Metabolomics of Thyroid Hormones
Metabolomics of Thyroid Hormones
The aim of this study is to develop a metabolome signature of thyroid hormone status. The
 metabolome signature could be useful in diagnosis and treatment of thyroid dysfunction
 diseases, especially in cases where TSH cannot be reliably used.
Primary Hypothyroidism is a frequent endocrine disorder, where the thyroid gland does not
 produce sufficient amounts of thyroid hormones. The substitution therapy is guided by
 measurement of the pituitary gland hormone thyrotropin (TSH). Patients with central
 hypothyroidism in whom pituitary insufficiency leads to hypothyroidism, TSH cannot be used to
 guide therapy. So far there are no reliable methods for therapy control in patients with
 central hypothyroidism.

 The measurement of small endogenous metabolites might give investigators a metabolomics
 profile. This could help to discriminate between euthyroid, hypothyroid and hyperthyroid
 state and therefore could be used for diagnosis and therapy control of thyroid dysfunction
 diseases.
Inclusion Criteria:

 All participants:

 -  Age 18 to 80 years

 -  BMI 19 to 35 kg/m2

 -  Informed consent as documented by signature

 A) Patients with primary hyperthyroidism TSH < 0.2 mIU/l and free thyroxine (fT4) > 25 pM
 or fT3 > 8 pM

 B) Patients with primary hypothyroidism, currently not sufficiently substituted TSH > 8
 milli-International unit (mIU)/l or fT4 < 10 pM

 C) Patients with diagnosis of primary hypothyroidism, sufficiently substituted Documented
 diagnosis of primary hypothyroidism Substitution with L-Thyroxin TSH in target range
 between 0.5 and 2.5 mIU/l

 D) Patients with secondary hypothyroidism Pituitary disease with documented secondary
 hypothyroidism

 Exclusion Criteria:

 -  Diabetes mellitus (HbA1c >6.5%)

 -  Severe concomitant diseases: chronic heart failure, liver cirrhosis, kidney failure,
 active cancer

 -  Abuse of alcohol or illicit drugs

 -  Women who are pregnant or breast feeding

 -  Inability to follow the procedures of the study, e.g. due to language problems,
 psychological disorders, dementia, etc. of the participant

 -  Previous enrolment into the current study