Status of the thyroid gland in pregnancy and its relation to postpartum depression

OBJECTIVES: Adequate adjustments by the hypothalamic-pituitary-thyroid axis during pregnancy allow women to remain euthyroid with only slight changes in thyroid volume and other thyroid functions. In approximately 10 percent of women, the challenge of thyroid economy results in sub-clinical hypothyroidism. This study is to elucidate the association between such hypothyroidism and postpartum depression, if any. METHOD: Blood samples were collected from 73 healthy subjects attending the antenatal clinc of the University Hospital of the West Indies, at booking, 28 weeks, 36 weeks of gestation, and 1 day and 6 weeks postpartum. Serum level of total thyroxine, free tri-iodothyronine, and thyroid stimulating hormone (TSH) were determined by radioimmunoassays. The thyroid volume was estimated by ultrasonography in some subjects. A self-rating depression scale was administered at 28 weeks of gestation and at 6 weeks postpartum for quantitative measurement of depression. The preliminary results revealed that 22 subjects (30 percent) had postpartum depression, 12 (16 percent) had mild depressin and 10 (14 percent) had moderated to marked depression. Of these, only 2 subjects had total thyroxine values less than 5.5g/100 ml and TSH values greater than 2.5 IU/ml. There were no significant changes between postpartum and antepartum thyroid volumes. CONCLUSION: Although a significant number of women in this study had postpartum depression, no significant relationship between depression and the serum levels of thyroid hormones was established.(Au)

Abnormal thyroid hormone and thyrotropin levels in homozygous sickle cell disease

Male patients with SS disease had significantly lower T3 and higher TSH levels than a comparison group. Stimulation with TRH in 10 male sibling pairs showed highly significant increases in T3 and TSH in both patients and sibling controls although the increase in TSH was significantly greater in SS disease. The interpretation of these findings unclear although the thyroid indices indicate an abnormal pituitary-thyroid axis most consistent with a modest primary thyroid failure

Thyroid-gonad relationship in chronic schizophrenia - abstract

The effects of the severity of psychiatric illness on thyroid functions and their relationship to serum testosterone were studied in 38 men of African origin in Bellevue Hospital suffering from schizophrenia of 3-11 years' duration. Serum levels of thyroxin (T4), triiodothyronine (T3) uptake (T3U), thyrotropin (TSH), free thyroxin index (FT4I), testosterone, luteinizing hormone (LH), prolactin and cortisol were determined, using specific radio-immuno-assay kits. The results were compared with 22 age-matched healthy control subjects. Mean serum levels of T4, T3, FT4I and testosterone were significantly (p<0.01) lower than control subjects. This indicates decreased thyroid-gonadal activity in acutely psychotic patients. Serum T4 and FT4I were significantly (p<0.05) higher, whereas serum TSH, testosterone and cortisol were lower in patients who were in remission. This may indicate the existence of a 'rebound' phenomenon. Levels of both FT4I and testosterone in clinically stable patients, however, were not different from those in healthy control subjects, suggesting recovery from the illness. No significant differences either in serum thyroid or gonadal hormones were observed between patients exhibiting depression or elated affects; or amongst disorganized, catatonic, paranoid and undifferentiated types of schizophrenics or in patients treated with different neuroleptic drugs. Simultaneous decreases in both thyroidal and gonadal hormones, with normal levels of pituitary hormones (TSH, LH and prolactin), suggest dysfunction of the pituitary-thyroid-gonad axis in acutely psychotic patients. It is hypothesised that some common mechanism(s) which may involve hypothalamic TRH and/or dopamine is (are) responsible for such dysfunction during schizophrenic illness (AU)

Free and total triiodothyronine and thyroxine in malnourished Jamaican infants. The effect of diet on plasma levels of thyroid hormones, insulin and glucose during recovery

Plasma concentrations of free triiodothyronine (FT3), total triiodothyronine (TT3) and total thyroxine (TT4) were reduced to 63.0, 37.7, 61.7 per cent of controls respectively in protein-energy malnutrition (PEM), while free thyroxine (FT4) was elevated by 23 per cent. There was a gradual increase of both TT4 and TT3 during recovery. The ratio of free to bound hormones was high in malnutrition and declined with recovery, indicating a deficiency of thyroid-hormone binding in malnutrition. The observation of a significant reduction (P<0.05) in T3/T4 ratios, which occurred in malnutrition and was induced during recovery after 3 d on a low energy maintenance diet, suggested depressed conversion of T4 to T3 due to energy restriction. Energy restriction also significantly (P<0.001) depressed plasma insulin concentrations in the presence of nearly constant glucose levels. (AU)

Thyroid-gonad relationship in marijuana smokers: a field study in Jamaica

Serum concentrations of thyroxine (T4), triiodothyronine (T3), thyrotropin (TSH), T3 uptake (T3U), free thyroxine index (FTI) and testosterone were studied by radioimmunoassays to elucidate thyroid-gonad relationship in 26 male marijuana smokers in Jamaica. Serum T3 levels were significantly lower (p<0.05) in smokers compared with non-smokers, whereas serum T4, TSH, T3U, FTI and testosterone levels were found to be within normal limits. Decrease in serum T3 levels has been attributed to ingestion of tetrahydrocannabinol in addition to other factors associated with marijuana smoking. Such a profile of thyroid hormones, with no change in TSH, is suggestive of euthyroidism in smokers. The study also did not indicate any alteration in the pituitary-thyroid-gonad axis in chronic marijuana smokers (AU)

Altered thyroid status in marihuana-exposed male rats

The effects of marihuana exposure, particularly of THC-free crude aqueous marihuana extract (CAME) on liver gycogen, total plasma cholesterol, BMR, Raw and growth rate were studied in male Wistar rats. Liver glycogen decreased following administration of CAME and T4 (P<0.01), and increased with methimazole (P<0.01). However, marihuana smoking did not affect liver glycogen. Both marihuana smoking and CAME administration decreased the levels of plasma cholesterol (P<0.01), and methimazole increased them (P,0.01). Airway resistance decreased in rats treated with CAME, T4 and marihuana smoking and decreased with methimazole. The growth rate with marihuana exposure improved slightly (AU)

Thyroid function in euthyroid Jamaicans

Thyroid function has been investigated in 32 hospitalized euthyroid Jamaicans. The in vivo investigations performed were measurement of 2«, 4 and 24 hr thyroidal uptake of 131I, thyroidal and renal clearances of radioiodide, absolute iodide uptakes and, in 6 subjects, radiothyroxine turnover studies. Thyroxine binding globulin and prealbumin capacities were measured in a small number of cases. Results obtained in all these investigations agreed well with those found in temperate climates and are at variance with previous finding of low 24 hr thyroidal uptakes of 131I in euthyroid Jamaicans, associated with a normal serum protein-bound iodine.(AU)

Thyroxine turnover studies in Jamaicans

Radioactively labelled thyroxine (T4 - 125 I) has been used to carry out studies on thyroxine turnover in Jamaicans subjects. The decrease in plasma radioactivity following intravenous injection of labelled T4 has two components. The slow component lasting from 1 to 10 days post injection may be mathematically analysed to give the following data: (a) thyroxine distribution space; (b) total extra thyroidal thyroxine; (c) fractional turnover rate of the hormone and (d) thyroxine secretion rate. The results obtained in six normal Jamaican subjects agree well with those found by workers in North America and Europe. The fast component (10 minutes to 4 hours post injection) has been analysed in 8 normal, 2 hypothyroid and 1 thyrotoxic subjects using simultaneously injected albumen 125I and thyroxine 131I. This technique has previously been used by Oppenheimer et al (1967). It has until recently been thought that the cellular uptake of thyroxine was dependent on the concentration of diffusible (non protein bound) thyroxine in plasma. The results presented here show cellular uptake values 100 times greater than can be explained on this basis. These data have been analysed by a computer programme designed by Dr. J. B. Shepherd, Department of Physics, U.W.I. (AU)

Case of juvenile hypoparathyroidism in Jamaica

A case of juvenile hypothyroidism occurring in Jamaica is described. Reasons are given for believing that this is not a case of cretinism. Factors which may explain the apparent infrequency of these conditions in Jamaica are discussed (AU)