Homeostatic equilibria between free thyroid hormones and pituitary thyrotropin are modulated by various influences including age, body mass index and treatment

  • Rudolf Hoermann, John E.M. Midgley, Adrienne Giacobino, Walter A. Eckl, Hans Günther Wahl, Johannes W. Dietrich, Rolf Larisch
  • Clinical Endocrinology, July 2014, Wiley
  • DOI: 10.1111/cen.12527

TSH, FT4 and FT3 have individual, but interlocking roles in thyroid homeostasis

What is it about?

This study investigated patterns of thyroid hormones in 1912 subjects with different thyroid conditions. It revealed that correlations between FT3, FT4 and TSH were modulated by multiple factors including age, body mass, thyroid volume, antibody status and L-T4 treatment. FT3 levels and calculated deiodinase activity (SPINA-GD) were significantly lower in subjects treated with levothyroxine.

Why is it important?

Equilibria typical of the healthy state are not invariant, but profoundly altered by multiple factors, e.g. L-T4 treatment. This study suggests that strategies for optimising treatment should be revisited. It delivered new evidence that T3 levels are lower in patients on substitution therapy with levothyroxine. In addition, the time point of taking levothyroxine, i.e. before or after blood drawing, was revealed to be of less influence on lab results than expected.

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The following have contributed to this page: PD Dr. med. Johannes W Dietrich and Professor Rudolf Hoermann