{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:54:37Z","timestamp":1773276877504,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>With increasing free thyroxine levels, a gradually rising risk of venous thromboembolism has been described in case\u2013control studies. However, reports on the influence of thyroid hormones on haemostasis, while suggesting a hypercoagulable state in thyrotoxicosis, have often been inconclusive. This study evaluates multiple markers of haemostasis and fibrinolysis in a paired design, making it more sensitive to changes in thyroid hormone levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We analysed multiple variables in patients who shifted from severe hypothyroidism to mild hyperthyroidism during thyroid cancer treatment. Those with possible residual disease were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety patients following total thyroidectomy were tested on two occasions: i) before radioiodine remnant ablation and ii) 6 weeks later, on levothyroxine (<jats:sc>l<\/jats:sc>T<jats:sub>4<\/jats:sub>) suppression treatment, and the results were compared using the Wilcoxon's test for paired data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During <jats:sc>l<\/jats:sc>T<jats:sub>4<\/jats:sub> treatment, significant increases (all <jats:italic>P<\/jats:italic>&lt;0.001) in fibrinogen (from median 3.4 to 3.8\u200ag\/l), von Willebrand factor (from 85 to 127%), factor VIII (from 111 to 148%) and plasminogen activator inhibitor 1 (from 6.5 to 13.9\u200a\u03bcg\/l) were observed. In addition, the activation times of platelet adhesion and aggregation stimulated with collagen and epinephrine (EPI)\/ADP, i.e. closure times in platelet function analyser (PFA-100), were significantly shortened (<jats:italic>P<\/jats:italic>&lt;0.001): for EPI from median 148 to 117\u200as and for ADP from 95 to 80\u200as. Changes in other tests were less prominent or insignificant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An increase in thyroid hormone levels shifts the haemostatic balance towards a hypercoagulable, hypofibrinolytic state. This may contribute to the increased cardiovascular morbidity and mortality observed even in mild thyrotoxicosis.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-14-0801","type":"journal-article","created":{"date-parts":[[2015,1,31]],"date-time":"2015-01-31T07:00:42Z","timestamp":1422687642000},"page":"537-542","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":47,"title":["Prothrombotic changes due to an increase in thyroid hormone levels"],"prefix":"10.1093","volume":"172","author":[{"given":"Jiri","family":"Horacek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaroslav","family":"Maly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Svilias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Smolej","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jitka","family":"Cepkova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaroslav","family":"Vizda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Sadilek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilona","family":"Fatorova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Zak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"issue":"22","key":"1_36909778","doi-asserted-by":"publisher","first-page":"4344","DOI":"10.1182\/blood-2009-11-253724","volume":"115","year":"2010","journal-title":"Blood","ISSN":"https:\/\/id.crossref.org\/issn\/0006-4971","issn-type":"print"},{"key":"2_50058509","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1111\/j.1538-7836.2012.04818.x","volume":"10","year":"2012","journal-title":"JOURNAL OF THROMBOSIS AND HAEMOSTASIS"},{"issue":"7","key":"3_28375916","doi-asserted-by":"publisher","first-page":"2415","DOI":"10.1210\/jc.2007-0199","volume":"92","year":"2007","journal-title":"Journal of Clinical Endocrinology &amp; 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