Most studies reported the prevalence of autoimmune thyroiditis in "typical" type 1 adult diabetic subjects about 20 - 40%.

 Iodine is an important exogenous modulating factor of the process. In general, iodine deficiency attenuates, while iodine excess accelerates autoimmune thyroiditis in autoimmune prone individuals. In nonautoimmune prone individuals, the effects of iodine are different. Here iodine deficiency precipitates a mild (physiological) form of thyroid autoimmune reactivity. Iodine excess stimulates thymus development. Iodine probably exerts these effects via interference in the various stages of the autoimmune process.

Patients with celiac disease are at high risk of having autoimmune disorders. Moreover, untreated patients with celiac disease have been found to have a higher than expected prevalence of organ-specific autoantibodies. In a prospective study of 90 patients with celiac disease, we found that the prevalence of diabetes and thyroid-related serum antibodies was 11.1% and 14.4%, respectively. Like antiendomysium autoantibodies, these organ-specific antibodies seem to be gluten-dependent and tend to disappear during a gluten-free diet.

The occurrence of autoimmune thyroid disorders among patients with coeliac disease (CD) is well documented, but the exact prevalence of CD among patients with autoimmune thyroid diseases (ATD) is as yet unclear. We screened 150 newly diagnosed patients with ATD by serum endomysial antibody detection (EmA). In 5 subjects (3.3%) EmA positivity was found; all underwent jejunal biopsy. On gluten-free diet an excellent clinical and histological response was recorded with an improvement of hypothyroidism and reduction of the thyroxine dosage. Our data suggest a significant high prevalence (3.3%) of CD in patients with ATD, in particular with Hashimoto's thyroiditis.

The coexistence of autoimmune endocrine diseases, particularly autoimmune thyroid disease and celiac disease (CD), has recently been reported. We here present a 23-year-old woman with a diagnosis of hypothyroidism due to Hashimoto's thyroiditis, autoimmune Addison's disease, and kariotypically normal spontaneous premature ovarian failure. Considering the close association between autoimmune diseases and CD, we decided to search for IgA anti-endomysium antibodies (EmA) in the serum. The positivity of EmA and the presence of total villous atrophy at jejunal biopsy allowed the diagnosis of CD. On a gluten-free diet the patient showed a marked clinical improvement accompanied, over a 3-month period, by a progressive decrease in the need for thyroid and adrenal replacement therapies. After 6 months, serum EmA became negative and after 12 months a new jejunal biopsy showed complete mucosal recovery. After 18 months on gluten-free diet, the anti-thyroid antibodies titre decreased significantly, and we could discontinue thyroid substitutive therapy. This case emphasizes the association between autoimmune polyglandular disease and CD; the precocious identification of these cases is clinically relevant not only for the high risk of complications (e.g. lymphoma) inherent to untreated CD, but also because CD is one of the causes for the failure of substitute hormonal therapy in patients with autoimmune thyroid disease.

PMID: 10401714 [PubMed - indexed for MEDLINE]

Ann Intern Med. 2004 Jan 20;140(2):128-41.  Related Articles, Links   

Comment in:

Ann Intern Med. 2004 Jan 20;140(2):I58.

Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force.

Helfand M; U.S. Preventive Services Task Force.

Oregon Health & Science University, Evidence-based Practice Center, Portland, Oregon 97239, USA.

BACKGROUND: Subclinical thyroid dysfunction is a risk factor for developing symptomatic thyroid disease. Advocates of screening argue that early treatment can prevent serious morbidity in individuals who are found to have laboratory evidence of subclinical thyroid dysfunction. PURPOSE: This article focuses on whether it is useful to order a thyroid function test for patients who have no history of thyroid disease and have few or no signs or symptoms of thyroid dysfunction. DATA SOURCES: A MEDLINE search, supplemented by searches of EMBASE and the Cochrane Library, reference lists, and a local database of thyroid-related articles. STUDY SELECTION: Controlled treatment studies that used thyroid-stimulating hormone (TSH) levels as an inclusion criterion and reported quality of life, symptoms, or lipid level outcomes were selected. Observational studies of the prevalence, progression, and consequences of subclinical thyroid dysfunction were also reviewed. DATA EXTRACTION: The quality of each trial was assessed by using preset criteria, and information about setting, patients, interventions, and outcomes was abstracted. DATA SYNTHESIS: The prevalence of unsuspected thyroid disease is lowest in men and highest in older women. Evidence regarding the efficacy of treatment in patients found by screening to have subclinical thyroid dysfunction is inconclusive. No trials of treatment of subclinical hyperthyroidism have been done. Several small, randomized trials of treatment of subclinical hypothyroidism have been done, but the results are inconclusive except in patients who have a history of treatment of Graves disease, a subgroup that is not a target of screening in the general population. Data on the adverse effects of broader use of L-thyroxine are sparse. CONCLUSION: It is uncertain whether treatment will improve quality of life in otherwise healthy patients who have abnormal TSH levels and normal free thyroxine levels.

Publication Types:

Review

Review, Academic

PMID: 14734337 [PubMed - indexed for MEDLINE]

Endocr Regul 2001 Sep;35(3):167-72            Related Articles, Links

Latent autoimmune diabetes in adults (LADA) and autoimmune thyroiditis.

Matejkova-Behanova M.

Institute of Endocrinology, 11694 Prague, Czech Republic. mbehanova@endo.cz

Latent autoimmune diabetes in adults (LADA) is characterized by clinical presentation as type 2 diabetes after 25 years of age, initial control achieved with diet or oral hypoglycaemic agents during at least 6 months, presence of autoantibodies (first of all GADA) and some immunogenetic features of diabetes mellitus type 1. In patients with an autoimmune endocrine disease, which could be also autoimmune diabetes, there is a high risk of development of another autoimmune endocrine disorder. The coexistence of two or more autoimmune endocrine diseases is pathognomonic for autoimmune polyglandular syndrome. Autoimmune thyroiditis and type 1 diabetes mellitus are the most common combination of autoimmune endocrine diseases reported. Most studies reported the prevalence of autoimmune thyroiditis in "typical" type 1 adult diabetic subjects about 20 - 40%. Little is known about the prevalence of autoimmune thyroiditis in subjects with LADA. Only a few studies confirmed a high prevalence of thyroid autoantibodies in type 2 diabetic subjects with GADA compared to type 2 diabetic subjects without GADA and compared to non-diabetic population too.

Publication Types:

Review

Review, Tutorial

PMID: 11674844 [PubMed - indexed for MEDLINE]

Thyroid 2001 May;11(5):427-36    Related Articles, Links

Iodine and thyroid autoimmune disease in animal models.

Ruwhof C, Drexhage HA.

Department of Immunology, Erasmus University, Rotterdam.

Thyroid autoimmune diseases are complex, polygenic afflictions the penetrance of which is heavily dependent on various environmental influences. In their pathogenesis, an afferent stage (enhanced autoantigen presentation), a central stage (excessive expansion and maturation of autoreactive T and B cells), and an efferent stage (effects of autoreactive T cells and B cells on their targets) can be discerned. At each stage, a plethora of inborn, endogenous or exogenous factors is able to elicit the abnormalities characteristic of that stage, thus opening the gateway to thyroid autoimmunity. Iodine is an important exogenous modulating factor of the process. In general, iodine deficiency attenuates, while iodine excess accelerates autoimmune thyroiditis in autoimmune prone individuals. In nonautoimmune prone individuals, the effects of iodine are different. Here iodine deficiency precipitates a mild (physiological) form of thyroid autoimmune reactivity. Iodine excess stimulates thymus development. Iodine probably exerts these effects via interference in the various stages of the autoimmune process. In the afferent and efferent stage, iodine-induced alterations in thyrocyte metabolism and even necrosis most likely play a role. By contrast, in the central phase, iodine has direct effects on thymus development, the development and function of various immune cells (T cells, B cells macrophages and dendritic cells) and the antigenicity of thyroglobulin.

Publication Types:

Review

Review, Tutorial

PMID: 11396701 [PubMed - indexed for MEDLINE]

Pediatrics 2001 Jun;107(6):E93       Related Articles, Links

Macroamylasemia attributable to gluten-related amylase autoantibodies: a case report.

Barera G, Bazzigaluppi E, Viscardi M, Renzetti F, Bianchi C, Chiumello G, Bosi E.

Department of Pediatrics, Scientific Institute H San Raffaele, University of Milan, Milan, Italy. barera.graziano@hsr.it

BACKGROUND: Macroamylasemia (MA) is a benign condition caused by circulating macroamylase complexes of pancreatic or salivary amylase bound to plasma proteins, which cannot be cleared by the renal glomeruli. In most cases, the macromolecular amylase represents a complex of normal amylase and either immunoglobulin A or G and may be a specific antigen-antibody complex. Celiac disease (CD) is a permanent intolerance to ingested gluten that results in immunologically mediated inflammatory damage of the small intestinal mucosa. Several recent population-based serologic surveys have shown CD to be a common disorder, possibly affecting 1 in 200 to 250 individuals in most countries studied, including the United States, where overt CD is rare, indicating a high proportion of subclinical disease. The diagnosis of CD currently rests on the histological demonstration of the characteristic lesion in the small intestine and the subsequent clinical response to the introduction of a gluten-free diet. MA associated with CD has been described in adult patients, and in a few cases, MA decreased or resolved after a strict gluten-free diet. A few single cases of MA have been described in childhood, but no association with CD has been reported so far. We report a girl with CD, autoimmune thyroiditis, and MA, in whom CD-related antibodies to amylase and to exocrine pancreas tissue resolved with a gluten-free diet. CASE REPORT: An 11-year-old girl was referred for chronic abdominal pain and growth retardation associated with persistent hyperamylasemia and suspected chronic pancreatitis. We confirmed elevated serum amylase, normal serum lipase, and very low 24-hour urine amylase and amylase clearance/creatinine clearance ratio, consistent with MA. Serologic tests for CD were positive, and the diagnosis was confirmed by small bowel biopsy showing subtotal villous atrophy. Thyroid function tests showed a pronounced hypothyroidism, associated with high titers of thyroid microsomal and thyroglobulin antibodies. Screening for other autoantibodies-including antinuclear, islet cell, glutamic acid decarboxylase, protein tyrosine phosphatase islet antigen 512, adrenal gland, and cytoplasmic neutrophil granulocyte antibodies-was negative. A diagnosis of CD, MA, and hypothyroidism attributable to autoimmune thyroiditis was made. A gluten-free diet and oral replacement with L-thyroxine was started with clinical improvement. Serum amylase and amylase clearance/creatinine clearance ratio normalized, consistent with resolution of MA. STUDY DESIGN AND METHODS: The patient's serum samples were obtained at the time of CD diagnosis and at 3 and 12 months after instituting a gluten-free diet. Serum samples from 10 consecutive untreated celiac children were disease controls, and 39 participants with no gastrointestinal symptoms and no family history of CD served as healthy controls. The origin of MA as determined by complexes of amylase with circulating immunoglobulins was tested by the measurement of amylase on supernatants after precipitation of immune complexes with either protein A Sepharose or polyethylene glycol. The precipitation of >60% of amylase activity was consistent with the presence of MA. Immunoglobulin G (IgG) and immunoglobulin A (IgA) circulating autoantibodies to amylase were measured using recently developed enzyme-linked immunosorbent assay (ELISA), using porcine amylase as antigen. Results were expressed as arbitrary units (AUs). Statistical analysis was performed by Student's t test for unpaired data. IgA and IgG antibodies to exocrine pancreas tissue were detected by indirect immunofluorescence on human pancreas cryosections. RESULTS: Serum immunoprecipitation with either protein A Sepharose or polyethylene glycol reduced amylase activity from 1698 to 89 U/L (94.8%) and to 75 U/L (95.6%), with only marginal reduction in control serum samples. The ELISA for autoantibodies to amylase detected high values, both IgA (3531 AU) and IgG (1855 AU), in the serum sample from the patient at CD diagnosis. IgA autoantibodies (mean +/- standard deviation) were 3.4 +/- 2.5 AU in healthy controls, and 2.1 +/- 1.2 AU in celiac controls; IgG autoantibodies were 10 +/- 4.8 AU in healthy controls and 8.5 +/- 3.2 AU, respectively. Autoantibodies to exocrine pancreas tissue were documented in patient sera at the time of CD diagnosis, both IgA and IgG, but not in control groups. Preincubation of patient's serum with excess of alpha-amylase specifically inhibited antibody binding to coated amylase in the ELISA, and partially inhibited immunoreactivity to exocrine pancreas. Autoantibodies to alpha-amylase and to exocrine pancreas declined in CD patients after institution of a gluten-free diet. CONCLUSIONS: Few cases of MA have been described in children, and in all amylase determination was part of the clinical investigation for abdominal pain or trauma. (ABSTRACT TRUNCATED)

PMID: 11389291 [PubMed - indexed for MEDLINE]

J Pediatr 2000 Aug;137(2):263-5     Related Articles, Links

Gluten-dependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease.

Ventura A, Neri E, Ughi C, Leopaldi A, Citta A, Not T.

Clinica Pediatrica e Laboratorio di Analisi, IRCCS "Burlo Garofolo" Trieste, Trieste, Italy.

Patients with celiac disease are at high risk of having autoimmune disorders. Moreover, untreated patients with celiac disease have been found to have a higher than expected prevalence of organ-specific autoantibodies. In a prospective study of 90 patients with celiac disease, we found that the prevalence of diabetes and thyroid-related serum antibodies was 11.1% and 14.4%, respectively. Like antiendomysium autoantibodies, these organ-specific antibodies seem to be gluten-dependent and tend to disappear during a gluten-free diet.

PMID: 10931424 [PubMed - indexed for MEDLINE]

Horm Res 1999;51(3):124-7            Related Articles, Links

Prevalence of coeliac disease in patients with thyroid autoimmunity.

Valentino R, Savastano S, Tommaselli AP, Dorato M, Scarpitta MT, Gigante M, Micillo M, Paparo F, Petrone E, Lombardi G, Troncone R.

CNR, Experimental Endocrinology and Oncology Center (CEOS), Department of Cellular and Molecular Biology and Pathology, University Federico II, Naples, Italy.

The occurrence of autoimmune thyroid disorders among patients with coeliac disease (CD) is well documented, but the exact prevalence of CD among patients with autoimmune thyroid diseases (ATD) is as yet unclear. We screened 150 newly diagnosed patients with ATD by serum endomysial antibody detection (EmA). In 5 subjects (3.3%) EmA positivity was found; all underwent jejunal biopsy. On gluten-free diet an excellent clinical and histological response was recorded with an improvement of hypothyroidism and reduction of the thyroxine dosage. Our data suggest a significant high prevalence (3.3%) of CD in patients with ATD, in particular with Hashimoto's thyroiditis.

Publication Types:

Clinical Trial

PMID: 10461017 [PubMed - indexed for MEDLINE]

J Endocrinol Invest 1999 May;22(5):390-4  Related Articles, Links

Unusual association of thyroiditis, Addison's disease, ovarian failure and celiac disease in a young woman.

Valentino R, Savastano S, Tommaselli AP, Dorato M, Scarpitta MT, Gigante M, Lombardi G, Troncone R.

Centro di Endocrinologia e Oncologia Sperimentale del CNR, Dipartimento di Biologia e Patologia Cellulare e Molecolare L. Califano, Italy.

The coexistence of autoimmune endocrine diseases, particularly autoimmune thyroid disease and celiac disease (CD), has recently been reported. We here present a 23-year-old woman with a diagnosis of hypothyroidism due to Hashimoto's thyroiditis, autoimmune Addison's disease, and kariotypically normal spontaneous premature ovarian failure. Considering the close association between autoimmune diseases and CD, we decided to search for IgA anti-endomysium antibodies (EmA) in the serum. The positivity of EmA and the presence of total villous atrophy at jejunal biopsy allowed the diagnosis of CD. On a gluten-free diet the patient showed a marked clinical improvement accompanied, over a 3-month period, by a progressive decrease in the need for thyroid and adrenal replacement therapies. After 6 months, serum EmA became negative and after 12 months a new jejunal biopsy showed complete mucosal recovery. After 18 months on gluten-free diet, the anti-thyroid antibodies titre decreased significantly, and we could discontinue thyroid substitutive therapy. This case emphasizes the association between autoimmune polyglandular disease and CD; the precocious identification of these cases is clinically relevant not only for the high risk of complications (e.g. lymphoma) inherent to untreated CD, but also because CD is one of the causes for the failure of substitute hormonal therapy in patients with autoimmune thyroid disease.

PMID: 10401714 [PubMed - indexed for MEDLINE]

Eur J Endocrinol 1998 Jun;138(6):719-23     Related Articles, Links

Dehydroepiandrosterone sulfate does not prevent spontaneous and iodine-induced lymphocytic thyroiditis and diabetes mellitus in the BB/Wor rat.

Alex S, Braverman LE, Fang SL, Norvell B, Robinson S, Franz C, Longcope C.

Department of Medicine, University of Massachusetts Medical School, Worcester, USA.

Chronic feeding of dehydroepiandrosterone (DHEA) and its sulfated metabolite, dehydroepiandrosterone sulfate (DHEAS), has previously been reported to decrease hyperglycemia, obesity, cancer, and autoantibody generation in a number of animal models and to increase muscle mass and physiological and psychological well-being in elderly humans, although these latter studies remain controversial. The present study was carried out to determine whether large amounts of DHEAS given orally would prevent the occurrence of spontaneous and iodine-induced autoimmune lymphocytic thyroiditis (LT) and/or spontaneous insulin-dependent diabetes mellitus (DM) in male and female BB/Wor rats. DHEAS was administered by gavage (44 mg/rat/day) or in the chow (133 mg/rat/day) to LT- and DM-prone rats from 30 to 120 days of life; some of these rats also received iodine in the drinking water to enhance the incidence and intensity of LT. Onset of DM requiring protamine zinc insulin and its maintenance dose were assessed. Rats were killed at 90 or 120 days of age and blood, thyroid, adrenals, pancreases, testes, and ovaries were removed. Serum glucose, DHEA, DHEAS, thyroxine (T4), tri-iodothyronine (T3) and thyrotropin (TSH) concentrations were measured in all rats in both experiments. Serum DHEAS concentrations were 10-fold higher in the rats given the steroid by gavage or in the diet compared with levels in control rats. DHEAS administered over a prolonged period of time had no significant effect on body weight, incidence and severity of DM, incidence and intensity of spontaneous and iodine-induced LT, and thyroid, pancreas and testes weights but did significantly decrease adrenal and ovarian weights. Serum T4, T3, and TSH concentrations were similar in control and DHEAS-treated rats. In conclusion, DHEAS did not prevent the occurrence of iodine-induced or spontaneous autoimmune LT or spontaneous DM in the BB/Wor rat, at variance with its reported immunosuppressive effects in other animal models.

PMID: 9678543 [PubMed - indexed for MEDLINE]

Proc Soc Exp Biol Med 1996 Dec;213(3):294-300      Related Articles, Links

Influence of diet on the induction of experimental autoimmune thyroid disease.

Bhatia SK, Rose NR, Schofield B, Lafond-Walker A, Kuppers RC.

Department of Molecular Microbiology & Immunology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.

Immunization of CBA/J mice with thryoglobulin (Tg) emulsified in complete Freund's adjuvant induces experimental thyroiditis (EAT), a well-characterized model of Hashimoto's disease. Recent studies have suggested that dietary factors play a role in the modulation of the immune response and that diet can have a profound effect on the induction of autoimmune diseases. In this study, we examined the influence of diet on autoimmune thyroiditis in mice. EAT was induced in mice fed ad libitum one of the three diets, a standard maintenance chow (Agway H1000), Purina 5020 Breeding Chow, and Purina 5010 Autoclavable (unautoclaved) Diet. Tg-immunized mice fed the Agway 1000 diet were found to be resistant to the development of autoimmune thyroid disease, with only 4 out of 25 mice developing mild thyroiditis. In contrast, 16 out of 25 mice fed the Purina 5010 diet developed moderate to severe thyroiditis. Mice fed the 5020 diet were partly susceptible: 7 out of 25 developed a mild to moderate thyroiditis. Histologic examination of thyroid glands of diseased mice fed the 5010 and 5020 diets showed marked lymphocytic infiltration with destruction of follicles, compared with mice fed the Agway diet, the latter showing only mild infiltration with preservation of thyroid follicles. Titers of antibody to Tg did not differ among the groups, and there was no significant difference in the IgG isotype subclass usage. The results demonstrate that diet can markedly affect the severity of autoimmune disease in the EAT model. In contrast, diet has little effect on the humoral autoimmune response in this system. These results implicate diet as a factor in the severity of cell-mediated autoimmune destruction and suggest that dietary modification could decrease pathology in some forms of autoimmune disease.

PMID: 8985315 [PubMed - indexed for MEDLINE]

Dev Comp Immunol 1994 Nov-Dec;18(6):533-42      Related Articles, Links

Effect of growth hormone and thyroid hormone on autoimmune thyroiditis in obese chickens.

Marsh JA, Johnson BE, Scanes CG.

Department of Microbiology, Immunology, and Parasitology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

The effect of thyroxine (T4) and recombinant (rcGH) or purified pituitary-derived (pcGH) chicken growth hormone on the development of spontaneous autoimmune thyroiditis (SAT) was examined in the Obese strain (OS) chicken. Day-old OS chicks were randomly assigned to a control or 1.0 ppm T4 supplemented diet and a vehicle or 500 micrograms rcGH/kg BW daily injection, using a 2 x 2 factorial design. At 4 weeks, sera were analyzed for anti-thyroglobulin autoantibody (TgAAb) using a kinetics-based ELISA. Leucocytic infiltration of the thyroid was assessed using computer-based video imaging techniques. A close correlation between TgAAb and thyroid infiltration was seen with both being decreased (p < 0.05) by the T4/rcGH treatment. Neither the T4 or rcGH alone produced this effect and the rcGH treatment significantly elevated TgAAb. In a second experiment, all but the control group received 1.0 ppm T4 supplementation and two of the T4-treated groups received either 50 or 200 micrograms pcGH/kg BW by daily injection. As before, T4/pcGH significantly reduced TgAAb and thyroid infiltration. T4 alone produced no significant effects. These data support the conclusion that the combined treatment of T4 and cGH exert an immunomodulatory effect within a strain that is predisposed to autoimmune thyroiditis while GH treatment alone exacerbated the condition. These results also show that video imaging techniques can be used to evaluate the extent of histopathology present within the OS thyroid.

PMID: 7768318 [PubMed - indexed for MEDLINE]

Am J Chin Med. 1998;26(3-4):275-81.  Related Articles, Links 

Acute effects of chundosunbup qi-training on blood concentrations of TSH, calcitonin, PTH and thyroid hormones in elderly subjects.

Lee MS, Kang CW, Shin YS, Huh HJ, Ryu H, Park JH, Chung HT.

Department of Qi-Medicine, Wonkwang University, Iksan, Korea.

The present study investigated how the systemic treatment of a programmed exercise, ChunDoSunBup (CDSB) Qi-training, affects the secretion of thyroid and parathyroid hormones in elderly subjects (10 male and 5 female). Plasma concentrations of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), parathyroid hormone (PTH), ionized calcium, and calcitonin were determined. CDSB Qi-training induces a slight increase in TSH. Both T4 and T3 were increased at the mid-time of CDSB Qi-training (p < 0.05). There were significant correlations only between T3 and T4 at mid-training. This shows that increase in the plasma level of T3 was associated with the secretion of T4. The plasma concentrations of calcitonin and PTH were increased at mid-time and post-time of CDSB Qi-training. But ionized calcium was decreased slightly by CDSB Qi-training. These results suggest that Qi-training modulates the secretion of thyroid hormones, calcium metabolism, and parathyroid hormones in the elderly. However, whether the long-term practice of CDSB Qi-training might change bone metabolism and have longitudinal effects on the thyroid hormone of the elderly need further investigation.

PMID: 9862015 [PubMed - indexed for MEDLINE]

 Psychoneuroendocrinology. 1997 May;22(4):277-95.  Related Articles, Links 

Effects of the Transcendental Meditation program on adaptive mechanisms: changes in hormone levels and responses to stress after 4 months of practice.

MacLean CR, Walton KG, Wenneberg SR, Levitsky DK, Mandarino JP, Waziri R, Hillis SL, Schneider RH.

Center for Health and Ageing Studies, Maharishi University of Management, Fairfield, IA 52557, USA.

Stress has been implicated in both somatic and mental disorders. The mechanisms by which stress leads to poor health are largely unknown. However, studies in animals suggest that chronic stress causes high basal cortisol and low cortisol response to acute stressors and that such changes may contribute to disease. Previous studies of the Transcendental Meditation (TM) technique as a possible means of countering effects of stress have reported altered levels of several hormones both during the practice and longitudinally after regular practice of this technique. In this prospective, random assignment study, changes in baseline levels and acute responses to laboratory stressors were examined for four hormones-cortisol, growth hormone, thyroid-stimulating hormone and testosterone-before and after 4 months of either the TM technique or a stress education control condition. At pre- and post-test, blood was withdrawn continuously through an indwelling catheter, and plasma or serum samples were frozen for later analysis by radioimmunoassay. The results showed significantly different changes for the two groups, or trends toward significance, for each hormone over the 4 months. In the TM group, but not in the controls, basal cortisol level and average cortisol across the stress session decreased from pre- to post-test. Cortisol responsiveness to stressors, however, increased in the TM group compared to controls. The baselines and/or stress responsiveness for TSH and GH changed in opposite directions for the groups, as did the testosterone baseline. Overall, the cortisol and testosterone results appear to support previous data suggesting that repeated practice of the TM technique reverses effects of chronic stress significant for health. The observed group difference in the change of GH regulation may derive from the cortisol differences, while the TSH results are not related easily to earlier findings on the effects of chronic stress.

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 9226731 [PubMed - indexed for MEDLINE]

Am J Chin Med. 1995;23(2):167-72.  Related Articles, Links 

Effects of ginseng on the blood chemistry profile of dexamethasone-treated male rats.

Lin JH, Wu LS, Tsai KT, Leu SP, Jeang YF, Hsieh MT.

Department of Animal Science, National Taiwan University, Taipei.

Ginseng, a panacea in the Orient, has been widely investigated in the last two decades and found to possess a wide range of pharmacological activities including anti-fatigue properties, a transient regulatory action on metabolism and blood pressure, and an increase in the hypothalamo-pituitary-adrenocortical activities. However, a panoramic clinical chemistry study including adrenal and thyroid functions has never been done before. Two experiments with the same design but different concentrations of dexamethasone were performed in this study. The results obtained from the two experiments indicated that ginseng administration at this regime did not influence the blood chemistry profiles in normal rats, but significantly decreased AST and ALT levels from those in dexamethasone-treated ones. It implies that ginseng has a liver-protective effect. Meanwhile, ginseng therapy restores the adrenal and thyroid functions of rats inhibited by dexamethasone treatment.

PMID: 7572778 [PubMed - indexed for MEDLINE]

Int J Biometeorol. 1994 May;38(1):44-7.  Related Articles, Links 

Effect of yogic exercises on thyroid function in subjects resident at sea level upon exposure to high altitude.

Rawal SB, Singh MV, Tyagi AK, Selvamurthy W, Chaudhuri BN.

Defence Institute of Physiology and Allied Sciences, Delhi Cantonment, India.

Using radioactive iodine, the effect of 1 month's yogic exercises has been investigated on the thyroid function of subjects resident at sea level (SL) specially after their exposure to high altitude (HA). The results have been compared with a group of SL subjects who underwent physical training (PT) exercises for the same duration. Ten healthy male volunteers in the age range of 20-30 years were used as test subjects in this study with each serving as his own control. The subjects were randomly divided into two groups of 5 each. One group practised hatha yogic exercises, while the other group performed the regular PT exercises. The thyroidal accumulation and release of radioactive iodine have been measured in each of the subjects of both groups before and after 1 month of their respective exercises at SL. One month of yogic exercises at SL has been observed to cause a significant reduction in the trans-thyroidal availability of radioiodine. The thyroid radioactivity in this group of subjects was always below normal levels with the exception of two peaks of radioactive iodine uptake, when the levels of radioactivity in the thyroid were similar to the control values of pre-yogic exercises. The release of radiolabel at 24-48 h was significantly increased after yogic exercises. In contrast, the subjects performing PT exercises for the same duration at SL showed significant thyroid uptake of radioactive iodine at 24 h. Subsequently their 131I uptake continued to rise slowly until 72 h without any demonstrable thyroidal release of radiolabel. This indicated that increased thyroid activity was induced by conventional PT exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types:

Clinical Trial

Randomized Controlled Trial

PMID: 8039950 [PubMed - indexed for MEDLINE]

Zh Nevropatol Psikhiatr Im S S Korsakova. 1994;94(6):49-52.  Related Articles, Links 

[Affective pathology and the function of the hypothalamo-hypophyseal-thyroid system in women with autoimmune thyroiditis]

[Article in Russian]

Buniavichius R.

Thyrotropin-releasing hormone (TRH) stimulation tests were performed in 27 women with autoimmune thyroiditis and concomitant DSM-III-R mood disorders. Increased thyrotropin (TTH) response to TRH stimulation (delta TTH > or = 25 microU/ml) was present only in 4 (14.8%) and blunted (delta TTH < 7 microU/ml) in 12 (44.4%) patients. The problem of hyperdiagnosis of hypothyroidism due to depression and methods of treatment of patients with autoimmune thyroiditis and concomitant affective disorders are discussed.

PMID: 7740877 [PubMed - indexed for MEDLINE]

Zhong Xi Yi Jie He Za Zhi. 1991 Jul;11(7):403-4, 388.  Related Articles, Links 

[Effect of moxibustion on the antibody-dependent cell-mediated cytotoxicity activity in peripheral blood of patients with Hashimoto's thyroiditis]

[Article in Chinese]

Hu GS, Chen HP, Hou YJ.

Shanghai Research Institute of Acupuncture and Meridian.

To investigate the immune regulating effect of moxibustion on the patients with Hashimoto's thyroiditis, 35 patients were treated by moxibustion and the changes of antibody-dependent cell-mediated cytotoxicity (ADCC) activity in the peripheral blood of the patients and their relationship with thyroid microsomal antibody (MCA) before and after treatment were observed. It was found that the activity of ADCC and the combining rate of MCA were higher than normal and they were closely related to each other. After treatment, both of them declined remarkably and the relationship between them remained the same. The result indicated that the treatment of Hashimoto's thyroiditis by moxibustion might well be related to its effect of decreasing the activity of ADCC and the titer of anti-thyroid antibodies.

PMID: 1914034 [PubMed - indexed for MEDLINE]

Physiol Behav. 1987;40(5):603-6.  Related Articles, Links 

Plasma thyroid hormones, thyroid stimulating hormone, and insulin during acute hypometabolic states in man.

Jevning R, Wells I, Wilson AF, Guich S.

Department of Medicine, School of Social Sciences, U.C., Irvine 92717.

Acute behavioral rest states in man are associated with marked hormonal and metabolic changes. In order to complete a hormonal profile of these states and to identify possible metabolic regulators, we measured thyroid hormones (T3 and T4), thyroid stimulating hormone (TSH), and insulin during the stylized mental practice of "transcendental mediation" (TM) and during ordinary unstylized eyes closed rest. Except for TSH, which declined acutely, hormone levels were normal and stable throughout the experiment. The stability of T3 and T4, and insulin make it unlikely that these hormones regulate the acute metabolic changes associated with these behavioral states. Decreased TSH, along with stable thyroid hormone levels, may suggest change of the set point for feedback control of TSH secretion during TM and is consistent with primarily neural modulation of TSH secretion by this behavior.

PMID: 3313447 [PubMed - indexed for MEDLINE]

Biofactors. 2003;19(3-4):113-9.  Related Articles, Links 

Flavonoids and thyroid disease.

van der Heide D, Kastelijn J, Schroder-van der Elst JP.

Human and Animal Physiology Group, Wageningen University, Wageningen, The Netherlands. daan.vanderheide@WUR.nl

The most potent natural plant-derived compounds that can affect thyroid function, thyroid hormone secretion and availability to tissues is the group of flavonoids, i.e. plant pigments. They are present in our daily food, such as vegetables, fruits, grains, nuts, wine, and tea. Epidemiological studies suggest beneficial effects on health of flavonoids, which are commonly attributed to their activity as antioxidants. Experimental studies in vitro, however, showed inhibition of organification in thyroid cells and follicles by several flavonoids. Studies in vivo and vitro with synthetic and natural flavonoids showed displacement of T4 from transthyretin leading to disturbances in thyroid hormone availability in tissues. Radioactive labeled flavonoids appeared to be eliminated rapidly from the body mainly through excretion in the feces. In pregnant rats synthetic flavonoids cross the placenta and accumulate in the fetal compartment, including the fetal brain. Therefore, a high intake of flavonoids is contraindicated. In conclusion: flavonoids show strong interference with many aspects of thyroid hormone synthesis and availability.

Publication Types:

Review

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PMID: 14757961 [PubMed - indexed for MEDLINE]

Indian J Exp Biol. 2002 Jun;40(6):735-8.  Related Articles, Links 

Effect of antioxidants (vitamin C, E and turmeric extract) on methimazole induced hypothyroidism in rats.

Deshpande UR, Joseph LJ, Patwardhan UN, Samuel AM.

Radiation Medicine Centre (BARC), C/o Tata Memorial Centre Annexe, Parel, Mumbai 400 012, India.

The study was to investigate the protective effect of antioxidants against methimazole (MMI) induced hypothyroidism in rats. Male Wistar rats were fed MMI, MMI plus vitamin C, MMI plus vitamin E and MMI plus turmeric extract (TE) supplemented diet. At the end of the experiments, thyroid weights, thyroxine (T4), triiodothyronine (T3) and cholesterol levels were determined. It was observed that MMI treated rats showed increase in thyroid weights, very low levels of circulating T4, T3 and increased levels of total cholesterol as compared to controls (P< 0.001). However, rats which received Vit. C, Vit. E or TE along with MMI showed reduced weights (38-55% less) in thyroid glands (P < 0.01), less suppressed T4 and T3 levels (2-6% and 7-35% respectively) and less increase in total cholesterol levels (19-52%) which are statistically significant. The data suggest the positive effect of antioxidants on thyroid gland which could be due to direct involvement of antioxidants on thyroid gland.

PMID: 12587721 [PubMed - indexed for MEDLINE]

Altern Med Rev. 2004 Jun;9(2):157-179.  Related Articles, Links 

Sub-laboratory hypothyroidism and the empirical use of Armour thyroid.

Gaby AR.

Private practice 17 years, nutritional medicine; past-president, American Holistic Medical Association; author Preventing and Reversing Osteoporosis (Prima, 1994), and The Doctor's Guide to Vitamin B6 (Rodale Press, 1984); coauthor The Patient's Book of Natural Healing (Prima, 1999); author, numerous scientific papers on nutritional medicine; contributing medical editor for The Townsend Letter for Doctors and Patients since 1985. Correspondence address: 301 Dorwood Drive, Carlisle, PA, 17013.

Evidence is presented that many people have hypothyroidism undetected by conventional laboratory thyroid-function tests, and cases are reported to support the empirical use of Armour thyroid. Clinical evaluation can identify individuals with sub-laboratory hypothyroidism who are likely to benefit from thyroid-replacement therapy. In a significant proportion of cases, treatment with thyroid hormone has resulted in marked improvement in chronic symptoms that had failed to respond to a wide array of conventional and alternative treatments. In some cases, treatment with desiccated thyroid has produced better clinical results than levothyroxine. Research supporting the existence of sub-laboratory hypothyroidism is reviewed, and the author's clinical approach to the diagnosis and treatment of this condition is described.

PMID: 15253676 [PubMed - as supplied by publisher]

Metabolism. 1982 Sep;31(9):900-5.  Related Articles, Links 

Bioavailability of thyroid hormones from oral replacement preparations.

LeBoff MS, Kaplan MM, Silva JE, Larsen PR.

We evaluated gastrointestinal absorption in normal subjects of T4 and T3 from synthetic T3 tablets (Cytomel, SKF), desiccated thyroid tablets (Armour), thyroglobulin tablets (Proloid, Warner-Chilcott) and synthetic L-T4 tablets (Synthroid, Flint and Levothroid, Armour). Measurements of serum T4 and T3 concentrations and free hormone indices were made at multiple times after tablet ingestion, and T3 content in tablets was measured by radioimmunoassay. The time to peak serum T3, and the 26 hr intergrated increment in serum T3, Corrected for the amount if T3 ingested, were not significantly different for 75 micrograms of synthetic T3, 6 grains of desiccated thyroid (containing 99 micrograms T3) and 5 grains of thyroglobulin (containing 90 micrograms T3), the mean integrated increment values for the biological preparations being within 12% of those for synthetic T3. The peak serum T4 concentration, the time to peak T4, and 48 hr integrated increments in serum T4 and T3 were similar after 3 mg of Synthroid and Levothroid. The mean peak serum Free T3 Index after 75 micrograms T3, 500, was much higher than the mean peak Free T3 Index after 3 mg T4, 290. The time to peak Free T3 Index was much less after 75 micrograms T3, 2 hr, than the time to peak after 3 mg T4, 2 days. These results indicate that the time course and extent of T3 absorption do not differ, whether the T3 is given as the synthetic iodothyronine or as part of the thyroid protein, thyroglobulin. This approach appears to be useful in determining bioavailability of thyroid hormones from oral preparations and to assess the possibility of thyroid hormone malabsorption.

PMID: 7121261 [PubMed - indexed for MEDLINE]