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      Assessment of Serum Minerals in Subclinical Hypothyroid and Overt Hypothyroid Patients

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          Abstract

          Background

          Hypothyroidism, the commonest form of hormonal dysfunction, is due to thyroid hormone deficiency or its impaired activity. Homeostasis of the metabolism of minerals is regulated by thyroid hormones. If there is any disorder of the thyroid it will lead to disturbances of metabolism of minerals.

          Aim

          To study and compare serum calcium and serum phosphorus levels in patients of subclinical hypothyroidism and correlation of these parameters with thyroid-stimulating hormone (TSH) levels.

          Materials and methods

          This study included 70 patients with subclinical hypothyroidism, 70 patients with overt hypothyroidism, and 70 age- and sex-matched healthy controls. Thyroid profile (estimation of free triiodothyronine [FT3], free thyroxine [FT4], TSH) was done. In both cases and controls serum calcium and serum phosphorus levels were estimated.

          Results

          Serum calcium and phosphorus levels in patients of subclinical hypothyroidism was 8.75 ± 0.40 mg/dL and 3.80 ± 0.62 mg/dL, respectively. In patients with hypothyroidism it was 8.37 ± 0.52 mg/dL and 4.10 ± 0.75 mg/dL, respectively, and in controls it was 9.67 ± 0.97 mg/dL and 3.70 ± 0.71 mg/dL, respectively. Difference between these groups was statistically significant (p<0.05 ). Mean serum calcium and phosphorus for patients with TSH level <10 was 8.81 ± 0.33 mg/dL and 3.67 ± 0.60 mg/dL, respectively, and for TSH level >10 was 8.59 ± 0.51 mg/dL and 4.12 ± 0.54 mg/dL, respectively. The difference between both groups was statistically significant (p<0.05) for calcium, phosphorus .

          Conclusions

          In subclinical hypothyroidism serum calcium and serum phosphorus levels are significantly altered. Regular follow-up and estimating serum levels of these minerals in subclinical hypothyroidism patients should be done so it is beneficial to give mineral supplementations to prevent bone complications during the treatment of the disease.

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          Most cited references17

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          Subclinical Hypothyroidism

          Subclinical hypothyroidism, defined as an elevated serum thyrotropin (often referred to as thyroid-stimulating hormone, or TSH) level with normal levels of free thyroxine (FT4) affects up to 10% of the adult population.
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            Epidemiology and prevention of clinical and subclinical hypothyroidism.

            Iodine deficiency is the most common cause of hypothyroidism worldwide. In persons living in iodine-replete areas, causes are congenital, spontaneous because of chronic autoimmune disease (atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis [Hashimoto's thyroiditis]), or iatrogenic because of goitrogens, drugs, or destructive treatment for thyrotoxicosis. Screening for congenital hypothyroidism exists and its use prevents mental retardation. The prevalence of spontaneous hypothyroidism is between 1% and 2% and is more common in older women and 10 times more common in women than in men. A significant proportion of subjects have asymptomatic chronic autoimmune thyroiditis and 8% of women (10% of women over 55 years of age) and 3% of men have subclinical hypothyroidism. Approximately one third of patients with newly diagnosed overt hypothyroidism have received destructive therapy for hyperthyroidism and indefinite surveillance is required. There is not much that can be done to prevent the occurrence of spontaneous autoimmune hypothyroidism, but if identified early, something can be done to prevent progression to overt disease. Controversy exists as to whether healthy adults would benefit from screening for autoimmune thyroid disease because a significant proportion of subjects tested will have evidence of mild thyroid failure. Case finding in women at menopause or visiting a primary care physician with nonspecific symptoms appears justified.
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              Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India.

              Hypothyroidism is believed to be a common health issue in India, as it is worldwide. However, there is a paucity of data on the prevalence of hypothyroidism in adult population of India.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                6 August 2021
                August 2021
                : 13
                : 8
                : e16944
                Affiliations
                [1 ] General Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, IND
                [2 ] General Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, IND
                Author notes
                Article
                10.7759/cureus.16944
                8418816
                34513512
                30a09604-0d91-46b2-bf34-6a65c668b7f1
                Copyright © 2021, Jat et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 August 2021
                Categories
                Internal Medicine

                calcium,phosphorus,subclinical hypothyroidism,thyroid stimulating hormone,thyroid hormones

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