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Jostel's TSH index (TSHI or JTI), also referred to as Jostel's thyrotropin index or Thyroid Function index (TFI), is a method for estimating the thyrotropic (i.e. thyroid stimulating) function of the anterior pituitary lobe in a quantitative way. [1] [2] The equation has been derived from the logarithmic standard model of thyroid homeostasis.
Thyroid hormone uptake (T uptake or T 3 uptake) is a measure of the unbound thyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone. [2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T 3 uptake. [2] Reference ranges:
In children, late blood sampling at 60 to 120 minutes is necessary. An increase in the serum TSH level following TRH administration means that the cause of the hypothyroidism is in the hypothalamus (tertiary hypothyroidism), i.e. the hypothalamus is not producing TRH. Therefore, when TRH is given exogenously, TSH levels increase.
Levothyroxine should be used to keep TSH levels within the normal range for that trimester. The first-trimester normal range is below 2.5 mIU/L and the second and third trimesters normal range is below 3.0 mIU/L. [16] [44] Treatment should be guided by total (rather than free) thyroxine or by the free T 4 index.
The principal benefit of LV shear strains is amplification of the 15% shortening of myocytes into 40% radial LV wall thickening, which ultimately translates into a >60% change in LV ejection fraction. Left ventricular shearing increases towards the subendocardium, resulting in a subepicardial to subendocardial thickening strain gradient.
The therapeutic target range TSH level for patients on treatment ranges between 0.3 and 3.0 μIU/mL. [18] For hypothyroid patients on thyroxine, measurement of TSH alone is generally considered sufficient. An increase in TSH above the normal range indicates under-replacement or poor compliance with therapy.
Thyroid cancer affects tens of thousands of people per year, and the majority are women. Of the 44,000 people who will likely be diagnosed with thyroid cancer this year, more than 31,000 will be ...
Stress suppresses TSH, [5] and alterations in thyroid hormone levels may arise in psychiatric illness. In major depressive disorder, an NTIS-like phenotype may be observed, with reduced T3 and increased rT3. T4 may be elevated, and TSH is usually normal, although TSH's normal circadian rhythm may be disrupted. [2]
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