Demir eksikliği anemisi tedavisinin tiroid volümüne etkisi
Özet
THE EFFECT OF TREATMENT OF İRON DEFICIENCY ANAEMIA ON THYROİD VOLUME Iron and iodine are two important micronutrients still deficient in developing countries. Iron status influences thyroid and iodine metabolism by which thyroperoxidases that catalyse thyroid hormone synthesis are iron dependent enzymes.lron deficiency may effect thyroid volume through impairment thyroid hormone metabolism. This study aimed to examine the thyroid hormone levels and the thyroid volumes of iron deficient, anaemic women before and after correction of the anaemia with oral iron supplementation. Iron status, hemoglobin(Hb) value, thyroid function tests, urinary iodine concentration(UIC) and thyroid gland volume were assessed in 66 women aged 18-45 years. Patients who have normal levels of thyroid hormones and iron deficiency anaemia(IDA) are included. Patients received an oral dose of 100 mg ferrous glycynesulphate with two times daily for six months and re evaluated for iron deficiency anaemia, thyroid hormone levels and thyroid volumes after iron supplementation. Initially mean+s.d serum Hb. and ferritin levels of the group were 9,84+1,26 gr/dL and 4,17±2,02 ng/mL respectively. After six months Hb and ferritin values were increased significantly to 13,18+1,19 gr/dL, 24,76±18,03 ng/mL respectively (p=0.001). Mean+s.d thyroid volume was 16.06+5.42 mL before treatment and decreased significantly to 14.23±5.55 mL after six months (p=0,001). sTSH, fT3 and UIC did not change during follow-up whereas fT4 increased significantly at the end of the treatment. The iron containing enzymes such as throperoxidases are sensitive to depletion of iron. Furthermore iron deficiency may decrease enzyme activity and interfere with thyroid hormone syntesis. Moreover improvement of hyperkinetic blood supply of thyroid gland may associated with a decrease in thyroid volume. The findings in this study suggest that iron supplementation has an effect on regression of thyroid volume in patients with iron deficiency anaemia. We suggest that iron supplementation should be prefered in goitrous patients with IDA before the treatment of goitre. Key words: iron deficiency, anaemia, goitre, iodine, thyroid hormones 25