title: Is thyroid hormone suppression therapy prothrombotic?
abstract: The purpose of this study was to determine whether chronic thyroid hormone suppression therapy (THST) is prothrombotic. We obtained blood samples from 14 thyroid cancer patients while on THST and after they had become hypothyroid for radioiodine whole-body scanning and therapy. Prothrombin fragment 1 + 2, fibrinogen, factor VIII, antithrombin, tissue plasminogen activator antigen (tPA), plasminogen activator inhibitor 1 (PAI-1), PAI-1/tPA, and C-reactive protein were significantly (P < 0.05) higher in the hyper- than in the hypothyroid state, whereas protein C and plasmin-antiplasmin complexes were significantly lower during the hyperthyroid period. When the 10 female patients were hyperthyroid, their levels of prothrombin fragment 1 + 2, fibrinogen, protein S, antithrombin, tPA, PAI-1, and PAI-1/tPA were significantly higher (P </= 0.05) than in healthy female controls, whereas when the female patients were hypothyroid, their antithrombin and plasmin-antiplasmin were lower and their protein S was higher than in controls. Factor II, plasminogen, and D-dimer were not significantly affected by the thyroid status in either assessment. In conclusion, we found evidence that the majority of patients treated with THST have a prothrombotic profile.
authors.affiliation: Department of Laboratory Medicine, National Institutes of Health, Building 10, Room 2C-306, Bethesda, Maryland 20892, USA. MHorne@mail.cc.nih.gov
authors.forename: McDonald K
authors.initials: MK
authors.lastname: Horne
authors.forename: Kulvinder K
authors.initials: KK
authors.lastname: Singh
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Rosenfeld
authors.forename: Robert
authors.initials: R
authors.lastname: Wesley
authors.forename: Monica C
authors.initials: MC
authors.lastname: Skarulis
authors.forename: Paula K
authors.initials: PK
authors.lastname: Merryman
authors.forename: Ann
authors.initials: A
authors.lastname: Cullinane
authors.forename: Rene
authors.initials: R
authors.lastname: Costello
authors.forename: Amy
authors.initials: A
authors.lastname: Patterson
authors.forename: Thomas
authors.initials: T
authors.lastname: Eggerman
authors.forename: Donna M
authors.initials: DM
authors.lastname: Bernstein
authors.forename: Frank
authors.initials: F
authors.lastname: Pucino
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Csako
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017293:Protein S / Q000032:analysis; D013927:Thrombosis / Q000209:etiology*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D013972:Thyrotropin / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000097:blood
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D017293:Protein S; D013972:Thyrotropin; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator