Association between serum ferritin level and thyroid hormones in hypothyroid pediatric patients

Abstract

Aim: The present study aimed to investigate the iron store status in patients with hypothyroidism due Hashimoto thyroiditis and subclinical hypothyroidism. Material and Method: We retrospectively reviewed the medical records of patients who were followed up at our university hospital with the diagnosis of hypothyroidism due to Hashimoto thyroiditis and subclinical hypothyroidism between 2010-2021. Results: Nineteen patients with Hashimoto thyroiditis, 17 with subclinical hypothyroidism, and 20 controls were enrolled in this study. There was no significant difference in mean age among three groups (138.3±46.8 months, 116.0±68.1 months, 151.8±50.3 months in groups of Hashimoto thyroiditis, subclinical hypothyroidism and controls respectively p=0.169) . There was a significant female preponderance in HT group (68.5%, p=0.001). There was no significant difference for mean ferritin levels among groups (p=0.440). There was no correlation between TSH and ferritin level (r=-0.132, p=0.410) but we found a positive correlation between ferritin and free T4 level (r=0.340, p=0.030). Conclusion: We found a positive relationship between ferritin and thyroxine hormone that made us think that iron supplementation may be effective in the treatment of hypothyroidism. But this hypothesis warrants further prospective and experimental studies.

Keywords

• Children
• ferritin
• Hashimoto thyroiditis
• hypothyroidism

References

1. Martinez-Torres C, Cubeddu L, Dillman E, et al. Effect of exposure to low temperature on normal and iron-deficient subjects. Am J Physiol 1984; 246: R380-3.
2. Beard JL, Borel MJ, Deer J. Impaired thermoregulation and thyroid function in iron deficiency anemia. Am J Clin Nutr 1990; 52: 813-9.
3. Eshragi P, Tamaddoni A, Zarifi K, et al. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy? Caspian J Intern Med 2011; 2: 189.
4. İpek İÖ, Kaçmaz E, Bozaykut A, Sezer RG, Seren L, Paketçi C. The effect of iron deficiency anemia on plasma thyroid hormone levels in childhood. Turk Arch Pediatr. 2011;46:122–5.
5. Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014;13(4-5):391-7
6. Gallizzi R, Crisafulli C, Aversa T, et al. Subclinical hypothyroidism in children: is it always subclinical? Ital J Pediatr 2018; 44: 25.
7. Tiwari R, Saharia GK, Mangaraj M. Evaluation of serum ferritin and anti-thyroid peroxidase antibody status in newly diagnosed subclinical cases of hypothyroidism. Endocr Metab Immune Disord Drug Targets 2020.
8. Shamshirsaz AA, Bekheirnia MR, Kamgar M, et al. Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC Endocr Disord 2003; 3: 4.

9. Chirico V, Antonio L, Vincenzo S, et al. Thyroid dysfunction in thalassaemic patients: ferritin as a prognostic marker and combined iron chelators as an ideal therapy. Eur J Endocrinol 2013; 169: 785–93.
10. Sakata S,Nagai K, Maekawa H, et al. Serum ferritin concentration in subacute thyroiditis. Metabolism 1991; 40: 683-8.
11. Hess SY, Zimmermann MB, Arnold M, Langhans W, Hurrell RF. Iron deficiency anemia reduces thyroid peroxidase activity in rats. J Nutr 2002; 132: 1951-5
12. Tienboon P, Unachak K. Iron deficiency anaemia and thyroid function. Asia Pac J Clin Nutr 2003; 12: 198-202.
13. Takamatsu J, Majima M, Miki K, Kuma K, Mozai T. Serum ferritin as a marker of thyroid hormone action on peripheral tissues. J Clin Endocrinol Metab. 1985; 614: 672-6.
14. Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood Rev. 2009; 23: 95–104.
15. Kumon Y, Suehiro T, Nishiya K, Hashimoto K, Nakatani K, Sipe JD. Ferritin correlates with C-reactive protein and acute phase serum amyloid A in synovial fluid, but not in serum. Amyloid 1999; 6: 130-5.
16. Misra GC, Bose SL, Samal AK. Malabsorption in thyroid dysfunctions. J Indian Med Assoc 1991; 89: 195-7.