Hashimoto's Group Research Articles

Study of Leaky Gut syndrome and its Correlation to Hashimoto’s Thyroid Disease with Respect to Antibodies Titre

Abstract Background Hashimoto's thyroiditis (HT) is the most common autoimmune disease worldwide, characterized by chronic inflammation and circulating auto antibodies against thyroid peroxidase and thyroglobulin. Alterations in the gut microbiota are associated with autoimmune diseases development. There is increasing evidence that gut microbiota is an important environmental factor directly or indirectly influencing the progression of thyroid diseases and that thyroid diseases can exacerbate disturbances in the microbiota Objective To evaluate serum zonulin levels and stool lactobacillus acidophilus growth as markers of leaky gut syndrome in patients with Hashimoto's thyroiditis. Methods This was a case control study that was conducted on 80 Egyptian subjects age (20 – 60 years old) & were divided into 60 patients with Hashimoto's thyroiditis and 20 control, the patient group was further divided into 3 equal groups according to the thyroid functions state (Euthyroid, sub clinical hypothyroid and overt hypothyroidism), evaluation of serum zonulin and stool lactobacillus acidophilus growth and correlation with TPO antibody titer was done. Results Our study showed statistically significant increase in serum zonulin level which was positively correlated to TPO level in Hashimoto's thyroiditis patients implicating a possible presence of leaky gut syndrome, this was present in the hypothyroid group significantly than the Euthyroid Hashimoto's group, as it was also associated with lactobacillus acidophilus stool culture positivity which may reflect a bacterial dysbiosis. Conclusion This data may reflect the interaction between the gut microbiota and possible leaky gut syndrome association with Hashimoto’s thyroiditis. However, whether this data is a result from Hashimoto's disease or a cause, this need a further evaluation.

Evaluation of Health-Related Quality of Life in Patients with Euthyroid Hashimoto's Thyroiditis under Long-Term Levothyroxine Therapy: A Prospective Case-Control Study.

Objectives: To investigate quality of life using the SF-12 scale in euthyroid Hashimoto's thyroiditis patients on levothyroxine therapy for at least three years. Methods: This prospective case-control study included 44 euthyroid Hashimoto's thyroiditis patients and 44 matched controls, conducted at a university hospital's endocrinology clinic from 6 November to 30 December 2023. Participants completed the SF-12 questionnaire; data were analyzed using Shapiro-Wilk, Student's t-test, Mann-Whitney U, Yates chi-squared, and Spearman's tests. Results: The study involved 88 participants (Hashimoto's group: 35 females, 9 males; control group: 31 females, 13 males), with average ages of 49.50 and 47.43 years old, respectively. Significant differences were observed in TSH, T4 levels, and family history (p < 0.05). The Hashimoto's thyroiditis group showed higher thyroid peroxidase antibodies (95.69 IU/mL) and lower scores on both physical and mental sub-dimensions of SF-12, with a significant difference in physical scores (p < 0.05). Significant correlations were found between age and Anti-TG; Anti-TPO and Anti-TG; BMI and T3; TSH and T4; HDL and triglycerides; MCS-12 and PCS-12; Anti-TPO and T3; cholesterol and T3; and LDL and cholesterol (p < 0.05). Other variables showed no significant correlations (p > 0.05). Conclusions: Our study shows that effective control of hypothyroidism is not sufficient to reduce the negative effects of Hashimoto's thyroiditis on patients' health-related quality of life. Beyond the normalization of hormone levels, comprehensive therapeutic strategies targeting the autoimmune aspects of the disease are essential for the management of Hashimoto's thyroiditis. This study provides a foundation for developing effective therapies that can enhance quality of life for patients with Hashimoto's thyroiditis.

Clinico-pathological Features and Survival Time of Papillary Thyroid Carcinoma in Patients With and Without Hashimoto’s Thyroiditis: A Cross-sectional Study

Objectives: Researchers have reported different results regarding the association between Hashimoto’s disease and papillary thyroid carcinoma (PTC). Some believe that the coexistence of these diseases can lead to fewer tumor invasion and recurrence rates. This study evaluated the clinico-pathological features and survival time of PTC in patients with and without Hashimoto’s thyroiditis. Materials and Methods: In this cross-sectional study, medical records of 251 participants who underwent total or subtotal thyroidectomy due to PTC from 2012 to 2019 were reviewed. The clinico-pathological features of participants, such as age, gender, tumor stage, tumor size, lymph node involvement, metastasis, capsular invasion, single or multi-focal tumor status, and survival time were recorded from their medical records and pathology report and compared in two groups with and without Hashimoto’s thyroiditis. Results: From 251 participants, 92 (36.6%) had Hashimoto’s thyroiditis, whereas 159 (63.4%) did not show any signs of this disease. Fifteen participants in the Hashimoto group and 46 in the non-Hashimoto group had a recurrence. Although there were no significant differences between the two groups in the term of recurrence rate (P = 0.08), the mean survival time was significantly difference between the two groups (69.03 and 58.78, respectively; P = 0.038) Conclusions: Results of the study revealed that Hashimoto’s thyroiditis could increase the survival time of patients with PTC.

Alterations of Serum Leptin Levels in Patients with Autoimmune Thyroid Disorders.

Background: Thyroid dysfunction is accompanied with significant metabolic alterations that affect body weight, appetite, and energy expenditure, as well as lipid and carbohydrate metabolism. Leptin, an adipokine produced by adipocytes, regulates food intake and energy storage. Thyroid hormones and leptin share some physiological effects. Changes in leptin have been shown in patients with dysfunction of the thyroid; however, the results are contradictory. The aim of this study was to evaluate the circulating levels of leptin in patients with Graves disease (GD) and Hashimoto thyroiditis (HT) before and after normalization of thyroid function compared with the control group. Methods: Newly diagnosed adult patients with GD, HT, and healthy euthyroid controls were recruited. Various clinical and biochemical parameters, including thyroid function tests and serum leptin level, were assessed before and after treatment and compared between groups. Results: Data from 56 patients with HT, 54 patients with GD, and 54 healthy controls were analyzed. Serum leptin levels of patients with HT (30.96 ± 3.88 ng/mL) were found to be significantly higher than the controls (22.35 ± 4.72 ng/mL) (p<0.001), whereas patients with Graves had lower serum leptin levels (14 ± 4.54 ng/mL) (p<0.001). In patients with HT, serum leptin levels showed a significant decrease after treatment (31 vs 27 ng/mL; p<0.001), while in patients with GD, leptin increased significantly after treatment (14 vs 17 ng/mL; p<0.001). Conclusion The present study showed that serum leptin levels increased in patients with HT and decreased in those with GD than the control group. However, after treatment, leptin decreased in the Hashimoto group and increased in the Graves group, although it was still significantly different from the control group.

The impact of familial predisposition on the development of Hashimoto’s thyroiditis

ABSTRACTObjectives: Hashimoto’s thyroiditis (HT) is a common autoimmune disease. Available data show that HT develops as a result of interaction between genetic susceptibility and environmental factors, but the exact pathogenesis of the disease is not yet fully understood. The aim of this investigation is to evaluate the potential relationship between family history of HT and the development of HT.Methods: Data regarding family history of all patients who were referred for a diagnostic evaluation of thyroid function for any reason between May 2014 and May 2018 was analyzed. Only first-degree relatives were considered significant, whereas the data of distant relatives was not collected.Results: A total of 39 patients with positive family history of HT were extracted (Hashimoto group). As a control group, 39 patients with negative family history of HT were randomly chosen from the same database for the final analysis. When analyzing cytological diagnoses, there were 17 patients with confirmed HT in the Hashimoto group, and 7 in the control group (p = 0.0262).Conclusion: To the best of our knowledge, this is the first study directly showing that there is genetic predisposition for the development of HT in patients with positive family history of the disease (43.59% of patients with positive family history developed HT themselves). Assessment of a patient’s family history in detail should become a standard procedure when a patient with any thyroid disorder is referred for diagnostic evaluation.

Vitamin D Treatment in Patients with Hashimoto's Thyroiditis may Decrease the Development of Hypothyroidism.

The relationship between Hashimoto's thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto's thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto's thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL. Vitamin D deficient patients were given 50.000 units of 25(OH)D3 weekly for eight weeks in accordance with the Endocrine Society guidelines. All evaluations were repeated after 2 months of treatment. Patients with Hashimoto's thyroiditis had significantly lower vitamin D concentrations compared with the controls (9.37±0.69 ng/mL vs 11.95±1.01 ng/mL, p < 0.05, respectively). Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with euthyroid Hashimoto's thyroiditis. Also, HDL cholesterol concentrations improved in the euthyroid Hashimoto group after treatment. The mean free thyroxine (fT4) concentrations were 0.89±0.02 ng/dL in patients with Hashimoto's thyroiditis and 1.07±0.03 ng/dL in the healthy control group (p < 0.001). The mean thyroid volumes were 7.71±0.44 mL in patients with Hashimoto's thyroiditis and 5.46±0.63 mL in the healthy control group (p < 0.01). Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

The Lipid Parameters and Lipoprotein(a) Excess in Hashimoto Thyroiditis.

Objective. The risk of atherosclerotic heart disease is increased in autoimmune thyroiditis, although the reason is not clear. Lipoprotein(a) (Lp(a)) excess has been identified as a powerful predictor of premature atherosclerotic vascular diseases. The aim of this study is to investigate the relationship between Lp(a) levels and thyroid hormones in Hashimoto patients. Method. 154 premenopausal female Hashimoto patients (48 patients with overthypothyroid (OH), 50 patients with subclinical hypothyroid (SH), and 56 patients with euthyroid Hashimoto to (EH)) were enrolled in this study. The control group consists of 50 age matched volunteers. In every group, thyroid function tests and lipid parameters with Lp(a) were measured. Lp(a) excess was defined as Lp(a) > 30 mg/dL. Results. Total-C, LDL-C, TG, and Lp(a) levels were increased in Hashimoto group. Total-C, LDL-C, and TG levels were higher in SH group than in the control group. Total-C and LDL-C levels were also higher in EH group compared to controls. Lp(a) levels were similar in SH and EH groups with controls. However, excess Lp(a) was more common in subclinical hypothyroid and euthyroid Hashimoto group than in the control group. Conclusion. The Total-C and LDL-C levels and excess Lp(a) were higher even in euthyroid Hashimoto patients. Thyroid autoimmunity may have some effect on Lp(a) and lipid metabolism.

Vitamin D status in children with Hashimoto thyroiditis

To investigate vitamin D status in children with Hashimoto thyroiditis. The study group consisted of 78 children recently diagnosed as Hashimoto thyroiditis and 74 subjects as the control group. Parameters of calcium metabolism, thyroid function tests, and 25-hydroxyvitamin D [25(OH)D] levels were measured. Vitamin D deficiency rate was significantly higher in the Hashimoto group compared with the control subjects (73.1% vs. 17.6%, p < 0.0001). In the Hashimoto group, mean 25(OH)D levels were significantly lower compared with the control group (31.2 +/- 11.5 versus 57.9 +/- 19.7 nmol/L, p < 0.001) and was inversely correlated with the anti-thyroid peroxidase (anti-TPO) levels (r = -0.30, p = 0.007). The higher vitamin D deficiency rates besides lower vitamin D levels in the Hashimoto group together with the inverse correlation between vitamin D and anti-TPO suggest that vitamin D deficiency may have a role in the autoimmune process in Hashimoto thyroiditis in children.

HLA Associations with Hashimoto's thyroiditis

There is disagreement over the HLA-DR associations of Hashimoto's (goitrous) thyroiditis. We have studied 86 English Caucasian patients with this condition whose DR types were determined by restriction fragment polymorphism analysis. HLA-DR3 was significantly more frequent in these patients than in 100 controls (chi 2 = 7.09; P less than 0.01). The relative risk was 2.23 and aetiological fraction 0.29. HLA-DPB and DQB alleles were analysed in a proportion of these subjects by enzymatic DNA amplification and oligonucleotide probing. The only significant finding was an excess of HLA-DQw2 (in linkage disequilibrium with DR3) in the Hashimoto group (chi 2 = 7.43, P less than 0.007). These results do not support a difference between goitrous and atrophic thyroiditis based on respective associations with HLA-DR5 and DR3, but confirm a recent study in which HLA-DR3 was associated with Hashimoto's thyroiditis. However, it is possible that genes telomeric to DR3 may be involved in determining which type of thyroiditis a patient with autoimmune hypothyroidism develops.