Ferrokinetics in Hyperthyroidism

Donati, Robert M.; Warnecke, M. A.; Gallagher, Neil I.

doi:10.7326/0003-4819-63-6-945

Cited by 17 publications

(6 citation statements)

References 11 publications

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“…Furthermore, red cell life span may be shortened 2,3,22 and some thyrotoxic patients may exhibit ineffective erythropoiesis 23,24 . T4 may also influence iron incorporation into red cells but previous findings conflict 14,23,24 . Why a subset of patients with hyperthyroidism, as in our cohort, should develop anaemia is not understood.…”

Section: Discussionmentioning

confidence: 84%

“…23,24 T4 may also influence iron incorporation into red cells but previous findings conflict. 14,23,24 Why a subset of patients with hyperthyroidism, as in our cohort, should develop anaemia is not understood. Some authors have suggested a 'suppressive effect' 8,25 of supra-physiologic doses of thyroid hormone on erythropoiesis.…”

Section: Discussionmentioning

confidence: 95%

“…They concluded that EPO provoked these effects. However, in a rodent model, both LT3 and its calorigenically inactive isomer, DT3, increased erythrocyte iron utilization while only LT3 stimulated oxygen consumption 14 . Thus, the calorigenic and erythropoietic actions of thyroid hormone may be uncoupled.…”

Section: Discussionmentioning

confidence: 96%

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Characterization of the anaemia associated with Graves’ disease

Gianoukakis

Leigh²,

Richards³

et al. 2009

Clinical Endocrinology

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SUMMARY Background Graves’ disease (GD) is associated with hyperthyroidism. Thyrotoxicosis adversely affects multiple organ systems including hematopoiesis. Anemia occurring specifically in GD has not been systematically studied previously. Objective To define the prevalence and characteristics of the anemia associated with GD. Design Eighty Seven newly diagnosed patients with GD were recruited. Hematologic indices, thyroid function and inflammatory parameters were examined at presentation and following successful treatment. Setting Tertiary care academic referral center. Results Thirty three percent of subjects presented with anemia. The prevalence of anemia not attributable to other causes (GD anemia) was 22%. GD anemia affected 41.6% (10/24) of men compared to 17.5% of women (11/63). Mean EPO levels (15.5 ± 5.3 mIU/ml) were within normal reference limits but significantly higher (P=0.004) than those of the non-anemic controls. Hgb correlated inversely with EPO (P=0.05) and CRP (P=0.04) levels, a relationship that persisted after multivariate adjustment for TT3 or TT4. With antithyroid therapy for 16 ± 6.3 weeks, Hgb levels normalized in 8/9 subjects with GD anemia (10.7 ± 0.8 g/dl to 13.5 ± 1.3 g/dl, P=0.0001). After correction of Hgb, mean MCV and TIBC were significantly increased and median ferritin and mean Epo were significantly decreased. Conclusions GD anemia is common, resembles the anemia of chronic disease and is associated with markers of inflammation. It corrects promptly with the return to the euthyroid state following treatment.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 95%

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Characterization of the anaemia associated with Graves’ disease

Gianoukakis

Leigh²,

Richards³

et al. 2009

Clinical Endocrinology

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“…In hyperthyroid states, plasma erythropoietin (EPO) levels are high, erythropoiesis is increased, and bone marrow is hypercellular . Hence, iron turnover due to augmented iron utilization is increased, but iron overload is absent, and the concomitant expansion of plasma volume masks the increase in red blood cell mass . The observed decline in plasma iron levels can be explained by faster incorporation of iron into haeme; however, any impact of hepcidin remains speculative because there are no data regarding the influence of thyroid hormones on hepcidin synthesis and regulation.…”

Section: Introductionmentioning

confidence: 99%

Iron metabolism in patients with Graves’ hyperthyroidism

Fischli

Wyl

Konrad

et al. 2017

Clinical Endocrinology

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“…Anaemia occurs in animals after thyroid ablation, and thyroid hormone augments erythropoiesis (Donati et al, 1965). Recent in vitro work indicates that thyroid hormones have direct effects on erythropoiesis and bone marrow haemoglobin synthesis (Malgor et al, 1975;Popovic et al, 1977;Dianiak et al, 1978;Fuhr and Medici, 1970).…”

Section: Resultsmentioning

confidence: 99%

Differential Effects of Propylthiouracil, Methimazole and Thyroidectomy on Liver Ferritin

Ur¹,

Gd²

2009

Exp Clin Endocrinol Diabetes

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Different groups of rats were made hypothyroid by thyroidectomy (Tx) or treatment with propylthiouracil (PTU) or methimazole (MMI). Some of the hypothyroid rats from each group were simultaneously treated with thyroxine (T4). Liver ferritin concentration and 14C-glycine incorporation into liver ferritin in these rats were studied. Only in MMI-treated rats the ferritin concentration was elevated, which was reduced by simultaneous T4 treatment. PTU treatment resulted in 36-42% reduction in ferritin synthesis, which was not responsive to T4. Thyroidectomy induced 23% enhancement in ferritin synthesis, which was normal in T4-treated Tx rats. The possible causes for these differential effects in hypothyroid rats have been discussed.

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Ferrokinetics in Hyperthyroidism

Cited by 17 publications

References 11 publications

Characterization of the anaemia associated with Graves’ disease

Characterization of the anaemia associated with Graves’ disease

Iron metabolism in patients with Graves’ hyperthyroidism

Differential Effects of Propylthiouracil, Methimazole and Thyroidectomy on Liver Ferritin

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