Discover and read the best of Twitter Threads about #Thyroid

Most recents (22)

Tony Ferrante MD PhD of @ColumbiaMed providing an excellent systems based overview of the "metabolic" complications of #obesity and potential mechanisms: lipotoxicity, inflammation, adipokines

Some highlights:

1/ Image
Neurology:
Check out this relationship where higher BMI is associated with ↑ risk of #dementia EXCEPT in age >70 when it's better to be in "overweight" category

👉Aiming for a "normal BMI" is not the best goal for everyone
2/ Image
Unsurprising relationships between #CVD and #obesity
3/ Image
Read 6 tweets
Sort of like ABSITE studying itself, our high yield #absite graphics series this year had some highs and some lows. What better way to reminisce than putting them all in one place... 🧵(1/n)
We kicked it off with the ruler of tricky anatomy, the #thyroid (2/n) Image
Found its close friend and confidante and remembered our dual criteria for the #parathyroids (3/n) Image
Read 18 tweets
The less we eat, the longer we live

1. This seems to be true.
A recent extensive review of studies done in geographies with maximum 100+ aged people showed that most of them practiced some form of calories restriction (CR) right from childhood.
#fasting #Longevity #MedTwitter
2. Calorie restriction (CR) is defined as consuming fewer (10-30% lower) calories as compared to usual.
This can be achieved by either intermittent fasting, or time-restricted feeding or substantially reducing carbohydrate intake.
#nutrition #HealthyEating
3. In ageing, #Insulin increases and insulin sensitivity decreases, which increase the risk of #diabetes, #obesity and #cardiovascular diseases. CR reverses these- reduces insulin levels and increases insulin sensitivity. #Glucose levels also reduce with CR.
Read 10 tweets
Examining pulse of a patient with “MOTOR NEURON DISEASE” helped me find a cure
1.Motor neuron disease (MND) or amyotrophic lateral sclerosis (ALS), is a progressive neurological disease causing severe weakness and wasting of muscles. It has no cure and results in death in most.
2. A 50-year old man consulted me 6 months ago for a second opinion. He had complaints of difficulty in swallowing, slurred speech, weakness and wasting of muscles of arms and legs, which had progressed over previous 9 months.
#MedTwitter #neurotwitter #ALS #MND
3. He was seen by neurologist and after needle electromyography; diagnosis of ALS was made. In view of grave prognosis, patient wished for second opinion. On examination, he had muscle fasciculation, wasting of tongue, arms and leg muscles. Deep tendon reflexes were exaggerated.
Read 7 tweets
T3 testing is not routinely needed in managing patients with primary #hypothyroidism

1. Primary hypothyroidism is a common hormonal disorder, which is treated with levo-thyroxine (T4) replacement.
#MedTwitter #endocrinology
2. In order to assess the adequacy of T4 dose, some clinicians routinely order #T3 along with #T4 and #TSH (thyroid stimulating hormone). Is routine T3 testing really needed in cases of primary hypothyroidism?
3. Clinician would be able to determine the adequacy or over-replacement of levo-thyroxine (T4) dose on the basis of T4 and TSH levels.
*In cases of over-replacement, T4 will be elevated and TSH suppressed.
*In cases of adequate dosing of T4, TSH and T4 levels would be normal.
Read 6 tweets
#thyroid #endocrine

1/4

THYROID AND HEME

1. Thyroid and RBCs

We often order a TSH as part of the w/u for anemia. But do we really understand the connection between thyroid disorders and anemia? Is there a causal relationship? If so, how common a cause are they?
2/4

2. Thyroid and other cytopenias

Did you know that hyperthyroidism may be associated with leukopenia, (microcytic) anemia, thrombocytopenia and even pancytopenia?
3/4

3. Thyroid and hemostasis

... and did you know that hypothyroidism is associated with a HYPOcoagulable state, while hyperthyroidism is associated with a HYPERcoagulable state?
Read 4 tweets
Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism
Hepatic enzymes responsive to #thyroid hormones will slow down when the liver is fatty. Thyroid hormone has a dominant effect on HMG-CoA reductase in the liver which regulates cholesterol levels which is why #hypothyroidism causes high cholesterol. #HepaticHypothyroidism
Thyroid hormone regulates fatty acid β-oxidation in the liver. This is a process that breaks down fat for energy. #NAFLD impedes the process in a viscous cycle where liver fat continues to build up, energy levels plummet, unresponsive to thyroid hormone. #HepaticHypothyroidism
Read 10 tweets
Let's hear The Evidence For and Against Combination #Thyroid Hormone therapy by Dr. Bianco #AACE2022 #Endotwitter. This conversation is controversial here are some of the main slides
Patient's on Lt4 reporting a lot of residual symptoms in energy, cognition
Normal physiology the majority of thyroid hormone production is T4 (16:1 T4:T3) and gets converted peripherally to T3 (5mcg made in thyroid, 25mcg made peripherally)
Read 9 tweets
#Mixtures matter! Check out our new study in @ScienceMagazine where we show the impact of real-life chemical exposure during pregnancy on language development, integrating epidemiology and experimental neurobiology (1/14) science.org/doi/10.1126/sc…
on the same issue, do not miss also the insightful perspective by @liew_zeyan and Pengfei Guo (2/10) science.org/doi/10.1126/sc… (2/14)
and here an animated summary of the story () by @secret_molecule (3/14)
Read 14 tweets
KSM-66 Ashwagandha Root Powder Extract, High Potency 5% Withanolides, 1000mg of Clinically Studied KSM66 & Black Pepper, #Adrenal Support, #Thyroid Support - Vegan, Non-GMO, 60 Capsules amzn.to/358NmtF via @amazon
And, from the view of #naturopathy, this is a recommended article.
#Ashwagandha #Withanolides
herbnutritionals.com/herbal-extract…
Read 4 tweets
¿Es la TSH el mejor parámetro para evaluar la Tiroides?🧐

¡ROTUNDAMENTE NO!🤯

Nos enseñaron mal!

Te explico por qué 🧵

#endotwitter #Tiroides #Thyroid #Fisiología #medicina #Tweetorial
Antes que nada hay que recordar que la fisiología del cuerpo depende de una homeostasis entre sistemas de comunicación.

Por lo tanto resulta importante entender que nunca un solo laboratorio determinará nada sin tener una congruencia con el individuo.
⚠️Recordemos que el eje Hipotálamo-Hipófisis-Tiroides es dependiente de una retroalimentación negativa.

T3 es la hormona que realiza la retroalimentación.
T3 depende directamente proporciconal de la T4 y de la actividad de las MDY1 y 2!

Cambios en las MDY = cambios en el eje
Read 16 tweets
Hey #MedTwitter,

❗️It is common to be told not to assess thyroid function in severely ill patients unless clearly indicated.

Why?🤔

Today's 🧵 is about the famous euthyroid-sick syndrome.🔎

#EndoTwitter #ICU #thyroid
Let's start with a poll.

Do you feel comfortable discussing euthyroid-sick syndrome?
How are thyroid function tests in euthyroid-sick syndrome?
Read 9 tweets
"If you're on thyroid medication, Dr. Duke stresses the importance of checking in with your thyroid throughout pregnancy. "The fetal brain [and] spinal cord start forming at around 21 days, and the pregnancy hormone can actually activate your thyroid,” she explains.
“So, sometimes medicine needs to be tweaked in the first trimester. I check it with the first pregnancy test, and then once per trimester, and at delivery."

Check out this blog from @modernfertility as I answer the most common questions about thyroid problems.
Read the full content here: modernfertility.com/blog/problems-…

You can also listen to the entirety of the webinar version on the link.
Read 4 tweets
Our next paper: Abnormal #thyroid function is common in #takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study onlinelibrary.wiley.com/doi/full/10.11…
In this study, we compared patients with #takotsubo syndrome (#TTS) with age- and sex-matched normal subjects from the #NHANES collective and with patients affected by acute coronary syndrome (#ACS) from the AQUA FONTIS study (@StudyAqua). Main outcome measure was serum #FT4. Image
With artificial intelligence / machine learning we identified two clusters of #thyroid function in #TTS and three clusters in the whole population. #AI #ML pubmed.ncbi.nlm.nih.gov/33179374/ Image
Read 7 tweets
Tweetorial on our new paper, part 1: #Thyrotropin (#TSH) concentration is elevated in post-traumatic stress disorder (#PTSD), reflecting an elevated #setpoint of #pituitary-#thyroid feedback control. doi.org/10.3389/fendo.…
2 | TSH correlates to #allostatic load, measured by #SIQALS 2 score. Although #TSH rises, #FT4 and #FT3 concentration don't go down. Therefore, TSH doesn't reflect #hypothyroidism, but an increased setpoint due to type 2 #allostasis. frontiersin.org/articles/10.33…
3 | #Jostel's TSH index (#JTI) correlates to the #SIQALS 2 score for type 2 #allostatic_load in a large dataset of the #NHANES collective. This supports an elevated reference input (set point) of #thyroid #homeostasis in chronic #stress. doi.org/10.3389/fendo.…
Read 6 tweets
We launched a new research topic on #Thyroid hormones and cardiac #arrhythmia in Frontiers in Endocrinology. Manuscript submissions are welcome. @FrontEndocrinol @dr_pmueller
frontiersin.org/research-topic… Image
First paper published: The Two Faces of Janus: Why Thyrotropin as a Cardiovascular Risk Factor May Be an Ambiguous Target frontiersin.org/article/10.338…
Read 3 tweets
9 common causes of heavy menstrual bleeding everyone should know

1. Fibroids
2. Pelvic infections
3. Drugs
4. Polyps
5. IUCDs
6. Endometriosis
7. Blood clotting problems
8. Cancers of the womb or cervix
9. Thyroid disease

A thread 🧵

{Share for awareness!}
If a woman loses more than 80ml of blood in one period, the bleeding is heavy.

Although methods of quantifying the exact amount of blood loss are not usually accurate, most women know when their period is heavy & heavy usually often come with blood clots.
1
Nearly 20% of women over 30 years have #fibroids.

They are of different types & may cause heavy menstrual bleeding.

Treatment depends on the many factors. So see your doctor. Source: National Health Service, Fibroids, United Kingdom,
Read 14 tweets
1/3
Many people, especially women in Perimenopause when Progesterone levels are rapidy dropping, start developing Low Thyroid symptoms yet tests show within reference range. common symptoms would show as

⬆️ sensitivity to the cold
Fatigue
Constipation
Difficulty w/ weight loss
2/3
Depression
Dry skin, hair and nails
Hair loss (including eyebrows)
Insomnia
Muscle weakness and joint pain
Menstrual problems
Infertility
Brain fog
Low stress resistance
Recurrent infections

The most common cause of this is unopposed Estrogen with inadequate Progesterone
3/3
To counter-balance leads to Estrogen both hindering the conversion of T4 to T3 but also binds to cell receptor sites where activated Thyroid hormone would bind & instruct the towards cell metabolic activity #Hormones #Menopause #Perimenopause #thyroid #keto #LCHPMF
Read 3 tweets
Strange cause for #cirrhosis
Maybe very #rare #MedEd
53yrs man, voice change, recurrent headaches, male breast enlargement. Stops socialising. Has bleed one day, #endoscopy varices, #biopsy fatty liver cirrhosis
No metabolic syndrome.
MRI Brain done. #livertwitter #radio
1/3 Image
What is the diagnosis?
In patients with cirrhosis, always try to find the cause in those who present early. There is no idiopathic, no cryptogenic. Its all 'missed' cirrhosis.
2/3 #liverpath
#MedTwitter #pathology #radiology #MRI #brain #Neurology #Endocrinology #NeuroTwitter Image
#diagnosis: #fatty liver related cirrhosis due to #pituatory macro adenoma with high prolactin, high GH, low #thyroid function. #clinical examination, acromegaly features with central obesity. #Examine 1st, then investigate. #MedicalStudent #medicine #MedStudentTwitter
3/3
Read 4 tweets
Today, the 25th May is the World Thyroid Day. On this special day let me introduce to you the beta version of my dream project DecisionsMed.com (decisionsmed.com) #Endotwitter

(A thread..)
DecisionsMed.com is the one of its kind online Self-assessment tool for patients to help them understand their own disease and symptoms.(Please watch this video to know more decisionsmed.com/knowmore )

@IndiaESI
For the world thyroid day, let me introduce to you two such Decision making tools for thyroid disorders.....

#WorldThyroidDay
Read 7 tweets
A to Z alphabet in #ENTpath #oralpath #endopath

A: angioinvasive fungal sinusitis, adenoid cystic carcinoma, ameloblastic fibroima and anaplastic thyroid carcinoma

@smlungpathguy @aakasharmand @VijayPatho @TheKarenPinto @histolover @Histopatolomon @luishcruzc @kriyer68
B
Basal cell adenoma
Biphenotypic sinonasal sarcoma
branchial cleft cyst
C
Clear cell carcinoma
Clear cell odontogenic carcinoma
Chordoma
CEOT
Read 29 tweets

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