Hematologic Effects of Levothyroxine in Iron-Deficient Subclinical Hypothyroid Patients: A Randomized, Double-Blind, Controlled Study

Cinemre, Hakan; Bilir, Cemil; Gökosmanoğlu, Feyzi; Bahçebaşı, Talat

doi:10.1210/jc.2008-1440

Cited by 69 publications

(81 citation statements)

References 23 publications

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“…In a study carried out by Cinemre H. and colleagues, they showed that the efficacy and absorption of oral iron treatment in women with subclinical hypothyroidism improved after levothyroxine replacement. This demonstrates that hypothyroidism should be assessed in patients with anemia [8].…”

Section: Discussionmentioning

confidence: 84%

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Characteristics of anemia in subclinical and overt hypothyroid patients

et al. 2012

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Section: Discussionmentioning

confidence: 84%

“…Iron deficiency anemia is related with menorrhagia occurring as a result of various hormonal imbalances and also malabsorption which is seen in hypothyroidism [7,8]. Folic acid is another vitamin with impaired intestinal absorption, and causing macrocytic anemia in hypothyroidism [9].…”

mentioning

confidence: 99%

Characteristics of anemia in subclinical and overt hypothyroid patients

et al. 2012

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“…[14,[20][21][22] To the best of our knowledge, this is the first study to report the prevalence of thyroiditis-induced anemia in non-pregnant females during the childbearing age in Saudi Arabia. The present study showed thyroid abnormalities in 19.6% of the study population and the most common thyroid disorders were subclinical hypothyroidism followed by overt hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

“…[21,22] Anemia of chronic disease, which is in the form of normocytic normochromic anemia, is the most frequently encountered type of anemia in hypothyroidism. [8,16] It has been suggested that thyroid hormone deficiency may lead to bone marrow repression and/or decrease in erythropoietin production due to the reduction of O 2 requirements.…”

Section: Discussionmentioning

confidence: 99%

“…[8,15,16] Furthermore, it has been found that all hematological parameters return to normal when a euthyroid state is achieved. [14,[20][21][22][23] Females are more prone to the development of thyroid disorders and/or anemia, especially during the reproductive age and pregnancy. [2,3,6,7,12] Little is known about the incidence of thyroid disorders and their associated types of anemia in Saudi Arabia.…”

Section: Original Articlementioning

confidence: 99%

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Prevalence and characteristics of anemia associated with thyroid disorders in non-pregnant Saudi women during the childbearing age: A cross-sectional study

Refaat¹

2015

Biomed J

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Background:Little is known about the prevalence of thyroid disorders and their associated anemia in the Kingdom of Saudi Arabia. The aim of the current study was to measure the prevalence and types of thyroid disorders and their relationship with anemia frequency and types in non-pregnant Saudi females during the childbearing age. Methods:Blood samples were collected from 600 non-pregnant females (between ≥18 and ≤45 years) with no history of thyroid dysfunction, chronic diseases, and/or anemia to measure serum thyroid stimulating hormone (TSH), free T4, erythrocyte indices, and iron parameters. Results:Thyroid disorders were detected in 118 participants (19.6%), and occult hypothyroidism was the most prevalent type (70/118) followed by overt hypothyroidism (38/118) and hyperthyroidism (10/118). Anemia was detected in 52 females with abnormal thyroid (44%) and the prevalence was significantly higher (p < 0.05) compared to euthyroid (14.3%). The red blood cell (RBC) count, hemoglobin, hematocrit value, serum iron, and serum ferritin were significantly lower in thyroid disorder compared to euthyroid group (p < 0.05). Erythrocyte indices correlated significantly with serum free T4, while iron parameters correlated with serum TSH (p < 0.05). Conclusion: Thyroid disorders are common in non-pregnant females in the Western province of Saudi Arabia, and they are associated with an increase in the prevalence of both anemia and iron deficiency. Further studies are needed to determine the underlying mechanism (s) contributing to the development of thyroiditis-induced anemia in the kingdom and the role of thyroid hormones in iron metabolism. (Biomed J 2015;38:307-316)

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Thyroid hormone—induced haemoglobin changes and antioxidant enzymes response in erythrocytes

Araújo

Seibel

Oliveira

et al. 2011

Cell Biochemistry & Function

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Thyroid hormones modulate haemoglobin and reactive oxygen species (ROS) production, leading to antioxidant changes. This study evaluated the antioxidant response to ROS in erythrocytes in hypothyroid and hyperthyroid rats. Wistar rats were divided into four groups: control; hyperthyroid (T4-12 mg 1(-1) in drinking water); sham operated (simulation of thyroidectomy); and hypothyroid (thyroidectomized). Four weeks after, blood was collected and haemoglobin and T(4) levels, lipid peroxidation (LPO), protein oxidation, superoxide dismutase (SOD), catalase (CAT) , glutathione S-transferase (GST) and glutathione peroxidase (GPx) activities, and total radical antioxidant potential (TRAP) were measured. SOD, CAT and GST immunocontent was evaluated. Haemoglobin levels were increased in hyperthyroid erythrocytes. LPO and carbonyls were augmented (65% and 55%, respectively) in hyperthyroid and reduced (31% and 56%, respectively) in hypothyroid group. SOD and CAT activities have not changed, as well as CAT immunocontent. TRAP was diminished in both hyperthyroid and hypothyroid groups (36% and 37%, respectively). GST activity and immunocontent, as well as GPx activity, were increased in hyper and hypothyroid rats. The data suggest that thyroid hormone changes determine ROS concentration changes and decrease of some antioxidant defences that would lead to a compensatory answer of the GST and GPx enzymes, which could be consider as credible biomarkers.

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Hematologic Effects of Levothyroxine in Iron-Deficient Subclinical Hypothyroid Patients: A Randomized, Double-Blind, Controlled Study

Abstract: Subclinical hypothyroidism should be treated in iron-deficiency anemia patients when both conditions coexist. This would provide a desired therapeutic response to oral iron replacement and prevent ineffective iron therapy.

Cited by 69 publications

References 23 publications

Characteristics of anemia in subclinical and overt hypothyroid patients

Characteristics of anemia in subclinical and overt hypothyroid patients

Prevalence and characteristics of anemia associated with thyroid disorders in non-pregnant Saudi women during the childbearing age: A cross-sectional study

Thyroid hormone—induced haemoglobin changes and antioxidant enzymes response in erythrocytes

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