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Serum thyroid hormone profile and trace elements in children receiving valproic acid therapy: a longitudinal and

Hakan Doneray1, Ilknur Surucu Kara, Akar Karakoc

  • 1Department of Pediatric Endocrinology, Ataturk University, Erzurum, Turkey. hdoneray@hotmail.com

Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS)
|June 12, 2012
PubMed

Insights

Valproic acid (VPA) therapy in children may lower copper levels, potentially impacting thyroid function. This study found reduced copper, increased TSH, and decreased FT4 during VPA treatment.

Area of Science:

  • Pediatric Endocrinology
  • Neuropharmacology
  • Clinical Chemistry

Background:

  • Valproic acid (VPA) is commonly used for epilepsy and bipolar disorder.
  • VPA has been anecdotally linked to thyroid dysfunction and altered trace element levels.
  • The specific impact of VPA monotherapy on thyroid hormone profile and trace elements in children requires further investigation.

Purpose of the Study:

  • To prospectively investigate the relationship between VPA monotherapy and thyroid hormone and serum trace element concentrations in children.
  • To evaluate changes in thyrotropin (TSH), free thyroxine (FT4), thyroxine (T4), and trace elements like copper (Cu) over a 6-month period.

Main Methods:

  • Prospective study involving children on VPA monotherapy and a control group.
  • Measurement of serum TSH, FT4, FT3, T4, T3, TG, Se, Zn, and Cu at baseline and 6 months.
  • Statistical analysis to compare patient and control groups and assess correlations.

Main Results:

  • Children on VPA showed significantly lower mean copper (Cu) levels at 6 months compared to controls.
  • Thyroid-stimulating hormone (TSH) levels were significantly increased, while free thyroxine (FT4) levels were significantly decreased in the VPA group.
  • A positive correlation was observed between Cu and T4 levels; changes in logCu and TSH were negatively correlated.

Conclusions:

  • VPA therapy in children may lead to a reduction in serum copper levels.
  • The observed alterations in thyroid hormone profile (increased TSH, decreased FT4) during VPA treatment might be associated with decreased serum copper concentrations.
  • This suggests copper deficiency as a potential mechanism for VPA-induced thyroid dysfunction in pediatric patients.

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