ArticleInternational journal of endocrinology and metabolism2025
Lazy Adrenals in Severe Hypothyroidism - Myth or Mirage?
Article in International journal of endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- An Unusual Presentation of Severe Hypothyroidism in a Child With Undiagnosed Systemic Lupus Erythematous.JCEM case reports · 2026Article
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2 authors.
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Abstract
Background: Clinical features of hypothyroidism and adrenal insufficiency (AI) often overlap. Objectives: To assess the morning serum cortisol levels of treatment-naïve patients with severe hypothyroidism. Methods: In this prospective, case-control study, treatment-naïve adults with severe hypothyroidism [thyroid-stimulating hormone (TSH) > 100 mIU/mL] were compared with age- and sex-matched euthyroid controls. Morning (08:00 AM) serum cortisol, TSH, triiodothyronine (T3), and thyroxine (T4) levels were measured. AI was defined clinically and biochemically as cortisol levels < 4 µg/dL. Correlation coefficients between T3, T4, and cortisol levels were calculated. Results: The case group (n = 71; women, 88.7%; mean age, 30.0 ± 9.0 years) had significantly lower serum cortisol levels than controls (n = 40; 8.6 ± 4.2 vs 16.0 ± 2.22 µg/dL; P < 0.0001). Six patients (8.5%) in the case group met criteria for AI. Patients with AI had significantly lower T3 and T4 levels than those without AI (P = 0.018 and P = 0.005, respectively). A negative correlation was observed between T3 and cortisol levels (r = -0.243, P = 0.041), while T4 showed no significant correlation (r = -0.103, P = 0.391). Conclusions: Treatment-naïve patients with severe hypothyroidism may exhibit biochemical evidence of AI. Routine screening for AI in these patients is recommended to avoid missed diagnoses and guide appropriate therapy.
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