2 months old group at all time points after treatment (P<0.05).

CONCLUSIONSThe standard dose group has a better treatment outcome than the low dose group, whereas the symptoms of hyperthyroidism deserve close attention. The treatment timing is vital to the neurodevelopment of children with CH. Once diagnosed, the patients should receive treatments immediately.

Child Development ; Congenital Hypothyroidism ; drug therapy ; physiopathology ; Female ; Humans ; Infant, Newborn ; Male ; Nervous System ; growth & development ; Thyrotropin ; blood ; Thyroxine ; blood ; Treatment Outcome

Hypothyroidism can cause a variety of signs and symptoms of the neuromuscular system. However, ptosis in a patient with hypothyroidism is very rare. We report here on a case of central hypothyroidism that was due to Sheehan's syndrome and it manifested as bilateral ptosis in a 51-yr-old woman. She complained of exertional dyspnea and weakness. About 25-yr ago, she had a history of severe postpartum vaginal bleeding. The laboratory studies demonstrated hypopituitarism with secondary hypothyroidism. The ptosis was improved by replacement of thyroid hormone. Hypothyroidism should be considered in the differential diagnosis of patients who manifest with ptosis and that prompt replacement of hormone can lead to a complete recovery.
Blepharoptosis/complications/*diagnosis/drug therapy ; Electromyography ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/complications ; Magnetic Resonance Imaging ; Middle Aged ; Muscular Diseases/etiology ; Neuromuscular Junction/physiopathology ; Prednisolone/therapeutic use ; Thyroxine/therapeutic use