Evaluation of iron in serum and urine and their relation with thyroid function in female goitrous patients

Association of multiple blood metals with thyroid function in general adults: A cross-sectional study

INTRODUCTION

Thyroid function has a large impact on humans' metabolism and is affected by iodine levels, but there is a scarcity of studies that elucidate the association between thyroid function and other elements.

METHODS

We performed a cross-sectional study on 1,067 adults to evaluate the associations of the common essential metals with thyroid function in adults living in an iodine-adequate area of China. Serum free thyroxine (FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH), and blood metals (zinc, iron, copper, magnesium, manganese, and calcium) were measured. Further, the thyroid hormone sensitivity indexes, FT3:FT4 ratio, and thyrotropin T4 resistance index (TT4RI) were calculated. Linear regression, quantile g-computation, and Bayesian kernel machine regression methods were used to explore the association of metals with thyroid function.

RESULTS

We found that the TSH levels correlated with copper (negative) and zinc (positive). Iron and copper were positively associated with FT3 and FT4 levels, respectively. Iron (positive) and copper (negative) were correlated with the FT3:FT4 ratio. Furthermore, we found that manganese was inversely correlated with TT4RI, while zinc was positively correlated.

DISCUSSION

Our findings suggest that manganese, iron, copper, and zinc levels were strongly correlated with thyroid function, and patients with thyroid disorders are recommended to measure those metals levels.

Selected Essential and Toxic Chemical Elements in Hypothyroidism-A Literature Review (2001-2021)

Thyroid hormones are known for controlling metabolism of lipids, carbohydrates, proteins, minerals, and electrolytes and for regulating body temperature. Normal thyroid status depends on the chemical/elemental composition of body fluids and tissues, which changes depending on physiological state, lifestyle and environment. A deficiency or excess of certain essential chemical elements (selenium, zinc, copper, iron or fluorine) or exposure to toxic (cadmium or lead) or potentially toxic elements (manganese or chromium) interacts with thyroid hormone synthesis and may disturb thyroid homeostasis. In our review, accessible databases (Scopus, PubMed and Web of Science) were searched for articles from 2001-2021 on the influence of selected chemical elements on the development of hypothyroidism. Our review adopted some of the strengths of a systematic review. After non-eligible reports were rejected, 29 remaining articles were reviewed. The review found that disruption of the physiological levels of elements in the body adversely affects the functioning of cells and tissues, which can lead to the development of disease.

A Lifestyle (Dietary) Intervention Reduces Tiredness in Children with Subclinical Hypothyroidism, a Randomized Controlled Trial

Purpose: Subclinical hypothyroidism (SH) in children and adults is a subject for discussion in terms of whether to treat it or not with respect to the short-term clinical implications and consequences of SH and in the long term. If treatment with thyroxine supplementation is not indicated, no other treatment is available. We investigated whether a lifestyle (dietary) intervention improves or normalizes SH or decreases the presence of Thyroid Stimulating Hormone (TSH) and/or tiredness. Methods: We randomized children aged 1–12 years with SH to the control group (standard care = no treatment) or intervention group (dietary intervention). The dietary intervention consisted of green vegetables, beef, whole milk and butter for 6 months. The rest of the diet remained unchanged. We measured TSH, FreeT4, Lipid profile, Body Mass Index (BMI) and Pediatric Quality of Life (PedQL) multidimensional fatigue scale scores. Results: In total, 62 children were included. After 6 months, TSH decreased in both groups without a significant difference between the groups (p = 0.98). PedQL fatigue scores for sleep (p = 0.032) and total fatigue scores (p = 0.039) improved significantly in the intervention group, compared to the control group. No unfavorable effects occurred in the lipid profile or BMI. Conclusion: The lifestyle (dietary) intervention did not normalize SH and TSH levels, but it significantly reduced tiredness. These results suggest that children’s well-being can be improved without medication.

Do free thyroxine levels influence the relationship between maternal serum ferritin and gestational diabetes mellitus in early pregnancy?

PURPOSE

The objective of this study was to estimate the combined effect of serum ferritin (SF) concentration and free thyroxine (fT4) levels on the risk of gestational diabetes mellitus (GDM).

METHODS

Women presented for antenatal care at a tertiary hospital in Shanghai, China were included in this study from December 2012 to March 2014. Women were divided into six groups according to the SF and fT4 level. Multiple logistical regression model was used to estimate odds ratio (OR) among different groups. Relative excess risk of interaction (RERI), the attributable proportion (AP) of the interaction and the synergy index (SI) were applied to evaluate the additive interaction of SF concentration and fT4 level.

RESULTS

A total of 6542 qualifying pregnant women were included in this study. We observed that a high SF concentration in early pregnancy was related to an increased risk of GDM (OR = 1.21, 95%CI: 1.02-1.43); while a low fT4 level was not (OR = 1.18, 95%CI: 0.89-1.58). There is no addictive interaction between SF and fT4 level on the presence of GDM.

CONCLUSIONS

The study suggests that only high serum ferritin concentration is associated with an increased risk of GDM in early pregnancy. The level of fT4 in early pregnancy might have no effect on the association between high SF and risk of GDM.

Association of Iodine and Iron with Thyroid Function

Iodine and iron are essential elements for healthy thyroid function. However, little is known about the association of iron and iodine with thyroid function in the general US population. We investigated iron and iodine status in relation to concentrations of thyroid hormones. We included 7672 participants aged 20 and older from three surveys (2007-2008, 2009-2010, and 2011-2012) of the National Health and Nutrition Examination Survey. Serum thyroid measures (including free and total T3 and T4, and TSH), serum iron concentration, and urinary iodine concentrations were measured. Multivariate linear regression models were conducted with serum thyroid measures as dependent variables and combinations of serum iron concentration and urinary iodine concentration as predictors with covariate adjustment. Logistic regression models were performed with TSH levels (low, normal, and high) and combinations of serum iron concentration and urinary iodine concentration. Overall, 10.9% of the study population had low iron; 32.2 and 18.8% had low or high iodine levels, respectively. Compared with normal levels of iron and iodine, normal iron and high iodine were associated with reduced free T3 and increased risk of abnormal high TSH. Combined low iron and low iodine was associated with reduced free T3 and increased TSH. In addition, high iodine was associated with increased risk of abnormal high TSH in females but not in males. Thyroid function may be disrupted by low levels of iron or abnormal iodine, and relationships are complex and sex-specific. Large prospective studies are needed to understand the mechanisms by which iron interacts with iodine on thyroid function.

Assessment of metal contents in spices and herbs from Saudi Arabia

In the recent years, there has been a growing interest in monitoring heavy metal contamination of spices/herbs. Spices and herbs are sources of many bioactive compounds that can improve the tastes of food as well as influence digestion and metabolism processes. In the present study, the levels of some essential and toxic elements such as iron (Fe), zinc (Zn), copper (Cu), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), lead (Pb), and cadmium (Cd), present in common spices/herbs that were purchased from the local market in Saudi Arabia, were analyzed by atomic absorption spectroscopy after digestion with nitric acid/hydrogen peroxide mixture. Samples from the following spices/herbs were used: turmeric, cloves, black pepper, red pepper, cumin, legume, cinnamon, abazir, white pepper, ginger, and coriander. The concentration ranges for the studied elements were found as 48.8-231, 4.7-19.4, 2.5-10.5, below detection level (BDL)-1.0, 8.8-490, 1.0-2.6, and BDL-3.7 µg g(-1) for Fe, Zn, Cu, Cr, Mn, Ni, and Pb, respectively, while Cd and Co levels were below the detection limit. Consumers of these spices/herbs would not be exposed to any risk associated with the daily intake of 10 g of spices per day as far as metals Fe, Zn, Cu, Cr, Mn, Ni, and Pb are concerned.

Evaluation of calcium and lead interaction, in addition to their impact on thyroid functions in hyper and hypothyroid patients

There is compelling evidence in support of interaction between calcium (Ca) and lead (Pb) in thyroid disorders. The aim of present study was to compare the level of Ca and Pb with thyroid hormones such as thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxin (FT4) in serum samples of hyperthyroid (HPRT) and hypothyroid (HPOT) patients of both genders. For comparative purpose, age-matched (25-50 years) subjects having no thyroid disorders were selected as referents/controls. The serum samples were acid-digested prior to analysis by atomic absorption spectrometry. The validity and accuracy of the methodology were checked by certified reference materials. The resulted data indicates that the mean values of Ca in serum samples of HPRT patients were significantly higher than those of referent subjects (p < 0.01), while reverse pattern was observed in the case of HPOT patients. The level of Pb was higher in the serum samples of both types of thyroid patients, but difference was significant in case of HPOT patients as compare to referent subjects (p < 0.01). A negative correlation was observed between serum Ca levels and TSH of HPRT patients (-r = 0.37-0.39, p < 0.01), while FT3 and FT4 have positive correlation (r = 0.49-0.52 and r = 0.46-0.47), p values <0.01. The Pb in serum had positive correlation with TSH (r = 0.48-0.51, p < 0.005), while negative correlation was observed for FT3 and FT4 (-r = 0.55-0.56, 0.5-0.54, p < 0.05) in HPRT patients. On the other hand, a reverse pattern was observed, for correlation of Ca and Pb with thyroid functions in HPOT patients.

Correlation of manganese with thyroid function in females having hypo- and hyperthyroid disorders

The aim of present study was to compare the level of manganese (Mn) with thyroid functions, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxin (FT4) of females having hyper- (HPRT) and hypothyroid (HPOT) disorder. For comparative study, females of the same age group (16-30 years) having no thyroid disorders were selected as referents. The serum samples were acid digested prior to analysis by electrothermal atomic absorption spectrometry. The validity and accuracy of the methodology was checked by a certified sample. The resulted data indicated that the mean values of Mn in serum samples of females have hyperthyroidism was significantly higher than referent subjects (p < 0.01), while lower values of Mn was observed in serum samples of hypothyroid patients. The mean values of FT3 and FT4 were found to be lower while TSH higher is in HPRT patients than age-matched healthy control females (p = <0.01). The reverse resulted data of these thyroid hormones was observed in HPOT patients (0.003).

Magnesium, calcium, and trace elements excretion in 24-h urine

Urine is a clinical specimen often used in medical diagnostics for monitoring of elements concentrations and kidneys function. We determined the contents of magnesium (Mg), calcium (Ca), zinc (Zn), copper (Cu), iron (Fe), lead (Pb), and cadmium (Cd) in 74 samples of 24-h urine (from 46 women and 28 men). The measurements were realized by the atomic absorption spectrometry (AAS) with atomization in the flame (FAAS) and in the graphite furnace (GFAAS). The received results were the subject of statistical analysis including the sex and age of volunteers. Moreover, correlations between the elements and the relationships between age and amounts of excreted elements with urine were tested. We found the statistically significant higher content of Zn in men's urine than in women(')s one. Moreover, both adult women and men (>18 years) excreted much more Ca in urine in comparison to young subjects. Only in case of Pb the significant positive correlation between its amount in 24-h urine of all donors and age was stated. The correlation analysis has shown the significant positive relationships between Ca-Mg, Ca-Fe, Mg-Fe, Cu-Fe, Cu-Cd, Fe-Cd, and Pb-Cd in total samples of urine. Basing on our results, we concluded that the gender and age of donors may impact on the elemental status of 24-h urine.

Trace element concentrations in hair of healthy Chinese centenarians

Trace element concentrations, as indicators of micronutrient status of healthy centenarians, have not been widely analyzed. This study aimed to assess trace element concentrations in the hair of healthy centenarians. The effects of gender and age on element concentrations were also investigated. Eleven trace elements (Al, Ba, Cd, Cr, Cu, Fe, Mo, Pb, Se, Sr and Zn) in the scalp hair of 107 healthy Chinese centenarians were examined. The overall reference values (RVs) in mg/kg for the hair concentrations of trace elements in centenarians were as follows: Al, 14.95; Ba, 2.68; Cd, 0.06; Cr, 0.59; Cu, 6.21); Fe, 19.37; Mo, 0.50; Pb, 4.64; Se, 0.37; Sr, 4.84; and Zn, 154.37. Data analysis found that only Cu and Zn concentrations show a normal distribution, and there is no significant difference between males and females in any element except Zn. However, the levels of Al, Cd, Cr, Fe, Mo, Pb decrease and the levels of Ba, Cu, Se, Sr, Zn increase with age in the centenarian cohort. Results also revealed that sufficient Zn and Se concentrations as well as low exposure to heavy metals pollution contribute to the longevity of centenarians. The results imply the possibility of manipulating trace element concentrations, especially Zn and Se concentrations in tissues, as a means for therapeutic modality in geriatric disease.

Evaluation of iodine, iron, and selenium in biological samples of thyroid mother and their newly born babies

BACKGROUND

There is accumulating facts that the metabolism of essential trace elements is altered in thyroid patients.

AIM

The aim of present study was to compare the status of essential trace elements, iodine, iron (Fe), and selenium (Se) in biological samples (serum and urine) of goitrous mothers (age ranged 30-40) and their newly born infants (n=76). An age matched 68 non-goitrous mothers and their infants, residing in the same locality, were selected as referents. For a comparative study, the biological samples of non-goitrous and goitrous pregnant and non pregnant female subjects of the same age group and socio-economic status were also analyzed.

METHODS

The Fe and Se concentrations in biological samples were determined by a flame and hydride generation atomic absorption spectrometry respectively, while iodine was measured by iodide-ion selective electrode, prior to microwave assisted acid digestion. The validity and accuracy of the methodology was checked by certified reference materials.

RESULTS

The mean values of iodine, Fe and Se in serum and urine samples of thyroid mothers and their infants were significantly lower as compared to the referent mothers-infants pairs (p<0.01).

CONCLUSIONS

The deficiencies of essential trace elements may adversely affect the health of women and their neonates.

Interaction of copper with iron, iodine, and thyroid hormone status in goitrous patients

In many developing countries, men and women are at high risk of goiter and iron deficiency. The aim of the recent study is to assess the interaction of (Cu), with iron (Fe), iodine/iodide (I), and thyroid hormones in goitrous patients. Sixty goitrous male (GMPs) and 72 female patients (GFPs) were evaluated for the Cu, Fe, I, and thyroid hormones status in biological samples (serum and urine), and compared to non-goitrous subjects of both genders (M = 106, F = 120). The biological samples were analyzed for Cu and Fe concentration using atomic absorption spectrometer, while I was measured by the potentiometric method, prior to microwave-assisted acid digestion (MD). Quality control for the method was established with certified samples. Significantly higher mean values of Cu in serum, and urine samples of GMPs and GFPs, while lower value of Fe and I were observed as compared to control subjects (p < 0.015), respectively. The mean values of free triiodothyronine (FT3) and free thyroxin (FT4) were found to be lower in goitrous patients of both genders than in the age-matched healthy controls (p < 0.006 and 0.002), respectively, in contrast high mean values of thyroid-stimulating hormone (TSH) were detected in patients (p < 0.009), as compared to non-goitrous subjects. It was observed that the deficiencies of Fe, I, and thyroid hormone in goitrous patients could be influenced by efficiency of Cu.

Effect of zinc supplementation on the zinc level in serum and urine and their relation to thyroid hormone profile in male and female goitrous patients

BACKGROUND & AIMS

Zinc (Zn) is an essential element involved in many basic biochemical reactions in thyroid. The aims of present study is to evaluate the Zn status in biological samples and thyroid hormones levels in 60 goitrous male (GMPs) and 72 female patients (GFPs), before and after 6 months treatment with Zn supplementation and compared with non-goitrous subjects of both genders (M=106, F=120) of age range 16-30 years.

METHODS

The biological samples were analyzed for Zn concentration using flame atomic absorption spectrophotometer, following their microwave assisted acid digestion. Quality control for the methodology was established with certified samples and with those obtained by conventional wet acid digestion method on the same CRMs and real samples.

RESULTS

The results showed that the significantly lower mean values of Zn in serum, while high level urine samples of GMPs and GFPs were observed as compared to control subjects (p<0.005 and 0.007) respectively. The mean values of free triiodothyronine and thyroxin were found to be lower in goitrous patients of both genders than in the age matched healthy control (p<0.006 and 0.002) respectively, in contrast high mean values of thyroid stimulating hormone were detected in GMPs and GFPs (p<0.009).

CONCLUSION

It was observed that Zn status and serum thyroid hormone levels were improved in goitrous patients after six months treatment with Zn supplementation.