Background: Hypothyroidism is the second most prevalent endocrine disease in women, characterized by insufficient production of thyroid hormone by the thyroid gland.

Objectives: The present study aims to assess the serum level of osteocalcin, T3, T4, TSH, and thyroid peroxidase in women with hypothyroidism and to investigate the effect of medical therapy on osteocalcin, T₃, T₄, TSH, and thyroid peroxidase levels in subjects with hypothyroidism.

Methods: This study has investigated 180 women (70 women before treatment, 70 after treatment and 40 controls), who’s ages range between (15-54) years. Patients were referred to two primary hospitals, Azadi Hospital in Kirkuk City and Kirkuk General Hospital, between September 2023 and December 2023. The participants in this research are categorized into three groups: Before therapy, a group of 70 women with hypothyroidism was diagnosed by medical professionals. The second group consisted of 70 women who had hypothyroidism and had undergone therapy compared to the control group. Serum levels of osteocalcin and thyroid peroxide (TPO), TSH, T₃, and T₄ were measured.

Results: According to the presented data show a decrease in the mean of the serum level of osteocalcin, T₃, and T₄ in hypothyroidism women before and after treatment compared with the control group (13.4±4.9 versus 19.8±5.1 and 21.5±5.0), (2.49±0.65 versus 6.17±1.40 and 5.65±2.04 ng/ml), (6.85±1.72 versus 14.83±4.21 and 14.86±3.11 ng/ml) respectively. The result was significant (p<0.01) while increasing the mean of TSH and TPO in hypothyroidism before and after treatment compared with the control group (32.78±8.83 versus 4.26±1.77 and 4.48±1.68 ng/ml).

Conclusion: It was concluded that the osteocalcin, T₃, and T₄ decreased in women with hypothyroidism before treatment in comparison with women after treatment and healthy women, while Furthermore increase the mean of TSH and TPO in hypothyroidism before and after treatment compared with the control group.