Background: Although selenium is one of the nutrients that has an important role in the metabolism of thyroid hormones, it has been investigated in rare studies. This study aimed to evaluate role of selenium deficiency in children and adolescents with ACQUIRED HYPOTHYROIDISM. Methods: This case and control study was conducted on 60 ACQUIRED HYPOTHYROIDISM and 60 healthy children who had been referred to the pediatrics endocrine clinic in Shiraz, Iran, from November 2018 to April 2019. Some information such as age, gender, weight, height, duration of disease, and level of plasma selenium were recorded. Plasma selenium level was measured by atomic absorption spectrophotometer. Data were analyzed using SPSS software 21. 0. Results: The mean of selenium level in the case and control groups were 93. 77 ±,24. 90 μ, g/dl and 85. 96 ±,25. 20 μ, g/dl, respectively. There was no significant difference between the two groups in the mean levels of selenium. Independent t‑, test showed no significant difference in the mean levels of selenium in male and female samples in the case group, but this difference was significant in the control group. Conclusion: Selenium deficiency may not have significant role as a cause of ACQUIRED HYPOTHYROIDISM in pediatric and adolescent age group, in south of Iran. Thus, it does not seem necessary to routinely check the level of selenium for patients with thyroid dysfunction.

Introduction: Both clinical and laboratory evidence confirm that hearing loss can result from congenital and ACQUIRED HYPOTHYROIDISM. There is a confirmed correlation between congenital HYPOTHYROIDISM and hearing loss, but significant controversy still surrounds the association between ACQUIRED HYPOTHYROIDISM and hearing loss. The aim of this study was to evaluate this relationship. Materials and Methods: Fifty patients with confirmed primary HYPOTHYROIDISM, were studied and compared with 50 age- and sex- matched controls. All patients were evaluated in the HYPOTHYROIDISM state before treatment with thyroxine. Auditory assessments included: Toutine ENT examinations, speech reception threshold, pure tone audiometry, speech discrimination score, acoustic reflex and tympanometery. Results: The hearing thresholds in all frequencies in both ears of the case group were higher than in controls. Also hearing loss frequencies, i.e. 2000, 4000, 8000 dB in the left and 4000, 8000 dB in the right ears in the case group, were higher than in controls. Hearing loss was symmetric, sensory neural and mild to moderate. Mean speech reception threshold in the right and left ears in the case group were 15 and 15.1 respectively and in controls, 10.6 dB for both the right and left ears. Mean speech discrimination score in the right and left ears in the case group was 97 and in the control group was 99 dB. Conclusion: Results demonstrate a strong correlation between ACQUIRED primary HYPOTHYROIDISM and hearing loss.

Subclinical HYPOTHYROIDISM (SCH) is defined as a normal serum FT4 and a high serum thyrotropin (TSH) concentration. Up to 30% of patients with SCH may have vague, non-specific symptoms of HYPOTHYROIDISM, but attempts to identify the patients on the basis of clinical finding have not been successful, so the diagnosis can only be made with laboratory testing.The causes of SCH are the same as those of overt HYPOTHYROIDISM. Most patients have Hashimoto’s thyroiditis. The worldwide prevalence of SCH ranges from 1-10%. A substantial proportion of patients with SCH develop overt HYPOTHYROIDISM. Serum TSH concentration and positive antithyroid antibodies (ATA) are significant predictors of progression to clinical HYPOTHYROIDISM. Some patients with SCH have some symptoms of HYPOTHYROIDISM, while some studies show significant improvement in hypothyroid symptom scores and psychometric testing; others found no improvement in symptoms with levothyroxine therapy. There is consensus that SCH in pregnancy is a risk factor for poor developmental outcomes in the offspring and the condition should be treated in women who wish to become pregnant. There is also agreement that patients with SCH and TSH levels over 10 mU/L, or with goiter should be treated. Population-based screening for SCH is not warranted, but thyroid function should be tested in high risk groups, e.g. in women aged over 60 yr, persons with previous radiation therapy of thyroid gland or external radiation, those with previous thyroid surgery of thyroid dysfunction, type 1 diabetes mellitus patients and those with a family history of autoimmune disease. Evidence documenting routine determination of TSH in pregnant women or women planning to become pregnant are insufficient, and it would be reasonable to consider TSH measurement in those at high risk for thyroid dysfunction.