Study of copper and ceruloplasmin in hypothyroidism and Grave’s hyperthyroidism as compared to euthyroidism: Hospital-based case–control study

Abstract

Background: Hypothyroidism was highly prevalent in India, with 10.95% affected patients as compared with only 2% in the United Kingdom and 4·6% in the USA. The prevalence of Hyperthyroidism was found to be 1.6%. Copper has an essential role in thyroid metabolism, thyroid hormone production, and absorption. Copper is an essential part of thyroxine (T4) hormone and thyroid-stimulating hormone (TSH) synthesis. Objectives: This study evaluated the status of serum copper and ceruloplasmin levels in hypothyroidism and Grave’s hyperthyroidism in comparison with euthyroid participants. Materials and Methods: This was a hospital-based case–control study that involved 100 cases of hypothyroidism and 60 cases of Grave’s hyperthyroidism compared with 100 euthyroid participants aged 15–60 years. After detailed case history and examination, the blood sample was collected and analyzed the same day for FreeT3, FreeT4, TSH, serum copper, and ceruloplasmin levels. Results: Compared to euthyroid participants, patients with clinical hypothyroidism had statistically significant (P < 0.05) lower levels of serum copper and ceruloplasmin. The scenario was the opposite in the case of Grave’s hyperthyroidism patients. Our study found statistically significant (P < 0.05) higher serum copper and ceruloplasmin levels in Grave’s hyperthyroidism patients. Conclusion: Our study found serum copper levels directly affected the thyroid profile and vice versa. The deficiency of one parameter affected the other. Patients with hypothyroidism and hyperthyroidism should be routinely screened for serum copper and ceruloplasmin levels for more effective thyroid treatment.

Keywords

• ceruloplasmin
• copper
• cross-sectional study
• grave’s hyperthyroidism
• hypothyroidism
• thyroid profile