Thyroid-Stimulating Hormone as a Biomarker for Stress After Thyroid Surgery: A Prospective Cohort Study

[helvella]

Posted by Johannes W. Dietrich

Type 2 allostatic load is an important confounder in the diagnostic interpretation of thyroid function: TSH is elevated in situations of #stress.

My comment:

There have been many posts which have linked stress and thyroid issues.

20 October 2022: Clinical Research

[In Press]Thyroid-Stimulating Hormone as a Biomarker for Stress After Thyroid Surgery: A Prospective Cohort Study

Hua Hong , Jeonghun Lee

DOI: 10.12659/MSM.937957

Med Sci Monit In Press; DOI: 10.12659/MSM.937957

Abstract

BACKGROUND

Thyroid-stimulating hormone (TSH), which is regulated by the negative feedback of triiodothyronine (T3) and thyroxine (T4), is affected by cortisol (a stress hormone) and cytokines during allostasis. Thus, we assessed changes in TSH levels under stress and its potential as a stress marker in patients lacking T3 or T4 feedback after thyroid surgery.

MATERIAL AND METHODS

Three stress questionnaires (Korean version of the Daily Stress Inventory, Social Readjustment Rating Scale, and Stress Overload Scale-Short [SOSS]), an open-ended questionnaire (OQ), and thyroid function tests were administered twice to 106 patients enrolled from January 2019 to October 2020.

RESULTS

In a multiple generalized linear mixed-effect model (GLMM) involving 106 patients, the T3 and free T4 levels, OQ, body weight, extent of thyroidectomy, and preoperative TSH levels were significantly correlated with log-transformed TSH (lnTSH). The modified SOSS (category) based on recent stressors on OQ interview was significantly associated with lnTSH. In the GLMM with modified SOSS (category), the lnTSH increased by 2.3 and 0.56 in the unconscious high- and high-risk groups, respectively, compared to that in the low-risk group (P<0.05). The calculated power of this study was 0.92 based on α=0.05.

CONCLUSIONS

TSH had a significant relationship with stress and the extent of thyroidectomy. An OQ supported the SOSS to help detect unrecognized stressors. TSH has potential utility as a stress marker combined with the modified SOSS (category) with sufficient power. However, questionnaires on social environments and research on coping strategies for stress are necessary for future studies.

Keywords:Thyroid Neoplasms; Stress; Thyroid-Stimulating Hormone; Thyroidectomy

Currently open access but am not sure what will happen when published:

medscimonit.com/abstract/in...

[SarahJane1471]

I still have my thyroid but I certainly believe 20 odd years of PTSD ( plus the menopause) has caused my thyroid problems.

[Charlie-Farley]

Hi helvella

- my body breakdown as I called it - because that’s what it felt like was during 10 years of caring for both parents in decline from Dad with Alzheimer's and Mum with Vascular Dementia (whilst running a business with hubby). Hypothyroidism runs in both sides of my family but I believe stress was the activator, so to speak.

Absolutely…..

[TSH110]

My thyroid disorder seemed to gallop away completely out of control after my partner tried to commit suicide twice in close succession. It wasn’t the cause but I can’t imagine it helped.