Iodine status of pregnant women in iodine-sufficient regions: A tertiary care unit experience.

Background: The recommended urinary iodine concentration (UIC) levels in the overall adult population is 100-199 µg/L whereas 150-249 µg/L in pregnant women. Objectives: The objective is to determine the prevalence and severity of iodine deficiency in pregnant women in Amasya, which is located in the Western Black Sea region in Turkey, where sufficient iodine levels were achieved in the normal population. Methods: In this single-center study, we retrospectively searched hospital patient records and identified pregnant women who were assessed for iodine levels between January 2019 and January 2021. A total of 408 pregnant women were found eligible for the study. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase antibodies, and antithyroglobulin antibodies in serum samples and UIC were evaluated and compared between the trimesters. Insufficient iodine intake in pregnancy was defined as UIC <150 µg/L. Results: Median UIC and median TSH levels were 129 (range 45-452) µg/L and 2.98 (range 0.01-71.2) µIU/ml, respectively. 81.1% of pregnant women had UIC <150 µg/L. Iodine intake was adequate in 17.4% of pregnant whereas excessive in 1.5%. Prevalence of iodine deficiency during 1st, 2nd, and 3rd trimesters were 82.1%, 82.4%, and 74.5%, respectively. There was no significant difference in UIC levels between trimesters (P = 0.399). 72.9% of pregnant womens had TSH >2.5 mIU/L in the 1st trimester. Conclusion: Iodine deficiency in pregnancy may exist in an iodine-sufficient population. Appropriate measures must be taken to ensure sufficient iodine levels in these individuals.

Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study.

CONTEXT: The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. METHODS: This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. RESULTS: Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. CONCLUSION: Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.

Factors affecting recurrence in subacute granulomatous thyroiditis.

Objective: This study aimed to evaluate the factors affecting recurrence in subacute granulomatous thyroiditis (SAT). Methods: A total of 137 patients with SAT were enrolled in the study; 98 (71.5%) were women and 39 (28.5%) were men. The patients received either steroid or nonsteroidal anti-inflammatory drug (NSAID) for eight weeks. Erythrocyte sedimentation rate (ESR), C-reactive protein, serum thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine (FT4), anti-thyroid peroxidase antibodies and thyroglobulin antibodies, neutrophil, lymphocyte, platelet, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio levels were evaluated. In addition, recurrence rates were compared between patients who received NSAID treatment and those who received steroid therapy. Results: Treatment modality and pretreatment TSH, FT4, and ESR were significantly different between patients with and without recurrence (p = 0.011, 0.001, 0.004, and 0.026, respectively). Compared with patients without recurrence, those with recurrence had higher pretreatment TSH levels, but lower FT4 and ESR levels. On logistic regression analysis, treatment modality was found to be an independent risk factor for recurrence. The risk of recurrence was higher in those taking steroids than in those taking NSAIDs (p = 0.015). The optimal TSH cutoff value for recurrence was 0.045 µIU/mL, with a sensitivity of 83.3% and specificity of 76% (AUC 0.794, 95% CI 0.639-0.949). Conclusion: The risk of SAT recurrence was higher with steroid therapy than with NSAIDs. Patients who had mild thyrotoxicosis had relatively high recurrence rate and may need a relatively longer duration of treatment.