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August 2009
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Clinical Thyroidology for Patients
Up- to-date information to help you understand thyroid disease through the latest research.
ATA ALLIANCE PUBLIC FORUM, PALM BEACH, FLORIDA Annual Alliance Patient Educational Forum at The Breakers in Palm Beach, FL on Saturday September 26, 2009. This is free and open to the public. Come and get answers to your questions about thyroid disease diagnosis and management.
Calendar of Events highlights educational forums and support groups sponsored by the Alliance for Thyroid Patient Education
IN THIS ISSUE, STUDIES ASK THE FOLLOWING QUESTIONS:
-- What is the relationship between TSH and miscarriage in pregnant women?
-- Is the TSH normal range different according to age and race?
-- What is the best time to give rhTSH to increase RAI uptake into the thyroid?
-- How common is anemia in Graves’ disease?
-- What is the best way to give RAI to thyroid cancer patients after their initial surgery?
We welcome your feedback and suggestions. Let us know what you want to see in this publication. I hope you find these summaries interesting and informative.
— Alan Farwell, MD
Clinical Thyroidology for Patients July 2009 Volume 2 Issue 3
THYROID AND PREGNANCY During pregnancy, thyroid hormone is very important for the baby to develop normally. While it is rare, fetal and neonatal death is often due to hypothyroidism in their mothers. Further, it appears that the rate of miscarriage is higher in mothers that are hypothyroid during their pregnancy. The purpose of this study was to examine the association between the mother’s TSH and FT4 levels during pregnancy and the rate of miscarriage and fetal and neonatal death.
HYPOTHYROIDISM The diagnosis of hypothyroidism is made most often by increased levels of Thyroid Stimulating Hormone (TSH). The upper normal limit of TSH is the subject of considerable controversy. As a result, the TSH normal range limits, as determined from national databases, have not yet been uniformly applied to clinical practice. This study looked at whether the levels of TSH changed according to age groups and ethnic groups.
GOITER Multinodular goiters are very common as we get older. Most function normally and do not require any treatment. Occasionally, multinodular goiters can enlarge and put pressure on structures in the neck, causing choking and difficulty swallowing. When that occurs, the usual treatment is surgery. Recently, some studies have suggested that large multinodular goiters can shrink if treated with radioactive iodine (RAI). Further, some studies have shown that the RAI can be more effective if the thyroid is turned on first by treatment with recombinant human TSH (rhTSH), a compound used in patients with thyroid cancer. The aim of this study was to determine how long before the RAI treatment that rhTSH should be given to get the best effect.
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GRAVES’ DISEASE Graves’ disease is the most common form of hyperthyroidism in the United States. A mild anemia, with low hemoglobin levels, can sometimes develop in patients with Graves’ disease. A major symptom of anemia is fatigue, so this may play a role in the tiredness that some patients have when the Graves’ disease is active. The cause of this anemia is uncertain. The aim of this study was to determine how common it occurs and what might be the cause of anemia associated with Graves’ disease.
THYROID CANCER After surgery, most thyroid cancer patients are treated with radioactive iodine (RAI) to destroy any remaining thyroid cells, both normal and cancerous. In order for the RAI to be effective, the patient’s TSH levels need to be increased to stimulate the thyroid cells to take up the RAI and be destroyed. There are two ways to increase TSH: 1) withdraw the patient from thyroid hormone (THW), making the patient hypothyroid for a short period of time or 2) use recombinant human TSH (rhTSH) to allow patients to stay on their thyroid hormone and avoid the short term hypothyroidism. Recently, smaller doses of I-131 have been used effectively with THW to destroy remaining thyroid cells in low-risk-patients with thyroid cancer. This study was done to find out whether smaller amounts of I-131 would also be effective using rhTSH.
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ATA Alliance for Patient Education
The goal of our organizations is to provide accurate and reliable information for patients about the diagnosis, evaluation and treatment of thyroid diseases.
UPCOMING MEETINGS
| DATE |
EVENT |
PLACE |
ORGANIZATION |
September 2009 |
|
|
ThyCa |
September 12, 2009 |
|
Denver, CO |
ThyCa |
September 12-13, 2009 |
Drewstock — a musical tribute to the life of Drew Glackin, who died of uncontrolled Graves’ disease www.drewstock.com |
Easton, PA |
Drewstock, Inc Benefitting the American Thyroid Association and the Graves’ Disease Foundation |
September
23–27, 2009 |
|
The Breakers Hotel Palm Beach, FL |
ATA |
Saturday,
September 26, 2009
1–3 pm |
|
The Breakers Hotel Palm Beach, FL |
ATA |
More upcoming Alliance meetings >>
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Why the American Thyroid Association? Because the ATA is dedicated to improving the lives of the millions of Americans of all ages living with thyroid problems. The ATA is strongly committed to serving as a resource for the public by promoting the prevention, treatment, and cure of thyroid-related diseases.
Your tax-deductible contribution helps to support valuable patient education and ground-breaking thyroid research – two of our primary goals – with the belief that new discoveries and better understanding will translate into improved ways to prevent, diagnose, and treat thyroid disease.
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