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Cited by 70Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

Effect of seasonal changes on the transition between subclinical hypothyroid and euthyroid status

Kim, Tae Hyuk, Kim, Kyung Won, Ahn, Hwa Young, Choi, Hoon Sung, Won, Hojeong, Choi, Yunhee, Cho, Sun Wook, Moon, Jae Hoon +6 more·2013·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2013-1607
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Abstract

CONTEXT: The widespread use of thyroid tests in asymptomatic individuals identifies many patients with transient subclinical hypothyroidism. OBJECTIVE: Our objective was to determine the effect of seasonal change on serum TSH levels and the transition between subclinical hypothyroid and euthyroid status. DESIGN, SETTING, AND SUBJECTS: This was a retrospective longitudinal study of 1751 subclinical hypothyroid and 28 096 euthyroid subjects aged over 18 years who underwent serial thyroid function tests at a health screening center between October 2003 and May 2011. MAIN OUTCOME MEASURES: Age-adjusted geometric mean values of the TSH level by month were calculated using linear mixed models. Adjusted odds ratios of test season and multiple baseline clinical factors were determined using generalized estimating equations. RESULTS: During a median 36 months of follow-up, 57.9% of subclinical hypothyroid subjects reverted to euthyroidism, and 4.3% of euthyroid subjects developed subclinical hypothyroidism. The monthly distribution of follow-up TSH levels indicated a biphasic pattern, ie, an increase during the winter-spring season and a decrease during the summer-fall season, with a maximal TSH difference of 0.69 mIU/L in subclinical hypothyroid and 0.30 mIU/L in euthyroid subjects. Normalization of subclinical hypothyroidism was increased 1.4-fold in follow-up tests during the summer-fall follow-up, whereas subclinical hypothyroidism increased 1.4-fold in euthyroid subjects during the winter-spring follow-up. CONCLUSIONS: The season in which thyroid testing was performed was independently related to the transition between subclinical hypothyroid and euthyroid status. Seasonal variations in TSH concentration should be considered before deciding on treatment of subclinical hypothyroidism, particularly in the areas with a wide annual temperature range.

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Crossref · 10.1210/jc.2013-1607

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  • Large population studies have shown that there are seasonal variations in TSH concentrations, with higher TSH in winter and spring than in summer and autumn.

    “Large population studies have also shown that there are seasonal variations in TSH concentrations, with higher TSH in winter and spring than in summer and autumn.114”

    From Hypothyroidism (2024) · cites this paper as [114]

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Authors
Kim, T. H., Kim, K. W., Ahn, H. Y., Choi, H. S., Won, H., Choi, Y., Cho, S. W., Moon, J. H., Yi, K. H., Park, D. J., Park, K. S., Jang, H. C., Kim, S. Y., & Park, Y. J.
Affiliations
  • Seoul National University (KR)
  • Chung-Ang University Hospital (KR)
  • Seoul National University Bundang Hospital (KR)
Corresponding author
Park, Young Joo
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2013-08
Volume
98
Issue
8
Pages
3420-3429
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2013-1607
OpenAlex
W2156758562
Cited by
70
References
36
Citations by year
2026: 3 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 10 · 2020: 5 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 3 · 2015: 6 · 2014: 7
FWCI
4.20
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • University of Seoul
  • College of Medicine, Seoul National University
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
subclinical hypothyroidism, seasonal variation, thyroid-stimulating hormone, euthyroid status, seasonal temperature, thyroid function tests
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Hypothyroidism, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Seasons, Social Class, Thyroid Diseases, Thyrotropin

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