The role of functional thyroid capacity in pituitary thyroid feedback regulation

European Journal of Clinical Investigation
Rudolf HoermannJohannes W Dietrich

Abstract

Thyroid feedback regulation and equilibria between thyroid hormones differ in the presence or absence of a functioning thyroid remnant. This study examines the relationship between the sensitivity of TSH feedback and thyroid capacity in untreated patients with thyroid autoimmune disease (n = 86) and healthy controls (n = 271). Functional capacity was estimated at maximum TSH stimulation, and pituitary TSH response was FT4-standardised with two established indices, the TSH index and the thyrotroph thyroid hormone resistance index. The two indices correlated inversely with thyroid volume and functional thyroid capacity. Relationships were shifted upwards in patients with thyroid autoimmune disease. This positioned patients with thyroid autoimmune disease predominantly at the lower capacity range and upper part of TSH index. The relationship was modulated by serum FT3 concentrations, shifting 0.19 [95%CI: 0.12, 0.26] mIU/L per pmol FT3 increase. FT3 correlated with TSH index in total group ( τ  = 0.09, P = 0.009) and both subgroups. FT3 levels were maintained despite a substantial capacity loss by progressively increasing conversion rates of T3 from T4, only collapsing at capacities below <1.5 pmol/s. Functional thyroid capacity...Continue Reading

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References

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Apr 6, 2018·Frontiers in Endocrinology·Julian BerberichMatthias A Müller

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Citations

Jul 10, 2019·The Journal of International Medical Research·Zhan Bingyan, Wei Dong
Nov 17, 2020·Frontiers in Endocrinology·Johannes Wolfgang DietrichPatrick Müller

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