Hypothyroidism: The difficulty in attributing symptoms to their underlying cause

Frontiers in Endocrinology, Год журнала: 2023, Номер 14

Опубликована: Фев. 6, 2023

Common symptoms of overt hypothyroidism are non-specific and include fatigue, lethargy, dry skin. Although the diagnosis is considered to be straightforward, no single symptom can used identify patients with hypothyroidism, while many subclinical asymptomatic. A large population-based study on spectrum in showed similar rates thyroid disease-related compared euthyroid subjects, TSH concentration had impact score. Together, these findings make it challenging attribute their underlying cause. This also true case unexplained persistent levothyroxine-treated patients. generally a life-long replacement therapy, successful hormone discontinuation resulting euthyroidism has been reported approximately one third Thus, we overtreat (subclinical) highlighting importance reliable diagnostic criteria. The process, including implementation robust FT4 reference intervals, especially specific situations aging, pregnancy, non-thyroidal illness, central hypothyroidism. There clear need for improved adherence current guidelines from scientific societies willingness manage without pathological correlate, mild elevations. review will highlight recent literature this topic offers some practice points.

Язык: Английский

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Brain fog in central disorders of hypersomnolence: a review

Journal of Clinical Sleep Medicine, Год журнала: 2024, Номер 20(4), С. 643 - 651

Опубликована: Янв. 16, 2024

Brain fog is an undefined term describing a cluster of symptoms related to fatigue and impaired memory, attention, concentration. or brain fog-like have been reported in central disorders hypersomnolence range seemingly unrelated disorders, including coronavirus disease 2019, major depressive disorder, multiple sclerosis, lupus, celiac disease. This narrative review summarizes current evidence proposes consensus definition for fog. prevalent narcolepsy idiopathic hypersomnia, with more than three-quarters patients either disorder reporting this symptom registry study; it has also as particularly difficult treat hypersomnia. Studies directly evaluating are rare; tools typically patient reports, few objective measures validated any disorder. Evaluating further complicated by confounding symptoms, such excessive daytime sleepiness, which hallmark disorders. No treatments specifically address The paucity literature, assessment tools, medications highlights the need research leading better disambiguation treatment. Until clear established, we propose hypersomnia be defined cognitive dysfunction that may not linked underlying neuronal dysfunction, reduces concentration impairs information processing, complaint lack clarity mental thinking awareness.

Язык: Английский

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Brain Fog in Hypothyroidism: What Is It, How Is It Measured, and What Can Be Done About It

Thyroid, Год журнала: 2022, Номер 32(7), С. 752 - 763

Опубликована: Апрель 13, 2022

Some levothyroxine (LT4)-treated hypothyroid patients report a constellation of persistent and distressing cognitive symptoms that has been termed brain fog. This narrative review focuses on attempts to define measure hypothyroid-associated fog, summarize possible etiologies contributing factors, present treatment options, propose avenues for future research.

Язык: Английский

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Unraveling brain fog in post‐COVID syndrome: Relationship between subjective cognitive complaints and cognitive function, fatigue, and neuropsychiatric symptoms

European Journal of Neurology, Год журнала: 2023, Номер unknown

Опубликована: Окт. 5, 2023

"Brain fog" is a frequent and disabling symptom that can occur after SARS-CoV-2 infection. However, its clinical characteristics the relationships among brain fog objective cognitive function, fatigue, neuropsychiatric symptoms (depression, anxiety) are still unclear. In this study, we aimed to examine of understand how performance, mutual these variables influence subjective complaints.A total 170 patients with complaints in context post-COVID syndrome were evaluated using comprehensive neuropsychological protocol. The FLEI scale was used characterize complaints. Correlation analysis, regression machine-learning algorithms, mediation analysis calculated.Cognitive mainly attention episodic memory symptoms, while executive functions (planning) issues less often reported. scale, mental ability questionnaire, showed high correlations fatigue moderate Stroop test, anxiety depressive symptoms. Random forest algorithms an R2 value 0.409 for prediction score, several tests, depression being best prediction. Mediation main mediator between cognition, effect indirect mediated through fatigue.Brain associated COVID-19 characterized by memory, which cognition. Our findings contribute understanding pathophysiology emphasize need unravel mechanisms underlying fog, considering aspects.

Язык: Английский

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Association between hypothyroidism subtypes and major depression: A two-sample Mendelian randomization study

Journal of Affective Disorders, Год журнала: 2024, Номер 351, С. 843 - 852

Опубликована: Фев. 8, 2024

Язык: Английский

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Mapping Thyroid Hormone Action in the Human Brain

Thyroid, Год журнала: 2024, Номер 34(7), С. 815 - 826

Опубликована: Май 17, 2024

Normal brain development, mood, and cognitive functions depend on thyroid hormone (TH) action. However, little is known about how TH mediates its actions in the human brain. This due to limited access brains deprived of during fetal early postnatal life, as well from adults with altered status. One way partially bypass these limitations by using magnetic resonance imaging spectroscopy, two neuroimaging techniques that provide detailed, noninvasive information structure function. Another human-induced pluripotent stem cell (hiPSCs)-derived three-dimensional

Язык: Английский

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Iron and ferritin deficiency in women with hypothyroidism and chronic lymphocytic thyroiditis — systematic review

Endokrynologia Polska, Год журнала: 2024, Номер unknown

Опубликована: Июнь 26, 2024

Iron is one of the essential microelements necessary for maintaining body's homeostasis. It serves various roles, including being a crucial component in proper structure many enzymes and supporting transport oxygen electrons. Its deficiency can lead to anaemia, which common clinical condition often associated with thyroid diseases. most nutritional deficiencies, its prevalence strongly socioeconomic status. primary cause anaemia 42% children 50% women. Importantly, iron placed among top 5 causes disability Thyroid peroxidase (TPO) an enzyme production hormones, key factor functioning. Therefore, case deficiency, activity this also reduced. that important epigenetic modification processes, may contribute genomic changes potentially promoting development autoimmune Adequate supplementation patients Hashimoto's disease elements effective therapy. In addition iodine, selenium, magnesium supplementation, attention should be paid intake. element heme — peroxidase, owes binding haem, function hormones. delivered body haem non-haem forms. The form found particularly haemoglobin-rich red meat, but eggs, fish, poultry. On other hand, legumes, grains, fruits, vegetables. Our study aimed gather summarise knowledge from scientific literature regarding association hypothyroidism women, as well possible mechanisms pathogenesis these conditions. paper aims highlight considering high risk assessing status along ferritin integral part additional diagnostic measures cases hypothyroidism, disease.

Язык: Английский

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Variable transduction of thyroid hormone signaling in structures of the mouse brain

Proceedings of the National Academy of Sciences, Год журнала: 2025, Номер 122(6)

Опубликована: Фев. 4, 2025

L-thyroxine (L-T4) monotherapy is the standard treatment for hypothyroidism, administered daily to normalize TSH levels. Once absorbed, T4 converted T3 alleviate most symptoms. However, this abnormally elevates plasma levels in over 50% of patients. Using L-T4-treated Thyroid Hormone (TH) Action Indicator mice, which express a T3-regulated luciferase (Luc) reporter, we examined whether these elevations disrupt TH signaling. Hypothyroid mice exhibited reduced Luc expression across brain regions, and L-T4 failed restore signaling uniformly. There was also variability activity type 2 deiodinase (D2), enzyme that generates T3. Intracerebroventricular administration achieved higher elevation mediobasal hypothalamus compared cortex, studies on cultured cortical astrocytes hypothalamic tanycytes revealed cell-type-specific responses T4. In tanycytes, exposure sustained D2 activity, leading progressive signaling, whereas astrocytes, triggered drop limiting production through ubiquitin-dependent, self-limiting mechanism. The linked rapid deubiquitination by USP33, as confirmed using ubiquitin-specific protease (USP) pan-inhibitor USP33 knockout mice. conclusion, brain’s response heterogeneous, influenced cell-specific regulation D2-mediated production. While exhibit limited due ubiquitination, coexpressing amplify rescuing ubiquitinated from proteasomal degradation. These findings provide mechanistic insights into limitations therapy highlight need tailored approaches managing hypothyroidism.

Язык: Английский

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Health information behavior during the life transition among people diagnosed with hypothyroidism

Journal of the Association for Information Science and Technology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 5, 2025

Abstract Being diagnosed with a chronic illness can lead to life transition that invokes new kinds of information behavior for an individual. This qualitative study focuses on behavior—particularly needs, use, and barriers—during the transitions people hypothyroidism. Ten interviews were conducted in 2022 individuals who The data analyzed using content analysis. Based intermediate theory by I. Ruthven, (An transitions. Journal Association Information Science & Technology , 73 (4), 579–593), process includes phases understanding, negotiating, resolving, as well processes event, engaging, enacting, establishing. findings, barriers varied according stage disease different stages transition. Interviewees had wide range needs related diagnosis, treatment balance, monitoring. use included promotion personal well‐being through physical activity improvement information‐seeking skills. most significant acquisition communication issues health care providers symptoms hypothyroidism such fatigue brain fog. For providers, results provide important knowledge during illness.

Язык: Английский

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Defining brain fog across medical conditions

Trends in Neurosciences, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

'Brain fog' is commonly reported in more than a dozen chronic diseases, but what it? We review research across conditions which has characterised brain fog and evaluate its definitions objective correlates. Brain been used to refer variable set of overlapping symptoms implicating cognition, fatigue, affect. It defined as distinct symptom, syndrome, or nonspecific term. consider the evidence that transdiagnostic entity with common phenomenology profile cognitive deficits. discuss where these commonalities arise argue linguistic ambiguity, shared impairments, noncognitive factors are likely neurobiology. suggest how future might apply existing tools disambiguate phenomena conflates.

Язык: Английский

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