Recent advances in thyroid hormone regulation: toward a new paradigm for optimal diagnosis and treatment
Open accessAbstract
In thyroid health, the pituitary hormone thyroid-stimulating hormone (TSH) raises glandular thyroid hormone production to a physiological level and enhances formation and conversion of T4 to the biologically more active T3. Overstimulation is limited by negative feedback control. In equilibrium defining the euthyroid state, the relationship between TSH and FT4 expresses clusters of genetically determined, interlocked TSH-FT4 pairs, which invalidates their statistical correlation within the euthyroid range. Appropriate reactions to internal or external challenges are defined by unique solutions and homeostatic equilibria. Permissible variations in an individual are much more closely constrained than over a population. Current diagnostic definitions of subclinical thyroid dysfunction are laboratory based, and do not concur with treatment recommendations. An appropriate TSH level is a homeostatic concept that cannot be reduced to a fixed range consideration. The control mode may shift from feedback to tracking where TSH becomes positively, rather than inversely related with FT4. This is obvious in pituitary disease and severe non-thyroid illness, but extends to other prevalent conditions including aging, obesity, and levothyroxine (LT4) treatment. Treatment targets must both be individualized and respect altered equilibria on LT4. To avoid amalgamation bias, clinically meaningful stratification is required in epidemiological studies. In conclusion, pituitary TSH cannot be readily interpreted as a sensitive mirror image of thyroid function because the negative TSH-FT4 correlation is frequently broken, even inverted, by common conditions. The interrelationships between TSH and thyroid hormones and the interlocking elements of the control system are individual, dynamic, and adaptive. This demands a paradigm shift of its diagnostic use.
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These setpoints also seem to extend to LT4-treated patients.
“These setpoints also seem to extend to LT4-treated patients [14,15,16].”
From Changes in Thyroid Metabolites after Liothyronine Administration: A Secondary Analysis of Two Clinical Trials That Incorporated Pharmacokinetic Data (2022) · cites this paper as [15]
A 20% decrease in T4 can increase TSH levels by as much as 2-fold, particularly in patients with no thyroid remnant, as partially functioning thyroids can serve as a buffer.
“A 20% decrease in T4 can increase TSH levels by as much as 2-fold, particularly in patients with no thyroid remnant, as partially functioning thyroids can serve as a buffer (37).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [37]
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Cites
Stagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E. N., Soldin, O. P., Sullivan, S., et al. (2011) · Thyroid · doi:10.1089/thy.2011.0087 · Cited by 2,942 · see citing works
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
Alexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., et al. (2017) · Thyroid® · doi:10.1089/thy.2016.0457 · Cited by 2,731 · see citing works
The interpretation of interaction in contingency tables
Simpson, E. H. (1951) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1951.tb00088.x · Cited by 2,301 · cited 1× · see citing works
“The heterogeneity bias is known as Simpson’s amalgamation paradox (75, 76).”
BackgroundJonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
Subclinical Hypothyroidism and the Risk of Coronary Heart Disease and Mortality
Rodondi, N., den Elzen, W. P. J., Bauer, D. C., Cappola, A. R., Razvi, S., Walsh, J. P., Åsvold, B. O., Iervasi, G., Imaizumi, M., Collet, T.-H., et al. (2010) · JAMA · doi:10.1001/jama.2010.1361 · Cited by 1,216 · see citing works
Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease
(2003) · Thyroid · doi:10.1089/105072503321086962 · Cited by 1,212 · see citing works
Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30703-1 · Cited by 1,159 · see citing works
Latent Variable Modeling in Heterogeneous Populations
Muthén, B. (1989) · Psychometrika · doi:10.1007/bf02296397 · Cited by 1,008 · see citing works
Thyroid Status, Disability and Cognitive Function, and Survival in Old Age
Gussekloo, J. (2004) · JAMA · doi:10.1001/jama.292.21.2591 · Cited by 899 · see citing works
Cellular and Molecular Basis of Deiodinase-Regulated Thyroid Hormone Signaling1
Gereben, B., Zavacki, A. M., Ribich, S., Kim, B. W., Huang, S. A., Simonides, W. S., Zeöld, A., & Bianco, A. C. (2008) · Endocrine Reviews · doi:10.1210/er.2008-0019 · Cited by 891 · see citing works
2013 ETA Guideline: Management of Subclinical Hypothyroidism
Pearce, S. H. S., Brabant, G., Duntas, L. H., Monzani, F., Peeters, R. P., Razvi, S., & Wemeau, J.-L. (2013) · European Thyroid Journal · doi:10.1159/000356507 · Cited by 877 · see citing works
Andersen, S., Pedersen, K. M., Bruun, N. H., & Laurberg, P. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8165 · Cited by 686 · see citing works
Cooper, D. S. (2001) · New England Journal of Medicine · doi:10.1056/nejm200107263450406 · Cited by 524 · see citing works
Saravanan, P., Chau, W. ‐., Roberts, N., Vedhara, K., Greenwood, R., & Dayan, C. M. (2002) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2002.01654.x · Cited by 514 · see citing works
Hypothalamic tanycytes: a key component of brain-endocrine interaction
RODRIGUEZ, E., BLAZQUEZ, J., PASTOR, F., PELAEZ, B., PENA, P., PERUZZO, B., & AMAT, P. (2005) · International review of cytology · doi:10.1016/s0074-7696(05)47003-5 · Cited by 475 · cited 1× · see citing works
“While detailed examination of the complex subject is beyond the scope of this article and dedicated reviews are available (36, 39, 41, 43, 45, 46), a brief explanation may be helpful.”
Background2012 ETA Guidelines: The Use of L-T4 + L-T3 in the Treatment of Hypothyroidism
Wiersinga, W. M., Duntas, L., Fadeyev, V., Nygaard, B., & Vanderpump, M. P. J. (2012) · European Thyroid Journal · doi:10.1159/000339444 · Cited by 427 · see citing works
Minireview: Thyroid Hormone Transporters: The Knowns and the Unknowns
Visser, W. E., Friesema, E. C. H., & Visser, T. J. (2011) · Molecular Endocrinology · doi:10.1210/me.2010-0095 · Cited by 390 · see citing works
Simpson's Paradox in Real Life
Wagner, C. H. (1982) · The American Statistician · doi:10.1080/00031305.1982.10482778 · Cited by 389 · see citing works
Zulewski, H., Müller, B., Exer, P., Miserez, A. R., & Staub, J.-J. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.3.3810 · Cited by 389 · see citing works
Thyroid-Pituitary Interaction: Feedback Regulation of Thyrotropin Secretion by Thyroid Hormones
Bleich, H. L., Moore, M. J., & Larsen, P. R. (1982) · New England Journal of Medicine · doi:10.1056/nejm198201073060107 · Cited by 357 · see citing works
Fekete, C., & Lechan, R. M. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1087 · Cited by 342 · see citing works
Thyroid and Obesity: An Intriguing Relationship
Biondi, B. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1245 · Cited by 330 · see citing works
Non-Thyroidal Illness in the ICU: A Syndrome with Different Faces
Van den Berghe, G. (2014) · Thyroid® · doi:10.1089/thy.2014.0201 · Cited by 316 · see citing works
Levothyroxine Monotherapy Cannot Guarantee Euthyroidism in All Athyreotic Patients
Gullo, D., Latina, A., Frasca, F., Le Moli, R., Pellegriti, G., & Vigneri, R. (2011) · PLoS ONE · doi:10.1371/journal.pone.0022552 · Cited by 307 · see citing works
Wekking, E. M., Appelhof, B. C., Fliers, E., Schene, A. H., Huyser, J., Tijssen, J. G. P., & Wiersinga, W. M. (2005) · European Journal of Endocrinology · doi:10.1530/eje.1.02025 · Cited by 299 · see citing works
Grozinsky-Glasberg, S., Fraser, A., Nahshoni, E., Weizman, A., & Leibovici, L. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0448 · Cited by 296 · see citing works
Thyroid Hormone Concentrations, Disease, Physical Function, and Mortality in Elderly Men
van den Beld, A. W., Visser, T. J., Feelders, R. A., Grobbee, D. E., & Lamberts, S. W. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0872 · Cited by 294 · see citing works
Thyroid hormone transporters—functions and clinical implications
Bernal, J., Guadaño‐Ferraz, A., & Morte, B. (2015) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2015.66 · Cited by 293 · see citing works
Selmer, C., Olesen, J. B., Hansen, M. L., von Kappelgaard, L. M., Madsen, J. C., Hansen, P. R., Pedersen, O. D., Faber, J., Torp-Pedersen, C., & Gislason, G. H. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4184 · Cited by 288 · see citing works
Escobar-Morreale, H. F., del Rey, F. E., Obregón, M. J., & de Escobar, G. M. (1996) · Endocrinology · doi:10.1210/endo.137.6.8641203 · Cited by 261 · see citing works
Treatment with thyroid hormone
Biondi, B., & Wartofsky, L. (2014) · Endocrine Reviews · doi:10.1210/er.2013-1083 · Cited by 259 · see citing works
Baumgartner, C., da Costa, B. R., Collet, T., Feller, M., Floriani, C., Bauer, D. C., Cappola, A. R., Heckbert, S. R., Ceresini, G., Gussekloo, J., et al. (2017) · Circulation · doi:10.1161/circulationaha.117.028753 · Cited by 256 · see citing works
Biologic Variation is Important for Interpretation of Thyroid Function Tests
Andersen, S., Bruun, N. H., Pedersen, K. M., & Laurberg, P. (2003) · Thyroid · doi:10.1089/105072503770867237 · Cited by 241 · see citing works
Waring, A. C., Arnold, A. M., Newman, A. B., Bùžková, P., Hirsch, C., & Cappola, A. R. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2481 · Cited by 237 · see citing works
Hyperthyrotropinemia in Obese Children Is Reversible after Weight Loss and Is Not Related to Lipids
Reinehr, T., de Sousa, G., & Andler, W. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0095 · Cited by 235 · see citing works
Russell, W., Harrison, R. F., Smith, N., Darzy, K., Shalet, S., Weetman, A. P., & Ross, R. J. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2674 · Cited by 219 · see citing works
Vadiveloo, T., Donnan, P. T., Murphy, M. J., & Leese, G. P. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3191 · Cited by 204 · see citing works
Hadlow, N. C., Rothacker, K. M., Wardrop, R., Brown, S. J., Lim, E. M., & Walsh, J. P. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-4223 · Cited by 203 · see citing works
Werner and Ingbarʼs The Thyroid
Goldman, J. A. (1993) · The Endocrinologist · doi:10.1097/00019616-199305000-00008 · Cited by 199 · see citing works
Quality of Life in Thyroid Cancer is Similar to That of Other Cancers with Worse Survival
Applewhite, M. K., James, B. C., Kaplan, S. P., Angelos, P., Kaplan, E. L., Grogan, R. H., & Aschebrook‐Kilfoy, B. (2015) · World Journal of Surgery · doi:10.1007/s00268-015-3300-5 · Cited by 196 · see citing works
Ehrenkranz, J., Bach, P. R., Snow, G. L., Schneider, A., Lee, J. L., Ilstrup, S., Bennett, S. T., & Benvenga, S. (2015) · Thyroid · doi:10.1089/thy.2014.0589 · Cited by 190 · see citing works
Ott, J., Promberger, R., Kober, F., Neuhold, N., Tea, M., Huber, J. C., & Hermann, M. (2011) · Thyroid · doi:10.1089/thy.2010.0191 · Cited by 190 · see citing works
Werneck de Castro, J. P., Fonseca, T. L., Ueta, C. B., McAninch, E. A., Abdalla, S., Wittmann, G., Lechan, R. M., Gereben, B., & Bianco, A. C. (2015) · Journal of Clinical Investigation · doi:10.1172/jci77588 · Cited by 184 · cited 2× · see citing works
“This was, however, done in rodents where various tissues remained in the hypothyroid state on LT4 monotherapy despite normal serum TSH levels, and only T3/ T4 combination could restore euthyroidism in tissues (91, 92).”
BackgroundIs a Normal TSH Synonymous With “Euthyroidism” in Levothyroxine Monotherapy?
Peterson, S. J., McAninch, E. A., & Bianco, A. C. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2660 · Cited by 182 · see citing works
Sheehan, M. T. (2016) · Clinical Medicine & Research · doi:10.3121/cmr.2016.1309 · Cited by 179 · see citing works
Rieben, C., Segna, D., da Costa, B. R., Collet, T., Chaker, L., Aubert, C. E., Baumgartner, C., Almeida, O. P., Hogervorst, E., Trompet, S., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2129 · Cited by 178 · see citing works
Chatzitomaris, A., Hoermann, R., Midgley, J. E. M., Hering, S., Urban, A., Dietrich, B., Abood, A., Klein, H. H., & Dietrich, J. W. (2017) · Frontiers in Endocrinology · doi:10.3389/fendo.2017.00163 · Cited by 176 · see citing works
Self-citationA NEW STRATEGY FOR THYROID FUNCTION TESTING
Caldwell, G., Gow, S., SWEETING, V. M., Kellett, H. A., Beckett, G. J., Seth, J., & Toft, A. D. (1985) · The Lancet · doi:10.1016/s0140-6736(85)92429-8 · Cited by 169 · see citing works
TSH stimulates leptin secretion by a direct effect on adipocytes
Menendez, C. E. E. A., Baldelli, R., Camiña, J. P., Escudero, B., Peino, R., Diéguez, C., & Casanueva, F. F. (2003) · Journal of Endocrinology · doi:10.1677/joe.0.1760007 · Cited by 158 · see citing works
Winther, K. H., Cramon, P., Watt, T., Bjorner, J. B., Ekholm, O., Feldt-Rasmussen, U., Groenvold, M., Rasmussen, Å. K., Hegedüs, L., & Bonnema, S. J. (2016) · PLOS ONE · doi:10.1371/journal.pone.0156925 · Cited by 152 · see citing works
Scope and limitations of iodothyronine deiodinases in hypothyroidism
Gereben, B., McAninch, E. A., Ribeiro, M. O., & Bianco, A. C. (2015) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2015.155 · Cited by 146 · see citing works
Homeostatic control of the thyroid-pituitary axis: perspectives for diagnosis and treatment
Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2015) · Frontiers in Endocrinology · doi:10.3389/fendo.2015.00177 · Cited by 143 · see citing works
Self-citationCentral hypothyroidism — a neglected thyroid disorder
Beck-Peccoz, P., Rodari, G., Giavoli, C., & Lania, A. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.47 · Cited by 140 · see citing works
Fekete, C., & Lechan, R. M. (2007) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2007.04.002 · Cited by 137 · see citing works
Ito, M., Miyauchi, A., Morita, S., Kudo, T., Nishihara, E., Kihara, M., Takamura, Y., Ito, Y., Kobayashi, K., Miya, A., et al. (2012) · European Journal of Endocrinology · doi:10.1530/eje-11-1029 · Cited by 133 · see citing works
Thienpont, L. M., Van Uytfanghe, K., Beastall, G., Faix, J. D., Ieiri, T., Miller, W. G., Nelson, J. C., Ronin, C., Ross, H. A., Thijssen, J. H., et al. (2010) · Clinical Chemistry · doi:10.1373/clinchem.2009.140178 · Cited by 128 · see citing works
Thyroid function in the nutritionally obese child and adolescent
Reinehr, T. (2011) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e328344c393 · Cited by 127 · see citing works
MECHANISMS IN ENDOCRINOLOGY: Beyond the fixed setpoint of the hypothalamus–pituitary–thyroid axis
Fliers, E., Kalsbeek, A., & Boelen, A. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0285 · Cited by 124 · see citing works
Panicker, V., Evans, J., Bjøro, T., Åsvold, B. O., Dayan, C. M., & Bjerkeset, O. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03521.x · Cited by 121 · see citing works
Endocrine Responses to Critical Illness: Novel Insights and Therapeutic Implications
Boonen, E., & Van den Berghe, G. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4115 · Cited by 105 · see citing works
Simpson's Paradox in Real Life
Wagner, C. H. (1982) · The American Statistician · doi:10.2307/2684093 · Cited by 104 · see citing works
Complex relationship between free thyroxine and TSH in the regulation of thyroid function
Hoermann, R., Eckl, W., Hoermann, C., & Larisch, R. (2010) · European Journal of Endocrinology · doi:10.1530/eje-10-0106 · Cited by 101 · see citing works
Peeters, R. P. (2008) · Hormones · doi:10.14310/horm.2002.1111035 · Cited by 98 · see citing works
Biochemical Markers Reflecting Thyroid Function in Athyreotic Patients on Levothyroxine Monotherapy
Ito, M., Miyauchi, A., Hisakado, M., Yoshioka, W., Ide, A., Kudo, T., Nishihara, E., Kihara, M., Ito, Y., Kobayashi, K., et al. (2017) · Thyroid · doi:10.1089/thy.2016.0426 · Cited by 91 · see citing works
Quality of life in patients with primary hypothyroidism related to BMI
Bolk, N., Visser, T. J., Tijssen, J. G. P., & Berghout, A. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0395 · Cited by 87 · see citing works
Hoermann, R., Midgley, J. E. M., Giacobino, A., Eckl, W. A., Wahl, H. G., Dietrich, J. W., & Larisch, R. (2014) · Clinical Endocrinology · doi:10.1111/cen.12527 · Cited by 82 · see citing works
Self-citationYeap, B. B., Alfonso, H. S., Hankey, G. J., Flicker, L. A., Golledge, J., Norman, P. E., & Chubb, S. A. P. (2013) · European Journal of Endocrinology · doi:10.1530/eje-13-0306 · Cited by 80 · see citing works
Regulation of TRH neurons and energy homeostasis-related signals under stress
Joseph‐Bravo, P., Jaimes-Hoy, L., & Charli, J. (2015) · Journal of Endocrinology · doi:10.1530/joe-14-0593 · Cited by 76 · see citing works
TSH enhancement of FT4 to FT3 conversion is age dependent
Strich, D., Karavani, G., Edri, S., & Gillis, D. (2016) · European Journal of Endocrinology · doi:10.1530/eje-16-0007 · Cited by 72 · see citing works
Induction of Outer and Inner Ring Monodeiodinases in Human Thyroid Gland by Thyrotropin
Ishii, H., Inada, M., Tanaka, K., Mashio, Y., Naito, K., Nishikawa, M., Matsuzuka, F., Kuma, K., & Imura, H. (1983) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-57-3-500 · Cited by 67 · see citing works
Subclinical hypothyroidism: Should we treat?
Redford, C., & Vaidya, B. (2017) · Post Reproductive Health · doi:10.1177/2053369117705058 · Cited by 66 · see citing works
Role of thyroid hormones in the neoplastic process: an overview
Goemann, I. M., Romitti, M., Meyer, E. L. D. S., Wajner, S. M., & Maia, A. L. (2017) · Endocrine Related Cancer · doi:10.1530/erc-17-0192 · Cited by 66 · see citing works
Inoue, K., Tsujimoto, T., Saito, J., & Sugiyama, T. (2016) · Thyroid · doi:10.1089/thy.2016.0156 · Cited by 63 · see citing works
Wan, W., Farboud, B., & Privalsky, M. L. (2005) · Molecular Endocrinology · doi:10.1210/me.2005-0014 · Cited by 61 · see citing works
Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2013) · European Journal of Endocrinology · doi:10.1530/eje-12-0819 · Cited by 59 · cited 2× · see citing works
“Clinical studies and theoretical modeling suggest that the shunt facilitates FT3 stability against variations in the glandular T4 output, and its absence may lead to T3 production instability in athyreotic patients (31, 33).”
BackgroundHerwig, A., Campbell, G., Mayer, C., Boelen, A., Anderson, R. A., Ross, A., Mercer, J. G., & Barrett, P. (2014) · Thyroid · doi:10.1089/thy.2014.0169 · Cited by 57 · see citing works
Hedman, C., Djärv, T., Strang, P. M., & Lundgren, C. I. (2017) · Thyroid · doi:10.1089/thy.2016.0604 · Cited by 57 · see citing works
Grasberger, H., & Refetoff, S. (2017) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2017.03.004 · Cited by 55 · see citing works
Kalló, I., Mohácsik, P., Vida, B., Zeöld, A., Bardóczi, Z., Zavacki, A. M., Farkas, E., Kádár, A., Hrabovszky, E., Arrojo e Drigo, R., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0037860 · Cited by 52 · see citing works
THERAPY OF ENDOCRINE DISEASE: T4 + T3 combination therapy: is there a true effect?
Wiersinga, W. M. (2017) · European Journal of Endocrinology · doi:10.1530/eje-17-0645 · Cited by 52 · see citing works
Ito, M., Miyauchi, A., Kang, S., Hisakado, M., Yoshioka, W., Ide, A., Kudo, T., Nishihara, E., Kihara, M., Ito, Y., et al. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0138 · Cited by 51 · see citing works
Hoermann, R., Midgley, J., Larisch, R., & Dietrich, J. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0034-1398616 · Cited by 50 · see citing works
Self-citationRelational Stability in the Expression of Normality, Variation, and Control of Thyroid Function
Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2016) · Frontiers in Endocrinology · doi:10.3389/fendo.2016.00142 · Cited by 48 · see citing works
Self-citationBrown, S. J., Bremner, A. P., Hadlow, N. C., Feddema, P., Leedman, P. J., O'Leary, P. C., & Walsh, J. P. (2016) · Clinical Endocrinology · doi:10.1111/cen.13107 · Cited by 46 · see citing works
Expanding the Role of Thyroid-Stimulating Hormone in Skeletal Physiology
Baliram, R., Latif, R., Zaidi, M., & Davies, T. F. (2017) · Frontiers in Endocrinology · doi:10.3389/fendo.2017.00252 · Cited by 46 · see citing works
Age modifies the pituitary TSH response to thyroid failure
Carlé, A., Laurberg, P., Pedersen, I. B., Perrild, H., Ovesen, L., Rasmussen, L. B., Jorgensen, T., & Knudsen, N. (2007) · Thyroid · doi:10.1089/thy.2006.0191 · Cited by 45 · see citing works
De novo triiodothyronine formation from thyrocytes activated by thyroid-stimulating hormone
Citterio, C. E., Veluswamy, B., Morgan, S. J., Galton, V. A., Banga, J. P., Atkins, S., Morishita, Y., Neumann, S., Latif, R., Gershengorn, M. C., et al. (2017) · Journal of Biological Chemistry · doi:10.1074/jbc.m117.784447 · Cited by 42 · see citing works
The relationship between serum TSH and free T4 in older people: Figure 1
Clark, P. M., Holder, R. L., Haque, S. M., Hobbs, F. D. R., Roberts, L. M., & Franklyn, J. A. (2012) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2011-200433 · Cited by 40 · see citing works
New insights into the variable effectiveness of levothyroxine monotherapy for hypothyroidism
McAninch, E. A., & Bianco, A. C. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00325-3 · Cited by 39 · see citing works
Erratum to “Cell-Type-Dependent Thyroid Hormone Effects on Glioma Tumor Cell Lines”
Liappas, A., Mourouzis, I. S., Zisakis, A., Economou, K., Lea, R.-W., & Pantos, C. I. (2012) · Journal of Thyroid Research · doi:10.1155/2012/176281 · Cited by 36 · see citing works
Midgley, J. E. M., Hoermann, R., Larisch, R., & Dietrich, J. W. (2013) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2012-201213 · Cited by 35 · see citing works
Self-citationHoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2016) · European Thyroid Journal · doi:10.1159/000447967 · Cited by 35 · see citing works
Self-citationMammen, J. S., McGready, J., Ladenson, P. W., & Simonsick, E. M. (2017) · Thyroid® · doi:10.1089/thy.2017.0211 · Cited by 34 · see citing works
Defining optimal health range for thyroid function based on the risk of cardiovascular disease
Chaker, L., Korevaar, T. I. M., Rizopoulos, D., Collet, T.-H., Völzke, H., Hofman, A., Rodondi, N., Cappola, A. R., Peeters, R. P., & Franco, O. H. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-00410 · Cited by 33 · see citing works
TSH Measurement and Its Implications for Personalised Clinical Decision-Making
Hoermann, R., & Midgley, J. E. M. (2012) · Journal of Thyroid Research · doi:10.1155/2012/438037 · Cited by 32 · see citing works
Self-citationMidgley, J. E. M., Larisch, R., Dietrich, J. W., & Hoermann, R. (2015) · Endocrine Connections · doi:10.1530/ec-15-0056 · Cited by 31 · see citing works
Self-citationMidgley, J. E. M., Larisch, R., Dietrich, J. W., & Hoermann, R. (2015) · Endocrine Connections · doi:10.1530/ec-150056 · Cited by 31 · see citing works
Self-citationTandem Mass Spectrometry as a Novel Tool for Elucidating Pituitary–Thyroid Relationships
Jonklaas, J., & Soldin, S. J. (2008) · Thyroid · doi:10.1089/thy.2008.0155 · Cited by 26 · see citing works
Advances in applied homeostatic modelling of the relationship between thyrotropin and free thyroxine
Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2017) · PLoS ONE · doi:10.1371/journal.pone.0187232 · Cited by 23 · see citing works
Self-citationClinical Response to Thyroxine Sodium in Clinically Hypothyroid but Biochemically Euthyroid Patients
Skinner, G. R. B., Holmes, D., Ahmad, A., Davies, J. A., & Benitez, J. (2000) · Journal of Nutritional & Environmental Medicine · doi:10.1080/13590840050043530 · Cited by 16 · see citing works
van de Ven, A. C., Netea-Maier, R. T., Medici, M., Sweep, F. C. G. J., Ross, H. A., Albert Hofman, D., Graaf, J. D., Kiemeney, L. A. L. M., Hermus, A. R., Peeters, R. P., et al. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-0680 · Cited by 15 · see citing works
Hoermann, R., Cheung, A. S., Milne, M., & Grossmann, M. (2017) · Journal of the Endocrine Society · doi:10.1210/js.2017-00057 · Cited by 13 · see citing works
Self-citationHoermann, R., Midgley, J. E. M., Dietrich, J. W., & Larisch, R. (2017) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018817716401 · Cited by 13 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [7]Spencer CA Thyroid function tests: assay of thyroid hormones and related substances. Thyroid Disease Manager. (2017). Available from: http://www.thyroidmanager.org/chapter/assay-of-thyroid-hormones-and-related-substances3/
Cited by
Sorted by citations
Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility
Soh, S.-B., & Aw, T.-C. (2019) · Annals of Laboratory Medicine · doi:10.3343/alm.2019.39.1.3 · Cited by 136 · see citing works
Optimal thyroid hormone replacement
Jonklaas, J. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab031 · Cited by 89 · see citing works
Levothyroxine: conventional and novel drug delivery formulations.
Liu, H., Li, W., Zhang, W., Sun, S., & Chen, C. (2023) · Endocrine Reviews · doi:10.1210/endrev/bnac030 · Cited by 63 · see citing works
Werneck, F. Z., Coelho, E. F., Almas, S. P., Garcia, M. M. D. N., Bonfante, H. L. M., Lima, J. R. P. D., Vigário, P. D. S., Mainenti, M. R. M., Teixeira, P. D. F. D. S., & Vaisman, M. (2018) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000073 · Cited by 57 · see citing works
“A point (1) was assigned when the presence of signal or symptoms or zero (0) in his absence was found.”
BackgroundLevothyroxine/Liothyronine Combination Therapy and Quality of Life: Is It All about Weight Loss?
Michaelsson, L. F., la Cour, J. L., Medici, B. B., Watt, T., Faber, J., & Nygaard, B. (2018) · European Thyroid Journal · doi:10.1159/000490383 · Cited by 30 · see citing works
Pang, X., Pu, T., Xu, L., & Sun, R. (2020) · Clinical Endocrinology · doi:10.1111/cen.14172 · Cited by 26 · see citing works
Hoermann, R., Pekker, M. J., Midgley, J. E. M., Larisch, R., & Dietrich, J. W. (2020) · European Journal of Clinical Investigation · doi:10.1111/eci.13192 · Cited by 14 · see citing works
Self-citationDiab, N., Desale, S., Danielsen, M., Köhrle, J., Shara, N., & Jonklaas, J. (2022) · Metabolites · doi:10.3390/metabo12060476 · Cited by 1 · see citing works
- Authors
- Hoermann, R., Midgley, J. E. M., Larisch, R., & Dietrich, J. W.
- Affiliations
- Klinikum Lüdenscheid (DE)
- Witten/Herdecke University (DE)
- Corresponding author
- Hoermann, Rudolf
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2017-12-22
- Volume
- 8
- Pages
- 364-364
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC5763098
- OpenAlex
- W2779801487
- Cited by
- 69
- References
- 104
- Citations by year
- 2026: 1 · 2025: 12 · 2024: 6 · 2023: 4 · 2022: 12 · 2021: 7 · 2020: 13 · 2019: 8 · 2018: 6
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- thyroid-stimulating hormone, free thyroxine, negative feedback control, thyroid homeostasis, subclinical thyroid dysfunction, levothyroxine therapy, pituitary disorders, aging, obesity, thyroid function diagnosis
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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