Mineral metabolism in Hyperthyroidism

  • DIANA ATHOKPHAM Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bengaluru, Karnataka, India.
  • SHRABANI MOHANTY Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bengaluru, Karnataka, India.
  • VENKATA BHARATKUMAR PINNELLI Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bengaluru, Karnataka, India.


Objective: The objective of the study was to estimate the levels of serum calcium, phosphorus, magnesium, and copper in hyperthyroid cases and to correlate each of the parameter with serum T3, T4, TSH, FT3, and FT4, respectively.

Methods: The study was conducted on 60 newly confirmed hyperthyroid cases based on the thyroid profile and 60 euthyroid cases were recruited as controls. Blood samples were collected from all these subjects and estimation of serum T3, T4, TSH, FT3, FT4, calcium, phosphorus, and magnesium was done by autoanalyzer method. Serum copper was measured by modified spectrophotometric micro-method using guanidine hydrochloride and bathocuproine disulfonate disodium salt. The statistical analysis was done by paired test and Pearson’s correlation.

Results: Study results in hyperthyroid cases show mean serum calcium and copper levels were significantly (p<0.001) increased, serum phosphorus levels were significantly (p<0.001) decreased when compared to euthyroid. However, there was no significant change in magnesium when compared with euthyroid controls (p=0.556). We also found a significant positive correlation among serum Ca versus T3, T4, FT3, and FT4. A negative correlation with serum Ca versus TSH as observed. We also found significant positive correlation between serum phosphorus with TSH and significant negative correlation of phosphorus with T3, T4, FT3, and FT4. No suggestive significant correlation was found between serum Mg with T3, T4, TSH, FT3, and FT4 and serum copper with serum T3, T4, TSH, FT3, and FT4.

Conclusion: The present study has shown that metabolism of minerals is altered in hyperthyroid cases. Impaired metabolism of calcium, phosphorus, magnesium, and copper can lead to various metabolic disorders. Estimation of serum calcium, phosphorus, magnesium, and copper may be helpful in better management to prevent further complication and can be used as diagnostic or prognostic aid in patients with hyperthyroidism along with other biochemical parameters.

Keywords: Hyperthyroidism, Mineral metabolism, Thyroid hormones


1. Dhanwal DK. Thyroid disorders and bone mineral metabolism. Indian J Endocrinol Metab 2011;15:S107-12.
2. Duntas LH. Environmental factors and thyroid autoimmunity. Ann Endocrinol (Paris) 2011;72:108-13.
3. Cayir A, Doneray H, Kurt N, Orbak Z, Kaya A, Turan MI, et al. Thyroid functions and trace elements in pediatric patients with exogenous obesity. Biol Trace Elem Res 2014;157:95-100.
4. Schomburg L. Selenium, selenoproteins and the thyroid gland: Interactions in health and disease. Nat Rev Endocrinol 2012;8:160-71.
5. Betsy A, Binitha MP, Sarita S. Zinc deficiency associated with hypothyroidism: An overlooked cause of severe alopecia. Int J Trichol 2013;5:40-2.
6. Kucharzewski M, Braziewicz J, Majewska U, Gozdz S. Copper, zinc, and selenium in whole blood and thyroid tissue of people with various thyroid diseases. Biol Trace Elem Res 2003;93:9-18.
7. Rayman MP. The importance of selenium to human health. Lancet 2000;356:233-41.
8. Maouche N, Meskine D, Alamir B, Koceir EA. Trace elements profile is associated with insulin resistance syndrome and oxidative damage in thyroid disorders: Manganese and selenium interest in Algerian participants with dysthyroidism. J Trace Elem Med Biol 2015;32:112-21.
9. Schweizer U, Chiu J, Kohrle J. Peroxides and peroxide-degrading enzymes in the thyroid. Antioxid Redox Signal 2008;10:1577-92.
10. Duntas LH, Benvenga S. Selenium: An element for life. Endocrine 2015;48:756-75.
11. Ozturk P, Kurutas EB, Ataseven A. Copper/zinc and copper/ seleniumratios, and oxidative stress as biochemical markers in recurrent aphthous stomatitis. J Trace Elem Med Biol 2013;27:312-6.
12. Bacic-Vrca V, Skreb F, Cepelak I, Mayer L, Kusic Z, Petres B. The effect of antioxidant supplementation on superoxide dismutase activity, Cu and Zn levels, and total antioxidant status in erythrocytes of patients with Graves’ disease. Clin Chem Lab Med 2005;43:383-8.
13. Pearce EN. Hypothyroidism and dyslipidemia: Modern concepts and approaches. Curr Cardiol Rep 2004;6:451-6.
14. Kavitha MM, Chandrashekharyya SH, Sunitha H, Neela BM, Ratna S. Alteration in levels of serum calcium, phosphorous and magnesium in hypothyroidism patients. Int J Biol Med Res 2014;5:4594-6.
15. Suneel B, Nagendra DR, Aparna RR, Balakrishna D, Naidu JN. Mineral status in thyroid disorder (hypo and hyper). Int J Appl Biol Pharm 2011;2:423-9.
16. Shivaleela MB, Poornima RT, Murthy DS. Serum calcium and phosphorus levels in thyroid dysfunction. Indian J Fundam Appl Life Sci 2012;2:179-83.
17. Mosekilde L, Eriksen EF, Charles P. Effects of thyroid hormones on bone and mineral metabolism. Endocrinol Metab Clin North Am 1990;19:35-63.
18. Pantazi H, Papapetrou PD. Changes in parameters of bone and mineral metabolism during therapy for hyperthyroidism J Clin Endocrinol Metab 2000;85:1099-106.
19. Modi A, Sahi N. Effect of thyroid hormones on serum calcium and phosphorous. Int J Clin Biochem Res 2018;5:570-3.
20. Bharti A, Shrestha S, Rai R, Singh MK. Assessment of serum minerals and electrolytes in thyroid patients. Int J Adv Sci Res 2015;1:259-63.
21. Schwarz C, Leichtle AB, Arampatzis S, Fiedler GM, Zimmermann H, Exadaktylos AK, et al. Thyroid function and serum electrolytes: Does an association really exist? Swiss Med Wkly 2012;142:w13669.
22. Abbas MM, Mahmoud AH, El-Desouky W. Biochemical changes in serum lipid fractions, calcium, magnesium and phosphorus levels in women with subclinical hypothyroidism. Nat Sci 2013;11:113-8.
23. Alcalde AI, Sarasa M, Raldu?a D, Aramayona J, Morales R, Biber J, et al. Role of thyroid hormone in regulation of renal phosphate transport in young and aged rats. Endocrinology 1999;140:1544-51.
24. Gohel MG, Shah AM, Shah AM, Makadia JS. A study of serum calcium, magnesium and phosphorous level in hypothyroidism patients. Int J Med Health Sci 2014;3:308-12.
25. Gammage MD, Parle JV, Holder RL, Roberts LM, Hobbs FD, Wilson S, et al. Association between serum free thyroxine concentration and atrial fibrillation. Arch Intern Med 2007;167:928-34.
26. Mane AY, Bhagwat VR. Assessment of some biochemical markers of bone turnover in thyroid dysfunction state. Int J Pharma Bio Sci 2012;3:B126-33.
27. Shibutani Y, Inoue D, Koshiyama H, Mori T. Thyroid hemiagenesis with subacute thyroiditis. Thyroid 1995;5:133-5.
28. Kaur J, Ahemad N, Gupta A. Changes in the electrolyte profile of patient having hypothyroidism. J Med Sci Clin Res 2014;2:633-7.
29. Frizell M, McLean WG. The effect of triiodothyronine on axonal transport in regenerating peripheral nerves. Exp Neurol 1979;64:225-30.
30. Kvaghela V, Khubchandani A, Vaghela BK. Study of serum zinc and copper levels in hyperthyroid patients. Int J Red Med 2017;6:90-2.
31. Akçay MN, Akçay G, Balik AA, Böyük A. Hydatid cysts of the adrenal gland: Review of nine patients. World J Surg 2004;28:97-9.
32. Liu Y, Liu S, Mao J, Piao S, Qin J, Peng S, et al. Serum trace elements profile in graves’ disease patients with or without orbitopathy in Northeast China. Biomed Res Int 2018;2018:3029379.
23 Views | 32 Downloads
How to Cite
ATHOKPHAM, D., S. MOHANTY, and V. BHARATKUMAR PINNELLI. “ALTERATIONS OF SERUM CALCIUM, PHOSPHORUS, MAGNESIUM, AND COPPER IN HYPERTHYROIDISM PATIENTS: A CASE–CONTROL STUDY: Mineral Metabolism in Hyperthyroidism”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 13, no. 12, Dec. 2020, pp. 95-98, doi:10.22159/ajpcr.2020.v13i12.39611.
Original Article(s)