Amelioration of iodine supply is notably associated with thyroid function in healthy subjects and in patients with euthyroid Hashimoto’s thyroiditis

Background: Our aim was to establish how healthy subjects (HS) and patients with euthyroid Hashimoto's thyroiditis (EuHT) faced the increase in mandatory salt iodization in Slovenia in 1999 from previous 10 mg of potassium iodide to 25 mg per kg since data about thyroid function with respect to iodine supply are scant.Methods: In this retrospective study we reviewed records of 24,899 patients referred for the first time between 1995 and 2002 to our tertiary referral centre with a stable catchment area for more than 20 years. HS were negative and patients with EuHT positive for thyroid peroxidase antibodies and/or thyroglobulin antibodies. Thyrotropin (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels were obtained. The fT4/fT3 ratio was calculated.Results: In the period 1995-1998, 917 HS had significantly lower fT4/fT3 ratio than 644 HS in the period 1999-2002 (2.6±0.6 and 2.9±0.9, respectively, p<0.001) on account of significantly higher fT3 (median 5.7 and 5.2 pmol/L, p<0.001). Similarly, in 1995-1998, 482 patients with EuHT had a lower fT4/fT3 ratio than 846 EuHT in 1999-2002 (2.4±0.6 and 2.8±0.7, respectively, p<0.001) on account of significantly higher fT3 (median 5.8 and 4.9, respectively, p=0.018). HS had a higher fT4/fT3 ratio than patients with EuHT in 1995-1998 but not in 1999-2002 (p<0.001 and p=0.206, respectively).Conclusions: Amelioration of iodine supply is associated with an increase in the fT4/fT3 ratio on account of lower fT3, and with a similar thyroid function in HS and in patients with EuHT.

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The Effect of Hypolipidemic Agents on Thyroid Autoimmunity in Women with Hashimoto’s Thyroiditis Treated with Levothyroxine and Selenomethionine

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0043-120342 ◽

2017 ◽

Vol 126 (05) ◽

pp. 321-326 ◽

Cited By ~ 1

Author(s):

Robert Krysiak ◽

Witold Szkróbka ◽

Bogusław Okopień

Keyword(s):

Hashimoto’S Thyroiditis ◽

Plasma Lipids ◽

Thyroid Autoimmunity ◽

Hdl Cholesterol ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Free Triiodothyronine ◽

Hypolipidemic Agents ◽

Antibody Titers ◽

Group B

Abstract Background Levothyroxine and selenomethionine were found to reduce thyroid antibody titers in patients with Hashimoto’s thyroiditis. The same effect was produced by intensive statin therapy. The aim of the present study was to assess whether hypolipidemic agents modulate the impact of thyroid hormone supplementation and selenomethionine on thyroid autoimmunity. Methods The study included 62 women with Hashimoto's thyroiditis treated for at least 6 months with levothyroxine and selenomethionine. On the basis of plasma lipids, women were divided into three groups: women with isolated hypercholesterolemia (group A; n=20), women with isolated hypertriglyceridemia (group B; n=17), and women with normal plasma lipids (group C; n=25). Group A were then treated with atorvastatin (20 mg daily), while group B received micronized fenofibrate (200 mg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyrotropin, free thyroxine and free triiodothyronine were measured at the beginning of the study and 6 months later. Results Fenofibrate decreased triglycerides and increased HDL cholesterol, while simvastatin decreased total and LDL cholesterol. Fenofibrate reduced titers of thyroid peroxidase and, to a lesser extent, thyroglobulin antibodies. Atorvastatin tended to increase thyroid peroxidase antibodies. No changes in thyrotropin, free thyroxine and free triiodothyronine were observed in any treatment group. Fenofibrate-induced changes in thyroid antibody titers correlated with baseline antibody titers, as well as with treatment-induced changes in HDL cholesterol and insulin sensitivity. Conclusions The obtained results indicate that only fibrates may potentiate the effect of selenomethionine and levothyroxine on thyroid autoimmunity in women.

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Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto’s Thyroiditis

Antioxidants ◽

10.3390/antiox9111070 ◽

2020 ◽

Vol 9 (11) ◽

pp. 1070

Author(s):

Rahim Rostami ◽

Sarmad Nourooz-Zadeh ◽

Afshin Mohammadi ◽

Hamid Reza Khalkhali ◽

Gordon Ferns ◽

...

Keyword(s):

Thyroid Function ◽

Hashimoto’S Thyroiditis ◽

Antioxidant Defense ◽

Thyroid Volume ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Urinary Iodine Concentration ◽

Serum Selenium ◽

Se Deficiency ◽

Se Status

Selenium (Se) deficiency has been implicated in the pathogenesis of Hashimoto’s thyroiditis (HT), although the available evidence is limited. The present study aimed to explore the interrelationships between serum Se status with measures of thyroid function and antioxidant defense in new cases of HT patients with hypoechogenic thyroid. HT patients (n = 49) and matched controls (n = 50) were recruited. Selenium, thyroid hormone panel, thyroid volume (TVol), glutathione (GSH), glutathione peroxidase3 (GPx3) activity, urinary iodine concentration (UIC), and urinary creatinine (Cr) were assessed. HT patients exhibited lower Se levels compared to controls (p < 0.001) with the rates of Se-deficient (<0.85 µmol/L) participants being 58.8% and 34%, respectively. Se-deficient patients exhibited higher thyroid stimulating hormone (TSH), Thyroid volume (TVol), thyroglobulin, antibody-titers, GPx3 activity and UIC/Cr compared to Se-sufficient patients (all p < 0.001). In the Se-deficient patients, inverse correlations were seen between Se-levels with TSH, TVol, and Thyroid peroxidase antibody (TPO-Ab) (all p < 0.001). This study is the first to uncover that coexisting Se-deficiency and elevated iodine in HT may enhance autoimmune reactions and accelerate the deterioration of thyroid function through oxidative stress. Our study also highlights the importance of optimal Se status in this disease, thus providing a rationale for the execution of intervention trials for the evaluation of the clinical benefits of antioxidant-status improvement in HT.

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SAT-497 Conversion of Hashimoto’s Thyroiditis to Grave’s Disease: A Case Report

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1447 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Tayba S Wahedi ◽

Najah Younes Douba

Keyword(s):

Thyroid Function ◽

Hashimoto’S Thyroiditis ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Autoimmune Thyroid ◽

Grave’S Disease ◽

Thyroid Uptake ◽

Common Causes ◽

Grave's Disease ◽

Tsh Levels

Abstract Introduction: Hashimoto’s thyroiditis and Grave’s disease are common causes for autoimmune thyroid disease. Conversion from Grave’s disease to hypothyroidism have been previously reported in literature. But development of Grave’s disease after a long standing hypothyroidism rarely occurs.Case report: a 22 -year-old Saudi pregnant female patient, was diagnosed with subclinical hypothyroidism with positive anti -thyroid peroxidase antibodies (Anti-TPO) in 2009. She was started on thyroxin and eventually became euthyroid with normal TSH levels till 2016. During subsequent follow-ups, patient was increasingly complaining of palpitations, weight loss and fine tremors. Thyroid function revealed increasingly suppressed TSH levels and over-replacement was suspected. Thyroxin dose was then gradually reduced and finally stopped for few months. Yet her symptoms persisted. Repeated thyroid function showed suppressed TSH level and elevated T4, T3 levels in keeping with overt hyperthyroidism. Thyroid scan further confirmed the diagnosis with diffuse thyroid uptake suggestive of Grave’s disease.Patient was started on medical treatment initially, then successfully treated with radioactive ablation.Conclusion: Although it rarely occurs, possibility of conversion from hypothyroidism to hyperthyroidism should always be kept in mind while treating hypothyroid patients with persistent clinical or biochemical evidence of hyperthyroidism despite dose reduction.References:[1] McLachlan SM. Rapoport B. Thyrotropin-blocking autoantibodies and thyroid-stimulating autoantibodies: Potential mechanisms involved in the pendulum swinging from hypothyroidism to hyperthyroidism or vice versa. Thyroid. 2013;23(1):14-24.[2] Ohye H, Nishihara E, Sasaki I, et al. Four cases of Graves’ disease which developed after painful Hashimoto’s thyroiditis. Intern Med. 2006;45(6):385-9.

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Cytomorphologic spectrum of Hashimoto's thyroiditis and its clinical correlation: A retrospective study of 52 patients

CytoJournal ◽

10.4103/1742-6413.131741 ◽

2014 ◽

Vol 11 ◽

pp. 9 ◽

Cited By ~ 13

Author(s):

Shirish S. Chandanwale ◽

Charusheela R. Gore ◽

Sunita A. Bamanikar ◽

Nidhi Gupta ◽

Kanika Gupta

Keyword(s):

Thyroid Function ◽

Hashimoto’S Thyroiditis ◽

Lymphocytic Infiltration ◽

Needle Aspiration ◽

Clinical Findings ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Follicular Hyperplasia ◽

Number Of Patients ◽

Antibody Profile

Background: Hashimoto's thyroiditis (HT) is an autoimmune disease and it is more prevalent in Asians. The incidence of HT seems to be increasing in the recent times. It is one of the most common cause of hypothyroidism. The purpose of this study is to review the cytomorphologic spectrum of HT and correlate it with clinical findings including thyroid function and antibody profile. Materials and Methods: We retrospectively analyzed the fine-needle aspiration (FNA) features of 52 HT patients. Based on cytomorphologic features patients were categorized into three groups. Clinical findings including thyroid function and thyroid peroxidase (TPO) antibody profile were correlated with cytomorphologic features in all three groups. Results: Majority of the patients were females and in 2nd, 3rd and 4th decades. Diffuse goiter and thyroid hypofunction were the common findings. Significant number of patients had thyroid hyperfunction. Increased lymphocytes on the background and lymphocytic infiltration of thyroid follicular cell clusters in cytology smears were diagnostic of HT. The 32 patients showed elevated titers of TPO antibodies. In the early stages and mild form of the disease, results of thyroid function and anti TPO antibodies are quite variable. Conclusions: HT is a disease of young and middle age and mostly occur in females. Clinical findings alone may not be adequate for definitive diagnosis. FNA is the gold standard for diagnosis. In the presence of abundant colloid, follicular hyperplasia or co-existing neoplasm, careful interpretation of cytology smears should be done. Aspiration from more than one site minimizes the diagnostic pitfalls.

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Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases

Journal of Thyroid Research ◽

10.1155/2018/5246516 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Shirish S. Chandanwale ◽

Rahul Nair ◽

Anushree Gambhir ◽

Supreet Kaur ◽

Aditi Pandey ◽

...

Keyword(s):

Thyroid Function ◽

Hashimoto’S Thyroiditis ◽

Thyroid Function Test ◽

Lymphocytic Infiltration ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Thyroid Follicular Cell ◽

Cell Clusters ◽

Thyroid Peroxidase Antibodies ◽

Function Test

Introduction. Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality. Aim. Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies). Materials and Methods. The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination. Results. The majority were Hashimoto’s thyroiditis (n=100) and females (n=103). Other forms of thyroiditis were Hashimoto’s thyroiditis with colloid goiter (n=5), De Quervain’s thyroiditis (n=3), and one case each of postpartum thyroiditis and Hashimoto’s thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 (n=70) and the majority (n=73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid (n=52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto’s thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. Conclusion. The diagnostic cytological features in Hashimoto’s thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto’s thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.

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Serum cystatin C is closely associated with euthyroid Hashimoto’s thyroiditis in adult female Chinese patients

Journal of International Medical Research ◽

10.1177/0300060520952973 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052095297

Author(s):

Qiaojing Qin ◽

Min Yang ◽

Wencai Ke ◽

Jinying Zhao ◽

Heyuan Ding

Keyword(s):

Cystatin C ◽

Hashimoto’S Thyroiditis ◽

Chinese Patients ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Serum Cystatin C ◽

Free Triiodothyronine ◽

Serum Cystatin ◽

Thyroglobulin Antibody ◽

The Status

Objective The aim of our study was to explore the association between serum cystatin C (CysC) and euthyroid Hashimoto’s thyroiditis. Methods There were 119 female euthyroid Hashimoto’s thyroiditis patients and 225 healthy controls who were recruited. Serum CysC, thyroid function, thyroid autoantibodies, fasting glucose, liver enzymes, and lipid profile were determined. Clinical parameters were compared between two groups. Results Serum CysC levels were significantly higher in euthyroid Hashimoto’s thyroiditis patients compared with controls. In the lowest, middle, and highest tertile groups of CysC, the percentage of Hashimoto’s thyroiditis was 15.9%, 34.2%, and 53.5%, respectively. The percentage of Hashimoto’s thyroiditis was significantly higher in the highest tertile than in the lowest and middle tertiles. Spearman’s correlation analysis showed that serum CysC levels were negatively correlated with free triiodothyronine (FT3), and positively correlated with serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb). Logistic regression analysis showed that serum CysC was independently related to the status of euthyroid Hashimoto’s thyroiditis. Conclusions The present study shows the first evidence suggesting that serum CysC levels are positively correlated with TPOAb and TGAb. Serum CysC might underlie the pathophysiologic features of euthyroid Hashimoto’s thyroiditis.

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Improving Hashimoto’s thyroiditis by eradicating Blastocystis hominis: Relation to IL-17

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018820907013 ◽

2020 ◽

Vol 11 ◽

pp. 204201882090701

Author(s):

Hanaa Tarek El-Zawawy ◽

Huda Fahmy Farag ◽

Mona Mohamed Tolba ◽

Hanaa Abdalbasit Abdalsamea

Keyword(s):

Hashimoto’S Thyroiditis ◽

Autoimmune Disorder ◽

Thyroid Stimulating Hormone ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Blastocystis Hominis ◽

Free Triiodothyronine ◽

Clinical Trial Registration ◽

Group I ◽

Group Ii

Background: Hashimoto’s thyroiditis (HT) is a common autoimmune disorder that causes significant morbidity. Interleukin (IL)-17 was identified as a major contributing factor in the pathogenesis of HT. Blastocystis hominis (BH) is a very common infection and has been shown to be associated with several diseases. Our aim was to determine serum IL-17 level in HT patients with and without BH infection and the effect of eradicating BH in patients with HT. Methods: A prospective cohort study was conducted on 20 HT patients not infected with BH (group I), 20 HT patients infected with BH (group II), and 20 healthy patients (group III). Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (anti-TPO), and IL-17 were performed by ELISA method and were repeated in group II after 6 weeks of eradication of BH. Results: Patients with HT showed a significantly higher serum IL-17 compared with controls. IL-17 was significantly higher in HT patients infected with BH compared with HT patients not BH infected (mean 6.93 ± 2.83 pg/ml versus 3.25 ± 1.55 pg/ml, p = 0.003). After BH eradication TSH, anti-TPO, and IL-17 were significantly decreased (mean 14.76 ± 11.11 µIU/ml versus 9.39 ± 7.11 µIU/ml, p < 0.001; mean 308 ± 175.6 IU/ml versus 295.4 ± 167.1 IU/ml, p = 0.006; and mean 6.93 ± 2.83 pg/ml versus 6.45 ± 2.48 pg/ml, p < 0.001), respectively. Multivariate analysis after treating BH infection showed that IL-17 was significantly negatively correlated with FT3 (adjusted p = 0.002) and significantly positively correlated with anti-TPO (adjusted p = 0.045). Conclusion: Treatment of BH infection ameliorates HT through reduction in IL-17, anti-TPO, and TSH. Clinical trial registration number: PACTR201909495111649

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Recovery of thyroid function with a decreased titre of antimicrosomal antibody in a hypothyroid man with Hashimoto's thyroiditis

Acta Endocrinologica ◽

10.1530/acta.0.1020531 ◽

1983 ◽

Vol 102 (4) ◽

pp. 531-534 ◽

Cited By ~ 9

Author(s):

Makiko Yamamoto ◽

Kazuro Kaise ◽

Hirofumi Kitaoka ◽

Katsumi Yoshida ◽

Nobuko Kaise ◽

...

Keyword(s):

Hashimoto’S Thyroiditis ◽

Serum Levels ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Normal Range ◽

Surgical Biopsy ◽

Low Levels ◽

Serum Thyroid Hormones ◽

Antimicrosomal Antibody ◽

Serum Tsh

Abstract. A 36 year old man with a diffuse goitre, signs of mild hypothyroidism, strikingly low levels of T4 (0.9 μg/dl) and T3 (24 ng/dl), elevated TSH (140 μU/ml) and elevated microsomal haemagglutination antibody (MCHA, 1:409 600), subsequently became non-goitrous and euthyroid with a decreased titre of antimicrosomal antibody without any medication. At the time of surgical biopsy, serum levels of T4 and T3 had risen to the normal range (4.6 μg/dl and 73 ng/dl, respectively), serum TSH had decreased to 30 μU/ml and the titre of MCHA to 1:25 600. Thyroid specimens showed Hashimoto's thyroiditis. The activity of thyroid peroxidase (TPO) was normal. The latest examination, 1 year and 3 months after initial evaluation, showed that the patient remained euthyroid with no goitre, that serum thyroid hormones were within the normal range (T4 7.7 μg/dl and T3 97 ng/dl), and that TSH was not detectable. The titre of MCHA decreased strikingly to 1:400.

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Relationship Between Thyroid Hormonal Status in Patients with a Hypothyroid Form of Hashimoto’s Thyroiditis and Iodine Concentrations in Drinking Water

Biological Trace Element Research ◽

10.1007/s12011-021-02640-2 ◽

2021 ◽

Author(s):

Olha Kasiyan ◽

Halyna Tkachenko ◽

Natalia Kurhaluk ◽

Svitlana Yurchenko ◽

Alek Manenko

Keyword(s):

Hashimoto’S Thyroiditis ◽

Iodine Concentration ◽

Iodine Intake ◽

Thyroid Stimulating Hormone ◽

Hashimoto's Thyroiditis ◽

Thyroid Peroxidase ◽

Supply Network ◽

Thyroid Status ◽

Thyroglobulin Antibodies ◽

Regressive Analysis

AbstractThe current study aimed to identify correlative and regressive dependencies between the water iodine concentration and the levels of TSH (thyroid-stimulating hormone), thyroglobulin antibodies (TgAbs), and thyroid peroxidase (TPOAb) in the serum of 168 in patients (34 men and 134 women) with a hypothyroid form of Hashimoto’s thyroiditis who use water from the supply network and individual wells. Based on the water iodine concentration, low and moderate degrees of iodine endemia in the location of the patients were determined. In the groups of men and women using water from different water supply sources, there were direct correlations between the water iodine concentrations and the TgAbs and TPOAb titers as well as an inverse dependence between iodine and TSH levels. Multivariate regressive analysis indicated that TgAb and TSH in the group of women using water from a supply network and TPOAb titers in the group of women using well water were independent factors associated with water iodine concentrations. Statistically significant correlations and regressive dependencies between the water iodine concentrations and the biomarkers of the thyroid status of the patients indicate the risk of Hashimoto’s thyroiditis progression, especially among women with additional iodine intake.

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Salivary gland function in women with Hashimoto’s thyroiditis without xerostomia and the correlation with auto-thyroid antibodies

Nuklearmedizin ◽

10.1055/a-1204-9748 ◽

2020 ◽

Author(s):

Xiao-an Pang ◽

Zhi-xiao Wei ◽

Jun-hong Li ◽

Xiao-qi Pang

Keyword(s):

Salivary Gland ◽

Hashimoto’S Thyroiditis ◽

Thyroid Stimulating Hormone ◽

Hashimoto's Thyroiditis ◽

Control Group ◽

Thyroid Peroxidase ◽

Thyroid Autoantibody ◽

Submandibular Glands ◽

Quantitative Parameters ◽

Salivary Function

Abstract Background Hashimoto’s thyroiditis (HT) may cause salivary dysfunction in patients resulting in xerostomia, but little is known about changes in salivary function in patients with no obvious dry mouth symptoms. In this study we assessed salivary function in women with HT, who had not experienced xerostomia and, for the first time, evaluated the effects of thyroid auto-antibodies on this function. Methods Sixty consecutive subjects were included, comprising 32 women (mean age, 36 ± 12 years) diagnosed with HT accompanied by differentiated thyroid cancer (DTC) in the study group (HT group), along with a control group (DTC group) of 28 women (mean age, 40 ± 12 years) diagnosed with DTC only. Salivary gland scintigraphy was used to assess salivary function with the semi-quantitative parameters of maximum absorption ratio and maximum secretion ratio, the decrease of which indicate impaired salivary function. Moreover, the HT and DTC groups were divided into four subgroups (Anti– HT, Anti+ HT, Anti– DTC, and Anti+ DTC), based on the presence of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). Finally, salivary gland semi-quantitative parameters were correlated with levels of thyroid-stimulating hormone (TSH), TGAb, and TPOAb in the HT and DTC groups. Results None of the semi-quantitative parameters examined in parotid or submandibular glands differed significantly between the HT and DTC groups. However, the maximum secretion ratio for the parotid and submandibular glands were significantly different in the subgroup comparison (p < 0.05). Furthermore, the TgAb, TPOAb, and TSH values correlated significantly with salivary excretive function (p ≤ 0.05). Conclusion Women with HT without xerostomia may not have salivary functional impairment during hypothyroidism. Serum thyroid autoantibody and TSH levels may mainly influence salivary excretive function but not uptake function.

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