Hypothyroidism and 25-Hydroxyvitamin D Correlation Study

ORIGINAL ARTICLE
Abdelgdair A. Altoum, Ahmed Luay Osman, Praveen Kumar Kandakurti, Fatma Mubarak, Ruqeya Murad, Salwa Abdulrahman, Sofiyat Ajoke, Zulekha Shemote

 
For citation: Altoum AA, Osman AL, Kandakurti PK, Mubarak F, Murad R, Abdulrahman S, Ajoke S, Shemote Z. Hypothyroidism and 25-Hydroxyvitamin D Correlation Study. International Journal of Biomedicine. 2024;14(2):270-274. doi:10.21103/Article14(2)_OA5
 
Originally published June 5, 2024
 

Abstract: 

Background: Thyroid disease is one of the most common illnesses in the UAE, which could be linked to vast numbers of people suffering from vitamin D deficiency. This study aimed to explore the association between serum 25(OH)D levels and thyroid function parameters in men and women with diagnosed hypothyroidism.
Methods and Results: This cross-sectional observational study included 86 patients (78[90.7%] women and 8[9.3%] men) with diagnosed hypothyroidism. The patients were divided into two groups, male and female. These two groups were compared in terms of age, TSH, free-T4 (FT4), vitamin D, free-T3 (FT3), and body mass index (BMI). In addition, the correlation between levels of vitamin D and TSH was also examined in these two groups.
The mean age of the patients was 27.5 years, and BMI was 28.00 kg/m2, indicating overweight. Vitamin D deficiency was found in 61(70.9%) patients and severe vitamin D deficiency in 10(11.6%) patients with hypothyroidism. 25(OH)D levels were significantly low in patients with high TSH levels, showing a weak negative correlation (r=-0.132, P=0.043). A negligible positive correlation was identified between 25(OH)D levels and FT4 r=0.089, P>0.05) and FT3 (r=0.071, P>0.05), and a negligible negative correlation with BMI (r=-0.059, P>0.05).   
Conclusion: There is a clear indication that vitamin D deficiency is prevalent in hypothyroid patients and that these subjects have lower levels of serum 25(OH)D. Suggesting that lower serum 25(OH)D is related to hypothyroidism and the deficiency in vitamin D plays a role in the development of the disease.

Keywords: 
25-hydroxyvitamin D • thyroid-stimulating hormone • hypothyroidism • vitamin D deficiency
References: 
  1. Unal AD, Tarcin O, Parildar H, Cigerli O, Eroglu H, Demirag NG. Vitamin D deficiency is related to thyroid antibodies in autoimmune thyroiditis. Cent Eur J Immunol. 2014;39(4):493-7. doi: 10.5114/ceji.2014.47735. Epub 2014 Dec 15. PMID: 26155169; PMCID: PMC4439962.
  2. Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009 Nov-Dec;22(6):698-706. doi: 10.3122/jabfm.2009.06.090037. Erratum in: J Am Board Fam Med. 2010 Jan-Feb;23(1):138. PMID: 19897699.
  3. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977 Dec;7(6):481-93. doi: 10.1111/j.1365-2265.1977.tb01340.x. PMID: 598014.
  4. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000 Feb 28;160(4):526-34. doi: 10.1001/archinte.160.4.526. PMID: 10695693.
  5. Gil Á, Plaza-Diaz J, Mesa MD. Vitamin D: Classic and Novel Actions. Ann Nutr Metab. 2018;72(2):87-95. doi: 10.1159/000486536. Epub 2018 Jan 18. PMID: 29346788.
  6. Kim D. The Role of Vitamin D in Thyroid Diseases. Int J Mol Sci. 2017 Sep 12;18(9):1949. doi: 10.3390/ijms18091949. PMID: 28895880; PMCID: PMC5618598.
  7. McDonnell DP, Pike JW, O'Malley BW. The vitamin D receptor: a primitive steroid receptor related to thyroid hormone receptor. J Steroid Biochem. 1988;30(1-6):41-6. doi: 10.1016/0022-4731(88)90074-x. PMID: 2838696.
  8. Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients. 2013 Jul 5;5(7):2502-21. doi: 10.3390/nu5072502. PMID: 23857223; PMCID: PMC3738984.
  9. Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010 Aug;10(4):482-96. doi: 10.1016/j.coph.2010.04.001. Epub 2010 Apr 27. PMID: 20427238.
  10. Feng M, Li H, Chen SF, Li WF, Zhang FB. Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: a meta-analysis. Endocrine. 2013 Apr;43(2):318-26. doi: 10.1007/s12020-012-9812-y. Epub 2012 Oct 12. PMID: 23065592.
  11. Meng S, He ST, Jiang WJ, Xiao L, Li DF, Xu J, Shi XH, Zhang JA. Genetic susceptibility to autoimmune thyroid diseases in a Chinese Han population: Role of vitamin D receptor gene polymorphisms. Ann Endocrinol (Paris). 2015 Dec;76(6):684-9. doi: 10.1016/j.ando.2015.01.003. Epub 2015 Dec 1. PMID: 26593863.
  12. Muscogiuri G, Tirabassi G, Bizzaro G, Orio F, Paschou SA, Vryonidou A, Balercia G, Shoenfeld Y, Colao A. Vitamin D and thyroid disease: to D or not to D? Eur J Clin Nutr. 2015 Mar;69(3):291-6. doi: 10.1038/ejcn.2014.265. Epub 2014 Dec 17. PMID: 25514898.
  13. Fawzy E, Mohammad SAS, Rabat AME. Hypovitaminosis d in autoimmune hypothyroidism. Journal of American Science. 2013;9:60-65.
  14. Zhou H, Xu C, Gu M. Vitamin D receptor (VDR) gene polymorphisms and Graves' disease: a meta-analysis. Clin Endocrinol (Oxf). 2009 Jun;70(6):938-45. doi: 10.1111/j.1365-2265.2008.03413.x. Epub 2008 Sep 8. PMID: 18782354.
  15. Dawodu A, Kochiyil J, Altaye N. Pilot study of sunlight exposure and vitamin D status in Arab women of childbearing age. East Mediterr Health J. 2011 Jul;17(7):570-4. PMID: 21972479.
  16. Al Attia HM, Ibrahim MA. The high prevalence of vitamin D inadequacy and dress style of women in the sunny UAE. Arch Osteoporos. 2012;7:307-10. doi: 10.1007/s11657-012-0104-1. PMID: 23150183.
  17. Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, Charles P, Eriksen EF. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med. 2000 Feb;247(2):260-8. doi: 10.1046/j.1365-2796.2000.00595.x. PMID: 10692090.
  18. Tanabe S, Yano S, Mishima S, Nagai A. Physical inactivity and vitamin D deficiency in hospitalized elderlies. J Bone Miner Metab. 2019 Sep;37(5):928-934. doi: 10.1007/s00774-019-00996-z. Epub 2019 Mar 26. PMID: 30915552.
  19. Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest. 2006 Aug;116(8):2062-72. doi: 10.1172/JCI29449. PMID: 16886050; PMCID: PMC1523417.
  20. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006 Mar;81(3):353-73. doi: 10.4065/81.3.353. PMID: 16529140.
  21. Bouillon R. Vitamin D: From photosynthesis, metabolism, and action to clinical applications. In: DeGroot LJ, Jameson JL, editors. Endocrinology. Philadelphia: WB Saunders; 2001:1009–1028.
  22. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005 Jul;16(7):713-6. doi: 10.1007/s00198-005-1867-7. Epub 2005 Mar 18. PMID: 15776217.
  23. Jahn D, Dorbath D, Schilling AK, Gildein L, Meier C, Vuille-Dit-Bille RN, Schmitt J, Kraus D, Fleet JC, Hermanns HM, Geier A. Intestinal vitamin D receptor modulates lipid metabolism, adipose tissue inflammation and liver steatosis in obese mice. Biochim Biophys Acta Mol Basis Dis. 2019 Jun 1;1865(6):1567-1578. doi: 10.1016/j.bbadis.2019.03.007. Epub 2019 Mar 21. PMID: 30905785.
  24. Kremer R, Campbell PP, Reinhardt T, Gilsanz V. Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab. 2009 Jan;94(1):67-73. doi: 10.1210/jc.2008-1575. Epub 2008 Nov 4. PMID: 18984659; PMCID: PMC2630864.
  25. Vimaleswaran KS, Berry DJ, Lu C, Tikkanen E, Pilz S, Hiraki LT, Cooper JD, et al.; Genetic Investigation of Anthropometric Traits-GIANT Consortium; Streeten EA, Theodoratou E, Jula A, Wareham NJ, Ohlsson C, Frayling TM, et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 2013;10(2):e1001383. doi: 10.1371/journal.pmed.1001383. Epub 2013 Feb 5. PMID: 23393431; PMCID: PMC3564800.
  26. Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. doi: 10.1056/NEJMra070553. PMID: 17634462.
  27. Nalbant A, Aydın A, Tilla H, Cinemre H. Hashimoto tiroiditli olguların klinik ve laboratuvar bulgularınındeğerlendirilmesi. Online Türk Sağlık Bilimleri Dergisi. 2016;1(3):8–20.
  28. EFSA Panel on Dietetic Products, Nutrition and Allergies (EFSA NDA Panel); Turck D, Bresson JL, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, Mangelsdorf I, McArdle HJ, Naska A, Nowicka G, Pentieva K, Sanz Y, Siani A, Sjödin A, Stern M, Tomé D, Loveren HV, Vinceti M, Willatts P, Fewtrell M, Lamberg-Allardt C, Przyrembel H, Arcella D, Dumas C, Fabiani L, Martino L, Tomcikova D, Neuhäuser-Berthold M. Update of the tolerable upper intake level for vitamin D for infants. EFSA J. 2018 Aug 7;16(8):e05365. doi: 10.2903/j.efsa.2018.5365. PMID: 32626014; PMCID: PMC7009676.
  29. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.
  30. Jones G. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr. 2008 Aug;88(2):582S-586S. doi: 10.1093/ajcn/88.2.582S. PMID: 18689406.
  31. Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D, Fang M, Yazdi F, Garritty C, Sampson M, Barrowman N, Tsertsvadze A, Mamaladze V. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep). 2007 Aug;(158):1-235. PMID: 18088161; PMCID: PMC4781354.
  32. Bozkurt NC, Karbek B, Ucan B, Sahin M, Cakal E, Ozbek M, Delibasi T. The association between severity of vitamin D deficiency and Hashimoto's thyroiditis. Endocr Pract. 2013 May-Jun;19(3):479-84. doi: 10.4158/EP12376.OR. PMID: 23337162.
  33. Ke W, Sun T, Zhang Y, He L, Wu Q, Liu J, Zha B. 25-Hydroxyvitamin D serum level in Hashimoto's thyroiditis, but not Graves' disease is relatively deficient. Endocr J. 2017 Jun 29;64(6):581-587. doi: 10.1507/endocrj.EJ16-0547. Epub 2017 Apr 11. PMID: 28413173.
  34. Barchetta I, Baroni MG, Leonetti F, De Bernardinis M, Bertoccini L, Fontana M, Mazzei E, Fraioli A, Cavallo MG. TSH levels are associated with vitamin D status and seasonality in an adult population of euthyroid adults. Clin Exp Med. 2015 Aug;15(3):389-96. doi: 10.1007/s10238-014-0290-9. Epub 2014 Jun 13. PMID: 24925636.
  35. Mackawy AM, Al-Ayed BM, Al-Rashidi BM. Vitamin d deficiency and its association with thyroid disease. Int J Health Sci (Qassim). 2013 Nov;7(3):267-75. doi: 10.12816/0006054. PMID: 24533019; PMCID: PMC3921055.
  36. Sedrani SH. Low 25-hydroxyvitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region. Ann Nutr Metab. 1984;28(3):181-5. doi: 10.1159/000176801. PMID: 6610383.
  37. Al-Jurayyan NA, El-Desouki ME, Al-Herbish AS, Al-Mazyad AS, Al-Qhtani MM. Nutritional rickets and osteomalacia in school children and adolescents. Saudi Med J. 2002 Feb;23(2):182-5. PMID: 11938395.
  38. Fida NM. Assessment of nutritional rickets in Western Saudi Arabia. Saudi Med J. 2003 Apr;24(4):337-40. PMID: 12754529.
  39. Naeem Z, Almohaimeed A, Sharaf FK, Ismail H, Shaukat F, Inam SB. Vitamin D status among population of Qassim Region, Saudi Arabia. Int J Health Sci (Qassim). 2011 Jul;5(2):116-24. PMID: 23267289; PMCID: PMC3521830.
  40. Mirhosseini N., Brunel L., Muscogiuri G., Kimball S. Physiological serum 25-hydroxyvitamin D concentrations are associated with improved thyroid function-observations from a community-based program. Endocrine. 2017;58:563–573. doi: 10.1007/s12020-017-1450-y. 

Download Article
Received April 4, 2024.
Accepted May 15, 2024.
©2024 International Medical Research and Development Corporation.