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. 2023 Dec 12:14:1236710.
doi: 10.3389/fendo.2023.1236710. eCollection 2023.

The negative impact of levothyroxine treatment on urinary luteinizing hormone measurements in pediatric patients with thyroid disease

And Demir  1 , Ece Böber  2 , Sükran Darcan  3 , Adem Aydın  4 , Ulf-Håkan Stenman  5 , Atilla Büyükgebiz  6 , Matti Hero  1
Affiliations

The negative impact of levothyroxine treatment on urinary luteinizing hormone measurements in pediatric patients with thyroid disease

And Demir et al. Front Endocrinol (Lausanne). .

Abstract

Objectives: Previous studies suggest urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements by immunofluorometric assays (IFMA) as noninvasive alternatives to serum assays for puberty assessment. However, these studies excluded patients with other endocrine disorders and those taking medications. Besides, the recent discontinuation of IFMA manufacturing is a concern. We explored the utility of luminometric assays (LIA) for urinary gonadotropins and thyroid-stimulating hormone (TSH) determinations in euthyroid patients with thyroid pathologies.

Methods: We used LIA and IFMA assays to measure serum and first-morning-voided (FMV) urine LH, FSH, and TSH concentrations in euthyroid patients with various thyroid disorders. Of the 47 euthyroid patients with normal serum TSH (S-TSH) levels, 14 were receiving levothyroxine therapy.

Results: FMV total urinary LH (U-LH) concentrations correlated significantly with those measured in serum using either LIA (r=0.67, P<.001) or IFMA (r=0.83, P=.003) in patients not receiving levothyroxine treatment; however, no significant correlation could be detected in patients receiving levothyroxine regardless of the assay method (for LIA: r=0.50, P=.08 and IFMA r=0.44, P=.15). Urinary TSH (U-TSH) concentrations correlated poorly with those in serum in both the untreated and the treated groups (r=-0.13, P=.49, and r=-0.45, P=.11, respectively).

Conclusion: FMV total U-LH determinations by LIA can be used to assess pubertal development in patients with thyroid pathology, provided the euthyroid patient is not on levothyroxine treatment. U-TSH measurements by LIA cannot replace invasive S-TSH measurements at least in patients with normal S-TSH levels. Further research may reveal the utility of U-TSH determinations in patients with elevated S-TSH levels.

Keywords: follicle-stimulating hormone; levothyroxine; luteinizing hormone; thyroid-stimulating hormone; urinary gonadotropins.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Correlation between serum and urine LH concentrations measured by LIA (upper panels) and IFMA (lower panels) in patients with various thyroid pathologies not treated with levothyroxine (left panels) and treated with levothyroxine (right panels). Concentrations are expressed in IU/L on a logarithmic scale.
Figure 2
Figure 2
Correlation between U-LH concentrations measured by IFMA and LIA in patients with various thyroid pathologies not receiving levothyroxine treatment (left panel) and receiving levothyroxine treatment (right panel). Concentrations are expressed in IU/L on a logarithmic scale.
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