Johannes W. Dietrich @drjwdietrich@qoto.org
- Sektion DES / Klinik
- http://www.endokrinologie.org
apl. Prof. Dr. med. Johannes Dietrich, endocrinologist, head of the diabetes, endocrinology and metabolism section of #KKB @RUBMedizin. Views are my own.
Joined Nov 2022
There is an ongoing debate in #endocrinology about whether to treat #hypothyroidism with L-T4 alone or a combination therapy with L-T4 and L-T3. But what about patients’ preferences? The majority would choose the combination therapy, as shown in a meta-analysis.
Einladung zur 3. Endokrinologischen Abendsprechstunde: Up-to-date Schilddrüse 2025
Von der #Kinderendokrinologie über #Schilddrüse und #Nebenschilddrüse bis zur Arbeit einer Selbsthilfegruppe in der #Endokrinologie
Patients with #hypothyroidism, even when treated with levothyroxine (L-T4), face increased risk of #dementia and #fatality. Fortunately, the risk can be lowered again by a combination therapy with L-T4 and L-T3, as shown by a recent study.
Freue mich über meine geheime Wahl in die #Leibniz-Sozietät der Wissenschaften zu Berlin.
Mehr Infos:
https://news.rub.de/leute/2025-07-30-auszeichnung-johannes-dietrich-neu-die-leibniz-sozietaet-aufgenommen
#Syndrome_T, i.e. persistent symptoms and reduced #QoL despite normal #TSH concentration, affects 10% of #hypothyroid patients on #levothyroxine. Careful, multimodal and personalised treatment can result in significantly improved outcomes.
For the diagnosis and management of #hypothyroidism, measuring #TSH (thyrotropin) concentration is necessary, but it isn’t sufficient. Additional #biomarkers help to improve diagnostic power and to identify #endotypes of dysregulation.
The background of our observation is poorly understood, but others could confirm the findings, e. g. in this case report.
Complex regional pain syndrome (CRPS) goes along with secondary #hyperparathyroidism. Our group was the first to describe this. The mechanism leading to #sHPT is unclear, but it may contribute to the loss of bone substance in #CRPS.
The interaction of three hormones, #TSH, #T4 and #T3, lays the foundation for #thyroid #homeostasis and its #allostatic responses.
It is necessary to forgo a univariable sight and to consider the evolution of the multihormonal working point to understand health and disease.
Multiple feedforward motifs and feedback loops maintain #thyroid #homeostasis and #allostasis. The mechanism of relational stability maintains T3 in a balanced and safe range, even in conditions of declining thyroid function.
Signalling via #thyroid hormones is more than T3 and T4. It involves 27 molecules based on the thyronine skeleton, 10 transmembrane transporters, 3 deiodinases, 6 receptors, and 4 types of action, unfolding a complex firework of possibilities, explaining health and disease.
Our book is now available in printed form. Use the code SPRAUT to get a discount of 20% at Springer Nature.
Relational stability is a major motif of the intertwined feedback loops of #thyroid #homeostasis. The integrated systemic roles and interdependent homeostatically regulated equilibrium of TSH, FT4 and #deiodinases maintains appropriate FT3 concentrations.
Our eBook on #hypothyroidism has been published. The new cybernetic theory presented here summarises our scientific work of more than 20 years and lays the foundation for improved diagnosis and therapy of #thyroid disorders.
The book is available in EPUB and PDF formats.
Eine #Ketoazidose ist eine gefürchtete Komplikation eines #Diabetes mellitus. Weniger bekannt ist, dass auch andere endokrine Erkrankungen zu einer Ketoazidose führen können. In unserem neuesten Paper stellen wir eine besondere Ursache vor.
https://pubmed.ncbi.nlm.nih.gov/40388982/
https://doi.org/10.1055/a-2540-9824
#Thyroid hormones play a pivotal role in #thermoregulation and the attunement to hot and cold #climates. Recent research found global patterns of variants in the UCP1 and UCP3 genes and #SPINA-GD (step-up #deiodinase activity), suggesting integrated adaptation.
Interestingly, both subclinical #hypothyroidism and #thyrotoxicosis predict #MACE. The free thyroxine (FT4) concentration is more associated with the HR for cardiovascular events than thyrotropin (TSH) levels. Our observations yield an integrated model including psychosocial and somatic mechanisms.
#Thyroid hormones profoundly impact the #cardiovascular system. They act at all levels, ranging from the tier of ion currents over cellular processes to the macroscopic levels of myocardial tissue and even the whole organism.
The #cardiovascular system is sensitive to #thyroid hormones. Even mild deviations of the free #thyroxine concentration from a (probably individual) optimum confer a significantly increased risk for #MACE (major adverse cardiovascular events).
Medical treatment of #hyperthyroidism, i.e. #thyrotoxicosis due to overproduction of #thyroid hormone, remains a challenge. We developed a new dosage methodology based on model predictive control (MPC), which is faster and more stable than the usual trial-and-error approach. https://doi.org/10.1016/j.ifacol.2025.03.041
- Sektion DES / Klinik
- http://www.endokrinologie.org
apl. Prof. Dr. med. Johannes Dietrich, endocrinologist, head of the diabetes, endocrinology and metabolism section of #KKB @RUBMedizin. Views are my own.
Joined Nov 2022
