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Background and purpose : Çongenital Hypothyroidism (ÇH) is one of the preventable causes of mental retardation, which according to its clinical manifestations within the neonatal perioid, can be diagnosed in only fewer than 10% of cases. Delayed diagnosis results in irreversible cerebro-auditory complications unless the problem is diagnosed by screening programs.
Materials and methods : From May to December 2003, serum T4 and TSH concentrations of 3005 newborns on the 3rd - 7th day of their birth were measured by RÏÂ and ÏRMÂ, respectively in all Kashan hospitals. The newborns with abnormal screening results were reexamined (TSH> 20 mÏÜ/L, T4<6.5 μg/dl and based on the weight). Newborns with TSH >10 mÏÜ/L and T4<6.5 μg/dl on the second measurment were considered to be hypothyroid. Âfter performing complementary tests, replacement therapy with levothyroxine was begun in neonates with ÇH.
Results : From 3005 neonates, 51 newborn were recalled (recall rate = 1.7%) and 10 newborns were diagnosed as hypothyroid cases. The prevalence of neonatal hypothyroidism was estimated to be 1 / 303.
Çonclusion : Çonsidering the high prevalence of ÇH in the population, the necessity of routine neonatal screening programs is emphasized.

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Background and Purpose: Thyroid dysfunctions are one of the most important diseases in endocrinology. Fine needle aspiration (FNA) is currently the first line diagnostic tool for the evaluation of thyroid nodules. The adequacy of specimens provided by this method is also very important. FNA puncture in thyroid causes intra- parenchyma hemorrhage, which may distribute the quality of tissue specimens. Fine needle non-aspiration (FNNA), may provide better specimens without this problem. The aim of this study was to evaluate the adequacy of thyroid nodules specimens provided by fine needle aspiration and fine needle non – aspiration sampling in Imam Hospital.
Materials and Methods: This descriptive study was performed on 200 patients with thyroid nodules in Imam Hospital, Sari, Iran. After a detailed clinical history, systemic examination and thyroid sonography, FNA and FNNA sampling were performed in all patients. The adequacy of specimens was evaluated by Mair scoring system in both techniques. All data, including demographic data and sonographic results and background blood, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture were recorded. Results were analyzed by means of SPSS (11) software and Wilcoxon Signed Rank Test. The P.value less than 0.05 were considered to be significant statistically.
Results: 200 patients, 189 (94.5%) females and 11 (5.5%) males, with mean age of 43.36±12.3 years were studied. Cytological findings showed that in FNA technique, 26(13%) of specimens were unsuitable for diagnosis, 97(48.5%) were diagnostic/adequate, while 77(38.5%) were diagnostic/superior for diagnosis. In FNNA technique, 32(16%) of specimens were unsuitable, 96 (48%) were diagnostic/ adequate, while 72 (36%) were diagnostic/superior for diagnosis. In the combined application of FNA and FNNA, 9 (4.5%) of specimens were not diagnostible and 191 (95.5%) were diagnostic. Mean of total score in FNA was 5.82±2.3, while in FNNA was 5.70±2.4, with the difference was not statistically significant. Furthermore, there was no statistically significant difference between other parameters.
Conclusion: Our study demonstrates that there is no difference between FNA and FNNA sampling, however, applying the combination of these two techniques, may improve the diagnostic quality.

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Background and purpose: Hypothyroidism is one of the most common diseases in endocrinology Thyroid hormone deficiency effects on nerve and muscle fibers, pulmonary system and alveolar ventilation. The aim of this study was to evaluate the effect of Levothyroxine therapy on pulmonary function in hypothyroidism patients in Imam Hospital.
Materials and methods: This study was performed on 50 patients with hypothyroidism in Imam Hospital, Sari, Iran, 2006-2007. After a detailed clinical history and systemic examination, level of TSH, T4 and ABG test, chest radiography and spirometery was performed in all patients. The spirometery indexes including FVC, FEV1, FEV1/FVC, FEF 25-75, PEF were recorded. All patients treated with Levothyroxine 1.6μg/kg. After that all systemic and clinical examination, and chest radiography and spirometery performed again. Results analyzed by means of SPSS (11) software and paired t test. The p value less than 0.05 was considered to be significant statistically
Results: 50 female patients, with mean age of 34.98±13.4 years were studied. The mean of TSH, T4 before treatment were 51.44±25.3 mIu/l and 2.8± 0.9 μg/dl and after treatment were 3.64±2.4 mIu/l and 9.80±4.9 μg/dl respectively (P= 0.0001). The ABG parameters were in normal range and there was no statistically significant difference between before and after treatment. Statistical analysis demonstrated significant differences between mean of FVC, FEV1, FEV1/FVC, FEF 25-75, and PEF before and after treatment.
Conclusion: Our study demonstrates that treatment of hypothyroidism with Levothyroxine can improves the pulmonary function according to spirometery findings.

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Background and purpose: Based on the high prevalence of diabetes mellitus and hypothyroidism and different disorders from their coincidence, the present study was designed to determine the correlation between type 2 diabetes mellitus and hypothyroidism.
Materials and methods: Ïn this case-control study, 103 type 2 diabetic patients were compared with 103 healthy subjects. Âge, gender and family history of thyroid disease were matched between the two groups. For all patients, anti-thyroid peroxidase antibody (Ânti-TPÔ), FBS, Triglyceride, Çholesterol, HDL and LDL were measured. Descriptive analysis, T-test and X2 were used for data analysis.
Results: Ïn each group, 14 (%13.59) cases were men and 89 (%86.4) cases were women. The prevalence of hypothyroidism in the case group and the control group were %17.5 and %26.2, respectively, which was not statistically significant (P>0.05). Twenty eight percent of hypothyroid patients in diabetic group and 55% in the control group had autoimmune hypothyroidism (P<0.05).
Çonclusion: The results of this study showed that the prevalence of hypothyroidism in type 2 diabetic patients is as high as normal population. Because of the interaction between diabetic mellitus and hypothyroidism, screening of hypothyroidism and suitable treatment in diabetic patients is recommended.

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Background and purpose: Nausea and vomiting are common complaints in early gestation. The most severe form of this disorder is hyperemesis gravidarum (HG), which occurs in 1–2% of pregnancies. Some researches showed that special type of HCG influence TSH receptor increase iodine removal. This process could result in chemical hypothyroid. This study investigated the relationship between beta human chorionic gonadotrophin (BHCG) and throyid function with HG among pregnant women admitted to Sari Imam Khomeini Hospital. Materials and methods: This case-control study was performed in 42 patients admitted to for nausea and vomiting whose gestational age was 8-18 weeks. The study was carried out during June 2011 to December 2011. In this rsearch 45 pregnant women enrolled in a control group who were matched for demographic features. The data including demographic features and levels of TSH, T3, FT4 and BHCG was recorded in both groups. It was then analyzed using t-test and chi square test in SPSS. Results: The mean ages of the participants in control group and experimental group were 25.33±5.9 and 23.17±4.28, respectively. Significant differences were seen in levels of TSH, FT4, T3, and BHCG between the two groups. Conclusion: The serum level of BHCG, FT4, and T3 was higher in patients with nausea and vomiting but the level of TSH was lower. There was chemical hypothyroid among the patients but none of the patients had clinical manifestations of hyperthyroidism.

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Background and purpose: Âlthough congenital hypothyroidism is a preventable cause of mental disabilities, less than 10% of newborns are diagnosed based on clinical symptoms in the first month. Ïf the diagnosis is not made based on screening programs, it would be delayed and irrepairable cerebral and auditory complications will occur. The purpose of this study was to determine the prevalence of congenital hypothyroidism in the Mazandaran province.
Materials and methods: The study is a descriptive (screening) survey. From infants born from January 2007 to January 2008 in Mazandaran province heel blood samples on filter paper were obtained. TSH values were measured by ËLÏSÂ method and TSH> 5 mlu/L was considered as the recall criterion. Diagnosis of neonatal hypothyroidism was made based on TSH>10 and T4<6.5. Treatment was performed based on the results of second tests. Ëxcept in cases where the initial TSH was greater or equal to 20 -where the treatment was started from the beginning- if the second test results were reported normal, treatment was discontinued and the case was considered as a transient hypothyroidism.
Results: Ôut of 45218 infants studied, 49% were female and 51% were male. 4.6% of newborns (2109) were recalled, among whom 1885 had 5< TSH< 10 mlu/L and 185 had 10< TSH< 20 mlu/L and 39 had TSH ³ 20.73 infants were diagnosed with hypothyroidism. Thus, the prevalence of neonatal hypothyroidism was 1.6/1000 in live births in Mazandaran province. Âlso prevalence of transient neonatal hypothyroidism was 1 in every 2500 live births.
Çonclusion: Given the high prevalence of hypothyroidism in the province, more screening programs are essential.

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Background and purpose: The prevalence of malignancy in thyroid nodules have been reported 1-10%. Epidemiological studies suggest that thyroid cancer incidence is rising over the last 20 years. The aim of this study was to evaluate the results of fine needle aspiration of thyroid nodules in patients referred to Imam Khomeini hospital in recent decades (2003-2011) in Sari. Materials and methods: This is a cross sectional, retrospective study. The results of cytology were recorded and compared with pathology results. The sensitivity, specificity, positive and negative predictive value of fine needle aspiration for prediction of malignancy were assessed. Results: The study population included 2002 patients with thyroid nodules, 210 cases were male (10.5%) and 1792 women (89.5%). Cytology results in 1598 cases (79.8%) were benign, 205(10.2 %) unsatisfactory, 53(2.6 %) suspicious and 146 (7.3 %) malignant. 217 reports of pathology results of patients with thyroidectomy were available, 153(70.5%) specimens were benign and 64 (29.5%) malignant. The sensitivity of fine needle biopsy was 81.2% and specificity, 75.1%. positive predictive value(PPV) and negative predictive value(NPV) were 63.4% and 93.5 percent respectively. Conclusion: According to the results of this study, thyroid fine needle aspiration is still a good way to predict thyroid malignancy and the incidence of thyroid malignancy in our patients has not increased in recent decades.

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Background and purpose: The gold standards for diagnosis of thyroid nodules are cytology (FNA) and pathology. However, the role of ultrasonography is rising in detection and characterization of malignant and benign thyroid nodules. This study compared these two diagnostic methods to establish a complementary role for ultrasonography. Materials and methods: This cross-sectional study was performed between June 2008 to October 2009. Two hundred and fifty four patients with thyroid gland nodule or nodules were evaluated by US, CFD and FNA in Sari Imam Khomeini Hospital. The collaboration between radiologist and pathologist/endocrinologist was double blind. After data acquisition we used SPSS-17 to calculate the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) for all 12 variables. We also determined cutoff point for thyroid nodule size by drawing Roc curve and measuring the cutoff point. The data was then analyzed using regression logistic analysis. Results: Frothy-four patients with inadequate cytology were excluded from the study. In the remaining 210 patients we found 191(91%) benign, 12(5.7%) suspicious and 7(3.3%) malignant nodules in cytology. All patients with malignant cytology and eight patients from twelve patients with suspicious cytology underwent surgery. After surgery and pathological study 11(5.34%) were found malignant. Malignant lesion showed higher frequency of enlarged thyroid lobe with prominent nodule (63.6 vs. 20.5% P<0.01) and blurred margin nodules than benign nodules (54 vs. 5.1% p<0.0001) Conclusion: Our study demonstrated that no single parameter could identify malignancy. We found that blurred margin and enlarged thyroid lobe with prominent nodule is the best differentiating factor between missing malignancy and benignicity.

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Background and purpose: Diabetes mellitus is the most common endocrinologic disease in children and adolescents. Type 1 diabetes mellitus (T1DM) is frequently associated with autoimmune thyroid disease. It is believed that the prevalence of thyroid disease in T1DM patients is higher than normal population. Various studies reported the incidence of hypothyroidism as 2-32% in T1DM. This study investigated the frequency of hypothyroidism in children with T1DM. Material & methods: In this retrospective study 85 patients with T1DM attending the Endocrine Clinic, 17-Shahrivar Hospital affiliated to Guilan University were recruited. The study was done in 2008-2011. Thyroid function tests including thyroid stimulating hormone (TSH) and thyroxine (T4) were performed. The data including the patients’ age, sex, results of TSH and T4 tests, and duration of disease were obtained. Results: The patients were 40 male (47.1%) and 45 female (52.9%) with the mean age of 9.24±3.57. They were aged 1-15 years old and the mean duration of disease was 18.75±27.36 months. Among the patients seven cases (8.2%) were hypothyroidism (subclinical hypothyroidism). There was no significant association between age, sex, duration of diabetes and hypothyroidism in T1DM patients. Conclusion: Our results demonstrated a high frequency (8.2%) of hypothyroidism in T1DM patients. We suggest regular and annual thyroid function testing in T1DM patients.

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Introduction: Previous studies have reported a relatively high incidence of total and subtotal thyroidectomy complications in Iran. Fear of this complication has led some internists and patients to avoid thyroid surgery. The aim of study was to determine the recent decade frequency of total and subtotal thyroidectomy complications in Sari, Iran. Material & Methods: In this cross-sectional study, the patients underwent total or subtotal thyroidectomy during 2001-2011 at two referral hospitals in sari (Imam Khomeini as academic and Shafa as private hospital) were enrolled. The questionnaire included demographic information, diagnosis and pathology of the disease, type of thyroid surgery, serum calcium level after the surgery, recurrent laryngeal nerve injury, and hematoma data. Frequencies, Odds ratio and their 95%CI were reported. Results: Among the 382 subjects (66 men and 316 women), 86 cases (22.5%) underwent total and 296 cases (77.5%) underwent subtotal thyroidectomy. The final pathology was malignant in 25.1%. Hypocalcaemia occurred in 40.3% of patients (CI95%: 35.5-45.3) that 4.2% (CI95%: 2.3-6.6) were permanent. Recurrent laryngeal nerve injury was reported in 0.8% (CI95%: 0.3-2.3) [0.3% permanent (CI95% :0.05-1.5)] and two cases (0.5%) complicated by cervical hematoma (CI95%: 0.1-1.9). Total thyroidectomy was associated with more complications than subtotal. [OR: 6.4 (CI95%: 2.6-16.1), P = 0.0001]. Conclusion: The findings of this study show that total and subtotal thyroidectomy complications has significantly decreased that can be due to improved surgical techniques and increased proficiency of surgeons.

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Background and purpose: The congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. The incidence rate of the disease is different in various societies, but it is reported in approximately 1 per 3000-4000 births. The purpose of this study was to determine the epidemiological features of congenital hypothyroidism in Qazvin province. Material and methods: This cross sectional, descriptive study was conducted in 141 infants hospitalized with hypothyroidism who were selected through census sampling in 2011-2012 in Qazvin province. The data was collected through patients’ files obtained from health deputy department and analyzed in SPSS. Results: The patients were 63 girls and 87 boys. No significant relationship was seen between initial TSH and sex, weight, and type of childbirths. The rate of CH was observed to be more in winter, while the lowest rate of the disease was seen in spring. No significant relationship was found between the prevalence of disease and sex of the newborns and season of birth. Most patients had normal body weight. The parents of 45 infants had consanguineous relationships. Among the newborns 43 were rural and 98 were urban. In 69.5% of the cases sampling was done between 3 to 5 days after birth. The mean time for starting treatment was 33.62 days. The incidence rate of CH was 24.3 and 3.49 per thousand live births in 2011 and 2012, respectively. Conclusion: High incidence of CH in Qazvin providence signifies the need for continuous screening and complementary studies to identify probable risk factors.

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Background and purpose: Screening for congenital hypothyroidism in newborns is carried out with TSH measurement of blood samples from newborn heel in Mazandaran province since 2006. This paper reports the status of these children until the end of 2012. Materials and Methods: The study was performed in 2013-2014 using current information. Babies with TSH levels greater than 5 mU / L were treated with levothyroxine for three years. If the drug was stopped abruptly or gradually in three years and normal TSH achieved the disease was regarded transient, otherwise the patients were considered for lifelong follow-up treatments. For data analysis SPSS V.16 was applied. Results: During this period, 269088 infants were screened. Among the cases 548 (54.4% male) were diagnosed with congenital hypothyroidism. The results showed that infants who were treated at each time interval were 43% of permanent and 57% transient hypothyroidism. Age at onset therapy in 95% of cases was before 60 days. The mean time to start treatment was 20.8 ± 10 days. No significant relationship was found between the sex and permanent or transient hypothyroidism. Conclusion: The screening program for congenital hypothyroidism is being performed successfully in Mazandaran province. In some cases, the dosage of drugs and infants’ follow-up intervals varied even between physicians. Also, levothyroxine is either not prescribed according to the infant’s weight or is recorded incorrectly. Follow-up procedures and the decision to discontinue treatment were not similar at 3 years of age of the subjects. Physicians should be informed for the strict implementation of the guidelines of the Ministry of Health. To obtain more accurate information cases of death or immigration should not be removed from the statistics.

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Introduction: Thyroid cancer is the most common malignancy of the endocrine. The factors involved in differentiation of thyroid nodules are highly important. This study was done to determine the relationship between serum TSH and cytology finding of thyroid nodules. Methods: In this cross-sectional study, 275 patients enrolled. Complete physical examination was done and the serum TSH was measured by IRMA method. The serum T4 and T3 were also measured if the TSH was outside the normal range. In all patients thyroid ultrasound was performed. Fine Needle Aspiration (FNA) biopsy was done on all thyroid nodules and cytology results were interpreted by a pathologist. Data was then analyzed applying Stata software. Finding: The mean age of the patients was 42.5±12.5 years and there were 85.8% female. The mean of BMI was 23.7±2.2 kg/m². Calcification was found in 36% of thyroid nodules and microcalcification was observed in 92%. The mean TSH level in patients with malignancy was higher than that of those with benign thyroid nodules. Each unit increase in levels of TSH increased the risk of thyroid malignancy by 23% (OR=1.23 CI: 1.01-1.5). This risk has also increased by 38% with each unit increase in BMI (OR= 1.38 CI: 1.15- 1.66). Conclusion: This study suggests that serum TSH level could be used as a predictor of the probability of malignancy in thyroid nodules.

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Thyroid carcinoma is the most common endocrine neoplasia. Like other cancers, early detection of thyroid cancer plays an important role in the treatment and prevention of disease progression. In recent years many efforts have been made to detect molecular biomarkers for early prediction, diagnosis, and prognosis of different types of cancers. This article is a review on different researches about biomarkers of thyroid cancers. Original articles published (between 1996 and 2015) about biomarkers and thyroid cancers were identified by searching different databases. According to different types of thyroid cancers, the articles were reviewed in different four sections. In most cases FNA could determine the nature of thyroid nodules. However, this method is faced with some limitations especially in detection of lesions associated with follicular thyroid cells. To optimize the accuracy of diagnosis and to offer new prognostic criteria, several immunohistochemical and molecular markers have been proposed which should be verified before clinical application. In spite of large volumes of data about discovery of different biomarkers for thyroid cancers, few of them could be used in clinical applications. In many cases using each of these molecules alone may not be useful, therefore, combination of two or more biomarkers could be of great help in diagnosis, prognosis and prediction of thyroid cancer.

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Background and purpose: Aloe vera is an anti-diabetic herb in traditional medicine. In the present study, the protective effect of aloe vera gel was studied on function of thyroid gland in diabetic rats.

Materials and methods: Fifty healthy male Wistar rats weighing 200-250g were randomized into 5 groups (n=10 per group). The animals in a control group were kept in normal conditions. In second group diabetes was induced by streptozotocin (STZ). In another group the streptozotocin induced diabetic rats received 400 mg/kg aloe vera gel once a day for 15 and 30 days. The next group included STZ-induced diabetic rats that received 10-15 units insulin once a day for 15 and 30 days. The Sham group included healthy normal rats that received 400 mg/kg aloe vera gel once a day for 15 and 30 days. By the end of days 15 and 30, the blood samples were taken. Then the animals were euthanized and the thyroid gland was removed and fixed in 10% buffered formalin. The semi-thin sections were prepared and stained using haematoxylin and eosin, and were observed under light microscope.

Results: Mean number and size of follicles significantly decreased in diabetic group compared to the control group (P<0.05). Histomorphometrical findings showed significant increase in mean number and size of follicles in the group receiving aloe vera gel compared to the diabetic group (P<0.05). There were significant decreases in concentrations of T3 and T4 hormones in diabetic group compared to those of the control group (P<0.05). Aloe vera treated animals showed significant increase in concentrations of T3 and T4 hormones compared to those of the control group (P<0.05).

Conclusion: Aloe vera gel could improve regeneration of damaged thyroid gland tissue in diabetic rats.

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Background and purpose: Measurement of thyroid stimulating hormone (TSH), usually through RIA and ELISA tests, is very useful for the diagnosis of thyroid disorders. Considering the structural similarity between alpha chain of TSH and the three glycoprotein hormones of luteinizing hormone, follicle stimulating hormone, and chorionic gonadotropin (CG), in this study, we aimed to examine the produced beta-subunit of TSH (TSHβ) in terms of antigenicity.
Materials and methods: In this study, human TSHβ gene was synthesized using recombinant method. The cloning, expression, and purification were performed in Escherichia coli. Thereafter, antigenicity of the protein against antibodies against animal monoclonal TSH was evaluated using
Western Blot technique.
Results: TSHβ gene was cloned and expressed correctly in the bacterial host. The purified protein reacted with the specific antibody in Western Blot.
Conclusion: Although recombinant TSHβ protein is different from the natural protein in some respects such as structure and spatial shape, it had acceptable antigenicity. On the other hand, it seems that this protein, due to having more TSH epitopes, can be applied in diagnostic kits to enahance the
specificity of these tests.

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Background and purpose: Okra plant has different properties and some studies reported that this plant can lower the complications of diabetes. Herein, we studied the effects of okra powder on histomorphometry and histochemitry of the thyroid gland, lipid profile, as well as T3 and T4 hormones in HDF/STZ diabetic Wistar rats.

Materials and methods: In this experimental study twenty-five adult male Wistar rats (200-250 g) were divided into five groups of control group, healthy rats without any treatment (G1), control group receiving 200 mg/kg of okra daily for four weeks (G2), diabetic rats without any treatment (G3), diabetic rats receiving 200 mg/kg of metformin daily for four weeks (G4), and diabetic rats receiving 200 mg/kg of okra daily for four weeks (G5). For inducing diabetes, the rats were fed high-fat diet (HFD) for four weeks. Then, streptozotocin (35 mg/kg) was injected intravenously. At the end of the experiment, blood samples were taken for measurement of triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), as well as T₃, and T₄ hormones levels. The animals were euthanized and the thyroid glands were removed and fixed in 10% buffered formalin. 5-6 μ slices were made from paraffin section and stained by H&E and aldehyde fuchsin.

Results: Compared to the control group, the number and size of large follicles of the thyroid gland decreased significantly in the diabetic group, while the number of small follicles increased significantly (P<0.05). There were significant reductions in concentrations of T₃ and T₄, whereas triglyceride and LDL-c levels elevated in the diabetic group (P<0.05). These changes were improved using metformin and okra compared to the diabetic group (P<0.05).

Conclusion: Okra powder can be effective in preventing, managing, and attenuating the complications of diabetes.

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  Background and purpose: Congenital hypothyroidism (CH) is one of the most common preventable causes of mental disabilities. The present study was conducted to determine the prevalence of permanent and transient congenital hypothyroidism in Mazandaran province, Iran.
Materials and methods: This retrospective descriptive survey was done based on medical records of children with primary diagnosis of congenital hypothyroidism between 2006 and 2014.
Results: Until March 2012, 176250 infants were screened for congenital hypothyroidism of whom 389 were diagnosed with the disease (1 per 453 births). Among these cases, 169 had permanent CH (1 per 1043 births) and 220 had transient CH (1 per 801 births).  Until 2014 a total of 269088 newborns was screened by which 548 case of primary congenital hypothyroidism were diagnosed (1 per 491 births) but their definitive diagnosis are not available until the next three years. The girl/boy ratio in permanent CH group was higher than that in transient CH (P=0.08).
Conclusion: This study showed a high prevalence of transient and permanent hypothyroidism in Mazandaran, but transient CH was found to be more prevalent. Therefore, the factors affecting the development of transient CH and its higher incidence among male infants in Mazandaran province are required to be specifically investigated in future researches.
 

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Background and purpose: Thyroid nodules are quite common witch are found in clinical or ultrasound examinations. They are detected in 4-8% of clinical examinations and 7-15% are malignant. TSH is one of the growth factors for nodule growth. Controversial reports are published on the effect of TSH on thyroid nodule malignancy. This study aimed at investigating the effect of TSH in predicting malignancy in thyroid nodules.
Materials and methods: In this cross sectional research, 500 patients were studied. Serum TSH level was measured prior to fine needle aspiration (FNA). Data analysis was done applying inferential statistics. 
Results: The patients were 457 (91.4%) females and 43 (8.6%) males and the mean age was 43.43±13.9 years.  Among the patients 240 had single nodule and 260 had multiple thyroid nodules (P=0.08). The mean size of nodules in benign and malignant nodules were 26.1±12.2 and 27.3±9.8 mm, respectively (P=0.6). Malignant and benign nodules were observed in 31 (6.2%) and 469 (93.8%) patients. Mean TSH level was 3.3±6.9 and 2.4±2 in patients with benign and malignant nodules, respectively (P= 0.47). To investigate the association between TSH and FNA cytology, TSH levels were divided into <0.5, 4.9-0.5, and ≥5 using person correlation. This study showed no significant difference between the three groups (P= 0.3).
Conclusion: TSH alone is not a suitable marker for predicting thyroid malignancy.