ReviewFrontiers in endocrinology2016
Relational Stability in the Expression of Normality, Variation, and Control of Thyroid Function.
Review in Frontiers in endocrinology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Genome-wide association meta-analysis for total thyroid hormone levels in Croatian population.Journal of human genetics · 2019Pooled it
- Maternal thyroid function in the first half of pregnancy and neurodevelopmental outcomes in early adolescence in the Amsterdam Born Children and their Development (ABCD) cohort.Comprehensive psychoneuroendocrinology · 2026Article
- Association between monocyte to high-density lipoprotein cholesterol ratio and thyroid function: a cross-sectional study.Scientific reports · 2025Article
- Four-Dimensional Dual-Energy Computed Tomography-Derived Parameters and Their Correlation with Thyroid Gland Functional Status.Tomography (Ann Arbor, Mich.) · 2025Article
- Gut microbiota in hypothyroidism: pathogenic mechanisms and opportunities for precision microbiome interventions.Frontiers in microbiology · 2025Review
- How Does Physical Activity Modulate Hormone Responses?Biomolecules · 2024Review
- Expressions of glycemic parameters, lipid profile, and thyroid hormone in patients with type 2 diabetes mellitus and their correlation.Immunity, inflammation and disease · 2024Article
- Vitamin D and the Thyroid: A Critical Review of the Current Evidence.International journal of molecular sciences · 2023Review
- The role of supporting and disruptive mechanisms of FT3 homeostasis in regulating the hypothalamic-pituitary-thyroid axis.Therapeutic advances in endocrinology and metabolism · 2023Article
- Dynamics of thyroid diseases and thyroid-axis gland masses.Molecular systems biology · 2022Article
- Relatively Lower FT3 Levels Are Associated with Impaired Quality of Life in Levothyroxine-Treated Patients with Hashimoto Thyroiditis.International journal of endocrinology · 2022Article
- Principles of Endocrine Regulation: Reconciling Tensions Between Robustness in Performance and Adaptation to Change.Frontiers in endocrinology · 2022Article
- Minor perturbations of thyroid homeostasis and major cardiovascular endpoints-Physiological mechanisms and clinical evidence.Frontiers in cardiovascular medicine · 2022Review
- T4 rather than TSH correlates with BMD among euthyroid adults.Frontiers in endocrinology · 2022Article
- Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels.International journal of molecular sciences · 2021Review
- Endocrine Autoimmune Disease as a Fragility of Immune Surveillance against Hypersecreting Mutants.Immunity · 2020Article
- Heterogenous biochemical expression of hormone activity in subclinical/overt hyperthyroidism and exogenous thyrotoxicosis.Journal of clinical & translational endocrinology · 2020Article
- Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study.BMJ (Clinical research ed.) · 2019Article
- Functional and Symptomatic Individuality in the Response to Levothyroxine Treatment.Frontiers in endocrinology · 2019Article
- Individualised requirements for optimum treatment of hypothyroidism: complex needs, limited options.Drugs in context · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Thyroid hormone concentrations only become sufficient to maintain a euthyroid state through appropriate stimulation by pituitary thyroid-stimulating hormone (TSH). In such a dynamic system under constant high pressure, guarding against overstimulation becomes vital. Therefore, several defensive mechanisms protect against accidental overstimulation, such as plasma protein binding, conversion of T4 into the more active T3, active transmembrane transport, counter-regulatory activities of reverse T3 and thyronamines, and negative hypothalamic-pituitary-thyroid feedback control of TSH. TSH has gained a dominant but misguided role in interpreting thyroid function testing in assuming that its exceptional sensitivity thereby translates into superior diagnostic performance. However, TSH-dependent thyroid disease classification is heavily influenced by statistical analytic techniques such as uni- or multivariate-defined normality. This demands a separation of its conjoint roles as a sensitive screening test and accurate diagnostic tool. Homeostatic equilibria (set points) in healthy subjects are less variable and do not follow a pattern of random variation, rather indicating signs of early and progressive homeostatic control across the euthyroid range. In the event of imminent thyroid failure with a reduced FT4 output per unit TSH, conversion efficiency increases in order to maintain FT3 stability. In such situations, T3 stability takes priority over set point maintenance. This suggests a concept of relational stability. These findings have important implications for both TSH reference limits and treatment targets for patients on levothyroxine. The use of archival markers is proposed to facilitate the homeostatic interpretation of all parameters.
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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.