109
diabetic patients may lead to thyroid gland enlargement and nodularity. Decreased
level of thyroid hormones in hypothyroid patients may result in obesity, hypoglycaemia, type III hyperlipoproteinemia and hypercholesterolemia. While hyperthyroidism is associated with increased synthesis and degradation of lipids,
hypolipidemia, hypertriglyceridemia, low levels of serum LDL and HDL, hyperinsulinemia, marked rise in fatty acid concentration in body, hyperglycemia, elevated
hepatic glucose turnover, reduced bone mineral density, altered calcium homeostasis, impaired bone metabolism and greater risk of bone fractures. The clinicians
should particularly alert to the possibility of thyroid dysfunctions in metabolic
disorders and vice versa. All the patients with metabolic disorders should be
screened for thyroid functions to prevent further complications. Further research
should be carried out to observe the exact mechanism of detrimental effects of
hypothyroidism on bone metabolism.
Conflict of Interest Authors declare no conflict of interest.
References
1. Rang HP, Ritter JM, Flower RJ, Henderson G. Rang & Dale’s pharmacology e-book.
Amsterdam: Elsevier Health Sciences; 2014.
2. Katzung BG, Masters SB, Trevor AJ. Basic & clinical pharmacology. New York: McGrawHill; 2012.
3. Whittlesea C, Hodson K. Clinical pharmacy and therapeutics e-book. Amsterdam: Elsevier
Health Sciences; 2018.
4. Kopp P, Solis-S JC. Thyroid hormone. In: Clinical management of thyroid disease e-book, vol.
19. Philadelphia: Elsevier; 2009.
5. Braun D, Schweizer U. Thyroid hormone transport and transporters. Vitam Horm.
2018;106:19–44.
6. Visser TJ. Regulation of thyroid function, synthesis and function of thyroid hormones. In:
Thyroid Diseases. Endocrinology. Cham: Springer; 2018. p. 1–30.
7. Yamauchi K. Thyroid hormones. Handbook of hormones. Amsterdam: Elsevier; 2016.
8. Mullur R, Liu Y-Y, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev.
2014;94(2):355–82.
9. Nygaard B. Hypothyroidism (primary). BMJ Clin Evidence. 2014;2014:0605.
10. Persani L. Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin
Endocrinol Metab. 2012;97(9):3068–78.
11. Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: an update. S Afr Fam Pract.
2012;54(5):384–90.
12. Duntas LH, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin. Thyroid. 2013;23(6):646–53.
13. Reinehr T, Isa A, De Sousa G, Dieffenbach R, Andler W. Thyroid hormones and their relation
to weight status. Horm Res Paediatr. 2008;70(1):51–7.
14. Al-Musa HM. Impact of obesity on serum levels of thyroid hormones among euthyroid Saudi
adults. J Thyroid Res. 2017;2017:5739806.
15. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316(2):165–71.
16. Biondi B. Thyroid and obesity: an intriguing relationship. Oxford: Oxford University Press;
2010.
6 Impaired Thyroid Function in Metabolic Disorders
diabetic patients may lead to thyroid gland enlargement and nodularity. Decreased
level of thyroid hormones in hypothyroid patients may result in obesity, hypoglycaemia, type III hyperlipoproteinemia and hypercholesterolemia. While hyperthyroidism is associated with increased synthesis and degradation of lipids,
hypolipidemia, hypertriglyceridemia, low levels of serum LDL and HDL, hyperinsulinemia, marked rise in fatty acid concentration in body, hyperglycemia, elevated
hepatic glucose turnover, reduced bone mineral density, altered calcium homeostasis, impaired bone metabolism and greater risk of bone fractures. The clinicians
should particularly alert to the possibility of thyroid dysfunctions in metabolic
disorders and vice versa. All the patients with metabolic disorders should be
screened for thyroid functions to prevent further complications. Further research
should be carried out to observe the exact mechanism of detrimental effects of
hypothyroidism on bone metabolism.
Conflict of Interest Authors declare no conflict of interest.
References
1. Rang HP, Ritter JM, Flower RJ, Henderson G. Rang & Dale’s pharmacology e-book.
Amsterdam: Elsevier Health Sciences; 2014.
2. Katzung BG, Masters SB, Trevor AJ. Basic & clinical pharmacology. New York: McGrawHill; 2012.
3. Whittlesea C, Hodson K. Clinical pharmacy and therapeutics e-book. Amsterdam: Elsevier
Health Sciences; 2018.
4. Kopp P, Solis-S JC. Thyroid hormone. In: Clinical management of thyroid disease e-book, vol.
19. Philadelphia: Elsevier; 2009.
5. Braun D, Schweizer U. Thyroid hormone transport and transporters. Vitam Horm.
2018;106:19–44.
6. Visser TJ. Regulation of thyroid function, synthesis and function of thyroid hormones. In:
Thyroid Diseases. Endocrinology. Cham: Springer; 2018. p. 1–30.
7. Yamauchi K. Thyroid hormones. Handbook of hormones. Amsterdam: Elsevier; 2016.
8. Mullur R, Liu Y-Y, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev.
2014;94(2):355–82.
9. Nygaard B. Hypothyroidism (primary). BMJ Clin Evidence. 2014;2014:0605.
10. Persani L. Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin
Endocrinol Metab. 2012;97(9):3068–78.
11. Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: an update. S Afr Fam Pract.
2012;54(5):384–90.
12. Duntas LH, Biondi B. The interconnections between obesity, thyroid function, and autoimmunity: the multifold role of leptin. Thyroid. 2013;23(6):646–53.
13. Reinehr T, Isa A, De Sousa G, Dieffenbach R, Andler W. Thyroid hormones and their relation
to weight status. Horm Res Paediatr. 2008;70(1):51–7.
14. Al-Musa HM. Impact of obesity on serum levels of thyroid hormones among euthyroid Saudi
adults. J Thyroid Res. 2017;2017:5739806.
15. Reinehr T. Obesity and thyroid function. Mol Cell Endocrinol. 2010;316(2):165–71.
16. Biondi B. Thyroid and obesity: an intriguing relationship. Oxford: Oxford University Press;
2010.
6 Impaired Thyroid Function in Metabolic Disorders