Volume 22, Issue 4 (9-2019)                   J Arak Uni Med Sci 2019, 22(4): 124-133 | Back to browse issues page

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Shiravand Z, Talaei A. Effect of Iron on Thyroid Function in Women With Hypothyroidism: A Double-blind Clinical Trial Study. J Arak Uni Med Sci 2019; 22 (4) :124-133
URL: http://jams.arakmu.ac.ir/article-1-6091-en.html
Effect of Iron on Thyroid Function in Women With Hypothyroidism: A Double-blind Clinical Trial Study
Zahra Shiravand1 , Afsaneh Talaei 2
1- Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
2- Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran. , afsanehtalaeii@yahoo.com
Keywords: Hypothyroidism, Iron, Levothyroxine
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1. Introduction
Hypothyroidism is a systemic disease affecting all organs [1]. Research has shown that thyroid hormone imbalance in hypothyroid patients is associated with anemia in these patients. Iron deficiency, on the other hand, can lead to a defect in thyroid hormone synthesis by reducing thyroid peroxidase activity [2-4]. Since hypothyroidism and iron deficiency are common in women, and iron deficiency can also be effective in many hormonal processes, treatment of anemia is needed to improve the response to hypothyroidism. Untreated anemia has irreparable consequences. On the other hand, iron therapy can improve thyroid function and even reduce the dose of levothyroxine drug. Therefore, this study aimed to investigate the effect of iron supplementation on thyroid function.
2. Materials and Methods
In this randomized clinical trial study, 94 women with hypothyroidism under treatment with levothyroxine were selected by a simple sampling method and randomly divided into the intervention and control groups. After obtaining informed consent from the patients, their T3, T4, and TSH (thyroid-stimulating hormone) levels and the iron profile (hemoglobin, serum iron, transferrin, ferritin) were measured and recorded. Then, the patients in the intervention group received levothyroxine with iron (100 mg oral per day), and the control group received levothyroxine plus a placebo for 2 months. After two months, the T3, T4, and TSH levels and the iron profile were again measured in both groups, and the results of before and after the treatment were compared. The SPSS V. 19 was used for data analysis.
3. Results
Table 1 compares thyroid hormone levels of the study patients before and after the intervention. The results showed that the mean level of T3 and T4 in the intervention group increased significantly, but the level of TSH decreased significantly. The results of statistical analysis showed that the mean difference of T3, T4, and TSH between the intervention and control groups was significant (P<0.05) (Table 2).








4. Discussion
The results of this study showed that the prevalence of iron deficiency anemia in patients with hypothyroidism was 42.6% (40 out of 94), which is higher than the normal population (15%). Also, adding 100 mg oral ferrous sulfate daily for 2 months results in a decrease in serum TSH levels and an increase in T3 and T4, in other words, improvement of thyroid hormones in women with hypothyroidism. On the other hand, a significant increase in serum iron, hemoglobin, and ferritin levels and a decrease in total iron-binding capacity also indicate that this amount of iron is effective in improving serum iron levels. That is to say, concomitant administration of iron with levothyroxine in patients with hypothyroidism leads to a decrease in TSH and improvement of laboratory parameters and response to treatment.
Ethical Considerations
Compliance with ethical guidelines
The study was approved by the Research Ethics Committee of Arak University of Medical Sciences (Code:1396154) and is a registered clinical trial (Code: IRCT20151114025031).
Funding
The present paper was extracted from the PhD. thesis of the first author, Zahra Shiravand, approved by Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Authors' contributions
All authors have met the standards of writing criteria based on the recommendations of the International Committee of Medical Journal Publishers (ICMJE).
Conflicts of interest
The authors declared no conflicts of interest.
Acknowledgements
The authors would like to thank the authorities of Arak University of Medical Sciences for their cooperation in conducting this research.

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Type of Study: Original Atricle | Subject: Internal
Received: 2019/06/10 | Accepted: 2019/08/24
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