Acute severe hypothyroidism is not associated with hyponatremia even with increased water intake: a prospective study in thyroid cancer patients
Hammami MM, Almogbel F, Hammami S, Faifi J, Alqahtani A, Hashem W
BMC endocrine disorders · 21 citations
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- University or hospital
- King Faisal Specialist Hospital and Research Centre
Based on 1 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2013-07-31 · BMC Endocr Disord · vol. 13 · issue 1 · p. 27
- Publisher
- BioMed Central
- Cited
- 26 citations · more than 83% of similar papers · 1.5× the field average
- References
- 24 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Electrolyte and hormonal disorders · Ion Transport and Channel Regulation · Thyroid Disorders and Treatments
- Keywords
- Hyponatremia, Medicine, Internal medicine, Endocrinology, Creatinine, Thyroid cancer, Renal function, Gastroenterology, Nausea, Sodium, Thyroid function, Incidence (geometry), Thyroid, Chemistry
6 authors
From SA
- Muhammad Maher Hammami · correspondingAlfaisal University; King Faisal Specialist Hospital & Research Centre
- Fahad AlmogbelKing Faisal Specialist Hospital & Research Centre
- Sumaya HammamiKing Faisal Specialist Hospital & Research Centre
- Jaber FaifiKing Faisal Specialist Hospital & Research Centre
- Awad AlqahtaniKing Faisal Specialist Hospital & Research Centre
- Walid A. HashemKing Faisal Specialist Hospital & Research Centre
Abstract
Background
Hypothyroidism, commonly induced in preparation for radioiodine treatment of differentiated thyroid cancer, is a text-book cause for hyponatremia. Nausea, stress, and increased fluid intake associated with the treatment are expected to exacerbate hyponatremia.
Methods
We prospectively studied 212 (80% females) consecutive thyroid cancer patients for the incidence of hypothyroidism-induced hyponatremia and associated risk factors.
Results
Mean(SD) age was 39.7(14.1) year, creatinine 82.0(20.8) μmol/l, TSH 141.6(92.0) mU/l, pre- and post-isolation sodium 139.5(2.3) and 137.8(3.0) mEq/l, respectively, and estimated fluid intake during isolation 9.7(6.2) L. Mild hyponatremia (≥130 mEq/l) was present in 18 patients (8.5%) and moderate hyponatremia (≥120 mEq/l) in 4(1.9%), 3 of the latter had elevated creatinine concentration and 2 were on diuretics. There was no significant correlation between post-isolation sodium concentration and TSH concentration (r = 0.03, p = 0.69) or estimated fluid intake (r = 0.10, p =0.17). There was significant correlation between post-isolation sodium concentration and age (r = -0.24, p < 0.0001) and creatinine concentration (r = -0.22, p = 0.001). Pre-post-isolation drop in sodium concentration was more in females (mean difference 1.21, p = 0.02). Compared to eunatremic patients, hyponatremic patients were more likely to have pre-isolation hyponatremia (9% vs. 0.5%, p = 0.03), elevated creatinine concentration (36% vs. 13%, p = 0.008), and to be on diuretics (23% vs. 1%, p = 0.0001).
Conclusions
In the setting of acute severe hypothyroidism: 1) clinically-important hyponatremia is uncommon; sodium concentration may not need to be monitored unless patients have impaired renal function or are on diuretics, 2) age and female gender are associated with lower sodium concentration. Uncomplicated acute severe hypothyroidism didn't cause clinically-important hyponatremia/SIADH in this cohort of patients.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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