Vitamin D supplementation does not prevent the recurrence of Graves\u2019 disease

Yoon Young Cho,Yun Jae Chung

doi:10.1038/s41598-019-55107-9

Abstract

Recent literature has reported a higher prevalence of vitamin D deficiency among people with Graves’ disease. No study has examined the effect of vitamin D supplementation on the clinical outcomes of Graves’ disease. We aimed to evaluate whether daily vitamin D supplementation reduces Graves’ disease recurrence. We enrolled 210 subjects with Graves’ disease and vitamin D deficiency and followed them for at least one year after anti-thyroid drug (ATD) discontinuation. Among 210 individuals, 60 (29%) were amenable to taking vitamin D supplements, resulting in sufficient vitamin D levels (from 10.6 to 25.7 ng/mL), whereas the mean vitamin D level was 11.6 ng/mL in the 150 patients who did not take vitamin D supplements. The recurrence rate was similar in both groups (38% vs. 49%, P = 0.086). However, recurrence occurred earlier in the latter group (7 months vs. 5 months, P = 0.016). In the multivariate analysis, vitamin D levels and TSH-binding inhibitory immunoglobulin (TBII) titers at ATD discontinuation remained significant factors for recurrence. Vitamin D levels and TBII titers at ATD discontinuation exhibited a weak negative correlation (R = −0.143, P = 0.041). Vitamin D supplementation might have a protective effect against Graves’ disease recurrence with a borderline significant recurrence rate reduction.

Highlights

Autoimmune thyroid diseases (AITDs), including Graves’ disease and Hashimoto’s thyroiditis, are the most common organ-specific autoimmune disorders[1]
We demonstrated no beneficial effect of daily supplementation of vitamin D on the recurrence of Graves’ disease within one year after anti-thyroid drug (ATD) discontinuation
The time to recurrence was delayed in patients who reached sufficient levels of vitamin D after vitamin D supplementation

Summary

Introduction

Autoimmune thyroid diseases (AITDs), including Graves’ disease and Hashimoto’s thyroiditis, are the most common organ-specific autoimmune disorders[1]. Recent studies have reported that low vitamin D levels are prevalent in patients with Graves’ disease. We reported similar vitamin D concentrations in 95 patients with Graves’ disease recurrence and 48 patients in remission (25(OH)D levels of 10.8 ng/mL vs 11.8 ng/mL, P = 0.405); the risk for Variables Age, years Sex, female Thyroid function at diagnosis T3, ng/dL FT4, ng/dL TSH, mU/L TBII, IU/L Thyroid function at the time of ATD discontinuation T3, ng/dL FT4, ng/dL TSH, mU/L TBII, IU/L Vitamin D supplementation Daily dose, IU Duration, months (range) Adjusted vitamin D level, ng/mL Before supplementation After supplementation Vitamin D measurement, no. We investigated the clinical outcomes of Graves’ disease patients, including recurrence rate, one year after anti-thyroid drug (ATD) cessation according to daily vitamin D supplementation status

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