The International Journal of Romanian Society of Endocrinology / Registered in 1938

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Acta Endocrinologica(Bucharest) is live in PubMed Central

January - March 2020, Volume 16, Issue 1
Case Series

Okuroglu N, Ozturk A, Ozdemir A

Is Iron Deficiency a Risk Factor for the Development of Thyroid Autoantibodies in Euthyroid Women with Reproductive Ages?

Acta Endo (Buc) 2020, 16 (1): 7-10
doi: 10.4183/aeb.2020.7

Contex. The first trimester of pregnancy is the most sensitive period in terms of thyroid hypofunction. Iron deficiency has been associated with both thyroid function and thyroid autoimmunity. Objective. We aimed to investigate whether iron deficiency is a risk factor for thyroid autoimmunity in nonpregnant women at childbearing age. Design. This cross- sectional study was conducted in non-pregnant women who presented to the Internal Medicine Policlinic between January 2018 and December 2018 in the University of Health Sciences “Fatih Sultan Mehmet” Training and Research Hospital. Methods. Three hundred fifty-eight non-pregnant women of reproductive ages (203 iron deficient-ID, 155 control) participated in this study. Women with known thyroid disease, currently undergoing treatment for thyroid disease or whose thyroid function tests were outside the reference range were excluded from the study. Blood sample was taken after at least 8-10 hours of fasting for measurement of serum iron (Fe), total iron binding capacity (TIBC), serum ferritin (SF), whole blood count, thyroid function tests (fT4, TSH), anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibody (TgAb). The patients with SF levels ≤ 15 ng/dL were accepted as iron deficiency. Results. The group with ID had higher TSH and lower T4 values that did not reach statistical significance compared to the control group (p=0.101 and p=0.098, respectively). Antibody positivity was more frequent in the ID group than in the control group (35.96% vs. 20.65%, p = 0.002). Conclusions. Iron deficiency is associated with thyroid autoimmunity and it should be considered as a risk factor for screening thyroid antibody, particularly in pregnancy planning women.

Keywords: iron deficiency, thyroid autoimmunity, reproductive age. INTRODUCTION Anemia affects one-quarter of the world’s population and is concentrated in preschool-aged children and women (1). Iron deficiency (ID) with or without anemia has been associated with thyroid dysfunction and shown to cause hypothyroidism through several mechanisms (2-4). Studies in rats have suggested that ID reduces plasma thyroid hormone concentrations by decreasing hepatic thyroxine deiodinase activity, disrupting peripheral conversion of T4 to T3, and decreasing TSH response to TRH (5). Presumably, ID affects thyroid hormone feedback by disturbing the pituitary threshold leading to TSH secretion. Additionally, ID may also lead to decreased TPO activity, which impairs the metabolism of iodine in the thyroid [6]. Few studies have shown a relationship between thyroid autoimmunity (TAI) and ID (7, 8). In this study, thyroid antibodies as well as thyroid function were examined in women of reproductive ages with ID and compared with agematch controls without ID. MATERIALS AND METHODS This cross-sectional study was conducted

Correspondence: Ali Özdemir PhD, “Fatih Sultan Mehmet” Training and Educational Hospital, Department of Internal Medicine, E-5 yolu uzeri Bostanci, Istanbul, 34750, Turkey, E-mail: