Endocrine Abstracts (2008) 16 P284

Correlation between postoperative hypothyroidism and seric homocysteine at the patients with thyroid carcinoma

Andrei Liviu Goldstein, Florin Alexiu & Mariana Purice


The National Institute of Endocrinology ‘C I Parhon’, Bucharest, Romania.


Carcinoma of the thyroid gland is an uncommon cancer but is the most common malignancy of the endocrine system. The treatment of the thyroid cancer includes surgery, radioactive iodine and hormone treatment. Postoperative hypothyroidism is the most common complication of thyroidectomy for thyroid cancer. After thyroidectomy, the patient takes a thyroid hormone drug (levothyroxine) in supresive dose for the rest of his life.

In hypothyroidism there has been reported an elevated plasma homocysteine. This may exacerbate the risk of cardiovascular disease in hypothyroidism that is traditionally attributed to lipid changes.

Combination therapy with L-thyroxine and multiple vitamins (B6, B12, folic acid) may correct plasma homocysteine in many patients.

Our study proposed following the changes after administration of folic acid daily. For this reason we chose a group of 20 patients with thyroidectomy for thyroid carcinoma, treated with 131I, who take a thyroid hormone replacement drug.

Before the begining of the study, we measured the seric level of homocysteine, TSH, T3, free T4, cholesterol (total, LDL, HDL), trigliceride, Tg and AbTg. We also made carotidian doppler ultrasounds for measuring the intima – media thickness (IMT).

Every 3 months after the administration of the folic acid, there was made clinical, serological and imagistic evaluation of the patients.

After the first evaluations we observed the decrease of the seric level of homocysteine. IMT remained almost unchanged.

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