Changes in Thyroid Function Across Adolescence: A Longitudinal Study
Open accessAbstract
Objective: There are no large, longitudinal studies of thyroid function across adolescence. The aims of this study were to examine longitudinal trends in thyrotropin (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) and determine age-specific reference ranges. Methods: Thyroid function was assessed in 3415 participants in the Brisbane Longitudinal Twin Study at ages 12, 14, and 16, using the Abbott ARCHITECT immunoassay. Longitudinal analyses were adjusted for body mass index and puberty. Results: In girls, mean fT4 (± SE) increased between age 12 and 14 (by 0.30 ± 0.08 pmol/L; P < 0.001), while remaining unchanged in boys; from age 14 to 16, fT4 increased in both girls (by 0.42 ± 0.07 pmol/L; P < 0.001) and boys (0.64 ± 0.07 pmol/L, P < 0.001). There was a slight increase in fT3 from age 12 to 14 years in girls (by 0.07 ± 0.03 pmol/L; P = 0.042), with a more marked increase in boys (0.29 ± 0.03 pmol/L; P < 0.001), followed by a decrease from age 14 to 16 in both sexes (girls, by 0.53 ± 0.02 pmol/L; P < 0.001; boys, by 0.62 ± 0.03 pmol/L; P < 0.001). From age 12 to 14, TSH showed no significant change in girls or boys, then levels increased from age 14 to 16 in both sexes (in girls, by 4.9%, 95% CI: 2.4%-10.3%, P = 0.020; in boys, by 7.2%, 95% CI: 3.0%-11.6%, P = 0.001). Reference ranges differed substantially from adults, particularly for fT4 and fT3. Conclusions: Thyroid function tests in adolescents display complex, sexually dimorphic patterns. Implementation of adolescence-specific reference ranges may be appropriate.
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In older children, there is marked, sexually dimorphic variation in thyroid hormone parameters throughout puberty.
“In older children, there is marked, sexually dimorphic variation in thyroid hormone parameters throughout puberty.124,130”
From Hypothyroidism (2024) · cites this paper as [130]
The two longitudinal studies are largely consistent in showing an increase in TSH across the pubertal years.
“Although different age ranges were examined in these studies, these two longitudinal findings are largely consistent in the increase in TSH across the pubertal years.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
In the Brisbane Longitudinal Twin study, there was no change in TSH concentration from age 12 to 14 years but a subsequent increase from 14 to 16 years.
“The study reported no change in TSH concentration from age 12 to 14 years but with a subsequent increase from 14 to 16 years.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
Applying adult reference ranges to children in both longitudinal studies would have misclassified TSH as either abnormal or normal in 3-6% of the population.
“Applying the adult reference ranges to children in both studies would have misclassified TSH as either abnormal or normal in 3-6% of the population [32, 42].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
In the Brisbane Longitudinal Twin study, FT3 in girls showed minimal change from 12 to 14 years and then declined sharply from 14 to 16 years, whereas in boys it increased from age 12 to 14 and decreased by age 16 years.
“In the study by Campbell et al, FT3 in girls showed minimal change from 12 to 14 years and then declined sharply from 14 to 16 years whereas in boys it increased from age 12 to 14 and decreased by age 16 years [42].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
Application of the adult FT3 reference range would have misclassified 35% of 12-year-old girls and 58% of 14-year-old boys as high.
“Application of the adult FT3 reference range would have misclassified 35% of 12-year-old girls and 58% of 14-year-old boys as high [42].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
In the Brisbane Longitudinal Twin study, FT4 increased from age 14 to 16 years in both sexes.
“FT4 on the other hand increased from age 14 to 16 years in both sexes.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [42]
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“Application of the adult FT3 reference range would have misclassified 35% of 12-yearold girls and 58% of 14-year-old boys as high [42].”
BackgroundMethodInfluentialThyroid function across the lifespan: do age-related changes matter?
Walsh, J. P. (2022) · Endocrinology and Metabolism · doi:10.3803/enm.2022.1463 · Cited by 59 · see citing works
Self-citation
- Authors
- Campbell, P. J., Brown, S. J., Kendrew, P., Lewer, M., Lim, E. M., Joseph, J., Cross, S. M., Wright, M. J., Martin, N. G., Wilson, S. G., & Walsh, J. P.
- Affiliations
- Sir Charles Gairdner Hospital (AU)
- Pathwest Laboratory Medicine (AU)
- Pathwest Laboratory Medicine, Nedlands, WA, Australia
- QIMR Berghofer Medical Research Institute (AU)
- The University of Queensland (AU)
- The University of Western Australia (AU)
- Corresponding author
- Walsh, John P
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2020-01-10
- Volume
- 105
- Issue
- 4
- Pages
- e1162-e1170
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2999096055
- Cited by
- 22
- References
- 40
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 2
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- National Health and Medical Research Council (1031119)
- Australian Research Council (DP1093900)
- Research Advisory Committee (2019–20/028)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- thyroid function, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, age-specific reference ranges, sexual dimorphism, puberty, adolescents, body mass index
- MeSH terms
- Adolescent, Child, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Prognosis, Puberty, Reference Values, Sex Factors, Thyroid Function Tests, Thyroid Gland, Thyroid Hormones, Biomarkers
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