Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50301" align="alignleft" width="129"]Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine Dr. Haymart[/caption] Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury. We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer. We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.
Author Interviews, Duke, Endocrinology, Environmental Risks, Thyroid Disease, Weight Research / 27.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48201" align="alignleft" width="128"]Christopher D. Kassotis, Ph.D.NRSA Postdoctoral Research ScholarStapleton LabDuke UniversityNicholas School of the EnvironmentDurham, NC 27708  Dr. Kassotis[/caption] Christopher D. Kassotis, Ph.D. NRSA Postdoctoral Research Scholar Stapleton Lab Duke University Nicholas School of the Environment Durham, NC 27708  MedicalResearch.com: What is the background for this study? What are the main findings?
  • So this was something that Heather Stapleton had been curious about for years, as she's been one of several researchers characterizing the hundreds of chemicals that have been measured in indoor house dust. Before I came to Duke, one of her PhD students had measured the ability of many common indoor contaminants to activate the peroxisome proliferator activated receptor gamma (PPARg). The majority of these chemicals did, often quite well, which led to them testing indoor house dust extracts, also finding that the majority of dust extracts were also able to do so at very low levels. As PPARg is often considered the master regulator of fat cell development, the next obvious question was whether these common contaminants (and house dust) could promote fat cell development in cell models. My first work at Duke evaluated a suite of common indoor contaminants, finding that many of these chemicals could promote fat cell development, and that low levels of house dust extracts did as well.
  • We next explored this more systematically in a group of adults involved in a thyroid cancer cohort (this was just recently published in Science of the Total Environment: https://www.sciencedirect.com/science/article/pii/S0048969719307715?dgcid=author
  • In this study we evaluated the extent to which house dust extracts could promote fat cell development in a common cell model, and associated this with the metabolic health of adults living in these homes. We found that the greater extent of fat cell development was associated with significantly greater thyroid stimulating hormone concentrations (control residents only, with no evidence of thyroid dysfunction) and lower free triiodothyronine (T3) and thyroxine (T4). We further found a significant and positive association between extent of fat cell development and the body mass index (BMI) of all adults in the study. So this suggested that the indoor environment might play a role in the BMI and metabolic health of residents, and we next wondered if this would be more pronounced in children, who may be exposed to these contaminants during a critical window of development.
  • The next step, for our current work, was to substantiate these effects in a larger group of households, each with children.
  • Our major conclusions thus far have been that ~80% of house dust extracts promote significant fat cell development in a cell model - either via development from precursor cells into mature fat cells, measured via accumulation of lipids into the cells, or via the proliferation of those precursor fat cells. We also reported positive correlations of fat cell development with the concentrations of 70 different contaminants in the dust from these homes, suggesting that mixtures of contaminants are likely all acting weakly to produce these effects in combination. We’ve also begun to assess the other chemicals present in dust - chemistry can be either targeted (measuring concentrations of specific known chemicals in a sample), or non-targeted, where you try and determine the identity of the other chemicals in a sample. This has greater utility for identifying many more chemicals, though you will often not get chemical concentrations from this, nor absolute confirmed identification - just varying degrees of certainty based on evidence. Thus far we report approximately 35,000 chemicals in house dust samples across this study, and differential analyses have begun to pick out the few (less than 10 in each case) chemicals most differentially expressed between samples that exhibit high degrees of fat cell development in the lab vs inactive samples, for example, or which are differentially present in the homes of children categorized as obese or overweight. We are now working to confirm identity of these select contaminants that are more likely to be causative factors in the results we have observed.
Author Interviews, JAMA, Thyroid, Thyroid Disease / 04.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47320" align="alignleft" width="120"]Joanna Klubo-Gwiezdzinska, M.D., Ph.D., M.H.Sc. Assistant Clinical Investigator/Assistant Professor Metabolic Disease Branch/NIDDK/NIH Bethesda, MD Dr. Klubo-Gwiezdzinska[/caption] Joanna Klubo-Gwiezdzinska, M.D., Ph.D., M.H.Sc. Assistant Clinical Investigator/Assistant Professor Metabolic Disease Branch/NIDDK/NIH Bethesda, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: People with intermediate- and high-risk differentiated thyroid cancer (DTC) are treated with surgical removal of the thyroid gland and radioactive iodine therapy.  After surgery and initial treatment, the thyroid hormone levothyroxine is used for long-term management not only to replace appropriate physiologic thyroid hormones post-surgery, but also to suppress thyrotropin (TSH) release from the pituitary gland at supraphysiologic doses. The current recommended American Thyroid Association TSH suppression goal in patients with a high-risk differentiated thyroid cancer presenting with distant metastases is less than 0.1mIU/ml, and between 0.1-0.5 mIU/ml for patients with intermediate-risk DTC presenting with local metastases to the neck lymph nodes. This TSH goal is much lower than physiologic TSH level, which ranges between 0.4-4.1 mIU/ml, depending on the measurement method and person’s age. TSH suppression is used because some preclinical evidence suggests that TSH can stimulate growth of cancer cells.  However, several preclinical studies show that thyroid hormones may also stimulate cancer growth. In addition, too much levothyroxine, leading to TSH suppression, may cause side effects such as abnormal heart rhythms and decreased bone mass. In this study, based on a large multicenter database analysis, we found that continuous TSH suppression with levothyroxine was not associated with better progression-free survival and overall survival in patients with either intermediate- and high-risk differentiated thyroid cancer. The patients were followed for an average of 7 years after surgical thyroid cancer removal and radioactive iodine therapy. 
Author Interviews, Heart Disease, JAMA, Thyroid Disease, Vanderbilt / 27.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47159" align="alignleft" width="150"]Joe-Elie Salem, MD, PhD Associate Professor - MCU-PH, Sorbonne Université - INSERM - CIC, Clinical Pharmacology, Cardio-oncology, APHP, La Pitié-Salpêtrière, Paris, France Adjunct Associate Professor, Vanderbilt University Medical Center, Cardio-oncology Clinical Pharmacology, Nashville, TN Dr. Salem[/caption] Joe-Elie Salem, MD, PhD Associate Professor - MCU-PH, Sorbonne Université - INSERM - CIC, Clinical Pharmacology, Cardio-oncology, APHP, La Pitié-Salpêtrière, Paris, France Adjunct Associate Professor, Vanderbilt University Medical Center, Cardio-oncology Clinical Pharmacology, Nashville, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: A study by researchers at Vanderbilt University Medical Center has strengthened the link between thyroid function and atrial fibrillation (AF), an irregular heart rhythm that increases the risk of stroke and other heart-related complications. They phenome-wide association study scanned the medical records of more than 37,000 people for an association between genetically determined variation in thyroid stimulating hormone levels (a measure of thyroid function) and AF risk. Previous observational studies have found that subclinical hyperthyroidism, an overactive thyroid which does not meet the clinical threshold for diagnosis or treatment, nevertheless can increase the risk of atrial fibrillation.  But whether to treat subclinical hypo- or hyperthyroidism to reduce AF risk remains a matter of debate in the medical community. 
Author Interviews, Endocrinology, JAMA, Thyroid Disease / 02.10.2018

MedicalResearch.com Interview with: thyroid-gland-wikipediaDr. med. Martin Feller, MSc Epidemiology (LSHTM) FMH Allgemeine Innere Medizin & Prävention und Gesundheitswesen Scientific Research Coordinator INSELSPITAL, Universitätsspital Bern Universitätsklinik und Poliklinik für Allgemeine Innere Medizin (RodondiResearch) MedicalResearch.com: What is the background for this study? What are the main findings? Response: SUBCLINICAL HYPOTHYROIDISM IS VERY COMMON, WITH AN ESTIMATED 13 MILLION AMERICANS AFFECTED. SUBCLINICAL HYPOTHYROIDISM IS OFTEN TREATED WITH LEVOTHYROXINE, PARTICULARLY WHEN IT CO-OCCURS WITH SYMPTOMS POTENTIALLY ATTRIBUTABLE TO HYPOTHYROIDISM SUCH AS TIREDNESS, CONSTIPATION, AND UNEXPLAINED WEIGHT GAIN. THIS PRACTICE MAY CONTRIBUTE TO LEVOTHYROXINE BEING THE MOST PRESCRIBED DRUG FROM 2014 ONWARDS IN THE US. HOWEVER, IN OUR META-ANALYSIS OF 21 RANDOMIZED CLINICAL TRIALS, WE OBSERVED NO BENEFIT OF LEVOTHYROXINE THERAPY (COMPARED TO PLACEBO) REGARDING GENERAL QUALITY OF LIFE, THYROID-RELATED SYMPTOMS, DEPPRESSIVE SYMPTOMS, FATIGUE, COGNITIVE FUNCTION, BLOOD PRESSURE OR BODY-MASS INDEX. 
Author Interviews, Cancer Research, Endocrinology, JAMA, Pediatrics / 02.07.2018

MedicalResearch.com Interview with: “Cancer awareness” by Susan Roberts is licensed under CC BY 2.0Mette Vestergaard Jensen, MD Danish Cancer Society Research Center MedicalResearch.com: What is the background for this study? Response: Cancer survival rates have improved and it is necessary to explore the long-term consequences of cancer treatment. Adolescents and young adults with cancer are at risk for several therapy-related late effects; however, these have not been studied extensively. We investigatet the lifetime risks of endocrine late effects of cancer and cancer treatment in adolescent and young adult cancer s
Author Interviews, Depression, Endocrinology, JAMA, Mental Health Research, Thyroid Disease / 14.05.2018

MedicalResearch.com Interview with: Thyroid gland Wikipedia imageTeja Grömer PD Dr. med. Habil Facharzt für Psychiatrie und Psychotherapie Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie Bamberg  MedicalResearch.com: What is the background for this study? 1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT) 2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness. 3) I thus decided to do a systematic review and meta-analysis. 
Author Interviews, Thyroid Disease / 22.03.2018

MedicalResearch.com Interview with: [caption id="attachment_40735" align="alignleft" width="200"]Begoña Ruiz Núñez PhD (c) Laboratory Medicine UMC Groningen Co-directora de Healthy Institute President of the Asociación Española de Psico-Neuro-Inmunologí Begoña Ruiz Núñez[/caption] Begoña Ruiz Núñez PhD (c) Laboratory Medicine UMC Groningen Co-directora de Healthy Institute President of the Asociación Española de Psico-Neuro-Inmunologí MedicalResearch.com: What is the background for this study? Response: The diagnosis of Chronic Fatigue Syndrome (​CFS)​ is based on the Fukuda criteria, i.e. symptoms, disability, and exclusion of explanatory illnesses, and not by means of physical signs or abnormalities in laboratory test results​. CFS has been described as a ´allostatic overload condition´, where the physiological mechanisms employed to deal with stress contribute to the perpetuation of the disorder. Chronic Fatigue Syndrome patients are 1.9 times more likely to have a high allostatic load index than healthy controls. Thyroid allostasis-adaptive responses, presenting as ​non-thyroidal-illness syndrome, have been found in many conditions, ranging from critical illness, uremia and starvation to tumor​s​. Taken together, it is possible that, despite TSH and T4 levels within reference ranges, Chronic Fatigue Syndrome symptoms may be attributable in part to allostatic responses, i.e. lower thyroid hormone activity, secondary to chronic (low-grade) inflammation caused by e.g. a compromised gut microbiome and gut wall integrity.
Author Interviews, Endocrinology, Fertility, JAMA, OBGYNE, Thyroid Disease / 13.12.2017

MedicalResearch.com Interview with: Professor Tianpei Hong, MD, PhD Of behalf of Prof. Jie Qiao and all the coauthors, Director, Department of Endocrinology & Metabolism Director, Department of Laboratory Medicine Peking University Third Hospital Beijing, China MedicalResearch.com: What is the background for this study?
  • Ÿ           Women who test positive for thyroid autoantibodies have been reported to be at 2- to 3-fold higher risk of spontaneous miscarriage than those who test negative. However, the effect of levothyroxine on miscarriage among women with positive thyroid autoantibodies and normal thyroid function has been documented in limited studies with conflicting results.
  • Ÿ           Given the substantial difficulty achieving successful pregnancy among infertile women, identifying optimal treatment for infertile women who test positive for thyroid autoantibodies is particularly important. There are a few randomized clinical trials showing a beneficial effect of levothyroxine treatment on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). However, the sample size of those trials was rather small which may weaken the quality of the evidence.
  • Ÿ           Therefore, the Pregnancy Outcomes Study in euthyroid women with Thyroid Autoimmunity after Levothyroxine (POSTAL) study was conducted in Peking University Third Hospital to evaluate whether levothyroxine treatment initiated before IVF-ET could decrease the miscarriage rate and improve the live birth rate in infertile women who tested positive for antithyroperoxidase antibody but had normal thyroid function.
AHA Journals, Author Interviews, Heart Disease, Thyroid, UCSF / 26.10.2017

MedicalResearch.com Interview with: Christine Baumgartner MD Inselspital Universitätsspital Bern Bern, Switzerland Research Fellow, Division of Hospital Medicine UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: Overt and subclinical hyperthyroidism increase the risk of atrial fibrillation, but it is unclear whether subclinical hypothyroidism, which is known to increase cardiovascular events, or thyroid function in the normal range are also associated with incident atrial fibrillation. Given the high prevalence of atrial fibrillation and its associated morbidity and mortality, identifying potentially modifiable risk factors is important. Therefore, we aimed to assess the risk of atrial fibrillation in individuals with subclinical hypothyroidism or variations of thyroid function within the normal range. Our main findings are that higher free thyroxine levels are associated with an increased risk of atrial fibrillation in euthyroid individuals, but thyroid-stimulating hormone levels within the euthyroid or subclinical hypothyroid range was not related to atrial fibrillation risk.
Author Interviews, Endocrinology, JAMA / 19.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37034" align="alignleft" width="119"]Arjola Bano, MD, MSc, DSc Researcher in the Departments of Internal Medicine and Epidemiology, Erasmus Medical Center, Rotterdam the Netherlands Dr. Bano[/caption] Arjola Bano, MD, MSc, DSc Researcher in the Departments of Internal Medicine and Epidemiology, Erasmus Medical Center, Rotterdam the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thyroid function is clinically defined by the measurements of serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. So far, abnormal TSH and FT4 levels as well as variations within the normal range have been linked to an increased risk of cardiovascular disease and death. However, it remains unclear whether there are differences in life span and years of life lived with and without cardiovascular disease, within the reference range of thyroid function. To investigate this, we performed a prospective study among 7785 middle-aged and elderly people with normal thyroid function. Participants were part of the Rotterdam Study, 65 years on average and 52% females. In our statistical analyses, we accounted for sociodemographic and cardiovascular risk factors. Over a median follow-up of 8.1 years, 789 incident cardiovascular deaths and 1357 deaths occurred. Analyses were performed separately among men and women. Our study found differences in life expectancy within the reference range of thyroid function. At the age of 50 years, people with low-normal thyroid function lived up to 3.5 years longer than those with high-normal thyroid function. Also, people with low-normal thyroid function lived a longer life without cardiovascular disease than those with high-normal thyroid function.
Author Interviews, Endocrinology, Heart Disease, Thyroid Disease / 09.04.2017

MedicalResearch.com Interview with: Arjola Bano, MD, DSc PhD candidate Departments of Internal Medicine and Epidemiology Erasmus Medical Center, Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atherosclerosis is a chronic condition, characterized by the accumulation of lipids and fibrous elements in the arterial walls. It can progress insidiously from an asymptomatic narrowing of the arterial lumen (subclinical phase) to the clinical onset of vascular events (as coronary heart disease or stroke) and death. Despite advances in prevention and treatment, atherosclerotic diseases remain a leading cause of mortality worldwide. Therefore, identifying additional modifiable risk factors for atherosclerosis is of major importance. So far, the role of thyroid hormone on atherosclerosis remains unclear. Moreover, a comprehensive investigation exploring the link of thyroid function with the wide spectrum of atherosclerosis, including subclinical atherosclerosis, clinical atherosclerosis and atherosclerotic mortality, within the same population is lacking. Therefore, in a prospective study of 9231 middle-aged and elderly people, we explored the association of thyroid function with subclinical atherosclerosis (coronary artery calcification), atherosclerotic events (fatal and nonfatal coronary heart disease or stroke) and atherosclerotic mortality (death from coronary heart disease, cerebrovascular or other atherosclerotic disease). Higher free thyroxine (FT4) levels were associated with higher risk of subclinical atherosclerosis, atherosclerotic events and atherosclerotic mortality, independently of cardiovascular risk factors. The risk of atherosclerotic mortality increased with higher FT4 levels (HR; CI: 2.35; 1.61-3.41 per 1 ng/dl) and lower thyroid-stimulating hormone (TSH) levels (HR; CI: 0.92; 0.84-1.00 per 1 logTSH), with stronger estimates among participants with a history of atherosclerotic disease (HR; CI: 5.76; 2.79-11.89 for FT4 and 0.81; 0.69-0.95 for TSH).
Author Interviews, NEJM, OBGYNE, Thyroid Disease, UT Southwestern / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32419" align="alignleft" width="70"]Professor, Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center Dr. Casey[/caption] Professor Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center  MedicalResearch.com: What is the background for this study? Response: For several decades now, subclinical thyroid disease, variously defined, has been associated with adverse pregnancy outcomes.  In 1999, two studies are responsible for increasing interest in subclinical thyroid disease during pregnancy because it was associated with impaired neuropsychological development in the fetus.  One study showed that children born to women with the highest TSH levels had lower IQ levels.  The other showed that children of women with isolated low free thyroid hormone levels performed worse on early psychomotor developmental tests. Together, these findings led several experts and professional organizations to recommend routine screening for and treatment of subclinical thyroid disease during pregnancy. Our study was designed to determine whether screening for either of these two diagnoses and treatment with thyroid hormone replacement during pregnancy actually improved IQ in children at 5 years of age.
Author Interviews, BMJ, Endocrinology, Mayo Clinic, OBGYNE, Thyroid Disease / 27.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31551" align="alignleft" width="200"]Dr. Spyridoula Maraka Assistant professor of medicine Division of Endocrinology and Metabolism Center for Osteoporosis and Metabolic Bone Diseases University of Arkansas for Medical Sciences and the Central Arkansas Veterans Health Care System Little Rock Arkansas Dr. Spyridoula Maraka[/caption] Dr. Spyridoula Maraka Assistant professor of medicine Division of Endocrinology and Metabolism Center for Osteoporosis and Metabolic Bone Diseases University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care System Little Rock Arkansas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Subclinical hypothyroidism, a mild thyroid dysfunction, has been associated in pregnancy with multiple adverse outcomes. Our aim was to estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Using a large national US dataset, we identified 5,405 pregnant women diagnosed with subclinical hypothyroidism. Of these, 843 women, with an average pretreatment TSH concentration of 4.8 milli-international units per liter, were treated with thyroid hormone. The remaining 4,562, with an average pretreatment TSH concentration of 3.3 milli-international units per liter, were not treated. Compared with the untreated group, treated women were 38 percent less likely to experience pregnancy loss. However, they were more likely to experience a preterm delivery, gestational diabetes or preeclampsia. Moreover, the benefit of thyroid hormone treatment on pregnancy loss was seen only among women with higher TSH levels (4.1 to 10 mIU/L) before treatment. We also found that for women with lower levels of TSH (2.5–4.0 mIU/L), the risk of gestational hypertension was significantly higher for treated women than for untreated women.
Author Interviews, Electronic Records, Endocrinology, Thyroid, Thyroid Disease / 25.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31505" align="alignleft" width="133"]Ilya Likhterov, MD Assistant Professor, Otolaryngology Icahn School of Medicine at Mount Sinai Dr. Ilya Likhterov[/caption] Ilya Likhterov, MD Assistant Professor, Otolaryngology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: As our understanding of thyroid cancer improves, the way these patients are diagnosed and treated is changing. It is difficult for clinicians to incorporate every individual scientific study into their practice. These studies are numerous and the results can be conflicting. To address this difficulty, organizations such as the American Thyroid Association (ATA) create summary recommendations that account for the latest research and translate it into a format that is easily usable for physicians. Such clinical practice guidelines are available not just for thyroid cancer care, but in many other fields. The difficulty however, is how to ensure that clinicians have access to the guidelines and incorporate the recommendations into their practice. There are a number of barriers to actually using the guidelines in practice, and we attempt to identify strategies on how to overcome these.
Author Interviews, Endocrinology, JCEM, Thyroid Disease / 14.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28881" align="alignleft" width="120"]Antonio C. Bianco, MD, PhD Rush University Medical Center Dr. Antonio C. Bianco[/caption] Antonio C. Bianco, MD, PhD Rush University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard of care for patients with hypothyroidism is treatment with levothyroxine. The dosage of levothyroxine is adjusted for each patient with the goal of normalizing blood levels of TSH. About 15% of the patients treated this way exhibit variable degrees of residual symptoms, despite having a normal TSH level. These symptoms include difficulty losing weight, low energy and depression. However, given the subjective nature of these complains and that the blood levels of TSH are normal, many times such symptoms are dismissed by physicians as non-thyroid related.
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Endocrinology, Heart Disease, Thyroid Disease / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28053" align="alignleft" width="200"]Layal Chaker, MD, MSc Research and Curriculum Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, MA Dr. Layal Chaker[/caption] Layal Chaker, MD, MSc PhD candidate Department of Endocrinology and Epidemiology Erasmus Medical Center Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets.
Author Interviews, BMJ, Radiology, Thyroid / 22.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26244" align="alignleft" width="148"]Megan Haymart, M.D. Assistant Professor Institute for HealthCare Policy and Innovation University of Michigan Dr. Megan Haymart[/caption] Megan Haymart, M.D. Assistant Professor Institute for HealthCare Policy and Innovation University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past three decades the incidence of thyroid cancer has risen. The majority of this rise in incidence is secondary to an increase in low-risk disease. In the setting of this rise in low-risk thyroid cancer, our team noted that over time there was a dramatic rise in imaging after initial treatment for thyroid cancer. We subsequently wanted to understand the implications of this increase in imaging. Does more imaging equal improved outcomes? In this study published in BMJ, we found that this marked rise in imaging after primary treatment of differentiated thyroid cancer was associated with increased treatment for recurrence but with the exception of radioiodine scans in presumed iodine-avid disease, no clear improvement in disease specific survival.
Author Interviews, Endocrinology / 22.01.2016

[caption id="attachment_20847" align="alignleft" width="130"]Marita Teng, MD Associate Professor of Otolaryngology Head and Neck Institute Icahn School of Medicine at Mount Sinai Dr. Marita Teng[/caption] MedicalResearch.com Interview with: Marita Teng, MD Associate Professor of Otolaryngology Head and Neck Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com Editor's note: January is Thyroid Awareness Month. In recognition, Dr. Teng discusses the thyroid gland's important role in the production of  hormones that help the body regulate its metabolism.  Dr. Teng also discusses the recognition of thyroid nodules and cancer. MedicalResearch: What does the thyroid gland do?  Why is it important for health? Dr. Teng: The thyroid gland produces thyroid hormone, which is carried through the circulation to the other organs in the body.  Thyroid hormone is responsible for the body’s metabolism, and therefore maintains functions such as keeping the body warm, and properly use the energy we derive from food. MedicalResearch: What is are some signs or symptoms of an underactive or overactive thyroid? Dr. Teng: Thyroid overactivity (hyperactivity) results in heat intolerance, weight loss, rapid heartbeat, nervousness, increased appetite, difficulty sleeping, skin thinning, and hair loss, among other symptoms.  Thyroid underactivity (hypothyroidism) causes fatigue, weight gain, cold sensitivity, slowed heart rate, depression, memory impairment, and weakness, among other symptoms.  It should be noted that these symptoms are all nonspecific and can certainly be caused by other medical conditions as well.
Author Interviews, Endocrinology, JAMA, Thyroid Disease / 05.03.2015

Sebastiano Filetti MD Dipartimento di Medicina Interna Università di Roma RomaMedicalResearch.com Interview with; Sebastiano Filetti MD Dipartimento di Medicina Interna Università di Roma Roma MedicalResearch: What is the background for this study? What are the main findings? Dr. Filetti: Thyroid nodule diagnosis is becoming more and more frequent in clinical practice. This trend stems largely from the incidental discovery of small nodules due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Ultrasound studies, for example, are widely used for evaluating other structures in the neck, such as the carotid arteries, parathyroid glands, lymph nodes, and salivary glands. Over 90% of detected thyroid nodules are clinically insignificant, in that they have been cytologically proven to be benign or they have no ultrasound features that raise the suspicion of malignancy. However, consensus is lacking regarding the best way to follow these nodules, mainly because little is known about the actual frequency and magnitude of their growth. The results of our study suggest that most benign nodules exhibit no significant size changes over time, and some actually decrease in size. Only a small subgroup of nodules can be expected to grow, about 15% in our series. However, the growth is slow and limited in magnitude. Most important, the occurrence of cancer is very rare in nodules like this, that appear to be benign.
Author Interviews, BMJ, Endocrinology, Thyroid Disease / 25.02.2015

Professor Stephen Peckham Director, Centre for Health Services Studies Professor of Health Policy Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine Director, Policy Research Unit in Commissioning and the Healthcare System University of KentMedicalResearch.com Interview with: Professor Stephen Peckham Director, Centre for Health Services Studies Professor of Health Policy Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine Director, Policy Research Unit in Commissioning and the Healthcare System University of Kent   Medical Research: What is the background for this study? What are the main findings? Response: Community water fluoridation remains a controversial public health measure. There have been continued debates about both its effectiveness in the prevention of dental caries and also its safety. Previous studies have suggested that there is an association between fluoride ingestion and the incidence of hypothyroidism few population level studies have been undertaken. In April 2014 Public Health England published a monitoring report that used secondary analysis of routine health statistics to identify whether water fluoridation in England was associated with any adverse health outcomes. While hypothyroidism data is available this was not included in their monitoring report.  In England approximately 10% of the population lives in areas with community fluoridation schemes and hypothyroidism prevalence can be assessed from general practice data. Tt examine whether there is a relationship – as suggested in smaller studies – we used a cross-sectional study design using secondary data to develop binary logistic regression models of predictive factors for hypothyroidism prevalence at practice level using 2012 data on fluoride levels in drinking water, 2012/13 Quality Outcomes Framework (QOF) diagnosed hypothyroidism prevalence data, 2013 General Practitioner (GP) registered patient numbers, and 2012 practice level Index of Multiple Deprivation scores. We found a positive association between fluoride levels and hypothyroidism. High hypothyroidism prevalence was found to be at least 30% more likely in practices located in areas with fluoride levels in excess of 0.3mg/L. This population study supports earlier hypotheses that fluoride is associated with hypothyroidism. In the UK water is fluoridated at 1ppm (1mg/L) and in areas where water is fluoridated the model predicts that after controlling for other factors, practice populations are significantly more likely to have higher levels of hypothyroidism than those in non-fluoridated areas. Higher levels of fluoride in drinking water, therefore, provide a useful contribution for predicting prevalence of hypothyroidism. For example in contrasting two urban areas we found that practices located in the West Midlands (a wholly fluoridated area) are nearly twice as likely to report high hypothyroidism prevalence in comparison to Greater Manchester (non-fluoridated area).
Author Interviews, CMAJ, Diabetes, Thyroid Disease / 07.10.2014

MedicalResearch.com Interview with: Jean-Pascal Fournier, MD, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and Laurent Azoulay, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Department of Oncology, McGill University, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36).
Author Interviews, Endocrinology, JCEM / 20.06.2014

Mette Andersen Nexø Psychologist, Ph.D. student at The National Research Center for the Working Environment Copenhagen Area, DenmarkMedicalResearch.com: Interview with Mette Andersen Nexø Psychologist, Ph.D. student at The National Research Center for the Working Environment Copenhagen Area, Denmark MedicalResearch: What is the background for this study? Answer: The present study is a systematic assessment of the influence of a spectrum of thyroid diseases on ability to work. By presenting new information on the possible socioeconomic consequences of thyroid diseases, the results can help bring awareness to important needs for rehabilitation of thyroid patients.
Author Interviews, JAMA, Lipids, Thyroid Disease / 18.11.2013

Angela M. Leung, MD, MSc Clinical Assistant Professor of Medicine Division of Endocrinology, Department of Medicine University of California Los AngelesMedicalResearch.com Interview with: Angela M. Leung, MD, MSc Clinical Assistant Professor of Medicine Division of Endocrinology, Department of Medicine University of California Los Angeles   MedicalResearch.com: What are the main findings of the study? Dr. Leung: Despite current guidelines to screen for thyroid dysfunction as a secondary cause of newly-diagnosed hyperlipidemia, this was performed only about 50% of the time by primary care providers in over 8,700 patients at a large, urban Boston academic medical center. Approximately 5% of patients who had thyroid function checked were found to have hypothyroidism. The majority of hypothyroid patients who received treatment with levothyroxine had successful correction of the initial hyperlipidemia within one year.