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Hirosuke Danno Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Eijun Nishihara Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Kazuyoshi Kousaka Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Tomohiko Nakamura Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Toshihiko Kasahara Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Takumi Kudo Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Mitsuru Ito Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Shuji Fukata Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Mitsushige Nishikawa Division of Internal Medicine, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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Akira Miyauchi Division of Surgery and Director, Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

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]. Materials and Methods Patients This study involved patients who visited our hospital between February 2005 and August 2019. Thyrotoxicosis was diagnosed when the thyroid-stimulating hormone (TSH) concentration was ≤0.1 μU/mL, and FT4 and/or FT3 level

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Kristian Hillert Winther Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Enrico Papini Department of Endocrinology and Metabolism, Ospedale Regina Apostolorum, Rome, Italy

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Roberto Attanasio Endocrine Unit, IRCCS Galeazzi Institute, Milan, Italy

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy

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Laszlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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investigated [ 2 , 3 ]. The first clinical intervention studies were published in populations with combined severe iodine and selenium deficiency [ 4 , 5 ], and it was soon recognized that the importance of the selenium status for the thyroid is dependent on

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Ola Lindgren Department of Endocrinology, Lund University, Malmö, Sweden
Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden

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Pernilla Asp Department of Oncology, Skåne University Hospital, Lund, Sweden

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Anna Sundlöv Department of Oncology, Lund University, and Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden

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Jan Tennvall Department of Oncology, Lund University, and Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden

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Bushra Shahida Department of Clinical Sciences Malmö, and Diabetes and Endocrinology, Lund University, Malmö, Sweden

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Tereza Planck Department of Endocrinology, Lund University, Malmö, Sweden
Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden

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Peter Åsman Department of Clinical Sciences Malmö, Ophthalmology, Lund University, and Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden

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Mikael Lantz Department of Endocrinology, Lund University, Malmö, Sweden
Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden

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have been studied in vitro, and it was suggested that irradiated lymphocytes of the thyroid are important in the synthesis of autoantibodies in response to iodine-131 [ 13 ]. The aim of the present study was to prospectively investigate if all patients

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P. Reed Larsen Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard Institutes of Medicine, Boston, Mass., USA

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Ann Marie Zavacki Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard Institutes of Medicine, Boston, Mass., USA

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vertebrates. These systems maintain the synthesis and secretion, and therefore the circulating concentration, of T4 at remarkably stable levels through the actions of thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH). However, since T4

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Denise Zwanziger Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany

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Helena Rakov Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany

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Kathrin Engels Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany

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Lars C. Moeller Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany

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Dagmar Führer Department of Endocrinology and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany

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Introduction Hypothyroidism is a pathophysiological state marked by decreased circulating thyroid hormone (TH) concentrations or impaired TH action in target tissues. In clinical practice, hypothyroidism is mostly due to afflictions of the

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Jan Calissendorff Department of Clinical Science and Education, Section of Endocrinology, Karolinska Institutet, Södersjukhuset, Sweden

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Emil Mikulski Department of Medicine, Mälarsjukhuset, Eskilstuna, Sweden
Centre for Clinical Research in Sörmland, Uppsala University, Uppsala, Sweden

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Erik H. Larsen National Food Institute, Technical University of Denmark, Søborg, Denmark

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Marika Möller Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
Centre for Clinical Research in Sörmland, Uppsala University, Uppsala, Sweden

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Measures of Hormones, Auto-Antibodies and Se Concentrations The median concentration of Se as SePP rose in the treatment group from 47 ng/ml (range 42-86) to 113 ng/ml (range 70-139), p < 0.001, whereas the levels remained unchanged in the PT group from

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Bernadette Biondi Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

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Luigi Bartalena Department of Clinical and Experimental Medicine, University of Insubria, Endocrine Unit, Ospedale di Circolo, Varese, Italy

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David S. Cooper Division of Endocrinology, Diabetes, and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Md., USA

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Laszlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Peter Laurberg Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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George J. Kahaly Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany

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concentrations [ 19 ]. In addition, a change in serum TSH levels may be observed in elderly patients due to potential changes in the hypothalamic-pituitary-thyroid axis with aging [ 20 , 21 ]. Iodine intake and the frequent alterations secondary to non

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Carolina C.P.S. Janovsky Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Rui M.B. Maciel Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Cleber P. Camacho Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Rosalia P. Padovani Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Claudia C. Nakabashi Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Ji H. Yang Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Eduardo Z. Malouf Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Elza S. Ikejiri Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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M. Conceição O.C. Mamone Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Jairo Wagner Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Danielle M. Andreoni Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Rosa Paula M. Biscolla Thyroid Diseases Center and Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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levels may remain detectable due to the presence of thyroid tissue not totally removed by surgery [ 18 ]. Durante et al. [ 19 ] have retrospectively studied the long-term development of incidental papillary thyroid cancer patients who did not undergo

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Josef Köhrle Institut für Experimentelle Endokrinologie, Charité Campus Virchow-Klinikum (CVK), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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labelling of the phenolic-ring once two iodine atoms have been introduced into the 3- and 5-position of the tyrosyl ring. Recently, an immunoassay based on monoclonal antibodies has been developed and applied [78], and concentrations reported are quite low

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Christiaan F Mooij Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands

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Timothy D Cheetham Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
Department of Pediatric Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Frederik A Verburg Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands

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Anja Eckstein Department of Ophthalmology, University Duisburg Essen, Essen, Germany

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Simon H Pearce Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
Endocrine Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Juliane Léger Department of Pediatric Endocrinology and Diabetes, Reference Center for Rare Endocrine Growth and Development Diseases, Endo-ERN HCP, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, University of Paris, NeuroDiderot Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France

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A S Paul van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands

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hyperthyroidism; often diffuse goiter at physical examination; headache, visual field defects or galactorrhea may be present Elevated (F)T4 and / or (F)T3 levels; normal or mildly elevated TSH levels; high serum alpha subunit concentration Other

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