Iron and ferritin deficiency in women with hypothyroidism and chronic lymphocytic thyroiditis - systematic review.

Endokrynologia Polska Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI:10.5603/ep.97860
Marcin Gierach, Monika Rudewicz, Roman Junik
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Abstract

Iron is one of the essential microelements necessary for maintaining the body's homeostasis. It serves various roles, including being a crucial component in the proper structure of many enzymes and supporting the transport of oxygen and electrons. Its deficiency can lead to anaemia, which is a common clinical condition often associated with thyroid diseases. Iron deficiency is one of the most common nutritional deficiencies, and its prevalence is strongly associated with socioeconomic status. It is the primary cause of anaemia in 42% of children and 50% of women. Importantly, iron deficiency is placed among the top 5 causes of disability in women. Thyroid peroxidase (TPO) is an enzyme essential for the production of thyroid hormones, and iron is a key factor in its proper functioning. Therefore, in the case of iron deficiency, the activity of this enzyme is also reduced. Iron is also a factor that is important in epigenetic modification processes, and its deficiency may contribute to genomic changes potentially promoting the development of autoimmune thyroid diseases. Adequate supplementation in patients with Hashimoto's disease is one of the crucial elements of effective therapy. In addition to iodine, selenium, and magnesium supplementation, attention should be paid to proper iron intake. Iron is an element that is a component of the heme enzyme- thyroid peroxidase, which owes its activity to the binding of haem, and its function is the production of thyroid hormones. Iron can be delivered to the body in haem and non-haem forms. The haem form is found particularly in haemoglobin-rich red meat, but also in eggs, fish, and poultry. On the other hand, non-haem iron can be found in legumes, grains, fruits, and vegetables. Our study aimed to gather and summarise knowledge from scientific literature regarding iron deficiency anaemia and its association with hypothyroidism in women, as well as the possible mechanisms and pathogenesis of these conditions. The paper also aims to highlight that considering the high risk of iron deficiency, assessing iron status along with ferritin should be an integral part of additional diagnostic measures in cases of hypothyroidism, particularly Hashimoto's disease.

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甲状腺功能减退症和慢性淋巴细胞性甲状腺炎妇女的铁和铁蛋白缺乏症--系统综述。
铁是维持人体平衡所必需的微量元素之一。它有多种作用,包括作为许多酶正常结构的重要组成部分,以及支持氧和电子的运输。缺铁会导致贫血,而贫血是一种常见的临床症状,通常与甲状腺疾病有关。缺铁是最常见的营养缺乏症之一,其发病率与社会经济地位密切相关。42%的儿童和50%的妇女贫血的主要原因就是缺铁。重要的是,缺铁是导致妇女残疾的五大原因之一。甲状腺过氧化物酶(TPO)是产生甲状腺激素所必需的一种酶,而铁是其正常运作的关键因素。因此,在缺铁的情况下,这种酶的活性也会降低。铁也是表观遗传修饰过程中的一个重要因素,缺铁可能会导致基因组变化,从而诱发自身免疫性甲状腺疾病。对桥本氏病患者进行充分补充是有效治疗的关键因素之一。除了补充碘、硒和镁之外,还应注意适当摄入铁。铁是血红素酶--甲状腺过氧化物酶的一种成分,它的活性归功于与血红素的结合,其功能是产生甲状腺激素。铁可以血红素和非血红素两种形式进入人体。血红素形式主要存在于富含血红素的红肉中,也存在于鸡蛋、鱼和家禽中。而非血红素铁则存在于豆类、谷物、水果和蔬菜中。我们的研究旨在收集和总结科学文献中有关女性缺铁性贫血及其与甲状腺功能减退症的关系的知识,以及这些病症的可能机制和发病机理。本文还旨在强调,考虑到缺铁的高风险,在甲状腺功能减退症(尤其是桥本氏病)的额外诊断措施中,应将评估铁状况和铁蛋白作为不可或缺的一部分。
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