Treatment of Iron-deficiency Anemia in Patients with Subclinical Hypothyroidism

Ravanbod, Mohammad Reza; Asadipooya, Kamyar; Kalantarhormozi, Mohammadreza; Nabipour, Iraj; Omrani, Gholamhosein R.

doi:10.1016/j.amjmed.2012.12.009

Cited by 48 publications

(44 citation statements)

References 14 publications

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“…[28] Moreover, subclinical hypothyroidism was investigated in iron-deficient patients and those who did not respond to iron salt alone and interestingly, the combination of levothyroxine and iron salt has shown a better performance compared to each treatment alone. [30] Thyroid hormones were also shown to regulate the gene expression of transferrin; hence, it has been suggested that the thyroid hormones regulate the iron metabolism. [29][30][31][32] On the other hand, several other studies have demonstrated that iron deficiency could be a risk factor for the development of thyroid abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…[30] Thyroid hormones were also shown to regulate the gene expression of transferrin; hence, it has been suggested that the thyroid hormones regulate the iron metabolism. [29][30][31][32] On the other hand, several other studies have demonstrated that iron deficiency could be a risk factor for the development of thyroid abnormalities. A recent experimental study reported that iron deficiency prior to pregnancy in female rats led to maternal hypothyroxinemia during gestation.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…In addition, we enrolled 24.8% pregnant women with TSH greater than 4.0 mIU/L while Zimmermann MB et al included 6% pregnant women with TSH exceeding 4.0 mIU/L [19]. However, SF is not [26]. No significant differences were found in Hb and SF before and after levothyroxine treatment, which suggested that thyroid hormone alone does not influence SF level.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of serum ferritin and thyroid function in the second trimester of pregnancy

Shen

Zhang

et al. 2018

Endocr J

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Abstract. Ferritin is a universal intracellular protein that acts as an iron carrier. Several studies have indicated that iron deficiency affects thyroid function in non-pregnant women. Our objective was to assess the relationship between serum ferritin levels and thyroid function in pregnant women during the second trimester. Pregnant women with sufficient iodine intake and normal antithyroid antibodies during the second trimester were recruited from the obstetric outpatient department of the Fifth People's Hospital of Fudan University. Serum ferritin (SF) levels, thyroid function, anti-thyroid antibodies and vitamin B12 were determined by electrochemiluminescence immunoassay kit. Maternal serum iron (Fe), unsaturated iron binding capacity (UIBC), hemoglobin (Hb), creatinine (Cr), fasting blood glucose (FBG), and alanine aminotransferase (ALT) were also evaluated. Stepwise regressions performed to evaluate the associations between SF and other maternal parameters. In the second trimester, 11.4% pregnant women had a SF concentration less than 12 μg/L, and 7.6% pregnant women were anemic. SF levels were negatively correlated with serum TSH levels (r = -0.219, p < 0.05), and positively correlated with FT4 levels (r = 0.203, p < 0.05). Linear regression analysis showed only SF, age, week of gestation were significant predictors of regression with TSH as the dependent variable (β: -0.007, -0.059, and 0.118 respectively; all p < 0.05). However consistent relation between the SF levels and FT4 was not observed in stepwise linear regression. Maternal iron status is a determinant of TSH concentrations during pregnancy in pregnant women during the second trimester.Key words: Serum ferritin, Thyroid function, Thyroid stimulating hormone, Pregnancy, The second trimester THYROID DISEASE is a common endocrine disorder prevalent in pregnant women. The prevalence of subclinical hypothyroidism and hypothyroxinemia during the second trimester of pregnancy is 5.96% and 2.29%, respectively in China [1]. Maternal thyroid dysfunction has been reportedly associated with gestational hypertension, gestational diabetes, spontaneous abortion, fetal loss, dysplasia, and inadequate neuropsychological development in children [2][3][4][5]. Chronic autoimmune thyroiditis is the main cause of hypothyroidism during pregnancy [6,7]. Iodine deficiency during pregnancy is also

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“…A possible mechanism for the lower exercise capacity could be higher oxygen requirements during exercise in people with subclinical hypothyroidism 25 as well as a possible association with anaemia. 26 On the other hand, large cohort studies did not find a reduction in functional mobility or functional capacity assessed in elderly individuals with subclinical hypothyroidism 27,28 and persons with only mild elevations of TSH even revealed a slightly better mobility than euthyroid controls. 27 High TSH levels as seen in hypothyroidism have been shown to directly affect bone metabolism through inhibition of osteoclast formation and survival, osteoblast differentiation and expression of collagen type 1.…”

Section: B Lipid Abnormalities and Other Cardiac Risk Factorsmentioning

confidence: 99%

Subclinical Hypothyroidism: A Review on Clinical Consequences and Management Strategies

2017

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Abstract Abstract AbstractSubclinical hypothyroidism (SCH) is defined as an elevated serum thyroid-stimulating hormone (TSH) level with normal free thyroid hormone values. The prevalence of subclinical hypothyroidism is 3 to 8 percent in the general population, and up to 15 to 18 percent in women who are older than 60 years. It is more common in women than men, and its prevalence increases with age. Of patients with SCH, 80% have a serum TSH of less than 10 mIU/L. Management strategies including screening and treatment of subclinical hypothyroidism are still controversial. The strongest arguments for levothyroxine therapy are the high risk of progression to overt hypothyroidism. Initiating levothyroxine replacement therapy is recommended for all patients with a TSH greater than 10 mIU/L, even if the free thyroxine concentration is within normal laboratory range. However, treatment of patients with a serum TSH level between 5 and 10 mIU/L remains controversial. There was insufficient evidence for a clinically significant relationship between subclinical hypothyroidism and adverse cardiac events or cardiac dysfunction. Conflicting results have been found on the association between subclinical hypothyroidism and cognitive impairment, depression and the risk of fractures. This narrative review aims to assess current evidence on the clinical aspects, as well as screening and treatment recommendations in adults with subclinical hypothyroidism.

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Treatment of Iron-deficiency Anemia in Patients with Subclinical Hypothyroidism

Cited by 48 publications

References 14 publications

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

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

Evaluation of serum ferritin and thyroid function in the second trimester of pregnancy

Subclinical Hypothyroidism: A Review on Clinical Consequences and Management Strategies

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