Abstract
BackgroundEarly-onset androgenic alopecia is regarded as the phenotypic equivalent of polycystic ovary syndrome in men. Women with polycystic ovary syndrome are at high risk of autoimmune thyroiditis. The aim of the current study was to investigate whether early-onset androgenic alopecia determines the impact of exogenous vitamin D on thyroid autoimmunity and thyroid function in men with autoimmune thyroiditis.MethodsThe study included 67 young men with autoimmune thyroiditis, 25 of whom had early-onset androgenic alopecia (group A). All 25 men with alopecia and 23 out of the 42 men with no evidence of hair loss, matched for age, antibody titers and thyrotropin levels (group B), were then treated with vitamin D (100 μg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin, free thyroid hormones, total and calculated free testosterone, dehydroepiandrosterone-sulfate, estradiol, prolactin and 25-hydroxyvitamin D, as well as the calculated parameters of thyroid homeostasis were assessed before vitamin D treatment and 6 months later.ResultsAt baseline, thyroid antibody titers were higher in subjects with than without alopecia and correlated with calculated free testosterone levels. Vitamin D reduced antibody titers in both groups but this effect was stronger in group B than group A. Only in group B, vitamin D increased SPINA-GT. The impact of vitamin D on antibody titers correlated with 25-hydroxyvitamin D levels, calculated free testosterone, treatment-induced increase in 25-hydroxyvitamin D levels and the improvement in insulin sensitivity.ConclusionThis study suggests that euthyroid men with early-onset androgenic alopecia may benefit to a lesser degree from vitamin D treatment than other subjects with autoimmune thyroiditis.
Highlights
Autoimmune (Hashimoto’s) thyroiditis is the most prevalent organ-specific autoimmune disorder and the leading cause of hypothyroidism in developed countries [1]
Baseline antibody titers correlated with thyrotropin levels (TPOAb: r = 0.46 [p = 0.0004], thyroglobulin antibodies (TgAb): r = 0.41 [p = 0.0008]), calculated free testosterone (TPOAb: r = 0.46 [p = 0.0001], TgAb: r = 0.41 [p = 0.0006]), 25-hydroxyvitamin D levels (TPOAb: r = − 0.37 [p = 0.0047], TgAb: r = − 0.30 [p = 0.0325]) and SPINA-GT (TPOAb: r = − 0.29 [p = 0.0218], TgAb: r = − 0.25 [p = 0.0421])
In line with previous studies [7, 8], men with early-onset androgenic alopecia were characterized by increased androgen levels and impaired insulin sensitivity
Summary
Autoimmune (Hashimoto’s) thyroiditis is the most prevalent organ-specific autoimmune disorder and the leading cause of hypothyroidism in developed countries [1]. Early-onset male pattern hair loss may predispose to obesity, insulin resistance, dyslipidemia, hypertension and atherosclerosis [6, 9] Both men with androgenic alopecia and male siblings of women with PCOS were found to have lower levels of 25-hydroxyvitamin D than control subjects [10, 11]. All 25 men with alopecia and 23 out of the 42 men with no evidence of hair loss, matched for age, antibody titers and thyrotropin levels (group B), were treated with vitamin D (100 μg daily). The impact of vitamin D on antibody titers correlated with 25-hydroxyvitamin D levels, calculated free testosterone, treatment-induced increase in 25-hydroxyvitamin D levels and the improvement in insulin sensitivity. Conclusion This study suggests that euthyroid men with early-onset androgenic alopecia may benefit to a lesser degree from vitamin D treatment than other subjects with autoimmune thyroiditis
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