Reversal of Graves’ Disease with a Whole Foods Plant Based Diet: A Case Report

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Rishi Kalia ◽  
Ravi Kalia ◽  
Abdullah El-Naji ◽  
Joshua Musih ◽  
Soham Patel
Keyword(s):  
Cardiovascular Health ◽  
Hemoglobin A1c ◽  
Endocrine System ◽  
Graves Disease ◽  
Thyroid Antibodies ◽  
System Function ◽  
Vitamin D Levels ◽  
History Of ◽  
Hba1c Levels ◽  
Whole Foods

The benefits of a whole-food, plant-based diet (WFPBD) include, but are not limited to, improvement of cardiovascular health, decreased inflammation, as well as enhanced endocrine system function. We present the case of a 51-year-old pre-diabetic female with a 22-year history of Graves’ disease who reversed her conditions following the ini- tial 28-week WFPBD period. In this time, she was able to reduce her thyroid stimu- lating immunoglobulin (TSI) and hemoglobin A1c (HbA1c) levels and discontinue methimazole and cetirizine intake. It was also found that maintaining vitamin D levels are beneficial for promoting a more balanced immune response to help lower thyroid antibodies.

scholarly journals Effect of Vitamin D3 on Untreated Graves' Disease with Vitamin D Deficiency

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13157 ◽  
Author(s):  
Omar N. Alhuzaim ◽  
Naji Aljohani
Keyword(s):  
Vitamin D ◽  
Thyroid Gland ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Graves Disease ◽  
Bone Homeostasis ◽  
Heterogeneous Distribution ◽  
Satisfactory Outcome ◽  
Vitamin D Levels ◽  
History Of

Objective Besides its classical role in calcium and bone homeostasis, vitamin D is considered a potent immunomodulator that can affect the pathogenesis of several autoimmune diseases. Our aim is to evaluate the effect of vitamin D correction to a patient with new onset Graves' disease (GD) with an underlying vitamin D deficiency. Method We describe the effect of vitamin D3 on untreated Graves' disease with vitamin D deficiency. Results A healthy Saudi woman in her 40s sought consultation with a three-month history of palpitation. She denied any history of heat intolerance, weight loss, menstrual irregularity or sweating. She has a history of chronic muscle aches and pains. Physical examination revealed a mild diffusely enlarged and non-tender thyroid gland with no bruit. She had no signs of Graves' ophthalmopathy. In laboratory examinations, the initial thyroid function test, which was done in an outside hospital, revealed a TSH, 0.01 mIU/L; FT4, 22.5 pmol/L and FT3, 6.5 pmol/L. Vitamin D 25-OH level was done in our hospital and showed a result of 26.0 nmol/L with a TSH, 0.013 mIU/L; FT4, 16.7 pmol/L; and FT3, 3.8 pmol/L. TSH receptor antibody was positive. TC-99 m thyroid scintigraphy demonstrated an enlarged thyroid gland with increased radiotracer trapping and heterogeneous distribution. The patient was given only oral cholecalciferol 4000 IU per day since November 2012 (prescribed by an outside hospital) then from May 2013 onwards she was given 50,000 IU per month. Follow-up laboratory exams revealed improved vitamin D levels as well as TSH and FT4. She eventually improved both clinically and biochemically with a satisfactory outcome. Conclusion Vitamin D deficiency may exacerbate the onset and/or development of GD and correction of the deficiency may be able to reverse it. However, further prospective clinical studies will be needed to define the role of vitamin D treatment in GD.

scholarly journals SAT-678 New Onset Type 1 Diabetes and Immune Thrombocytopenic Purpura in an Adolescent Male: A Case Report

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Milagros Gonzalez-Garcia
Keyword(s):  
Type 1 Diabetes ◽  
Platelet Count ◽  
Hemoglobin A1c ◽  
Thyroid Antibodies ◽  
Thrombocytopenic Purpura ◽  
History Of ◽  
Autoimmune Condition ◽  
New Onset

Abstract INTRODUCTION: Type 1 diabetes mellitus (T1D) is an autoimmune condition caused by anti-pancreatic antibodies which attack and destroy the insulin-producing beta cells. Similarly, in immune thrombocytopenic purpura (ITP), anti-platelet antibodies destroy platelets, causing low platelet counts which can lead to petechiae and bleeding. Common autoimmune conditions seen in children with T1D include thyroid and celiac disease. Previous case reports discussed ITP in children with known T1D. Our patient presented with new onset T1D and diabetic ketoacidosis (DKA) in addition to new onset ITP. CLINICAL CASE: The patient is a 12 year old previously healthy male with a several week history of polyuria, polydipsia and nocturia, in addition to fatigue and lack of weight gain in the previous two years. Initial labs confirmed diagnosis of T1D with hemoglobin A1c of 12.9% and serum glucose of 460 mg/dL, in addition to DKA, with bicarbonate of 13 mmol/L, pH of 7.30, elevated anion gap and beta-hydroxybutyrate. Due to the presence of DKA, the patient was started on an insulin drip. Thyroid labs showed hyperthyroidism, with TSH- <0.02 (0.5-4.5 mIU/L) and free T4- 2.84 (0.7-1.68 ng/dL), so he was started on methimazole 20 mg daily. Confirmatory pancreatic antibodies and thyroid antibodies were sent. CBC showed thrombocytopenia with initial platelet count of 41,000, hemoglobin of 16.9 g/dL, and white blood cells of 5.05. Follow up platelets continued low at 37,000, so he was seen by a hematologist, which confirmed the Diagnosisx of ITP. Patient had a history of easy bruising in arms and legs, one episode of epistaxis and minimal bleeding after brushing teeth, with negative history of hematuria. Follow up labs resulted in negative thyroid antibodies (TPO Ab, TSI and thyroglobulin Ab) with normalization of labsthyroid function tests, so the methimazole was discontinued. Patient is being followed by Hematologya hematologist, and pancreatic antibodies were done, which were negative. Hematology concurred with diagnosis of ITP despite negative antibodies due to diagnosis of T1D. First line therapy for ITP is IVIG and steroids, however due to national shortage of IVIG and risk for worsening hyperglycemia with steroids, these were avoided. Instead, patient was started on Eltrombopag daily for treatment of his ITP. Platelet count has improved on eltrombopag, with latest range of 126-146,000. Latest hemoglobin A1c is of 6.2%. CONCLUSION: In the case of new onset type 1 diabetes mellitusT1D, it is’s important to keep in mind that ITP is another autoimmune condition that can present in these patientspresent. In addition to IVIG and steroids, Eltrombopag is a good ttreatment option that does not interfere with glycemic control. More research is needed to measure the frequency of ITP among patients with type 1 diabetes.

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

2004 ◽  
Vol 43 (06) ◽  
pp. 217-220 ◽  
Author(s):  
J. Dressler ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
Chr. Reiners ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Thyroid Diseases ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Co Morbidity ◽  
History Of ◽  
Individual Decisions ◽  
Prophylactic Use ◽  
Benign Thyroid

SummaryThe version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves’ disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves’ disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient’s preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients’ preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version.

HETEROGENEITY OF LONG ACTING THYROID STIMULATING (LATS) – ACTIVITY, THYROGLOBULIN ANTIBODIES AND THYROID MICROSOMAL ANTIBODIES

1973 ◽  
Vol 73 (3) ◽  
pp. 483-488 ◽  
Author(s):  
F. Adlkofer ◽  
H. Schleusener ◽  
L. Uher ◽  
A. Ananos ◽  
C. Brammeier
Keyword(s):  
Isoelectric Focusing ◽  
Graves Disease ◽  
Thyroid Antibodies ◽  
Thyroglobulin Antibodies ◽  
Ph Range ◽  
Long Acting ◽  
Thyroid Microsomal Antibodies

ABSTRACT Crude IgG of sera from 3 patients with Graves' disease, which contained LATS-activity and/or thyroid antibodies, was fractionated by isoelectric focusing in a pH-range between 6.0 to 10.0. LATS-activity was found in IgG-subfractions from pH 7.5 to 9.5, thyroglobulin antibodies and thyroid microsomal antibodies from pH 6.0 to 10.0. It was not possible to separate LATS-activity from the thyroid antibodies by this technique. The results indicate that LATS and the thyroid antibodies are heterogeneous and of polyclonal origin.

The natural history of subclinical hyperthyroidism due to Graves' disease

2015 ◽  
Author(s):  
Sviatlana Zhyzhneuskaya ◽  
Caroline Addison ◽  
Jola Weaver ◽  
Vasileios Tsatlidis ◽  
Salman Razvi
Keyword(s):  
Natural History ◽  
Graves Disease ◽  
Subclinical Hyperthyroidism ◽  
History Of

scholarly journals Rationale and design of a type 2 diabetes prevention intervention for at-risk mothers and children at a Federally Qualified Healthcare Center: EPIC El Rio Families Study Protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David G. Marrero ◽  
Robert M. Blew ◽  
Kelly N. B. Palmer ◽  
Kyla James ◽  
Denise J. Roe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Cardiovascular Health ◽  
Excess Body Weight ◽  
Lifestyle Behaviors ◽  
Increased Risk ◽  
Group Randomized Trial ◽  
Prevention Model ◽  
History Of

Abstract Background Exposure to gestational diabetes mellitus (GDM) is associated with increased risk for type 2 diabetes (T2DM) in mothers, and poor cardiovascular health among offspring. Identifying effective methods to mitigate T2DM risk has the potential to improve health outcomes for mothers with a history of GDM and their children. The goal of the EPIC El Rio Families Study is to implement and evaluate the effects of a 13-week behavioral lifestyle intervention on T2DM risk factors in at-risk mothers and their 8- to 12-year-old children. We describe herein the rationale for our specific approach, the adaption of the DPP-based curriculum for delivery to patients of a Federally Qualified Health Center (FQHC), and the study design and methodology. Methods The effects of the intervention on reduction in excess body weight (primary outcome), hemoglobin A1c, blood pressure, and changes in lifestyle behaviors associated with weight trajectory and T2DM risk in mother-child dyads will be evaluated during a 13-week, group randomized trial wherein 60 mothers and their children will be recruited to the intervention or wait-listed control conditions at one of two FQHC locations. Intervention participants (n = 30) will begin the group program immediately, whereas the wait-listed controls (n = 30) will receive a booklet describing self-guided strategies for behavior change. Associated program delivery costs, acceptability of the program to participants and FQHC staff, and potential for long-term sustainability will also be evaluated. Discussion Successful completion in our aims will produce a scalable program with high potential for replication and dissemination, and estimated intervention effects to inform T2DM prevention efforts on families who use the FQHC system. The results from this study will be critical in developing a T2DM prevention model that can be implemented and scaled across FQHCs serving populations disproportionately burdened by T2DM. Trial registration ClinicalTrials.gov NCT03781102; Date of registration: 19 December 2018.

scholarly journals Association between Physical Activity and Sport Participation on Hemoglobin A1c Among Children and Adolescents with Type 1 Diabetes

2021 ◽  
Vol 18 (14) ◽  
pp. 7490
Author(s):  
Kristi M. King ◽  
Jason R. Jaggers ◽  
Lindsay J. Della ◽  
Timothy McKay ◽  
Sara Watson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Medical Records ◽  
Hemoglobin A1c ◽  
Pediatric Patients ◽  
Sport Participation ◽  
Multiple Linear Regression Model ◽  
Significant Difference ◽  
Hba1c Levels

Purpose: To determine associations between physical activity (PA) and sport participation on HbA1c levels in children with type 1 diabetes (T1D). Method: Pediatric patients with T1D were invited to complete a PA and sport participation survey. Data were linked to their medical records for demographic characteristics, diabetes treatment and monitoring plans, and HbA1c levels. Results: Participants consisted of 71 females and 81 males, were 13 ± 3 years old with an average HbA1c level of 8.75 ± 1.81. Children accumulating 60 min of activity 3 days or more a week had significantly lower HbA1c compared to those who accumulated less than 3 days (p < 0.01) of 60 min of activity. However, there was no significant difference in HbA1c values based on sport participation groups. A multiple linear regression model indicated that PA, race, age, duration of diagnosis, and CGM use all significantly predicted HbA1c (p < 0.05). Conclusion: This study demonstrated the significant relationship between daily PA and HbA1c. Those in this sample presented with lower HbA1c values even if accumulating less than the recommended number of days of activity. Further, it was shown that sport participation alone may not be adequate enough to impact HbA1c in a similar manner.

scholarly journals Hemoglobin A1c in Patients with Diabetes Predict Long-Term Mortality Following Coronary Artery Surgery

2021 ◽  
Vol 10 (12) ◽  
pp. 2739
Author(s):  
Muhammad Abu Tailakh ◽  
Shlomo-yaron Ishay ◽  
Jenan Awesat ◽  
Liat Poupko ◽  
Gidon Sahar ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Hemoglobin A1c ◽  
Smoking Status ◽  
Artery Bypass ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Hba1c Levels

Objective: to estimate the association between preoperative hemoglobin A1c (HbA1c) levels below and above 7%, and the rate of all-cause mortality (ACM) in diabetes mellitus (DM) patients after coronary artery bypass grafting (CABG) within a ten-year follow-up period. Methods: we collected data on patient HbA1c levels that were measured up to 3 months prior to isolated CABG in consecutive patients with DM, and analyzed the rates of ACM over a median of a 5.9-year post-operative period. Results: preoperative HbA1c levels were collected in 579 DM patients. The mean HbA1c was 8.0 ± 1.7%, where 206 (35.6%) patients had an HbA1c ≤ 7% and 373 (64.4%) had an HbA1c > 7%. During the follow-up period, mortality rates were 20.4% and 28.7% in the HbA1c ≤ 7% and HbA1c > 7% groups, respectively (Kaplan-Meier estimates, log-rank p = 0.01). Multivariable Cox proportional hazards regression, adjusted for age, gender, smoking status, chronic obstructive pulmonary disease, hypertension, chronic renal failure, old myocardial infarction, number of coronary artery bypass surgeries, and post-operative glycemic control, showed a hazard ratio of 2.67 for long-term ACM (p = 0.001) in patients with HbA1c > 7%. Conclusions: DM patients with high HbA1c levels prior to CABG are at higher risk for long-term complications, especially late ACM.

Evaluation of the Use of a Diabetes Risk Test to Identify Prediabetes in an Employee Wellness Screening

2021 ◽  
pp. 089719002199701
Author(s):  
Eileen D. Ward ◽  
Whitney A. Hopkins ◽  
Kayce Shealy
Keyword(s):  
At Risk ◽  
American Diabetes Association ◽  
Hemoglobin A1c ◽  
Screening Tool ◽  
Screening Program ◽  
Diabetes Risk ◽  
Risk Scores ◽  
Cutoff Score ◽  
Employee Wellness ◽  
History Of

Background: The American Diabetes Association (ADA) Diabetes Risk Test (DRT) is a screening tool to identify people at risk for developing diabetes. Individuals with a DRT score of 5 or higher may have prediabetes or diabetes and should see a healthcare provider. Objective: To determine how many additional employees are identified as being at risk for developing diabetes during an employee wellness screening by using a more stringent DRT cutoff score of 4 instead of 5. Methods: During an annual employee wellness screening event, a hemoglobin A1C (A1c) was drawn for participants with a DRT score of > 4 or by request regardless of risk score. A1C values were classified as normal (<5.7%), prediabetes (>5.7 and <6.5%) or diabetes (>6.5%). Risk scores and A1C values were analyzed using descriptive statistics. Cost of additional laboratory testing was also reviewed. Results: An A1C was collected for 158 participants. Fourteen of 50 (28%) participants with a DRT of 4 had A1c values in the prediabetes range and no history of diabetes or prediabetes. Using the lower DRT score of 4 resulted in an additional expenditure of $305 with $85.40 resulting in the identification of an otherwise unaware person at risk for developing diabetes. Conclusion: Using a DRT cutoff score of 4 as part of an employee wellness screening program resulted in additional laboratory costs to identify persons at risk for developing diabetes but also allowed for earlier education to slow or stop the progression to diabetes which may reduce healthcare costs over time.

ROLE OF VITAMIN D IN COVID VACCINE EFFICACY IN ELDERLY IN INDIAN POPULATION

2021 ◽  
pp. 55-56
Author(s):  
Gujjarlapudi Deepika ◽  
Duvuru Nageshwar Reddy
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Immune Response ◽  
Indian Population ◽  
Integrated Approach ◽  
Inclusion Criteria ◽  
Vitamin D Levels ◽  
History Of ◽  
Study Inclusion

Background: Aim of this study is to summarise the role of Vitamin D in supporting the immune system,in covid vaccinated recipients. This is a observational study done between April 2021 t Methods: o June 2021 in Indian population. We compared anti-SARS-CoV-2 spike RBDIgG antibody & antispike antibodies following vaccination of non-hospitalized participants along with vitamin D levels in recipients above 60 years. They were tested after vaccination after two doses between 15-45 days. Before study inclusion criteria is, we have checked whether they were as seropositive or seronegative based on nucleocapsid total antibody results. of 310 Results vaccine recipients, 46 reported a prior COVID-19 diagnosis and we have excluded them from the study of the 264 with no history of Covid-19, 70 were vitamin d decient (50M;20 F) & 194 (130 M:64 F) were vitamin d Sufcient. Responses were evaluated after two doses on an average post-vaccine RBD IgG concentration and Spike antibodies were each signicantly higher among the Vit d sufcient recipients compared to the vitamin D Decient recipients. An integrated approach is required to bett Conclusions: er understand aging and how vaccines work in elderly which will help in improving the immune response in older adults after vaccination.

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