The Effect of Vitamin D Replacement on Patient with Subclinical Hypothyroidism: A Pilot Randomized Clinical Trial

Abstract

Background: Subclinical hypothyroidism (SCH) is characterized by an elevated Thyroid Stimulating Hormone (TSH) with a normal T4. The prevalence of Vitamin D deficiency in patients SCH is high. Some studies suggested that Vitamin D supplements could be reduced serum concentration of TSH so improve SCH and prevent overt hypothyroidism. This study aims to explore the effect of vitamin D replacement on subclinical hypothyroidism. Materials and Methods: Fifty-nine patients, diagnosed with both subclinical hypothyroidism and Vitamin D deficiency by the Endocrinology outpatient clinics between January 2018 and March 2019, were included in this trial. The patients with overt hypothyroidism, cardiovascular risk factors, or positive TPO antibody, abnormal T4, and pregnant women were excluded from this study. The 40 subjects were investigated who received vitamin D supplements for two months. Analyses were conducted through paired-samples t-test and independent-samples t-test using SPSS 24 (Armonk, NY: IBM Corp). Results: The mean serum levels of TSH was decreased from 6.89 mIU/l in the pre-test to 3.34 mIU/l in the post-test, and the difference was found to be statistically significant at P<0.001. Conclusion: We found that the TSH mean level significantly dropped through the use of vitamin D supplements. Thus, it is recommended that all the patients with subclinical hypothyroidism be screened and treated with vitamin D supplements. [GMJ.2020;9:e1592]

Vitamin D deficiency and TSH level, a relationship in nonautoimmune hypothyroidism pediatrics

“…Ahi et al's case-control study linked non-autoimmune hypothyroidism in adults to vitamin D de ciency, suggesting a potential underlying connection (20). Notably, Pezeshki et al's randomized clinical trial demonstrated that vitamin D supplementation signi cantly lowered TSH levels in adult patients with subclinical hypothyroidism and vitamin D de ciency (21). This aligns with our study's ndings and supports the potential bene t of supplementation in this population.…”

Relationship Between Vitamin D and Thyroid: An Enigma

“…Pezeshki et al conducted a pilot randomized clinical trial in 2020 to investigate the efficacy of vitamin D therapy on subclinical hypothyroidism. The researchers discovered that using vitamin D supplements significantly reduced TSH mean levels, emphasizing the need for screening and vitamin D treatment in subclinical hypothyroid individuals [ 99 ]. Musa et al observed that hypothyroid patients had significantly higher TSH and lower FT4 levels compared to healthy controls in a case-control study of 116 females with hypothyroidism in Saudi Arabia.…”

“…Table 1 gives details of some clinical studies showing the various associations between Vitamin D and thyroid [ 42 , 46 , 48 , 49 , 52 , 59 , 82 , 83 , 84 , 85 , 88 , 90 , 94 , 98 , 99 , 100 , 102 , 103 , 104 , 109 ], all of which are mentioned in this review.…”

“…gives details of some clinical studies showing the various associations between Vitamin D and thyroid[42,46,48,49,52,59,82,83,84,85,88,90,94,98,99,100,102,103,104,109], all of which are mentioned in this review.No associations were identified between vitamin D levels and diagnosis, disease stage, malignancy rate, prognostic features of thyroid cancer.…”

Vitamin D Deficiency in Subclinical Hypothyroid Dysfunction Patients: A Case Control Study

“…Limited studies discuss association between early hypothyroid disorders and vitamin D deficiency [9]. Giving vitamin D supplements may prevent form developing overt hypothyroidism [10,11].…”