• Sinaaabdul Amir Kadhim Department of Pharmacology and Therapeutics, College of Medicine, University of AL-Qadisiyah, AL-Diwaniyah Province, Iraq.
  • Shaimaa Abdul Ameer Kadhum Department of Surgery, Radiology, College of Medicine, University of AL-Qadisiyah, AL-Diwaniyah Province, Iraq.
  • Ali Jawad Hamza epartment of Surgery, College of Medicine, University of AL-Qadisiyah, AL-Diwaniyah Province, Iraq.


Objective: Even previous reports mentioned that thyroxine has beneficial effects on subclinical hypothyroidism (SCH); however, the mechanism by which thyroxine mediated such effect still unclear. Thus, we aim to find out the potential benefit of thyroxine administration in women with SCH through assessment of lipids profile with evaluation of uterine and ovarian blood flow indexes.

Methods: The current study included 80 women with SCH who had a history of recurrent intrauterine death. Those women were chosen from the cohort of pregnant ladies that routinely seek medical advice. For each woman, estimation of serum thyroid-stimulating hormone (TSH), serum lipids profile (low-density lipoprotein [LDL], total cholesterol [TC], and triglyceride [TG]), and also uterine and ovarian pulsatile index (PI) and resistance index (RI) using color Doppler ultrasound, was done at the beginning of study and then repeated following 2 months during which women were given oral thyroxine supplementation (50 μg/d). The study was carried out in Al-Diwaniyah Maternity and Child Teaching Hospital in Al-Diwaniyah province, Iraq and extended from September 2016 to January 2018.

Results: Mean serum TSH, LDL, TG, and TC were significantly reduced (p<0.05). Mean early follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05). In addition, mean late follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05).

Conclusion: Thyroxine administration to women with SCH significantly decreases serum lipids and increases uterine and ovarian blood flow by mechanism involving reduction in arterial RI and PI.

Keywords: Subclinical hypothyroidism, Thyroxine, Uterine, Ovarian blood flow.


1. Ramprasad M, Bhattacharyya SS, Bhattacharyya A. Thyroid disorders in pregnancy. Indian J Endocrinol Metab 2012;16:S167-70.
2. Kataria J, Gill GK, Kaur M. A sian J Pharm Clin Res 2018;11:136-7.
3. Williams GR. Neurodevelopmental and neurophysiological actions of thyroid hormone. J Neuroendocrinol 2008;20:784-94.
4. Jaseem T, Hegdea A, Chakrapani M, Rao S, Manjrekar P, Rukmini MS. Lipids and ischemia-modified albumin in mild subclinical hypothyroidism response to levothyroxine replacement. Asian J Pharm Clin Res 2017;10:336-8.
5. Nazarpour S, Ramezani Tehrani F, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. Iran J Reprod Med 2015;13:387 96.
6. Ezzeddine D, Ezzeddine D, Hamadi C, Abbas HA, Nassar A, Abiad M, et al. Prevalence and correlation of hypothyroidism with pregnancy outcomes among lebanese women. J Endocr Soc 2017;1:415-22.
7. Tudosa R, Vartej P, Horhoianu I, Ghica C, Mateescu S, Dumitrache I, et al. Maternal and fetal complications of the hypothyroidism-related pregnancy. Maedica (Buchar) 2010;5:116-23.
8. Browne VA, Julian CG, Toledo-Jaldin L, Cioffi-Ragan D, Vargas E, Moore LG. Uterine artery blood flow, fetal hypoxia and fetal growth. Philosophical transactions of the royal society B. Biol Sci 2015;370:20140068.
9. Adibi A, Khadem M, Mardanian F, Hovsepian S. Uterine and arcuate arteries blood flow for predicting of ongoing pregnancy in in vitro fertilization. J Res Med Sci 2015;20:879-84.
10. Shah D, Shah S, Parikh J, Bhatt CJ, Vaishnav K, Bala DV, et al. Doppler ultrasound: A good and reliable predictor of ovarian malignancy. J Obstet Gynaecol India 2013;63:186-9.
11. Wang L, Qiao J, Li R, Zhen X, Liu Z. Role of endometrial blood flow assessment with color doppler energy in predicting pregnancy outcome of IVF-ET cycles. Reprod Biol Endocrinol 2010;8:122.
12. Liu XL, He S, Zhang SF, Wang J, Sun XF, Gong CM, et al. Alteration of lipid profile in subclinical hypothyroidism: Ameta-analysis. Med Sci Monit 2014;20:1432-41.
13. Alamdari S, Amouzegar A, Tohidi M, Gharibzadeh S, Kheirkhah P, Kheirkhah P, et al. Hypothyroidism and lipid levels in a community based study (TTS). Int J Endocrinol Metab 2016;14:e22827.
14. Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J 2011;5:76-84.
15. Bartels Ä, O’Donoghue K. Cholesterol in pregnancy: A review of knowns and unknowns. Obstet Med 2011;4:147-51.
16. Butte NF. Carbohydrate and lipid metabolism in pregnancy: Normal compared with gestational diabetes mellitus. Am J Clin Nutr 2000;71:1256S-61S.
17. Catov JM, Bodnar LM, Kip KE, Hubel C, Ness RB, Harger G, et al. Early pregnancy lipid concentrations and spontaneous preterm birth. Am J Obstet Gynecol 2007;197:610.e1-7.
18. Avis HJ, Hutten BA, Twickler MT, Kastelein JJ, van der Post JA, Stalenhoef AF, et al. Pregnancy in women suffering from familial hypercholesterolemia: A harmful period for both mother and newborn? Curr Opin Lipidol 2009;20:484-90.
19. Palinski W. Maternal-fetal cholesterol transport in the placenta: Good, bad, and target for modulation. Circ Res 2009;104:569-71.
20. Roberts CG, LadensonPW. Hypothyroidism. Lancet 2004;363:793 803.
21. Muderris II, Boztosun A, Oner G, Bayram F. Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism. Ann Saudi Med 2011;31:145-51.
22. Krassas GE. Thyroid disease and female reproduction. Fertil Steril 2000;74:1063-70.
23. Bals-Pratsch M, De Geyter C, Müller T, Frieling U, Lerchl A, Pirke KM, et al. Episodic variations of prolactin, thyroid-stimulating hormone, luteinizing hormone, melatonin and cortisol in infertile women with subclinical hypothyroidism. Hum Reprod 1997;12:896-904.
24. Sharma N, Sharma A. Thyroid profile in menstrual disorders. JK Science 2012;14:14-7.
25. Abraham R, Srinivasa Murugan V, Pukazhvanthen P, Sen SK. Thyroid disorders in women of puducherry. Indian J Clin Biochem 2009;24:52 9.
26. Saran S, Gupta BS, Philip R, Singh KS, Bende SA, Agroiya P, et al. Effect of hypothyroidism on female reproductive hormones. Indian J Endocrinol Metab 2016;20:108-13.
27. Aghajanova L, Lindeberg M, Carlsson IB, Stavreus-Evers A, Zhang P, Scott JE, et al. Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue. Reprod Biomed Online 2009;18:337-47.
28. Wagner MS, Wajner SM, Maia AL. The role of thyroid hormone in testicular development and function. J Endocrinol 2008;199:351-65.
29. Acharya N, Acharya S, Shukla S, Inamdar SA, Khatri M, Mahajan SN, et al. Gonadotropin levels in hypothyroid women of reproductive age group. J Obstet Gynaecol India 2011;61:550-3.
30. Ajayi AF, Akhigbe RE, Ajayi LO. Hypothalamic-pituitary-ovarian axis in thyroid dysfunction. West Indian Med J 2013;62:835-8.
31. Binita G, Suprava P, Mainak C, Koner BC, Alpana S. Correlation of prolactin and thyroid hormone concentration with menstrual patterns in infertile women. J Reprod Infertil 2009;10:207-12.
32. Atis G, Dalkilinc A, Altuntas Y, Atis A, Caskurlu T, Ergenekon E, et al. Sexual dysfunction in women with clinical hypothyroidism and subclinical hypothyroidism. J Sex Med 2010;7:2583-90.
33. Chang K, Lubo Zhang. Review article: Steroid hormones and uterine vascular adaptation to pregnancy. Reprod Sci 2008;15:336-48.
34. Velkoska Nakova V, Krstevska B, Bosevski M, Dimitrovski Ch, Serafimoski V. Dyslipidaemia and hypertension in patients with subclinical hypothyroidism. Prilozi 2009;30:93-102.
35. Pearce EN. Hypothyroidism and dyslipidemia: Modern concepts and approaches. Curr Cardiol Rep 2004;6:451-6.
36. Efstathiadou Z, Bitsis S, Milionis HJ, Kukuvitis A, Bairaktari ET, Elisaf MS, et al. Lipid profile in subclinical hypothyroidism: Is L-thyroxine substitution beneficial? Eur J Endocrinol 2001;145:705 10.
217 Views | 142 Downloads
How to Cite
Kadhim, S. A., S. A. A. Kadhum, and A. J. Hamza. “THE POTENTIAL BENEFIT AND THE MECHANISM OF ACTION OF THYROXINE ON SERUM LIPIDS AND BLOOD FLOW INDEXES IN SUBCLINICAL HYPOTHYROIDISM WOMEN”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 8, Aug. 2018, pp. 491-4, doi:10.22159/ajpcr.2018.v11i8.27421.
Original Article(s)