612:) of the gland. In hypothyroid states or iodine deficiency, the body recognizes that it is not producing enough thyroid hormone and starts to produce more TSH to help stimulate the thyroid to produce more thyroid hormone. This stimulation causes the gland to increase in size to increase production of thyroid hormone. In hyperthyroidism caused by Graves' Disease or toxic multinodular goiter, there is excess stimulation of the TSH receptor even when thyroid hormone levels are normal. In Graves' Disease this is because of an autoantibodies (Thyroid Stimulating Immunoglobulins) which bind to and activate the TSH receptors in place of TSH while in toxic multinodular goiter this is often because of a mutation in the TSH receptor that causes it to activate without receiving a signal from TSH. In more rare cases, the thyroid may become enlarged because it becomes filled with thyroid hormone or thyroid hormone precursors that it is unable to release or because of congential abnormalities or because of increased intake of iodine from supplementation or medication.
621:
thyroid hormone. During pregnancy, there is also an increase in estrogen which causes the mother to produce more thyroxine binding globulin, which is what carries most of the thyroid hormone in the blood. These normal hormonal changes often make pregnancy look like a hyperthyroid state but may be within the normal range for pregnancy, so it necessary to use trimester specific ranges for TSH and free T4. True hyperthyroidism in pregnancy is most often caused by an autoimmune mechanism from Graves' Disease. New diagnosis of hypothyroidism in pregnancy is rare because hypothyroidism often makes it difficult to become pregnant in the first place. When hypothyroidism is seen in pregnancy, it is often because an individual already has hypothyroidism and needs to increase their levothyroxine dose to account for the increased thyroxine binding globulin present in pregnancy.
127:
to tolerate the cold, slow heart rate, dry skin and constipation. Common hyperthyroid symptoms include irritability, anxiety, weight loss, fast heartbeat, inability to tolerate the heat, diarrhea, and enlargement of the thyroid. Structural abnormalities may not produce symptoms, however some people may have hyperthyroid or hypothyroid symptoms related to the structural abnormality or notice swelling of the neck. Rarely goiters can cause compression of the airway, compression of the vessels in the neck, or difficulty swallowing. Tumors, often called thyroid nodules, can also have many different symptoms ranging from hyperthyroidism to hypothyroidism to swelling in the neck and compression of the structures in the neck.
599:
the body produces antibodies against the TSH receptor on thyroid cells. This causes the receptor to activate even without TSH being present and causes the thyroid to produce and release excess thyroid hormone (hyperthyroidism). Another common form of autoimmune thyroid disease is
Hashimoto's thyroiditis where the body produces antibodies against different normal components of the thyroid gland, most commonly thyroglobulin, thyroid peroxidase, and the TSH receptor. These antibodies cause the immune system to attack the thyroid cells and cause inflammation (lymphocytic infiltration) and destruction (fibrosis) of the gland.
1134:
iodine uptake can be high in countries with iodine deficiency, but low in iodine sufficient countries. To enhance iodine-131 uptake by the thyroid and allow for more successful treatment, TSH is raised prior to therapy in order to stimulate the existing thyroid cells. This is done either by withdrawal of thyroid hormone medication or injections of recombinant human TSH (Thyrogen), released in the United States in 1999. Thyrogen injections can reportedly boost uptake up to 50-60%. Radioiodine treatment can also cause hypothyroidism (which is sometimes the end goal of treatment) and, although rare, a pain syndrome (due to
63:
783:(TRH) is injected into the body through a vein. This hormone is naturally secreted by the hypothalamus and stimulates the pituitary gland. The pituitary responds by releasing thyroid-stimulating hormone (TSH). Large amounts of externally administered TRH can suppress the subsequent release of TSH. This amount of release-suppression is exaggerated in primary hypothyroidism, major depression, cocaine dependence, amphetamine dependence and chronic phencyclidine abuse. There is a failure to suppress in the manic phase of bipolar disorder.
386:
889:
444:
35:
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biologically active. T3 and T4 levels can thus be measured as free T3 and T4, or total T3 and T4, which takes into consideration the free hormones in addition to the protein-bound hormones. Free T3 and T4 measurements are important because certain drugs and illnesses can affect the concentrations of transport proteins, resulting in differing total and free thyroid hormone levels. There are differing guidelines for T3 and T4 measurements.
639:
1147:
affected by thyroid disease. Hypothyroidism affects 3-10% percent of adults, with a higher incidence in women and the elderly. An estimated one-third of the world's population currently lives in areas of low dietary iodine levels. In regions of severe iodine deficiency, the prevalence of goiter is as high as 80%. In areas where iodine-deficiency is not found, the most common type of hypothyroidism is an autoimmune subtype called
752:(TG) levels can be elevated in well-differentiated papillary or follicular adenocarcinoma. It is often used to provide information on residual, recurrent or metastatic disease in patients with differentiated thyroid cancer. However, serum TG levels can be elevated in most thyroid diseases. Routine measurement of serum TG for evaluation of thyroid nodules is therefore currently not recommended by the American Thyroid Association.
1155:, another autoimmune condition, is the most common type with a prevalence of 0.5% in males and 3% in females. Although thyroid nodules are common, thyroid cancer is rare. Thyroid cancer accounts for less than 1% of all cancer in the UK, though it is the most common endocrine tumor and makes up greater than 90% of all cancers of the
958:
not perfect. The accuracy of the diagnosis depends on obtaining tissue from all of the suspicious areas of an abnormal thyroid gland. The reliability of fine needle aspiration is increased when sampling can be guided by ultrasound, and over the last 15 years, this has become the preferred method for thyroid biopsy in North
America.
732:
TSH is elevated, but free T4 is normal), and can help predict progression to overt hypothyroidism. The
American Association Thyroid Association thus recommends measuring TPOAb levels when evaluating subclinical hypothyroidism or when trying to identify whether nodular thyroid disease is due to autoimmune thyroid disease.
929:
of suppressing the activity of the rest of the gland—is usually a thyrotoxic adenoma, a surgically curable form of hyperthyroidism that is rarely malignant. In contrast, finding that a substantial section of the thyroid is inactive ("cold") may indicate an area of non-functioning tissue, such as thyroid cancer.
1146:
In the United States, autoimmune inflammation is the most common form of thyroid disease while worldwide hypothyroidism and goiter due to dietary iodine deficiency is the most common. According to the
American Thyroid Association in 2015, approximately 20 million people in the United States alone are
957:
Fine needle aspiration has the advantage of being a brief, safe, outpatient procedure that is safer and less expensive than surgery and does not leave a visible scar. Needle biopsies became widely used in the 1980s, though it was recognized that the accuracy of identification of cancer was good, but
792:
Many people may develop a thyroid nodule at some point in their lives. Although many who experience this worry that it is thyroid cancer, there are many causes of nodules that are benign and not cancerous. If a possible nodule is present, a doctor may order thyroid function tests to determine if the
699:
Free T4 and total T3 can be measured when hyperthyroidism is of high suspicion as it will improve the accuracy of the diagnosis. Free T4, total T3 or both are elevated and serum TSH is below normal in hyperthyroidism. If the hyperthyroidism is mild, only serum T3 may be elevated and serum TSH can be
155:
is the mainstay of treatment for people with hypothyroidism, while people with hyperthyroidism caused by Graves' disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid gland. Thyroid surgery may also be performed to remove a thyroid nodule or to reduce
130:
Diagnosis starts with a history and physical examination. Screening for thyroid disease in patients without symptoms is a debated topic although commonly practiced in the United States. If dysfunction of the thyroid is suspected, laboratory tests can help support or rule out thyroid disease. Initial
126:
In some types, such as subacute thyroiditis or postpartum thyroiditis, symptoms may go away after a few months and laboratory tests may return to normal. However most types of thyroid disease do not resolve on their own. Common hypothyroid symptoms include fatigue, low energy, weight gain, inability
928:
A normal radioiodine scan shows even uptake and activity throughout the gland. Irregular uptake can reflect an abnormally shaped or abnormally located gland, or it can indicate that a portion of the gland is overactive or underactive. For example, a nodule that is overactive ("hot") -- to the point
731:
Elevated anti-thryoglobulin (TgAb) and anti-thyroid peroxidase antibodies (TPOAb) can be found in patients with
Hashimoto's thyroiditis, the most common autoimmune type of hypothyroidism. TPOAb levels have also been found to be elevated in patients who present with subclinical hypothyroidism (where
607:
Goiter is the general enlargement of the thyroid that can be associated with many thyroid diseases. The main reason this happens is because of increased signaling to the thyroid by way of TSH receptors to try to make it produce more thyroid hormone. This causes increased vascularity and increase in
598:
Autoimmune thyroid disease is a general category of disease that occurs due to the immune system targeting its own body. It is not fully understood why this occurs, but it is thought to be partially genetic as these diseases tend to run in families. In one of the most common types, Graves' Disease,
620:
There are many changes to the body during pregnancy. One of the major changes to help with the development of the fetus is the production of human chorionic gonadotropin (hCG). This hormone, produced by the placenta, has similar structure to TSH and can bind to the maternal TSH receptor to produce
1133:
with iodine-131 can be used to shrink the thyroid gland (for instance, in the case of large goiters that cause symptoms but do not harbor cancer—after evaluation and biopsy of suspicious nodules has been done), or to destroy hyperactive thyroid cells (for example, in cases of thyroid cancer). The
982:(T4) which is degraded much more slowly and can be administered once daily in patients with hypothyroidism. Natural thyroid hormone from pigs is sometimes also used, especially for people who cannot tolerate the synthetic version. Hyperthyroidism caused by Graves' disease may be treated with the
691:
Because a single abnormal TSH level can be misleading, T3 and T4 levels must be measured in the blood to further confirm the diagnosis. When circulating in the body, T3 and T4 are bound to transport proteins. Only a small fraction of the circulating thyroid hormones are unbound or free, and thus
541:
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any
932:
The amount of radioactivity can be quantified and serves as an indicator of the metabolic activity of the gland. A normal quantitation of radioiodine uptake demonstrates that about 8-35% of the administered dose can be detected in the thyroid 24 hours later. Overactivity or underactivity of the
735:
When the etiology of hyperthyroidism is not clear after initial clinical and biochemical evaluation, measurement of TSH receptor antibodies (TSHRAb) can help make the diagnosis. In Graves' disease, TSHRAb levels are elevated as they are responsible for activating the TSH receptor and causing
801:
benign vs. cancerous thyroid nodules that can particularly be detected by the high-frequency sound waves in an ultrasound scan. The ultrasound may also locate nodules that are too small for a doctor to feel on a physical exam, and can demonstrate whether a nodule is primarily solid, liquid
679:
system in which high levels of T3 and T4 suppress the production of TSH, and low levels of T3 and T4 increase the production of TSH. TSH levels are thus often used by doctors as a screening test, where the first approach is to determine whether TSH is elevated, suppressed, or normal.
589:
Most thyroid disease in the United States stems from a condition where the body's immune system attacks itself. In other instances, thyroid disease comes from the body trying to adapt to environmental conditions like iodine deficiency or to new physiologic conditions like pregnancy.
2431:
Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT (2004). "Subclinical thyroid dysfunction: a joint statement on management from the
American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society".
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replacement. Consequently, individuals who have undergone a total thyroidectomy are typically placed on thyroid hormone replacement (e.g. levothyroxine) for the remainder of their lives. Higher than normal doses are often administered to prevent recurrence.
879:
Although ultrasonography is a very important diagnostic tool, this method is not always able to separate benign from malignant nodules with certainty. In suspicious cases, a tissue sample is often obtained by biopsy for microscopic examination.
2067:"2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer"
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department of a hospital or clinic. Radioiodine collects in the thyroid gland before being excreted in the urine. While in the thyroid, the radioactive emissions can be detected by a camera, producing a rough image of the shape (a
629:
Diagnosis of thyroid disease depends on symptoms and whether or not a thyroid nodule is present. Most patients will receive a blood test. Others might need an ultrasound, biopsy or a radioiodine scanning and uptake study.
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2659:
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gland, as may occur with hyperthyroidism or hypothyroidism, is usually reflected in increased or decreased radioiodine uptake. Different patterns may occur with different causes of hypo- or hyperthyroidism.
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Five scintigrams taken from thyroids with different syndromes: A) normal thyroid, B) Graves' disease, diffuse increased uptake in both thyroid lobes, C) Plummer's disease, D) Toxic adenoma, E) Thyroiditis.
945:
refers to the obtaining of a tissue sample for examination under the microscope or other testing, usually to distinguish cancer from noncancerous conditions. Thyroid tissue may be obtained for biopsy by
763:. However, the measurement of calcitonin levels as a diagnostic tool is currently controversial due to falsely high or low calcitonin levels in a variety of diseases other than medullary thyroid cancer.
1099:
each day. In the event that the blood supply to any one of the parathyroid glands is endangered through surgery, the parathyroid gland(s) involved may be re-implanted in surrounding muscle tissue.
275:
Note: certain symptoms and physical changes can be seen in both hypothyroidism and hyperthyroidism —fatigue, fine / thinning hair, menstrual cycle irregularities, muscle weakness / aches (
147:
can also be obtained. Procedures such as ultrasound, biopsy and a radioiodine scanning and uptake study may also be used to help with the diagnosis, particularly if a nodule is suspected.
696:
Free T4 levels should be measured in the evaluation of hypothyroidism, and low free T4 establishes the diagnosis. T3 levels are generally not measured in the evaluation of hypothyroidism.
1385:
672:(TSH) is another important hormone that is secreted by the anterior pituitary cells in the brain. Its primary function is to increase the production of T3 and T4 by the thyroid gland.
305:
is a state in which the body is not producing enough thyroid hormones, or is not able to respond to / utilize existing thyroid hormones properly. The main categories are:
90:
There are five general types of thyroid disease, each with their own symptoms. A person may have one or several different types at the same time. The five groups are:
1653:"Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association"
3147:
806:), or a mixture of both. It is an imaging process that can often be done in a doctor's office, is painless, and does not expose the individual to any radiation.
1553:
Turkish
Endocrinology and Metabolism Association. (2013). Tiroid hastalıkları tanı ve tedavi kılavuzu (5th Edition). Ankara, Turkey: Miki Matbaacılık.
2301:"Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery"
1466:
1110:, which also runs along the posterior thyroid. Accidental laceration of either of the two or both recurrent laryngeal nerves may cause paralysis of the
1270:"Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)"
1268:
Hollowell, Joseph G.; Staehling, Norman W.; Flanders, W. Dana; Hannon, W. Harry; Gunter, Elaine W.; Spencer, Carole A.; Braverman, Lewis E. (2002).
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Cirocchi R, Arezzo A, D'Andrea V, Abraha I, Popivanov GI, Avenia N, et al. (Cochrane
Metabolic and Endocrine Disorders Group) (January 2019).
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1452:
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Giannini AJ, Malone DA, Loiselle RH, Price WA (January 1987). "Blunting of TSH response to TRH in chronic cocaine and phencyclidine abusers".
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symptoms or clinical changes, and may not require treatment. The following medications have been linked to various forms of thyroid disease:
1361:
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The most useful marker of thyroid gland function is serum thyroid-stimulating hormone (TSH) levels. TSH levels are determined by a classic
1609:
MĂĽller PE, Jakoby R, Heinert G, Spelsberg F (November 2001). "Surgery for recurrent goitre: its complications and their risk factors".
2914:
2776:
1865:
Vitti P, Latrofa F (2013-01-01). "Iatrogenic
Hypothyroidism and Its Sequelae". In Miccoli P, Terris DJ, Minuto MN, Seybt MW (eds.).
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809:
The main characteristics that can help distinguish a benign vs. malignant (cancerous) thyroid nodule on ultrasound are as follows:
1419:
Kasper DL, Fauci AS, Hauser SL, Longo DL, Larry
Jameson J, Loscalzo J (2018-02-06). "Thyroid Nodular Disease and Thyroid Cancer".
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There are several hormones that can be measured in the blood to determine how the thyroid gland is functioning. These include the
3133:
2960:
1699:"2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis"
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for the treatment of recurrent thyroid cysts and metastatic thyroid cancer in lymph nodes can also be an alternative to surgery.
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Free T4 levels may also be tested in patients who have convincing symptoms of hyper- and hypothyroidism, despite a normal TSH.
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1118:
concluded that the available evidence shows no difference between visually identifying the nerve or utilizing intraoperative
2214:
2024:
Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, Harrison TR (2018). "Medical Disorders During Pregnancy".
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In the US, hypothyroidism and hyperthyroidism were respectively found in 4.6 and 1.3% of the >12y old population (2002).
2348:
Shah KK, Tarasova VD, Davidian M, Anderson RJ (2014-06-01). "Non-Neoplastic Thyroid Disorders-Clinical and Case Reports".
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Abnormal thyroid function tests without any clinical symptoms (subclinical hypothyroidism or subclinical hyperthyroidism).
1337:
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to the thyroid gland may be detected in various disease states. There are several anti-thyroid antibodies, including
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Atasayar S, Guler Demir S (June 2019). "Determination of the Problems Experienced by Patients Post-Thyroidectomy".
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87:. These hormones normally act in the body to regulate energy use, infant development, and childhood development.
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If the thyroid gland must be removed surgically, care must be taken to avoid damage to adjacent structures, the
389:
Exophthalmos is the eye bulging that may be seen with Graves Disease, one of the major causes of hyperthyroidism
793:
thyroid gland's activity is being affected. If more information is needed after a clinical exam and lab tests,
143:(T3) levels are less commonly used. If autoimmune disease of the thyroid is suspected, blood tests looking for
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1135:
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344:(the majority of cases do not affect thyroid function, but approximately 30% of cases lead to hypothyroidism)
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is a state in which the body is producing too much thyroid hormone. The main hyperthyroid conditions are:
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Symptoms of the condition vary with type: hypo- vs. hyperthyroidism, which are further described below.
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Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. (January 2016).
1467:"Final Recommendation Statement: Thyroid Dysfunction: Screening - US Preventive Services Task Force"
549:(more commonly can lead to hypothyroidism, but can be associated with some types of hyperthyroidism)
62:
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2762:
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2116:"Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma"
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during surgery, when trying to prevent injury to recurrent laryngeal nerve during thyroid surgery.
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17:
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Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, Okosieme OE (May 2018).
1091:(PTH), a hormone needed to maintain adequate amounts of calcium in the blood. Removal results in
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Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. (2012-12-17).
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2269:. In Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al. (eds.).
1900:"Thyroid function abnormalities during amiodarone therapy for persistent atrial fibrillation"
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151:
Thyroid diseases are highly prevalent worldwide, and treatment varies based on the disorder.
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Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. (October 2016).
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can help determine the nature of thyroid nodule(s). There are some notable differences in
8:
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To differentiate between different types of hypothyroidism, a specific test may be used.
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Suppressed TSH levels can point to excessive thyroid hormone production (hyperthyroidism)
468:
2051:(19th ed.). New York: NY: McGraw-Hill. pp. Ch 405 – via Access Medicine.
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that travel through the blood to help regulate many other organs, meaning that it is an
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1941:
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Elevated TSH levels can signify inadequate thyroid hormone production (hypothyroidism)
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The recurrent laryngeal nerves provide motor control for all external muscles of the
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Wells SA, Asa SL, Dralle H, Elisei R, Evans DB, Gagel RF, et al. (June 2015).
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1084:. Both are susceptible to accidental removal and/or injury during thyroid surgery.
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larger, broad calcifications (note: these can be seen in medullary thyroid cancer)
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the size of a goiter if it obstructs nearby structures or for cosmetic reasons.
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2793:
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Burch HB, Cooper DS (December 2015). "Management of Graves Disease: A Review".
1998:
Gardner DG, Shoback DM, Greenspan FS (eds.). "The Endocrinology of Pregnancy".
1957:
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Batcher EL, Tang XC, Singh BN, Singh SN, Reda DJ, Hershman JM (October 2007).
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2007:
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Papadakis MA, McPhee SJ, Rabow MW, eds. (2018-09-07). "Endocrine Disorders".
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1257:(Seventh ed.). New York, NY.: McGraw-Hill – via AccessMedicine.
373:: a deficiency of thyroid hormone from birth, which untreated can lead to
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1002:. Additionally, hyperthyroidism and thyroid tumors may be treated with
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Pathophysiology of disease : an introduction to clinical medicine
34:
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1946:
Best Practice & Research. Clinical Endocrinology & Metabolism
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983:
979:
866:"comet tail" artifact as sound waves bounce off intranodular colloid
665:
374:
176:
136:
79:. The thyroid gland is located at the front of the neck and produces
2484:
1899:
2818:
2570:
Vanderpump MP (2011-09-01). "The epidemiology of thyroid disease".
2469:"Subclinical hypothyroidism: an update for primary care physicians"
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levels in the blood have been shown to be associated with the rare
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and their associated muscles, changing the voice quality. A 2019
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Overview of the thyroid system and the various hormones involved.
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1255:
Pathophysiology of Disease: An Introduction to Clinical Medicine
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documented progressive increase in size of nodule on ultrasound
97:(low function) caused by not having enough free thyroid hormones
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1763:"Underactive thyroid (hypothyroidism) - Symptoms - NHS Choices"
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521:
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245:
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190:
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103:(high function) caused by having too many free thyroid hormones
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significant intranodular / central blood flow by power Doppler
2851:
2518:"Thyroid hormone replacement for subclinical hypothyroidism"
2515:
2347:
1608:
1064:. Removal of the bulk of the thyroid gland usually produces
2738:
Medline Plus Medical Encyclopedia entry for Thyroid Disease
2365:"Global epidemiology of hyperthyroidism and hypothyroidism"
2162:
2064:
803:
2516:
Villar HC, Saconato H, Valente O, Atallah AN (July 2007).
1650:
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or because of the presence of an autonomously functioning
2215:"Diagnostic approach to and treatment of thyroid nodules"
1942:"Drugs that suppress TSH or cause central hypothyroidism"
1021:
Thyroid surgery is performed for a variety of reasons. A
434:
hyperthyroidism that can occur in Hashimoto's thyroiditis
2023:
75:
is a medical condition that affects the function of the
1696:
863:
nodule appears more tall than wide on transverse study
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hypoechoic (less echogenic than the surrounding tissue)
776:
levels may be abnormal; these are not routinely tested.
2430:
1507:
Hammer GD, McPhee SJ (2018-11-26). "Thyroid Disease".
1418:
1274:
The Journal of Clinical Endocrinology & Metabolism
1897:
1151:, with a prevalence of 1-2%. As for hyperthyroidism,
2641:
2267:"Fine-Needle Aspiration Biopsy of the Thyroid Gland"
2113:
1327:
42:
An illustration of goiter, a type of thyroid disease
2242:"Radioactive Iodine - American Thyroid Association"
1997:
1565:
1049:that is unsightly or impinges on vital structures.
746:There are two markers for thyroid-derived cancers.
3155:
1037:. A large majority of the thyroid may be removed (
883:
2046:
1935:
1933:
1611:The European Journal of Surgery = Acta Chirurgica
900:, in which the thyroid is imaged with the aid of
3272:
2191:"Thyroid Nodules - American Thyroid Association"
1869:. John Wiley & Sons, Ltd. pp. 291–303.
1815:"Hyperthyroidism - American Thyroid Association"
1788:"Hyperthyroidism - American Thyroid Association"
1561:
1559:
1025:or lobe of the thyroid is sometimes removed for
908:, which does not harm thyroid cells, or rarely,
260:Sensitivity to hot temperatures, excess sweating
116:which can be benign (not cancerous) or cancerous
1842:"Hypothyroidism - American Thyroid Association"
1739:"Hypothyroidism - American Thyroid Association"
727:(TPOAb), and TSH receptor antibodies (TSHRAb).
668:(T4), which are produced by the thyroid gland.
455:: an abnormal enlargement of the thyroid gland
355:Medication- or radiation-induced hypothyroidism
2236:
2234:
2000:Greenspan's Basic & Clinical Endocrinology
1930:
1330:Current medical diagnosis & treatment 2019
1219:Guyton and Hall textbook of medical physiology
3141:
2770:
1556:
1502:
1500:
1498:
1496:
1494:
1492:
1490:
1488:
1486:
1253:Bauer DC (2013). Hammer G, McPhee SJ (eds.).
593:
580:(block TSH, which can lead to hypothyroidism)
2509:
2460:
2424:
1864:
1506:
1056:of the entire thyroid, including associated
2604:
2522:The Cochrane Database of Systematic Reviews
2305:The Cochrane Database of Systematic Reviews
2231:
1602:
438:
3148:
3134:
2777:
2763:
2569:
2466:
2414:"Prevalence and Impact of Thyroid Disease"
2264:
2026:Harrison's principles of internal medicine
1539:: CS1 maint: location missing publisher (
1483:
1451:: CS1 maint: location missing publisher (
1421:Harrison's principles of internal medicine
536:
106:Structural abnormalities, most commonly a
61:
33:
2915:Familial dysalbuminemic hyperthyroxinemia
2541:
2492:
2324:
2273:. South Dartmouth (MA): MDText.com, Inc.
2139:
2090:
2049:Harrison's Principal of Internal Medicine
1965:
1714:
1668:
1285:
707:
646:
2352:. Meeting A bstracts: SAT–0523–SAT–0523.
1095:and a need for supplemental calcium and
887:
700:low or may not be detected in the blood.
637:
442:
384:
312:: an inflammation of the thyroid gland
3273:
2565:
2563:
2561:
2047:Longo DL, Jameson JL, Kaspe D (2015).
2019:
2017:
1993:
1991:
1989:
1987:
1985:
1939:
1362:"Hypothyroidism (Underactive Thyroid)"
1248:
1246:
1244:
1242:
1240:
1238:
1236:
1216:
3129:
2758:
2060:
2058:
1836:
1834:
1809:
1807:
1692:
1690:
1688:
1646:
1644:
1642:
1640:
1471:www.uspreventiveservicestaskforce.org
1414:
1412:
1410:
1323:
1321:
1319:
1317:
1315:
1313:
1252:
736:increased thyroid hormone production.
159:
2961:Abadie's sign of exophthalmic goiter
2784:
2558:
2014:
1982:
1233:
13:
2165:The Journal of Clinical Psychiatry
2055:
1831:
1804:
1685:
1637:
1407:
1310:
725:anti-thyroid peroxidase antibodies
584:
110:(enlargement of the thyroid gland)
14:
3292:
3242:Congenital absence of parathyroid
2937:Amiodarone induced thyrotoxicosis
2637:
1060:, is the preferred treatment for
1904:The American Journal of Medicine
1423:(Twentieth ed.). New York.
1041:to treat the hyperthyroidism of
740:
380:
202:Sensitivity to cold temperatures
2598:
2406:
2356:
2341:
2292:
2258:
2207:
2183:
2156:
2107:
2040:
1891:
1858:
1780:
1755:
1731:
1547:
1141:
1087:The parathyroid glands produce
884:Radioiodine scanning and uptake
291:
2534:10.1002/14651858.CD003419.pub2
2317:10.1002/14651858.CD012483.pub2
1459:
1378:
1354:
1261:
1210:
1125:
633:
1:
2743:National Institutes of Health
2372:Nature Reviews. Endocrinology
2028:. The McGraw-Hill Companies.
1511:(Eighth ed.). New York.
1203:
966:
850:marked peripheral blood flow
787:
781:Thyrotropin-releasing hormone
717:anti-thyroglobulin antibodies
3197:Persistent thyroglossal duct
2418:American Thyroid Association
1916:10.1016/j.amjmed.2007.04.022
1198:Thyroid disease in pregnancy
961:
624:
615:
352:Postoperative hypothyroidism
7:
1940:Haugen BR (December 2009).
1162:
670:Thyroid-stimulating hormone
286:
145:Anti-thyroid autoantibodies
133:thyroid-stimulating hormone
10:
3297:
3174:Congenital hypopituitarism
2910:Thyroid hormone resistance
2265:Dean DS, Gharib H (2000).
1958:10.1016/j.beem.2009.08.003
1875:10.1002/9781118444832.ch32
1016:
650:
594:Autoimmune Thyroid Disease
392:
361:Thyroid hormone resistance
349:Iatrogenic hypothyroidism
295:
279:), and different forms of
131:blood tests often include
15:
3250:
3232:
3217:Thyroid dyshormonogenesis
3207:Congenital hypothyroidism
3182:
3164:
3101:Toxic multinodular goiter
3078:
3015:
2948:
2895:
2859:Thyroid dyshormonogenesis
2834:Van Wyk-Grumbach syndrome
2812:Congenital hypothyroidism
2792:
2645:
1623:10.1080/11024150152717634
1568:Clinical Nursing Research
1082:recurrent laryngeal nerve
936:
921:) and tissue activity (a
602:
484:
371:Congenital hypothyroidism
46:
41:
32:
27:
2572:British Medical Bulletin
1705:(Submitted manuscript).
1580:10.1177/1054773817729074
1068:unless the person takes
925:) of the thyroid gland.
761:medullary thyroid cancer
439:Structural abnormalities
18:Thyroid disease in women
2927:Thyrotoxicosis factitia
2829:Euthyroid sick syndrome
2619:10.1001/jama.2015.16535
2473:Mayo Clinic Proceedings
1186:Hashimoto's thyroiditis
1149:Hashimoto's thyroiditis
1039:subtotal thyroidectomy)
912:), is performed in the
815:Possible thyroid cancer
795:medical ultrasonography
664:(T3) and its precursor
537:Medication side effects
366:Euthyroid sick syndrome
316:Hashimoto's thyroiditis
181:Unexplained weight gain
3003:Graves' ophthalmopathy
2667:: E00-E07, Q89.1-Q89.2
2384:10.1038/nrendo.2018.18
1287:10.1210/jcem.87.2.8182
1136:radiation thyroiditis)
948:fine needle aspiration
893:
842:spongiform appearance
708:Antithyroid antibodies
653:Thyroid function tests
647:Thyroid function tests
643:
479:Thyroglossal duct cyst
448:
390:
327:Postpartum thyroiditis
2941:Hyperthyroid myopathy
2868:Hypothyroid myopathy
2467:Fatourechi V (2009).
2132:10.1089/thy.2014.0335
2083:10.1089/thy.2015.0020
1716:10.1089/thy.2016.0229
891:
651:Further information:
641:
446:
388:
318:/ Hashimoto's disease
232:Difficulty sleeping (
224:Possible symptoms of
167:Possible symptoms of
139:(T4). Total and free
16:Further information:
3260:Absent adrenal gland
3096:Toxic nodular goiter
3040:Subacute lymphocytic
1217:Hall JE, Guyton AC.
578:somatostatin analogs
422:Toxic nodular struma
412:Toxic thyroid nodule
342:Riedel's thyroiditis
3158:endocrine disorders
2957:Signs and symptoms
2838:Signs and symptoms
2446:10.4158/ep.10.6.497
1131:Radioiodine therapy
1108:cricothyroid muscle
1089:parathyroid hormone
855:microcalcifications
818:More likely benign
768:Very infrequently,
469:Multinodular goiter
424:(Plummer's disease)
3212:Thyroid dysgenesis
2996:Pretibial myxedema
2748:2015-02-25 at the
2584:10.1093/bmb/ldr030
2434:Endocrine Practice
1670:10.4158/ep12280.gl
1657:Endocrine Practice
1093:hypoparathyroidism
1078:parathyroid glands
1004:radioactive iodine
923:radioiodine uptake
902:radioactive iodine
894:
644:
449:
391:
332:Silent thyroiditis
160:Signs and symptoms
3268:
3267:
3202:Thyroglossal cyst
3123:
3122:
3011:
3010:
2905:Hyperthyroxinemia
2877:Hoffmann syndrome
2864:Pickardt syndrome
2842:Queen Anne's sign
2802:Iodine deficiency
2724:
2723:
2613:(23): 2544–2554.
1709:(10): 1343–1421.
1390:www.niddk.nih.gov
1386:"Hyperthyroidism"
1366:www.niddk.nih.gov
1116:systematic review
1045:, or to remove a
998:, or rarely with
877:
876:
839:incomplete "halo"
823:irregular borders
677:negative feedback
574:dopamine agonists
337:Acute thyroiditis
322:Ord's thyroiditis
250:Fast heart rate (
195:Slow heart rate (
70:
69:
22:Medical condition
3288:
3222:Pendred syndrome
3150:
3143:
3136:
3127:
3126:
3025:Acute infectious
2971:Dalrymple's sign
2946:
2945:
2779:
2772:
2765:
2756:
2755:
2643:
2642:
2631:
2630:
2602:
2596:
2595:
2567:
2556:
2555:
2545:
2513:
2507:
2506:
2496:
2464:
2458:
2457:
2428:
2422:
2421:
2410:
2404:
2403:
2369:
2360:
2354:
2353:
2345:
2339:
2338:
2328:
2296:
2290:
2289:
2287:
2285:
2262:
2256:
2255:
2253:
2252:
2238:
2229:
2228:
2226:
2225:
2219:www.uptodate.com
2211:
2205:
2204:
2202:
2201:
2187:
2181:
2180:
2160:
2154:
2153:
2143:
2111:
2105:
2104:
2094:
2062:
2053:
2052:
2044:
2038:
2037:
2021:
2012:
2011:
1995:
1980:
1979:
1969:
1937:
1928:
1927:
1895:
1889:
1888:
1862:
1856:
1855:
1853:
1852:
1838:
1829:
1828:
1826:
1825:
1811:
1802:
1801:
1799:
1798:
1784:
1778:
1777:
1775:
1773:
1759:
1753:
1752:
1750:
1749:
1735:
1729:
1728:
1718:
1694:
1683:
1682:
1672:
1648:
1635:
1634:
1606:
1600:
1599:
1563:
1554:
1551:
1545:
1544:
1538:
1530:
1504:
1481:
1480:
1478:
1477:
1463:
1457:
1456:
1450:
1442:
1416:
1405:
1404:
1402:
1401:
1392:. Archived from
1382:
1376:
1375:
1373:
1372:
1358:
1352:
1351:
1325:
1308:
1307:
1289:
1265:
1259:
1258:
1250:
1231:
1230:
1214:
1157:endocrine glands
1000:Lugol's solution
988:propylthiouracil
919:radioiodine scan
914:nuclear medicine
812:
811:
662:triiodothyronine
659:thyroid hormones
555:(hypothyroidism)
527:Thyroid adenomas
141:triiodothyronine
81:thyroid hormones
66:
65:
57:medical genetics
37:
25:
24:
3296:
3295:
3291:
3290:
3289:
3287:
3286:
3285:
3281:Thyroid disease
3271:
3270:
3269:
3264:
3246:
3228:
3192:Thyroid disease
3178:
3160:
3154:
3124:
3119:
3074:
3007:
2986:Griffith's sign
2976:Stellwag's sign
2950:Graves' disease
2944:
2897:Hyperthyroidism
2891:
2788:
2786:Thyroid disease
2783:
2750:Wayback Machine
2729:Thyroid disease
2725:
2720:
2719:
2654:
2640:
2635:
2634:
2603:
2599:
2568:
2559:
2528:(3): CD003419.
2514:
2510:
2485:10.4065/84.1.65
2465:
2461:
2429:
2425:
2412:
2411:
2407:
2367:
2361:
2357:
2346:
2342:
2311:(1): CD012483.
2297:
2293:
2283:
2281:
2263:
2259:
2250:
2248:
2246:www.thyroid.org
2240:
2239:
2232:
2223:
2221:
2213:
2212:
2208:
2199:
2197:
2195:www.thyroid.org
2189:
2188:
2184:
2161:
2157:
2112:
2108:
2063:
2056:
2045:
2041:
2022:
2015:
1996:
1983:
1938:
1931:
1910:(10): 880–885.
1896:
1892:
1885:
1867:Thyroid Surgery
1863:
1859:
1850:
1848:
1846:www.thyroid.org
1840:
1839:
1832:
1823:
1821:
1819:www.thyroid.org
1813:
1812:
1805:
1796:
1794:
1792:www.thyroid.org
1786:
1785:
1781:
1771:
1769:
1761:
1760:
1756:
1747:
1745:
1743:www.thyroid.org
1737:
1736:
1732:
1695:
1686:
1663:(6): 988–1028.
1649:
1638:
1607:
1603:
1564:
1557:
1552:
1548:
1532:
1531:
1519:
1505:
1484:
1475:
1473:
1465:
1464:
1460:
1444:
1443:
1431:
1417:
1408:
1399:
1397:
1384:
1383:
1379:
1370:
1368:
1360:
1359:
1355:
1340:
1326:
1311:
1266:
1262:
1251:
1234:
1215:
1211:
1206:
1174:Graves' disease
1169:Hyperthyroidism
1165:
1153:Graves' disease
1144:
1128:
1106:except for the
1070:thyroid hormone
1043:Graves' disease
1035:hyperthyroidism
1019:
969:
964:
939:
886:
826:smooth borders
790:
743:
721:anti-microsomal
710:
655:
649:
636:
627:
618:
605:
596:
587:
585:Pathophysiology
570:Glucocorticoids
539:
487:
475:Lingual thyroid
441:
407:Graves' disease
400:Hyperthyroidism
397:
395:Hyperthyroidism
383:
300:
294:
289:
273:
226:hyperthyroidism
222:
162:
150:
135:(TSH) and free
101:Hyperthyroidism
85:endocrine organ
73:Thyroid disease
60:
28:Thyroid disease
23:
20:
12:
11:
5:
3294:
3284:
3283:
3266:
3265:
3263:
3262:
3256:
3254:
3248:
3247:
3245:
3244:
3238:
3236:
3230:
3229:
3227:
3226:
3225:
3224:
3219:
3214:
3204:
3199:
3194:
3188:
3186:
3180:
3179:
3177:
3176:
3170:
3168:
3162:
3161:
3153:
3152:
3145:
3138:
3130:
3121:
3120:
3118:
3117:
3116:
3115:
3113:Colloid nodule
3108:Thyroid nodule
3105:
3104:
3103:
3098:
3093:
3091:Endemic goitre
3082:
3080:
3076:
3075:
3073:
3072:
3071:
3070:
3065:
3060:
3049:
3048:
3047:
3042:
3037:
3027:
3021:
3019:
3013:
3012:
3009:
3008:
3006:
3005:
3000:
2999:
2998:
2993:
2988:
2983:
2978:
2973:
2968:
2963:
2954:
2952:
2943:
2942:
2939:
2934:
2929:
2924:
2922:Hashitoxicosis
2919:
2918:
2917:
2912:
2901:
2899:
2893:
2892:
2890:
2889:
2888:
2887:
2884:
2879:
2874:
2866:
2861:
2856:
2855:
2854:
2849:
2844:
2836:
2831:
2826:
2821:
2816:
2815:
2814:
2804:
2798:
2796:
2794:Hypothyroidism
2790:
2789:
2782:
2781:
2774:
2767:
2759:
2753:
2752:
2740:
2735:
2722:
2721:
2718:
2717:
2706:
2695:
2668:
2655:
2650:
2649:
2647:
2646:Classification
2639:
2638:External links
2636:
2633:
2632:
2597:
2557:
2508:
2459:
2440:(6): 497–501.
2423:
2405:
2378:(5): 301–316.
2355:
2340:
2291:
2257:
2230:
2206:
2182:
2155:
2126:(6): 567–610.
2106:
2054:
2039:
2013:
1981:
1952:(6): 793–800.
1929:
1890:
1883:
1857:
1830:
1803:
1779:
1754:
1730:
1684:
1636:
1617:(11): 816–21.
1601:
1574:(5): 615–635.
1555:
1546:
1517:
1482:
1458:
1429:
1406:
1377:
1353:
1339:978-1260117431
1338:
1309:
1280:(2): 489–499.
1260:
1232:
1208:
1207:
1205:
1202:
1201:
1200:
1195:
1193:Thyroid nodule
1190:
1189:
1188:
1181:Hypothyroidism
1178:
1177:
1176:
1164:
1161:
1143:
1140:
1127:
1124:
1066:hypothyroidism
1062:thyroid cancer
1018:
1015:
968:
965:
963:
960:
938:
935:
885:
882:
875:
874:
872:
868:
867:
864:
860:
859:
856:
852:
851:
848:
844:
843:
840:
836:
835:
832:
828:
827:
824:
820:
819:
816:
789:
786:
785:
784:
777:
766:
765:
764:
753:
742:
739:
738:
737:
733:
713:Autoantibodies
709:
706:
705:
704:
701:
697:
689:
688:
685:
648:
645:
635:
632:
626:
623:
617:
614:
604:
601:
595:
592:
586:
583:
582:
581:
567:
558:Some types of
556:
550:
538:
535:
534:
533:
524:
515:
514:
513:
508:
503:
498:
491:Thyroid cancer
486:
483:
482:
481:
476:
473:
472:
471:
466:
464:Diffuse goiter
461:
459:Endemic goiter
447:Endemic goiter
440:
437:
436:
435:
428:Hashitoxicosis
425:
419:
414:
409:
393:Main article:
382:
379:
378:
377:
368:
363:
358:
357:
356:
353:
347:
346:
345:
339:
334:
329:
324:
319:
303:Hypothyroidism
298:Hypothyroidism
296:Main article:
293:
290:
288:
285:
272:
271:, irritability
266:
261:
258:
248:
243:
237:
230:
221:
220:
214:
208:
203:
200:
193:
185:
182:
179:
173:
169:hypothyroidism
161:
158:
121:
120:
117:
111:
104:
98:
95:Hypothyroidism
68:
67:
50:
44:
43:
39:
38:
30:
29:
21:
9:
6:
4:
3:
2:
3293:
3282:
3279:
3278:
3276:
3261:
3258:
3257:
3255:
3253:
3249:
3243:
3240:
3239:
3237:
3235:
3231:
3223:
3220:
3218:
3215:
3213:
3210:
3209:
3208:
3205:
3203:
3200:
3198:
3195:
3193:
3190:
3189:
3187:
3185:
3181:
3175:
3172:
3171:
3169:
3167:
3163:
3159:
3151:
3146:
3144:
3139:
3137:
3132:
3131:
3128:
3114:
3111:
3110:
3109:
3106:
3102:
3099:
3097:
3094:
3092:
3089:
3088:
3087:
3084:
3083:
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3035:De Quervain's
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2824:Myxedema coma
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2350:Endo Meetings
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1396:on 2016-12-20
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1054:thyroidectomy
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972:Levothyroxine
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782:
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774:transthyretin
771:
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750:Thyroglobulin
748:
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741:Other markers
734:
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579:
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566:(thyroiditis)
565:
561:
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553:Lithium salts
551:
548:
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532:
531:benign tumors
528:
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417:Thyroid storm
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381:High function
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184:Slow movement
183:
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154:
153:Levothyroxine
148:
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115:
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105:
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88:
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77:thyroid gland
74:
64:
58:
54:
53:Endocrinology
51:
49:
45:
40:
36:
31:
26:
19:
3191:
2847:Woltman sign
2785:
2708:
2697:
2670:
2658:
2610:
2606:
2600:
2578:(1): 39–51.
2575:
2571:
2525:
2521:
2511:
2479:(1): 65–71.
2476:
2472:
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2437:
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2426:
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2304:
2294:
2282:. Retrieved
2270:
2260:
2249:. Retrieved
2245:
2222:. Retrieved
2218:
2209:
2198:. Retrieved
2194:
2185:
2171:(1): 25–26.
2168:
2164:
2158:
2123:
2119:
2109:
2077:(1): 1–133.
2074:
2070:
2048:
2042:
2025:
1999:
1949:
1945:
1907:
1903:
1893:
1866:
1860:
1849:. Retrieved
1845:
1822:. Retrieved
1818:
1795:. Retrieved
1791:
1782:
1770:. Retrieved
1766:
1757:
1746:. Retrieved
1742:
1733:
1706:
1702:
1660:
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1614:
1610:
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1571:
1567:
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1508:
1474:. Retrieved
1470:
1461:
1420:
1398:. Retrieved
1394:the original
1389:
1380:
1369:. Retrieved
1365:
1356:
1329:
1277:
1273:
1263:
1254:
1218:
1212:
1145:
1142:Epidemiology
1129:
1120:neuroimaging
1101:
1086:
1075:
1051:
1038:
1020:
976:stereoisomer
970:
956:
950:(FNA) or by
940:
931:
927:
922:
918:
898:scintigraphy
895:
878:
834:hyperechoic
808:
798:
791:
711:
690:
674:
656:
628:
619:
606:
597:
588:
540:
520:are usually
431:
398:
301:
292:Low function
274:
256:palpitations
239:Unexplained
223:
206:Constipation
166:
163:
149:
129:
125:
122:
89:
72:
71:
3234:Parathyroid
3156:Congenital
3079:Enlargement
3058:Hashimoto's
3017:Thyroiditis
2991:Möbius sign
1772:17 December
1767:NHS Choices
1126:Radioiodine
1112:vocal cords
1058:lymph nodes
1052:A complete
996:methimazole
992:carbimazole
634:Blood tests
610:hypertrophy
310:Thyroiditis
252:tachycardia
241:weight loss
197:bradycardia
3063:Postpartum
3052:Autoimmune
2251:2016-12-14
2224:2016-12-13
2200:2016-12-13
2034:1043046717
1851:2016-12-13
1824:2016-12-13
1797:2017-04-25
1748:2017-04-25
1527:1056106178
1476:2018-11-30
1400:2016-12-16
1371:2016-12-16
1348:1050994785
1204:References
1011:injections
967:Medication
941:A medical
910:iodine-131
906:iodine-123
788:Ultrasound
757:calcitonin
560:interferon
547:Amiodarone
511:Anaplastic
501:Follicular
219:difficulty
3166:Pituitary
3054:/chronic
3045:Palpation
2807:Cretinism
2710:SNOMED CT
2400:205482747
2271:Endotext
2008:995848612
1535:cite book
1447:cite book
1439:990065894
1227:434319356
1097:vitamin D
984:thioamide
980:thyroxine
962:Treatment
904:(usually
755:Elevated
666:thyroxine
625:Diagnosis
616:Pregnancy
522:malignant
518:Lymphomas
506:Medullary
496:Papillary
432:transient
375:cretinism
211:Depressed
177:Tiredness
137:thyroxine
48:Specialty
3275:Category
3068:Riedel's
3030:Subacute
2852:Myoedema
2819:Myxedema
2746:Archived
2715:14304000
2627:26670972
2592:21893493
2552:17636722
2503:19121255
2454:16033723
2392:29569622
2335:30659577
2279:25905400
2150:25810047
2101:26462967
1976:19942154
1924:17904459
1725:27521067
1679:23246686
1631:11848234
1588:28882054
1304:10850710
1296:11836274
1163:See also
1080:and the
1033:causing
896:Thyroid
719:(TgAb),
287:Diseases
281:myxedema
264:Diarrhea
234:insomnia
3252:Adrenal
3184:Thyroid
2981:lid lag
2704:D013959
2543:6610974
2494:2664572
2326:6353246
2177:3100509
2141:4490627
2120:Thyroid
2092:4739132
2071:Thyroid
1967:2784889
1703:Thyroid
1596:8593999
1031:adenoma
1017:Surgery
1008:Ethanol
952:surgery
799:typical
277:myalgia
269:Anxiety
246:Tremors
3086:Goitre
2733:Curlie
2625:
2590:
2550:
2540:
2501:
2491:
2452:
2398:
2390:
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2323:
2284:29 Jun
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2089:
2032:
2006:
1974:
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1629:
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1586:
1525:
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1427:
1346:
1336:
1302:
1294:
1225:
1104:larynx
1047:goiter
1027:biopsy
1023:nodule
986:drugs
943:biopsy
937:Biopsy
804:cystic
608:size (
603:Goiter
576:, and
485:Tumors
453:Goiter
217:Memory
191:cramps
188:Muscle
114:Tumors
108:goiter
59:
2693:759.2
2689:759.1
2396:S2CID
2368:(PDF)
1592:S2CID
1300:S2CID
974:is a
254:) or
171:are:
2882:LEMS
2872:KDSS
2699:MeSH
2676:9-CM
2623:PMID
2607:JAMA
2588:PMID
2548:PMID
2526:2007
2499:PMID
2450:PMID
2388:PMID
2331:PMID
2286:2020
2275:PMID
2173:PMID
2146:PMID
2097:PMID
2030:OCLC
2004:OCLC
1972:PMID
1920:PMID
1879:ISBN
1774:2016
1721:PMID
1675:PMID
1627:PMID
1584:PMID
1541:link
1523:OCLC
1513:ISBN
1453:link
1435:OCLC
1425:ISBN
1344:OCLC
1334:ISBN
1292:PMID
1223:OCLC
772:and
564:IL-2
562:and
529:are
228:are:
213:mood
2731:at
2685:246
2681:240
2672:ICD
2660:ICD
2615:doi
2611:314
2580:doi
2538:PMC
2530:doi
2489:PMC
2481:doi
2442:doi
2380:doi
2321:PMC
2313:doi
2136:PMC
2128:doi
2087:PMC
2079:doi
1962:PMC
1954:doi
1912:doi
1908:120
1871:doi
1711:doi
1665:doi
1619:doi
1615:167
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1282:doi
994:or
978:of
770:TBG
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