Effectiveness of Combined Treatment with L-Thyroxine and Iron Proteinsuccinylate in Patients with Subclinical Hypothyroidism and Manifested Sideropenic Anemia

Abstract

The aim of the study was to investigate the effects of treatment with 1-thyroxine on iron and ferritin concentrations, and the efficacy of continued treatment with iron substitution and 1-thyroxine in patients with subclinical hypothyroidism and manifested sideropenic anemia. Thirty-three premenopausal women with sub. hypothyroidism and manifested sideropenic anemia were randomly allocated to one of the three study groups (Gr) of 11 patients each, and were studied during a three month period. Patients in Gr I were treated with l-thyroxine-100 μg/daily, in Gr II with iron proteinsuccinylate corresponding to 80 mg Fe⁺⁺⁺ twice a day, and in Gr III with both medicaments. In Gr I, treatment with 1-thyroxine did increase significantly iron and ferritin from 35 ± 2.3 to 46 ± 4.5 μg/dl, p < 0.01; and from 7.7 ± 0.4 to 12.2 ± 0.6 ng/ml, p < 0.01, respectively. In Gr II, treatment with iron proteinsuccinylate increased iron from 36.6 ± 2.3 to 67.9 ± 6.8 pg/dl (p 0.001), and ferritin from 8 ± 0.5 to 14.1 ± 0.6 ng/ml (p < 0.001). In Gr III the combined treatment raised iron from 34.3 ± 2.3 to 78 ± 7 μg/dl (p < 0.0001), and ferritin from 8 ± 0.5 to 16.3 ± 1.5 ng/ml (p < 0.0001). T4 increased solidly from 89.6 ± 4.2 to 103.7 ± 10.2 nmol/1 (p < 0.01), T3 increased comparatively from 1.4 ± 0.1 to 1.7 ± 0.1 nmol/1 p < 0.01, while TSH fell from 5.5±0.4 to 1.2±0.1 mU/1, p < 0.0001. The combined treatment with iron preparation and l-thyroxine led to a marked improvement of clinical and biochemical-endocrine findings in patients, indicating a synergistic effect of both drugs at various levels, and it is hereby proposed in patients suffering from manifested sideropenic anemia and subclinical hypothyroidism. The liquid form of ferrum used in our study was well tolerated and compatible with l-thyroxine when it was taken at least 2–3 hours following l-thyroxine medication.

Keywords:

• Subclinical hypothyroidism
• Sideropenia
• Manifested sideropenic anemia
• Iron proteinsuccinylate
• l-Thyroxine