ArticleThe Journal of clinical endocrinology and metabolism2021
The Hypothalamic-Pituitary-Thyroid Axis in Cushing Syndrome Before and After Curative Surgery.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Thyroid function spectrum in Cushing's syndrome.BMC endocrine disorders · 2024Pooled it
- Thyroid axis adaptations to moderate short-term energy restriction in healthy, young women.European journal of endocrinology · 2025Trial
- A retrospective study of severity-dependent HPG Axis suppression by glucocorticoids in Chinese women with Cushing syndrome.Frontiers in endocrinology · 2026Article
- Case Report: Reversible central hypothyroidism-like thyroid dysfunction revealing ACTH-independent cushing syndrome during pregnancy.Frontiers in medicine · 2026Article
- Article
- Longitudinal Evaluation of Reproductive Endocrine Function in Men With ACTH-Dependent Cushing Syndrome.The Journal of clinical endocrinology and metabolism · 2025Article
- Article
- Evaluation of non-thyroidal illness syndrome in shock patients admitted to pediatric intensive care unit in a developing country.European journal of pediatrics · 2024Observational
- The recovery time of hypothalamic-pituitary-adrenal axis after curative surgery in Cushing's disease and its related factor.Endocrine · 2023Article
- The Thyroid Hormone Axis and Female Reproduction.International journal of molecular sciences · 2023Review
- Epidemiology of Male Hypogonadism.Endocrinology and metabolism clinics of North America · 2022Review
- Perioperative Management of a Patient With Cushing Disease.Journal of the Endocrine Society · 2022Article
- Ectopic Cushing's syndrome from an ACTH-producing pheochromocytoma with a non-functioning pituitary adenoma.Endocrinology, diabetes & metabolism case reports · 2022Article
- Consensus on diagnosis and management of Cushing's disease: a guideline update.The lancet. Diabetes & endocrinology · 2021Review
- Cushing's Syndrome Effects on the Thyroid.International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWe do not fully understand how hypercortisolism causes central hypothyroidism or what factors influence recovery of the hypothalamic-pituitary-thyroid axis. We evaluated thyroid function during and after cure of Cushing syndrome (CS).
methodsWe performed a retrospective cohort study of adult patients with CS seen from 2005 to 2018 (cohort 1, c1, n = 68) or 1985 to 1994 (cohort 2, c2, n = 55) at a clinical research center. Urine (UFC) and diurnal serum cortisol (F: ~8 am and ~midnight [pm]), morning 3,5,3'-triiodothyronine (T3), free thyroxine (FT4), and thyrotropin (TSH) (c1) or hourly TSH from 1500 to 1900 h (day) and 2400 to 04000 h (night) (c2), were measured before and after curative surgery.
resultsWhile hypercortisolemic, 53% of c1 had central hypothyroidism (low/low normal FT4 + unelevated TSH). Of those followed long term, 31% and 44% had initially subnormal FT4 and T3, respectively, which normalized 6 to 12 months after cure. Hypogonadism was more frequent in hypothyroid (69%) compared to euthyroid (13%) patients. Duration of symptoms, morning and midnight F, adrenocorticotropin, and UFC were inversely related to TSH, FT4, and/or T3 levels (r = -0.24 to -0.52, P < .001 to 0.02). In c2, the nocturnal surge of TSH (mIU/L) was subnormal before (day 1.00 ± 0.04 vs night 1.08 ± 0.05, P = .3) and normal at a mean of 8 months after cure (day 1.30 ± 0.14 vs night 2.17 ± 0.27, P = .01). UFC greater than or equal to 1000 μg/day was an independent adverse prognostic marker of time to thyroid hormone recovery.
conclusionsAbnormal thyroid function, likely mediated by subnormal nocturnal TSH, is prevalent in Cushing syndrome and is reversible after cure.
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