Thyrotropin levels high
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High Thyrotropin Levels: Implications and Associations
High Thyrotropin and Hypertension
Cross-Sectional Association with Hypertension
High serum thyrotropin (TSH) levels have been linked to increased arterial blood pressure and hypertension in adults. A large consortium study involving 17,023 individuals found a significant positive association between TSH levels and both systolic and diastolic blood pressure, as well as hypertension1. However, this association was not observed longitudinally over a five-year period, suggesting that the effect of TSH on blood pressure may be short-term or potentially spurious1.
Thyrotropin and Nonalcoholic Fatty Liver Disease (NAFLD)
Risk Factor for NAFLD in Type 2 Diabetes
In patients with type 2 diabetes mellitus (T2DM), high-but-normal TSH levels have been identified as an independent risk factor for nonalcoholic fatty liver disease (NAFLD). A study involving 2,289 euthyroid T2DM patients found that higher TSH levels were significantly associated with an increased incidence of NAFLD3. This suggests that monitoring TSH levels could be crucial in managing and preventing NAFLD in T2DM patients.
Thyrotropin and Lipid Profiles
Sex-Specific Associations
TSH levels have been shown to influence serum lipid profiles differently in men and women. In a pooled analysis of 13,571 individuals, high TSH levels were associated with higher triglyceride levels in men and higher total cholesterol and low-density lipoprotein (LDL) cholesterol levels in women4. This indicates that elevated TSH can lead to a less favorable lipid profile, potentially increasing cardiovascular risk, particularly in women.
Thyrotropin and Carotid Atherosclerosis
Association with Carotid Intima-Media Thickness
In euthyroid women, particularly postmenopausal women, higher TSH levels within the normal range have been associated with increased carotid intima-media thickness (IMT), a marker of atherosclerosis. A study of 468 women found that those with TSH levels ≥2.5 μIU/mL had significantly higher carotid max IMT values compared to those with lower TSH levels, suggesting a potential risk for cardiovascular diseases9.
Thyrotropin-Induced Hyperthyroidism
Pituitary Tumors and TSH Secretion
Elevated TSH levels can sometimes indicate thyrotropin-induced hyperthyroidism, often due to pituitary tumors. Patients with such tumors typically exhibit high serum TSH and alpha subunit levels, with little or no response to thyrotropin-releasing hormone (TRH) stimulation2 5. This condition, known as inappropriate secretion of TSH, can be differentiated from other causes of hyperthyroidism through specific diagnostic tests and imaging8.
Conclusion
High thyrotropin levels are associated with various health conditions, including hypertension, NAFLD, unfavorable lipid profiles, and carotid atherosclerosis. These associations highlight the importance of monitoring TSH levels in clinical practice to manage and prevent related health issues effectively. Further research is needed to fully understand the long-term implications of elevated TSH and to develop targeted interventions.
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Most relevant research papers on this topic
High serum thyrotropin levels are associated with current but not with incident hypertension.
High serum thyrotropin levels are associated with current hypertension and blood pressure, but not with a five-year change in blood pressure or incident hypertension.
Meta-AnalysisThyrotropin-induced hyperthyroidism: use of alpha and beta subunit levels to identify patients with pituitary tumors.
Patients with pituitary tumors have significantly elevated alpha and TSH levels, while those without tumors have normal alpha and TSH levels.
Observational Study
Highly Cited1915-P: High-but-Normal Serum Thyrotropin Levels Increased the Risk of Nonalcoholic Fatty Liver Disease in Euthyroid Subjects with Type 2 Diabetes
High-but-normal serum TSH levels are a significant risk factor for increased nonalcoholic fatty liver disease (NAFLD) in euthyroid type 2 diabetes patients.
Observational Study
Very Rigorous JournalSex-specific associations between thyrotropin and serum lipid profiles.
Increasing levels of thyrotropin are associated with a less favorable lipid profile in both men and women, with levels within the reference range being significantly positively associated with triglyceride concentrations.
Meta-Analysis
Rigorous JournalThyrotropin-induced hyperthyroidism caused by selective pituitary resistance to thyroid hormone. A new syndrome of "inappropriate secretion of TSH".
This case study highlights a new syndrome of TSH-induced hyperthyroidism caused by selective pituitary resistance to thyroid hormone, a new classification called "inappropriate secretion of TSH".
Case ReportHighly CitedSerum thyrotropin (TSH) in pituitary and-or hypothalamic hypothyroidism: normal or elevated basal levels and paradoxical responses to thyrotropin-releasing hormone.
TSH levels in patients with pituitary or hypothalamic hypothyroidism may be normal or slightly elevated, with paradoxical responses to thyrotropin-releasing hormone.
Observational StudyHighly CitedIncreased high-molecular-weight thyrotropin with impaired biologic activity in a euthyroid man.
A high-molecular-weight form of thyrotropin (TSH) in a healthy young man showed decreased stimulation of thyroid membranes, suggesting a possible cause for hypothyroidism.
Case ReportThyrotropin-secreting pituitary adenomas.
TSH-secreting pituitary adenomas are easily detectable by CT scan or MRI, and surgical removal leads to clinical and biochemical remission in most patients.
Highly CitedAssociation between high normal-range thyrotropin concentration and carotid intima-media thickness in euthyroid premenopausal, perimenopausal and postmenopausal women.
Serum TSH concentration 2.5 IU/mL may help assess the risk of atherosclerosis in postmenopausal women.
Observational StudyCurrent Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age.
Macro-thyrotropin is present in 0.17% of infertile women and can be diagnosed using commercial TSH immunoassays, leading to hyperthyrotropinemia diagnosis.
Observational StudyRigorous Journal