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Steven J Soldin

Steven J Soldin

NIH, USA

Title: The role of specificity in improving diagnosis and treatment o hypothyroidism and adrenal diseases

Biography

Biography: Steven J Soldin

Abstract

Thyroid studies:   Hypothyroidism affects around 5.5% of the population. Over the past 15 years we have shown that accurate and precise measurement of thyroid hormones employing mass spectrometry instead of immunoassay alters the classification of 2/3 of the patients with subclinical hypothyroidism and >50% of patients with hypothyroidism. Our studies have also shown that results for FT4 and FT3 measured by tandem mass spectrometry agree far better with TSH or log TSH and the patients clinical condition than FT4/FT3 measured by immunoassays. Also we show that measurement of FT3 and TT3 by immunoassay is unreliable, especially at low FT3/TT3.

Adrenal hypo and hyper function: Occurs approximately in 7.3% of the population.Employing tandem mass spectrometry to measure a serum steroid profile we have shown that 11-DOC and DHEA are superior to measuring cortisol after ACTH stimulation tests. Current practice requires measurement of only cortisol and are clearly suboptimal. Also right and left adrenal vein catheterization allow identification of excessive production and whether it was unilateral or bilateral .