Assessment Levels of some Electrolytes in Hypothyroidism Patients

*Corresponding Author: * DR. SALIM HUSSEIN HASSAN Assis. Prof. in Community Health Dept. Karbala Technical Institute, AlFurat Al-Awsat University, Iraq Email: Assessment Levels of some Electrolytes in Hypothyroidism Patients Dr. Salim Hussein Hassan*, Ahmed Ali & Jaafar Khalaf Ali Assis. Prof., 2 & 3 Lecturer in Community Health Dept. Karbala Technical Institute, AlFurat Al-Awsat University, Iraq

Hypothyroidism is a disease of thyroid gland that characterized with low level of thyroxin hormone (T3 & T4) besides too high level of thyroid stimulating hormone (TSH). Hypothyroidism is popular among women as ten times as in men and its prevalence increases with age. The occurrence of thyroid dysfunction, by definition, is testing patients in different geographical areas, primary care clinics and in population that have not been screened previously it can be severe with obvious, or moderate to mild or can be sub-clinical hypothyroidism. Insufficiency of thyroid hormones distresses whole metabolism of the body (Krishnaveni, 2011, Freidman, 1999. Electrolytes play an vital role in several body progressions, such as directing fluid levels, acid-base equilibrium (pH), nerve passage, blood coagulation and muscle tightening (Rao GM et al,.1992). Thyroid illness is common in the general population, and the frequency increases with oldness. In India, hyperthyroidism is considered the commonest form of thyroid disorder due to the high number of Indian people who are suffering from thyroid diseases [Unnikrishnan et al., 2011]. Thyroid hormone is a crucial controller of body hemodynamics, thermoregulation and breakdown. Thyroid hormones achieve a wide array of metabolic functions including directive of lipid, carbohydrate, protein, electrolyte and mineral metabolisms, whereas lipid metabolism as a result to increasing thyroid hormones is well known, while the effect on minerals and electrolytes has not been well-known and also the underlying mechanisms are not well  [Mariani et al. ,2012]. Sodium and potassium are main components of the enzyme Na+-K+ ATPase, which is an enzyme present on the cell membrane that aids in the transportation of water and nutrients through the cell membrane [Murgod et al., 2012]. Thyroid hormones order the action of sodium potassium pushes in best of the tissues. In ancient study the mortality rate was increased as outcomes of patients with electrolyte disorders, mainly hypoand hyper natremia, which were found to be associated with, increased mortality [Lindner et al., 2007]. Thyroid hormones are necessary for usual development and growth of skeletal system. Thyroid dysfunction is often linked with instabilities of calcium and phosphorous homeostasis. Thyroid disorders are important cause of secondary osteoporosis. Few studies show normal serum calcium and phosphorous levels while others show decreased levels in hypothyroidism . Even though the changes in the calcium and magnesium may be minor in thyroid disorders, these conflicts will be significant for patient in the semipermanent [12]. In hypothyroidism there is a miserable turnover due to reduced utilization of calcium into the bone that pointer to decrease the blood calcium level. In hypothyroidism increased creation of thyroid calcitonin can help the tubular reabsorption of phosphate and also favors the tubular excretion of calcium [Melmed et al., 2011]. This study aimed to assess the levels of serum electrolytes such as sodium, potassium and calcium in hypothyroidism patients.

Abstract Introduction
All patients with hypothyroidism who included in this study were attending the outpatient clinic. The study was performed on 30 (4 male and 26 female) hypothyroidism patients and 20 (5 male and 15 female) healthy individuals (control group). A paper of information was filled from each patient who includes name, age, sex, occupation, and family history of hypothyroidism. Blood sample (5ml) was taken from both (patient and control group) to evaluate the level of some electrolytes (sodium, potassium and calcium) by Genex Elyte 4 device according to manufactured company that approved with it. Also, thyroid stimulating hormone (TSH) was measured by ELISA technique according to procedure that provided with the kit. The obtained data of study were calculated as mean ± SD at P value less than 0.05 significant.
The study results showed that the high incidence of hypothyroidism was in female (86%) versus in male was (14%), and results showed 12 (40%) case out of 30 at age less or equal 50 years and only 18 cases (60%) were above 50 years, also the control group was in the same age range as showed in table (1).

IISJ
The results show the mean value of electrolytes (Na & Ca) were decreased significantly (P < 0.05) in hypothyroidism patients as compared with control as showed in table (2 & 3), while the level of potassium decreased non significantly (P > 0.05) as illustrated in table (4).   On the other hand, the correlation between TSH level and (calcium & sodium) value was significant, and there is no significant correlation between TSH, and serum Potassium as explained in table (5).  (Kumar et al., 2002) in animal model concludes that renal calcium excretion was elevated in rats with high/levels of TSH. In current study the serum sodium levels in hypothyroidism patients were markedly/decreased as compared to control group, whereas serum potassium level was found to be decreased no significantly in hypothyroidism patients as compared with control group. Water and nutrients can across the cell membrane with the present of Na-K ATPase enzyme. The key components of Na-K ATPase enzyme are potassium and Sodium. Thyroid hormones police the movement of sodium potassium deflates in most of the tissues. Hypothyroid patients could gain weight as a result to gathering of water inside the cell, which will lead to edema; the last one was caused due to low level of potassium [Murgod et al., 2012]. Also correlated the levels of serum electrolyte (calcium, sodium, potassium) with the level of TSH, serum calcium and sodium were significant correlated with/TSH (p<0.05), but serum potassium was no significant/correlated/with TSH  [Ashmaik et al., 2013] who was found a significant correlation of serum calcium, sodium and potassium with TSH levels.
In this study verified that hypothyroid patient's indication serum electrolyte disorders such as low calcium and sodium levels.