Category Archives: Endocrinology

Endocrinology

Im a Reproductive Endocrinologist, and Heres What To Expect During a Fertility Consultation – Well+Good

The journey to get pregnant isnt easy for everyone. Infertility is generally defined as not being able to get pregnant after one year of unprotected sex. For women over age 35, its often six months of trying. But the good news is that a reproductive endocrinologist, an obstetrician-gynecologist (ob-gyn) with special training in reproductive medicine, has more medical options available to help you conceive, and knowing what to expect at a fertility consultation can help you feel prepared for your first visit.

Roughly nine percent of men and 11 percent of women experience fertility problemsin the U.S., reportsto the Centers for Disease Control and Prevention (CDC). As we age, fertility declines for both women and men, but it happens faster with women. For most women,by their mid-30s fertility starts to decline compared to their teens and early 20s, and the chance of conception drops significantly after age 45, according to The American College of Obstericians and Gynecologists.

Though generalist doctors can order some fertility medication to increase egg production, they dont always know when to move on from front-line treatment, according to Elisabeth Ginsburg, MD, a reproductive endocrinologist and director of the Reproductive Endocrinology and Infertility Program at Brigham and Womens Hospital and a Harvard Medical School professor in obstetrics/gynecology. The tricky thing is knowing what treatment is appropriate for what patients and it depends on what is happening to the couple. It is not one size fits all. If you havent tested the partners sperm, you dont know if a treatment will be appropriate yet. To find out three, six months, or a year later that the sperm count is significantly low can be frustrating to think of all that time wasted.

During the consult youll share your timeline of how long youve been trying to conceive and other personal information. Its helpful to bring the medical and surgical history for you and your partner, any medication and supplements you each may take, and results of any previous testing. Youll dolab work, which may involve blood and urine tests.

We go through what testing needs to be done, and we explain each test, Dr. Ginsburg says. If your doctor is rattling off information quickly, ask what you can learn from each test.

Keep in mind that the reproductive endocrinologist may go over various possible tests and procedures, but that does not mean that you would have all of them.

I often ask women if there are any specific concerns or factors that may be impacting their fertility, Dr. Ginsburg says. Some have worries from the past. If a woman had a termination of a pregnancy for example, she may think that she did damage to her body that would impact fertility, which is not the case, but its a common concern.

Other women assume that they need to stop taking antidepressants or anti-anxiety medicine if they are trying to get pregnant. But they dont, says Dr. Ginsburg. Infertility can heighten the anxiety or depression on top of a career and the part time job of fertility treatment.We worry about the health risks if you take the medicine away.

Testing will often include a uterine exam, screening for infectious diseases, and a semen analysis if youre exploring fertility treatment with a male partner.

Blood tests

These can determine the quantity and quality of your eggs. Your doctor will look at the levels of the follicle-stimulating hormone (FSH), estradiol (estrogen) hormone level, and anti-mullerian hormone (AMH) in your blood roughly the first few days of your period. Other hormones we look at are thyroid function, says Dr. Ginsburg. We also make sure youre immune to German measles, chicken pox, and have no sexually transmitted diseases.

Hysterosalpingography

An X-ray procedure of the uterus and fallopian tubes to check for blockages. A radiologist injects dye into the uterus through the cervix and if the dye moves freely the fallopian tubes are open.

Sonohysterography

A procedure to check the inside of the uterus. Sterile fluid is injected into the uterus through the cervix while ultrasound images are taken.

When you have your follow up visit, your doctor will go over the findings of the tests, what the results mean, and what the appropriate treatments are. A high percentage of the time the tests find a reason for problem, for example, a large polyp in the uterus that can be an easy surgical correction, or maybe the sperm is not moving as well as should be, says Dr. Ginsburg. About 20 percent of time everything looks fine according to tests, and we are not showing a cause [for infertility].

After any potential hinderences are addressed, your doctor may suggest intrauterine insemination (IUI). Often called artificial insemination, the procedure is done near the time of ovulation and places the sperm directly into the uterus through the cervix using a catheter. It may be tried for six months, depending on the womans age.

Dr. Ginsburg says common reasons to go the IUI route,along with oral fertility medication to increase the number of eggs released, include mild male factor infertility, sexual dysfunction, unexplained infertility, or if the woman had small amount of endometriosis.

If thats unsuccessful, the next move is usually to invitro fertilization (IVF) so eggs can be surgically removed from the body and mixed with sperm in a lab to createfertilized eggs (embryos). After about 40 hours, the embryos are placed in the womens uterus, without having to travel through the fallopian tubes. Reason to go right to IVF may include, poor sperm quality, blocked fallopian tubes, and sometimes advanced maternal age.

At this point if a woman is 40 or over, its best to go to IVF, Dr. Ginsburg says. There is even a difference between age 40 and 41. Population studies of live birth rates are lower at 41 than 40. As women get older in general the number of eggs is lower. The drop-off of eggs is rapid in the 40s, and the older the egg, the greater the risk of chromosomal abnormalities.

Finding a doctor that is a good fit for you is important. Knowing if they are the right fit can be determined by a few key factors. Firstly, they should be willing to teach you during your consult and make sure that you understand what is going on. They should also make you feel comfortable and provide you with the time to voice any of your concerns that you have. Finally, they should be happy to answer any questions that you have without hesitation.

Read the original:

Im a Reproductive Endocrinologist, and Heres What To Expect During a Fertility Consultation - Well+Good

Endocrinology

Why Did Type 1 Diabetes Rise Early in the COVID-19 Pandemic? – Medscape

Both the incidence of type 1 diabetesand the severity at presentationrose among children and adolescents in Finland during the first 18 months of the COVID-19 pandemic, but it's unclear whether this was due to the SARS-CoV-2 virus itself, as few had confirmed infections prior to diagnosis.

"Our results suggest that the increase in the disease rate and in the frequency of diabetic ketoacidosis are related to the preventive measures introduced at the start of the pandemic, such as lockdown and physical distancing, rather than a direct effect of SARS-CoV-2," Mikael Knip, MD, of New Children's Hospital, Helsinki, Finland, and colleagues write in The Lancet Diabetes & Endocrinology.

However, in an accompanying editorial, Daniel Chan, MBBS, and Jan Hau Lee, MBBS, of KK Women's and Children's Hospital, Singapore, point out that up to a quarter of the study population didn't undergo SARS-CoV-2 testing.

Andthey note that the virus has been linked to the development of type 1 diabetes in previous studies, which have also shown that "children might not necessarily have 100% seropositivity because of T-cell response heterogeneity."

Asked for comment, Paul Zimmet, MBBS, MD, PhD, professor of diabetes at Monash University, Melbourne, Australia, said: "It's a very interesting study in the light of Finland having the highest incidence of type 1 diabetes globally, so it is a great place to address the relationship of SARS-CoV-2 with new diabetes."

However, he added, "While the authors' interpretation of causation is that lockdowns may play a role, my own view is that there is also an effect of the virus, either through inflammation or even a direct destructive effect on the pancreatic beta cells."

Zimmet, who co-chairs a global registry aimed at establishing the links between COVID-19 and diabetes, also noted:"There is still much to learn about SARS-CoV-2 and its destructive ways, and there is a lot of disagreement between 'experts' on the diabetes and COVID issue and the extent to which the virus has a role."

"There is certainly evidence that even mild SARS-CoV-2 infections increase the risk of type 2 diabetes. That in itself needs close longitudinal monitoring over time."

Knip and colleagues compared data from the Finnish Pediatric Diabetes Register for the period of March 1, 2020, through August 31, 2021, with those of the same periods for the years 2014-2019. A total of 785 children younger than 15 years old were diagnosed during the 18-month pandemic period, and a total of 2096 were diagnosed during the combined 54-month reference period.

The incidence of type 1 diabetes was 61.0 per 100,000 population younger than 15 years during the pandemic, significantly higher than the 52.3 per 100,000 seen during the reference period. Comparing the two periods, the age- and sex-adjusted incidence rate ratio was 1.16, which was significant (P < .0006).

Significantly more children had diabetic ketoacidosis at diagnosis during the pandemic(30.8% vs 22.6%; P < .001), with a significantly greater frequency of severe ketoacidosis at type 1 diabetes presentation (8.8% vs 5.6%; P = .009).

More of those diagnosed with type 1 diabetes during the pandemic tested positive for glutamic acid decarboxylase antibodies at diagnosis (P < .001) compared with those diagnosed prepandemic.

Of the 583 children in whom SARS-CoV-2 antibodies were analyzed, comprising 25.7% of those diagnosed with type 1 diabetes, only 5 (1%) were considered to have had an acute COVID-19 infection prior to the diagnosis based on two different antibody tests.

In the discussion section, Knip and colleagues point to previous studies showing no association between SARS-CoV-2 infection and type 1 diabetes-related islet autoimmunity.

And, they add, preliminary data suggest that the rate of type 1 diabetes has decreased in Finnish children since the pandemic lockdown was lifted in the summer of 2021. There were 211 new cases registered between September 2021 and February 2022, compared with 301 from March 1, 2020, to August 31, 2021.

"According to what is known as the biodiversity hypothesis, microbial exposure and infections in early childhood can boost the protection against autoimmune diseases. The reduction in contacts in connection with the societal lockdown significantly reduced acute infections in children, which may have increased the risk of developing [type 1] diabetes," Knip explainedin a press release from his institution.

On the other hand, Chan and Lee write, "The association observed in the study should not be equated to being causative, especially without biomarkers or comparisons of microbiota that could potentially substantiate the biological plausibility of this observation. The exact mechanisms to explain how social isolation measures affect biodiversity have yet to be examined."

Knip, Chan, Lee, and Zimmet have reported no relevant financial relationships.

Lancet Diabetes Endocrinol. 2023;11:251-260, 220-222. Full text, Editorial

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in The Washington Post, NPR's Shots blog, and Diabetes Forecast magazine. She is on Twitter: @MiriamETucker.

For more diabetes and endocrinology news, follow us on Twitter and Facebook.

Visit link:

Why Did Type 1 Diabetes Rise Early in the COVID-19 Pandemic? - Medscape

Endocrinology

Pancreatic cancer researchers take out-of-the-box approaches … – Boston Children’s Discoveries

Pancreatic cancers are deadly and hard to treat, in part because they are so often detected at an advanced stage; overall five-year survival rates are about 11 percent. Two separate labs at Boston Childrens Hospital took out-of-the-box approaches to this difficult cancer, and both uncovered some very promising leads.

Randolph Watnick, PhD, an investigator in the Vascular Biology Program, started with the insight that immunotherapy, an emerging approach for a variety of cancers, has largely failed in pancreatic cancer because the tumor microenvironment a protective cocoon surrounding the tumor secretes multiple factors that block immune responses.

Watnicks team previously showed that a naturally occurring protein, thrombospondin-1 (Tsp-1), strongly inhibits growth of various tumors. They also showed that a compound called prosaposin, and compounds derived from it, can stimulate Tsp-1 to block tumor growth. (Watnick has licensed these to Vigeo Therapeutics.) But pancreatic tumors are smart: They secrete a molecule called PRSS2 that suppresses Tsp-1.

Without Tsp-1, the tumor microenvironment throws up a slew of defenses that prevent the immune system from curbing the cancer. These cells secrete so many agents that kill or inhibit activation of immune cells that its hard to target all of them, Watnick says. The tumor can grow without fear of the immune system.

But when Watnicks team blocked PRSS2 in human cancer cell lines and in mice, they restored Tsp-1 expression, disabling many of the tumors defenses in one stroke. This enabled the immune system to suppress tumor growth.

Even more exciting, PRSS2 circulates in the blood, making it an ideal candidate to target with antibodies. And because it doesnt normally mutate (it is merely over-expressed by tumor cells), the cancer is less likely to develop resistance to the treatment. This approach, described in Nature Communications, might also work for ovarian and triple-negative breast cancer, which have similar self-protection strategies, says Watnick.

If we can make an antibody against PRSS2, it could potentially be a new lifeline for patients, he says. His lab is now working to develop an antibody and is considering strategies that would combine it with prosaposin and/or immunotherapies like PD1 inhibitors.

Nada Kalaany, PhD, an investigator in the Division of Endocrinology, took a completely different tack, asking the question, What do pancreatic tumors need to grow? She focused on pancreatic ductal adenocarcinoma, an aggressive cancer that relies on unusual metabolic pathways to obtain nutrients.

To support their growth, pancreatic tumors must make large amounts of compounds called polyamines. Kalaanys team showed that the tumor microenvironment lacks a key ingredient, arginine, forcing the tumors to resort to another metabolic pathway. That pathway, predominantly used in infancy and in the fasting adult intestine, requires an enzyme known as ornithine aminotransferase or OAT.

The cancer overcomes a challenging, arginine-depleted microenvironment by using OAT to make polyamines, explains Kalaany, who is also an associate member of the Broad Institute. If we target OAT, we can suppress tumor growth.

Indeed, when Kalaanys team inhibited OAT with a drug called 5-FMO, they curbed cancer growth both in a dish and in mouse models.

The findings, reported in Nature last month, add another potential option for pancreatic cancer treatment. Targeting OAT avoids toxicity, since normal pancreatic cells dont need OAT to make polyamines. Since 5-FMO has been used experimentally for other purposes, Kalaany sees strong potential to translate the findings to the clinic.

Cancers always figure out a way of getting around things, says Kalaany. But if we target this pathway, they may not have a way to go around it.

Learn more about research in the Kalaany and Watnick labs.

Here is the original post:

Pancreatic cancer researchers take out-of-the-box approaches ... - Boston Children's Discoveries

Endocrinology

TikTok Offers to ‘Balance Your Hormones’ Are Pure Hokum – Medscape

With more than 306 million views, #hormonebalance and #hormonebalancing are among the latest hacks to take over the social media platform TikTok, on which users post short videos. Influencers offer advice such as eating raw carrots for "happy hormones," eating protein followed by fat for breakfast to regulate blood glucose, or taking vitamin B2 supplements for thyroid health.

Raymond de la Rosa, MD

Have you ever wondered if you were asleep during the lecture on "hormone balancing" in medical school? No, you weren't. It was never a class for good reason, and you didn't fail to read any such breakthrough studies in The New England Journal of Medicine either.

Although the soundbites no doubt garner attention among TikTok users, "hormone balancing" is a fictional term that is practically meaningless.

There are over 50 different hormones produced by humans and animals, regulating sleep, growth, metabolism and reproduction, among many other biological processes, so there is certainly no one-size-fits-all solution to ensure these are all working in perfect harmony.

When someone mentions "hormone balancing," my mind wanders to the last time I took my car to have my tires rotated and balanced. If only it were as simple to balance hormones in real life. The best we can hope for is to get a specific hormone within the ideal physiologic range for that person's age.

The term "hormone" can mean many things to different people. When a woman comes in with a hormone question, for example, it is often related to estrogen, followed by thyroid hormones. A wealth of misinformation exists in popular literature regarding these hormones alone.

Estrogen can be replaced, but not everyone needs it replaced. It depends on variables including age, underlying medical conditions, the time of day a test was drawn, and concomitant medications. Having low levels of a given hormone does not necessarily call for replacement either.

Insulin is another example of a hormone that can never completely be replaced in people with diabetes in a way that exactly mimics the normal physiologic release.

There are many lesser-known hormones that are measurable and replaceable but are also more difficult to reset to original manufacturer specifications.

A Google search for "hormone balancing" often sends you to "naturopaths" or "integrative medicine" practitioners, who often propose similar solutions to the TikTok influencers. Users are told that their hormones are out of whack and that restoring this "balance" can be achieved by purchasing whatever "natural products" or concoction they are selling.

These TikTok videos and online "experts" are the home-brewed versions of the strip-mall hormone specialists. TikTok videos claiming to help "balance hormones" typically don't name a specific hormone either, or the end-organs that each would have an impact on. Rather, they lump all hormones into a monolithic entity, implying that there is a single solution for all health problems. And personal testimonials extolling the benefits of a TikTok intervention don't constitute proof of efficacy no matter how many "likes" they get. These influencers assume that viewers can "sense" their hormones are out of tune and no lab tests can convince them otherwise.

In these inflationary times, the cost of seeking medical care from conventional channels is increasingly prohibitive. It's easy to understand the appeal of getting free advice from TikTok or some other internet site. At best, following the advice will not have much impact; at worst, it could be harmful.

There are some things that should never be tried at home, and do-it yourself hormone replacement or remediation both fall under this umbrella.

Generally, the body does a good job of balancing its own hormones. Most patients don't need to be worried if they're in good health. If they're in doubt, they should seek advice from a doctor, ideally an endocrinologist, but an ob/gyn or general practitioner are also good options.

One of the first questions to ask a patient is "Which hormone are you worried about?" or 'What health issue is it specifically that is bothering you?" Narrowing the focus to a single thing, if possible, will lead to a more efficient evaluation.

Often, patients arrive with multiple concerns written on little pieces of paper. These ubiquitous pieces of paper are the red flag for the flood of questions to follow.

Ordering the appropriate tests for the conditions they are concerned about can help put their minds at ease. If there are any specific deficiencies, or excesses in any hormones, then appropriate solutions can be discussed.

TikTok hormone balancing solutions are simply the 21st-century version of the snake oil sold on late-night cable TV in the 1990s.

Needless to say, you should gently encourage your patients to stay away from these nonFDA-approved products, without making them feel stupid. Off-label use of hormones when these are not indicated is also to be avoided, unless a medical practitioner feels it is warranted.

For more diabetes and endocrinology news, follow us onTwitterandFacebook

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Link:

TikTok Offers to 'Balance Your Hormones' Are Pure Hokum - Medscape

Endocrinology

More than 30,000 European and international endocrinologists urge Brussels to take action on REACH revision – Newswise

Newswise A broad coalition of over 30,000 European and international endocrine experts have today called on EU legislators to publish the revised REACH proposal without any further delay and no later than June 2023.

Citing the urgent and immediate need to minimise exposure to Endocrine Disrupting Chemicals (EDCs) in the interest of public health, the experts insist that flaws in the REACH regulation must be addressed without delay. EDCs are not a compromise area, and extending the current legislation is required to fulfill the mentioned objectives.

The petition was launched by the Endocrine Society, the European Society of Endocrinology (ESE), and 42 European national and specialist endocrine societies represent the European and international endocrine research and clinical community. The petition has been submitted to the European Commission.

The experts are extremely concerned that the current REACH regulation does not effectively address the numerous health impacts stemming from EDC exposure. The necessary steps to reduce exposure to hazardous EDCs and establish lasting protection for human health can only come in a revision of REACH itself.

EDCs are not an area for compromise. An immediate and rigorous revision and extension to the current legislation is needed to effectively address the many current adverse health impacts. Any further delay is unacceptable.

In addition to the huge impact on human and ecological health, EDCs are also linked to massive economic costs borne by EU citizens: conservative estimates have linked EDC exposures to some157 billion in additional health care costs and lost earnings.

EDCs, which include bisphenols, phthalates, and PFAS, among other chemicals in commerce, are pervasive and linked to serious adverse effects on endocrine systems leading to diseases such as infertility, diabetes, cancer, and altered neurological development. Health impacts from EDC exposures are widespread and cause suffering throughout the European Union. Moreover, individuals such as pregnant women and children are uniquely susceptible to the effects of endocrine disruption, meaning that action now can prevent harm to current and future generations.

Go here to read the rest:

More than 30,000 European and international endocrinologists urge Brussels to take action on REACH revision - Newswise

Endocrinology

Over 1500 healthcare professionals attend 7th Qatar Diabetes … – The Peninsula

Delegates attend a session during the Seventh Qatar Diabetes, Endocrinology, and Metabolic Conference (QDEM-7).

Doha: More than 1500 healthcare professionals attended the Seventh Qatar Diabetes, Endocrinology, and Metabolic Conference (QDEM-7) which was hosted by Hamad Medical Corporations (HMC) Endocrine and Diabetes Division, Department of Medicine, and the Qatar Metabolic Institute (QMI).

The conference, held in person and online with attendees and speakers from around the world, brought together local and international experts in the fields of endocrinology, obesity, and diabetes to discuss the latest research, treatments, technological advances, and preventative measures for these conditions.

The event also incorporated the 2nd Qatar Diabetes and Obesity Research Symposium a flagship activity of the National Diabetes Strategy, 2016-2022, and intends to promote diabetes and obesity research in Qatar.

World-renowned international, regional and local speakers presented and updated delegates on a diverse range of topics including non-alcoholic fatty liver disease; Pediatric Endocrinology; Perimenopausal management; Neuroendocrine disorders and calcium and electrolytes disorders

Dr. Mahmoud Ali Zirie, Chair of the Conferences Organizing Committee and Head of HMCs Endocrinology and Diabetes Division, said the conference provided an opportunity to share the work being done here in Qatar and to deliver improvements tailored to the local population.

This year our program focused on a range of important and emerging areas including diabetes and obesity in pediatric patients and the latest technologies available, Dr. Zirie said. Its more important than ever that healthcare professionals have access to the most up-to-date research and information about diabetes, endocrinology and metabolic medicine.

Professor Abdul Badi Abou Samra, Director of Qatar Metabolic Institute, said the event provided an important platform for frontline clinicians, scientists, and researchers to discuss strategies and approaches for the management and prevention of diabetes and associated conditions.

Diabetes is a complex condition which can lead to debilitating long-term complications and acute illness. The disease in Qatar is quite prevalent with about 17 percent of Qatars adult population thought to have diabetes. About 20 percent of Qatars population is estimated to be pre-diabetic, he said.

Dr. Ibrahim Al Janahi, Chair of the Scientific Committee and Senior Consultant in Endocrine and Diabetes Division said many diabetics live with other associated complications such as high blood pressure, kidney disease, and vision impairment which require additional consideration.

It is important for the local and international medical community to meet and discuss trends, best practice, and long-term strategies for the prevention and mitigation of complications related to this disease so we can continue to provide the best care for our patients, Dr. Al Janahi said.

Among the speakers at this years event were Dr. Richard Quinton is a Consultant Endocrinologist at the Royal Victoria Infirmary, Newcastle-upon-Tyne, UK; Marius N. Stan, M.D., consultant in endocrinology at Mayo Clinic and Martin Savage is Emeritus Professor of Pediatric Endocrinology at William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary, University of London.

Excerpt from:

Over 1500 healthcare professionals attend 7th Qatar Diabetes ... - The Peninsula

Endocrinology

Age- and sex-specific values needed to avoid subclinical thyroid … – Healio

March 14, 2023

2 min read

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are posted on

Back to Healio

Providers should use age- and sex-specific reference ranges to diagnose subclinical hypothyroidism or hyperthyroidism, especially for older adults, according to a study published in Thyroid.

These data clearly demonstrate the clinical relevance of using age- and sex-specific values, particularly serum thyroid-stimulating hormone levels, when diagnosing subclinical hypothyroidism, Masanobu Yamada, MD, PhD, assistant professor in the department of internal medicine, division of endocrinology and metabolism at Gunma University Graduate School of Medicine in Japan, and colleagues wrote. We found a high rate of overdiagnosed subclinical hypothyroidism, especially in those aged 60 years and older. Although it is a low rate, patients with subclinical hyperthyroidism were underdiagnosed, particularly in middle-aged men and women.

Researchers analyzed health records for 22,992 adults who underwent annual checkups at Takasaki Hidaka Hospital in Japan and 515 euthyroid adults who visited Okamoto Thyroid Clinic in Japan. Of those who visited Takasaki Hidaka Hospital, 14,860 had thyroid function evaluated using a Siemens test kit from 2006 to 2013, and 8,132 had thyroid function evaluated using an Abbott test kit from 2020 to 2022. The Okamoto Thyroid Clinic used kits from Toso to analyze thyroid function from 2016 to 2019.

Subclinical hypothyroidism was defined as elevated serum TSH with normal free thyroxine, and subclinical hyperthyroidism was defined as low serum TSH with normal free T4. The researchers estimated age- and sex-specific reference ranges based on TSH and free T4 measurements and compared them with the manufacturer reference ranges for all three tests.

Using the Siemens test kit, median serum TSH was 1.5 mIU/L for women aged 30 to 39 years and gradually increased with age to 1.9 mIU/L for women aged 60 to 69 years. Men aged 30 to 39 years had a median TSH of 1.4 mIU/L with an increase with age to 1.6 mIU/L for those aged 60 to 69 years. Similar increases were observed for adults tested with the Abbott kit.

Serum free T4 levels were constant with age for women using all three test kits. Men had higher free T4 levels than women and had a gradual decrease with age when using all three kits.

Using the Abbott test kit, median serum free triiodothyronine was 3.26 pg/mL for men aged 30 to 39 years and declined to 3.11 pg/mL for men aged 60 to 69 years. Levels were higher for men compared with women of the same age. Similar findings were observed using the Toso test kit.

About half of women aged 30 to 39 years who were classified as having subclinical hypothyroidism using manufacturer reference ranges had normal thyroid function when age- and sex-specific reference ranges were used. The proportion of overdiagnosed adults increased with age, with 78% of women aged 60 to 69 years classified as having subclinical hypothyroidism being reassessed with normal thyroid function using age- and sex-specific recommendations.

Overdiagnosis was less common for younger men, with no men aged 30 to 39 years and about 5% of those aged 40 to 49 years reclassified with normal thyroid function using age- and sex-specific cutoffs. However, about 62% of men aged 60 to 69 years diagnosed with subclinical hypothyroidism using manufacturer reference ranges were reclassified as having normal thyroid function using age- and sex-specific reference ranges.

The researchers acknowledged several limitations with the study, including a lack of data on adults younger than 30 years or older than 70 years, as well as the potential that reference ranges may be influenced by ethnicity in other countries.

Our findings should therefore be validated in future studies including other racial and ethnic groups, as the prevalence of autoimmune disease may differ according to ethnicity and the geographic location, the researchers wrote.

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are posted on

Back to Healio

Excerpt from:

Age- and sex-specific values needed to avoid subclinical thyroid ... - Healio

Endocrinology

Endocrine Society supports EPA rule regulating forever chemicals … – Newswise

Newswise WASHINGTONThe Endocrine Society supports a new U.S. Environmental Protection Agency (EPA) rule which includes provisions to regulate several per- andpolyfluoroalkyl substances (PFAS)including PFOA and PFOSfound in our drinking water.

The proposed regulation sets an aggressive limit for these PFAS and their mixtures and acknowledges effects at extremely low levels by proposing a health based Maximum Contaminant Level Goal (MCGL) of zero. This is the first time the government has regulated a new chemical in drinking water in more than 30 years.

The new rule would require major water treatment upgrades at utilities across the country.

PFAS are manmade chemicals used as oil and water repellents and coatings for common products including cookware, carpets and textiles. PFAS chemicals can contaminate drinking water supplies near facilities where the chemicals are used.

Theseendocrine-disrupting chemicalsdo not break down when they are released into the environment, and they continue to accumulate over time. They pose health dangers at incredibly low levels and have been linked to endocrine disorders such as cancer, thyroid disruption and reproductive difficulties.

While this rule makes important progress towards reducing PFAS in drinking water to improve public health, continued vigilance and a more comprehensive class-based approach will remain necessary as PFAS comprise a large and complex class of chemicals.

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site atwww.endocrine.org. Follow us on Twitter at@TheEndoSocietyand@EndoMedia.

See more here:

Endocrine Society supports EPA rule regulating forever chemicals ... - Newswise