ArticleTheoretical biology & medical modelling2014
The homeostatic set point of the hypothalamus-pituitary-thyroid axis--maximum curvature theory for personalized euthyroid targets.
Article in Theoretical biology & medical modelling, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 46 citations in OpenAlex.
- Signal Amplification in the HPT Axis-Evidence for Its Existence, Location, Significance, and Molecular Mechanisms.Acta physiologica (Oxford, England) · 2026Review
- Sinus bradycardia after intravenous methylprednisolone pulse therapy in patients with thyroid-associated ophthalmopathy.Frontiers in pharmacology · 2026Article
- Stability-aware LSTM-MPC framework for personalized levothyroxine dosing in Hashimoto's thyroiditis.Frontiers in endocrinology · 2026Article
- Quality of life in pregnant women with subclinical hypothyroidism: clinical management gaps.Thyroid research · 2025Article
- Model-based conceptualization of thyroid hormone equilibrium via set point and stability behavior.Journal of mathematical biology · 2024Article
- Testing for a causal role of thyroid hormone measurements within the normal range on human metabolism and diseases: a systematic Mendelian randomization.EBioMedicine · 2024Article
- Three candidate SNPs show associations with thyroid-stimulating hormone in euthyroid subjects: Tehran thyroid study.Journal of diabetes and metabolic disorders · 2024Article
- Changes in Thyroid Metabolites after Liothyronine Administration: A Secondary Analysis of Two Clinical Trials That Incorporated Pharmacokinetic Data.Metabolites · 2022Article
- Minor perturbations of thyroid homeostasis and major cardiovascular endpoints-Physiological mechanisms and clinical evidence.Frontiers in cardiovascular medicine · 2022Review
- Redefinition of Successful Treatment of Patients With Hypothyroidism. Is TSH the Best Biomarker of Euthyroidism?Frontiers in endocrinology · 2022Review
- Psychometric properties of the thyroid-specific quality of life questionnaire ThyPRO in Singaporean patients with Graves' disease.Journal of patient-reported outcomes · 2021Article
- Profiling retrospective thyroid function data in complete thyroidectomy patients to investigate the HPT axis set point (PREDICT-IT).Journal of endocrinological investigation · 2021Article
- Reinterpreting patterns of variation in human thyroid function: An evolutionary ecology perspective.Evolution, medicine, and public health · 2021Review
- Article
- Hyperthyroidism in the personalized medicine era: the rise of mathematical optimization.Journal of the Royal Society, Interface · 2019Article
- Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction.Journal of thyroid research · 2019Review
- Individualised requirements for optimum treatment of hypothyroidism: complex needs, limited options.Drugs in context · 2019Review
- Mathematical Modeling of the Pituitary-Thyroid Feedback Loop: Role of a TSH-TFrontiers in endocrinology · 2018Article
- Editorial: "Homeostasis and Allostasis of Thyroid Function".Frontiers in endocrinology · 2018Article
- Population correlations do not support the existence of set points for blood levels of calcium or glucose - a new model for homeostasis.Physiological reports · 2018Article
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite rendering serum free thyroxine (FT4) and thyrotropin (TSH) within the normal population ranges broadly defined as euthyroidism, many patients being treated for hyperthyroidism and hypothyroidism persistently experience subnormal well-being discordant from their pre-disease healthy euthyroid state. This suggests that intra-individual physiological optimal ranges are narrower than laboratory-quoted normal ranges and implies the existence of a homeostatic set point encoded in the hypothalamic-pituitary-thyroid (HPT) axis that is unique to every individual.
methodsWe have previously shown that the dose-response characteristic of the hypothalamic-pituitary (HP) unit to circulating thyroid hormone levels follows a negative exponential curve. This led to the discovery that the normal reference intervals of TSH and FT4 fall within the 'knee' region of this curve where the maximum curvature of the exponential HP characteristic occurs. Based on this observation, we develop the theoretical framework localizing the position of euthyroid homeostasis over the point of maximum curvature of the HP characteristic.
resultsThe euthyroid set points of patients with primary hypothyroidism and hyperthyroidism can be readily derived from their calculated HP curve parameters using the parsimonious mathematical model above. It can be shown that every individual has a euthyroid set point that is unique and often different from other individuals.
conclusionsIn this treatise, we provide evidence supporting a set point-based approach in tailoring euthyroid targets. Rendering FT4 and TSH within the laboratory normal ranges can be clinically suboptimal if these hormone levels are distant from the individualized euthyroid homeostatic set point. This mathematical technique permits the euthyroid set point to be realistically computed using an algorithm readily implementable for computer-aided calculations to facilitate precise targeted dosing of patients in this modern era of personalized medicine.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.