Influence of Age and Sex in Modulating TSH Level in Primary Hypothyroidism

Hammami, Muhammad M.; Al-Saihati, Basima; Alahmari, S.

doi:10.5144/0256-4947.1995.575

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…However, clinicians should have in mind that severe hypothyroidism can exist with TSH levels below 50 mIU/L. Indeed, a significant negative correlation between age and TSH levels has been shown in thyroid cancer patients 4 weeks after the withdrawal of thyroxine therapy in preparation for radioiodine scan/treatment (34). Additionally, severe secondary hypothyroidism can be the cause of low thyroid hormones.…”

Section: How Real Is the Association Between Hyponatremia And Hypothymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment

Liamis

Filippatos

Liontos

et al. 2017

European Journal of Endocrinology

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Background: Patients with moderate to severe hypothyroidism and mainly patients with myxedema may exhibit reduced sodium levels (<135 mmol/L). Summary: The aim of this short review is the presentation of the mechanisms of hyponatremia and of the available data regarding its implications and treatment in patients with hypothyroidism. Hypothyroidism is one of the causes of hyponatremia, thus thyroid-stimulating hormone determination is mandatory during the evaluation of patients with reduced serum sodium levels. The main mechanism for the development of hyponatremia in patients with chronic hypothyroidism is the decreased capacity of free water excretion due to elevated antidiuretic hormone levels, which are mainly attributed to the hypothyroidism-induced decrease in cardiac output. However, recent data suggest that the hypothyroidism-induced hyponatremia is rather rare and probably occurs only in severe hypothyroidism and myxedema. Other possible causes and superimposed factors of hyponatremia (e.g. drugs, infections, adrenal insufficiency) should be considered in patients with mild/moderate hypothyroidism. Treatment of hypothyroidism and fluid restriction are usually adequate for the management of mild hyponatremia in patients with hypothyroidism. Patients with possible hyponatremic encephalopathy should be urgently treated according to current guidelines. Conclusions: Severe hypothyroidism may be the cause of hyponatremia. All hypothyroid patients with low serum sodium levels should be evaluated for other causes and superimposed factors of hyponatremia and treated accordingly.

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Section: How Real Is the Association Between Hyponatremia And Hypothymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment

Liamis

Filippatos

Liontos

et al. 2017

European Journal of Endocrinology

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Prevalence and severity of hyponatremia and hypercreatininemia in short-term uncomplicated hypothyroidism

Baajafer

Hammami

Mohamed

1999

J Endocrinol Invest

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Hypothyroidism is widely accepted as a cause of hyponatremia and hypercreatininemia. However, the prevalence and severity of hyponatremia and hypercreatininemia in hypothyroid patients without comorbid conditions have not been well documented. We retrospectively studied serum sodium and creatinine levels in thyroid-ablated patients with differentiated thyroid cancer off (no.=128) and on (no.=60) thyroid hormone therapy. In the hypothyroid state, mean(+/-SD) TSH, sodium, and creatinine levels were 130.3+/-104.8 mU/l, 139.3+/-2.7 mEq/l, and 89.4+/-20 mmol/l respectively. Twenty-four patients (18.8%) had creatinine levels above the age- and sex-adjusted normal range, whereas only five patients (3.9%) had sodium levels below 135 mEq/l. No patient had a sodium level less than 130 mEq/l. Compared to their euthyroid values, mean sodium and creatinine levels of the hypothyroid patients changed by -1.18 mEq/l (p=0.003) and 17.2 mmol/l (p<0.0001), respectively. There was significant correlation of TSH levels in the hypothyroid state with the changes from the euthyroid state to the hypothyroid state in creatinine levels (r=0.29, p=0.02) but not with the corresponding changes in sodium levels (r=0.06, p=0.6). In thirty-seven patients studied in two hypothyroid episodes, there was a significant correlation between a) TSH levels in hypothyroid state 1 and hypothyroid state 2 (r=0.56, p=0.0003), and b) the change in creatinine levels from the euthyroid state to hypothyroid state 1 and the corresponding change from the euthyroid state to hypothyroid state 2 (r=0.48, p=0.003). There was no significant correlation between the change in sodium levels from the euthyroid state to hypothyroid state 1 and the corresponding change from the euthyroid state to hypothyroid state 2 (r=0.32, p=0.05). We conclude that hyponatremia is very uncommon, whereas mild to moderate elevation in serum creatinine level is not uncommon in patients with short-term uncomplicated hypothyroidism.

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Influence of Age and Sex in Modulating TSH Level in Primary Hypothyroidism

Cited by 2 publications

References 16 publications

MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment

MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment

Prevalence and severity of hyponatremia and hypercreatininemia in short-term uncomplicated hypothyroidism

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