Endocrine Abstracts

Background: Vitamin D deficiency contributes to elastographic hardening of thyroid nodules in patients with hypothyroidism. In such patients, the nodules are elastographically consistent with type 3b. Vitamin D regulation promotes the transition of nodules from type 3b to type 3a.

Objectives: The objective of the present study is to determine the effect of low level of vitamin D on calcium and phosphate metabolism.

Methods: The research lasted for 1.5 to 2 years, more than 30 patients were examined, and whose average age was 35-60 years old. TSH was 4.5-10.2 mIU/l, FT4 level was 0.8-1.2 ng/dL, vitamin D 2-20 ng/dL, PTH ranged from 6.1 to 10.2Pg/ml, calcium was within the normal range. Elastography was performed on a TOSHIBA Apilo 500. Elastographic examination revealed 3b nodules in the thyroid gland. The patients were prescribed Levothyroxine depending on body weight and vitamin D₃ 50,000 IU once a week.

Result: After 3-5 months of treatment, drug-induced euthyroidism, normalization of vitamin D and regulation of calcium and phosphate metabolism (TSH 0.5-1.5 mIU/l, vitamin D 40-60 ng/dL, PTH 3.1-4.5 Pg/ml) were diagnosed. Elastographic examination after 10-12 months revealed reduction of thyroid nodule stiffness and transition from type 3b to 3a.

Conclusion: The result of the research showed that the low levels of vitamin D can lead to the stiffness of thyroid nodules due to the disturbance of calcium and phosphate metabolism.