Animals ; Gonadal Hormones ; therapeutic use ; Growth Hormone ; therapeutic use ; Hormones ; therapeutic use ; Humans ; Insulin ; therapeutic use ; Neoplasms ; drug therapy ; Thyroid Hormones ; therapeutic use

Synthetic thyroxine has replaced animal thyroid gland extract as the preferred drug in chronic thyroid hormone replacement. Synthetic thyroxine monotherapy is used to treat overt primary and secondary hypothyroidism, and some cases of subclinical hypothyroidism. In addition, thyroid-stimulating hormone suppressive therapy with thyroxine is a component of the chronic treatment for differentiated thyroid carcinoma. Liothyronine, however, is conventionally for short-term usage, including thyroid hormone withdrawal preparation for radioactive iodine scanning and treatment of differentiated thyroid carcinoma and some cases of myxoedema coma. On very rare occasions where patients are apparently intolerant of or unresponsive to thyroxine, liothyronine may be used chronically. However, there is controversy concerning the use of alternative regimens of thyroid hormone, such as the use of thyroxine-liothyronine combination and thyroid extracts. Thyroid hormone has also been misused to promote weight loss and treat 'symptomatic' biochemically euthyroid patients. There is insufficient evidence to support the use of thyroid hormone to improve treatment response in depression and severe non-thyroidal illnesses.
Animals ; Depression ; drug therapy ; Hormone Replacement Therapy ; adverse effects ; methods ; Humans ; Hypothyroidism ; drug therapy ; Thyroid Function Tests ; Thyroid Hormones ; adverse effects ; therapeutic use ; Thyroid Neoplasms ; drug therapy

OBJECTIVETo investigate the effect of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude.

METHODSNinety patients with cardiovascular disease were divided into A group (n = 42, sodium selenite + VE), B group (n = 28, sodium selenite only) and control group (n = 20). Serum selenium (Se), plasma glutathione peroxidase (GSH-Px), plasma malondialdehyde (MDA) and serum T(3) and T(4) were determined before and after 6 month treatment.

RESULTSSerum Se in A and B group after 6 month treatment were higher than before [(0.71 +/- 0.22) micromol/L vs (0.31 +/- 0.17) micromol/L, (0.68 +/- 0.18) micromol/L vs (0.33 +/- 0.14) micromol/L respectively, P < 0.01], and so were plasma GSH-Px levels [(87.12 +/- 13.61) U/L vs (58.43 +/- 18.93) U/L, (84.79 +/- 12.13) U/L vs (57.12 +/- 17.36) U/L respectively] while plasma MDA were lower than before [(4.86 +/- 1.18) nmol/ml vs (8.66 +/- 0.96) nmol/ml, (4.18 +/- 1.23) nmol/ml vs (8.71 +/- 0.87) nmol/ml respectively, P < 0.01]. Serum T(3) and T(4) levels in A and B group were also obviously decreased (P < 0.01). The levels of plasma GSH-Px were positively correlated with those of serum Se (r = 0.781, P < 0.01). The levels of plasma MDA and serum T(3) and T(4) were negatively correlated with those of serum Se (r = -0.385, -0.687, -0.412 respectively, P < 0.05). 31 cases (73.81%) in A group and 20 cases (71.42%) in B group completely recovered to normal; 4 cases (9.52%) in A group and 2 cases (7.43%) in B group partly recovered. The recovered rates were significantly different from that of control (P < 0.05).

CONCLUSIONSupplementation of adequate selenium may correct the abnormal function of secretion in thyroid hormones of patients because of lack of selenium at altitude areas.

Adult ; Altitude ; Cardiovascular Diseases ; blood ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Sodium Selenite ; administration & dosage ; therapeutic use ; Thyroid Hormones ; blood ; Vitamin E ; administration & dosage ; therapeutic use

Traditionally, during the follow-up and in order to receive 131 I therapy, patients with differentiated thyroid carcinoma (DTC) have to withdraw from using thyroid hormone. The hypothyroidism induced by hormone withdrawal can negatively affect the quality-of-life (QOL) of DTC patients. Without the hormone withdrawal, recombinant human thyroid-stimulating hormone-aided management of DTC patients can effectively obviate the consequences of hypothyroidism. This review will focus on the clinical application of recombinant human thyroid-stimulating hormone (rhTSH) in the management of DTC patients.
Humans ; Iodine Radioisotopes ; therapeutic use ; Thyroglobulin ; blood ; Thyroid Hormones ; administration & dosage ; Thyroid Neoplasms ; blood ; drug therapy ; radiotherapy ; Thyrotropin Alfa ; administration & dosage

OBJECTIVETo study the efficacy and safety of Reinhartdt and sea cucumber capsule (RSC) combined with donepezil in treating Alzheimer's disease (AD), and its effect on thyroid function axis.

METHODSSixty-eight patients were randomly assigned to the RSC group, the Donepezil group and the combined treatment group, who were treated for 3 and 6 months with RSC, Donepezil and RSC combined with Donepezil, respectively. The curative effect was evaluated by scoring according to Mini-Mental State Examination (MMSE), ADAS-Cog and ADL chart, and the level of thyroid hormones, including TSH, FT3, FT4, TT3 and TT4, were measured with radioimmunoassay before treatment, 3 and 6 months after treatment respectively.

RESULTSAs compared with the baseline, MMSE score increased, ADAS-Cog score and ADL score decreased significantly in all the three groups after 3 months and 6 months of treatment (P < 0.05 and P < 0.01), but the improvement in the combined treatment group was more significant than that in the other two groups (P < 0.01). After 6 months of treatment, the levels of FT3 and FT4 in the combined treatment group were significantly changed (P < 0.01), but no significant change in all the thyroid hormones was found in the other two groups. No obvious adverse reaction occurred in all the three groups.

CONCLUSIONRSC combined with Donepezil in treating AD is effective and safe with no evident adverse reaction, better than single drug treatment, which may be through influencing the metabolism of thyroid hormones to improve the cognition function of AD patients.

Aged ; Aged, 80 and over ; Alzheimer Disease ; drug therapy ; Animals ; Capsules ; Drug Therapy, Combination ; Female ; Humans ; Indans ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nootropic Agents ; therapeutic use ; Piperidines ; therapeutic use ; Radioimmunoassay ; Sea Cucumbers ; chemistry ; Thyroid Hormones ; blood

OBJECTIVETo evaluate the effect of 90Y-DOTATOC and 131I-MIBG in treatment of metastatic medullary thyroid carcinoma (MTC).

METHODSTwelve histologically confirmed patients with metastatic MTC were included. All patients underwent both 111In-DTPA-octreotide imaging and 131I/ 123I-meta-iodobenzylguanidine (MIBG) imaging. According to the results of the combined imaging, positive patients were selected to be treated with 90Y-DOTA-D-Phe1-Tyr3-octreotide (90Y-DOTATOC) or 131I-MIBG, respectively. The therapeutic procedures of targeted internal radiation were performed with 3.33 GBq 90Y-DOTATOC at 6-week intervals, or 11.1 GBq 131I-MIBG with a minimum interval of three months.

RESULTSThe imaging procedure was positive in all 12 patients: 111In-DTPA-octreotide imaging in eight patients, 131I/ 123I-MIBG imaging in six patients. According to the results of combined imaging, we identified four patients to be treated with 90Y-DOTATOC, and five patients with 131 I-MIBG. After three to five sessions of treatment, three patients with partial remission and six with stable disease were observed. The effective rate was 3/9 (33.3%) and the overall tumor response rate was 9/9 (100%). No relevant toxicity was observed.

CONCLUSIONThe combined imaging technique can be used to identify patients for effective radionuclide treatment. The treatment with 90Y-DOTATOC or 131I-MIBG is well tolerated and may improve the fate of patients with metastatic MTC.

3-Iodobenzylguanidine ; therapeutic use ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Medullary ; metabolism ; radiotherapy ; secondary ; Female ; Follow-Up Studies ; Humans ; Indium Radioisotopes ; Male ; Middle Aged ; Octreotide ; analogs & derivatives ; therapeutic use ; Pentetic Acid ; analogs & derivatives ; Positron-Emission Tomography ; Remission Induction ; Thyroid Gland ; diagnostic imaging ; pathology ; radiation effects ; Thyroid Hormones ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; radiotherapy ; Treatment Outcome ; Yttrium Radioisotopes ; therapeutic use

OBJECTIVETo explore the clinical features of respiratory failure secondary to hypothyroidism.

METHODWe retrospectively analyzed the clinical data of 4 patients with respiratory failure secondary to hypothyroidism.

RESULTSRespiratory failure secondary to hypothyroidism usually happened in the aged patients, presenting as myxedema, disturbance of consciousness, anemia, and hyponatrium. Respiratory symptoms were rare. Type II respiratory failure might occur as disease progressed. The clinical presentation of hypothyroidism was atypical and easily neglected. The hypoxia and hypercapnia ameliorated after thyroid hormone therapy.

CONCLUSIONHypothyroidism is a rare reason of respiratory failure. The prognosis is good after hormone therapy and mechanical ventilation.

Aged ; Aged, 80 and over ; Female ; Humans ; Hypothyroidism ; complications ; drug therapy ; therapy ; Male ; Middle Aged ; Respiratory Insufficiency ; drug therapy ; etiology ; therapy ; Thyroid Hormones ; therapeutic use

Myxedema ascites caused by hypothyroidism is rare, so its diagnosis is often delayed and patients frequently receive unnecessary procedures such as liver biopsies and exploratory laparotomies. We report a 71-yr-old man with clinical ascites that was the first manifestation of hypothyroidism, and which resolved completely in response to thyroid hormone replacement therapy. To our knowledge, this is the first report of myxedema ascites in Korea. A review of the literature revealed 51 well-documented cases of myxedema ascites. Analyses of ascites from patients in this condition usually show high protein (>2.5 g/dL) and low white blood cell counts, with a high proportion of lymphocytes. A consistent feature is the good response to thyroid hormone replacement therapy, which has always led to resolution of the ascites. Myxedema ascites is thus rare but easy to treat; it should be borne in mind, especially if the ascites fluid has a high protein content.
Treatment Outcome ; Thyroid Hormones/deficiency/therapeutic use ; Myxedema/*etiology/pathology ; Male ; Hypothyroidism/*complications/diagnosis/drug therapy ; Humans ; Hormone Replacement Therapy ; Diagnosis, Differential ; Ascites/*etiology/pathology ; Aged

No abstract available.
Aged ; Anti-Inflammatory Agents/therapeutic use ; Carotid Artery Diseases/*complications/diagnosis/therapy ; Cerebral Angiography/methods ; Diagnosis, Differential ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hydrocortisone/therapeutic use ; Hypopituitarism/diagnosis/*etiology/therapy ; Intracranial Aneurysm/*complications/diagnosis/therapy ; Magnetic Resonance Imaging ; Plasma Substitutes/administration & dosage ; Predictive Value of Tests ; Prednisolone/therapeutic use ; Sella Turcica ; Thyroid Hormones/therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome

Adolescent ; Adult ; Aged ; Antithyroid Agents ; therapeutic use ; Female ; Graves Disease ; blood ; drug therapy ; Humans ; Iodides ; urine ; Iodine ; administration & dosage ; Male ; Middle Aged ; Propylthiouracil ; therapeutic use ; Prospective Studies ; Sodium Chloride, Dietary ; administration & dosage ; Thyroid Hormones ; blood