Improvement Of Thyroid Function Research Articles

Clinical efficacy of Yingliu mixture combined with metimazole for treating diffuse goitre with hyperthyroidism and its impact on related cytokines

Context: Yingliu mixture was developed in 1990s by Affiliated Longhua Hospital of Shanghai University of Traditional Chinese Medicine, for treating diffuse goitre with hyperthyroidism (Graves’ disease, GD). Former studies have shown Yingliu mixture combined with methimazole (Y-M) can effectively improve thyroid function and decrease thyrotropin-receptor antibody level. Furthermore, we researched its impact on related cytokines to prove that Y-M improve patients’ immunity status. Objective: To observe the clinical efficacy of Y-M for treating GD. Methods: A total of 120 GD patients were randomly divided into two groups, the treatment and the control groups (n = 60). The treatment group’s patients were treated with Y-M. The control group’s patients were treated with methimazole alone. Yingliu mixture was orally administered, 25 mL three times daily. Methimazole was administered at 5–25 mg/day. After 12 weeks of the treatment, the cytokines, antibodies related to thyroid function, and Chinese medical syndromes were evaluated. Results: After the treatment, the free triiodothyronine and thyroxine levels in both groups decreased. The thyroid-stimulating hormone level increased in the treatment group. The thyrotropin-receptor antibody levels and TNF-α levels decreased in both groups. In the control group, IL-6 and IFN-γ levels were lower than that before the treatment. In the treatment group, CD4+ and CD25+ levels were higher than pretreatment levels, but IL-10 levels were reduced. Clinical symptoms: the total CMS scores for both groups decreased. Conclusions: The Y-M combination can improve thyroid function, and decrease autoantibodies, cytokines, and clinical symptoms, so its efficacy may surpass that of methimazole alone.

Myo-inositol and melatonin in the menopausal transition

Introduction: The aim of the study was to evaluate the effects on serum insulin and serum thyroid profile of a dietary supplement, myo-inositol, given alone or in combination with melatonin to women during menopausal transition.Methods: Forty women aged 45–55 years and at least 6 months of amenorrhea were enrolled in this study. They were randomly assigned to two groups of 20 each. One group took myo-inositol (myo-Ins) (2 g twice a day) and the other group took 2 g/d myo-Ins plus 3 g/d melatonin before sleeping. At the beginning of the study and after 6 months, all women were evaluated for the following indices: waist circumference, body mass index, blood pressure, endometrial thickness, as well as serum concentrations of TSH, FT3, FT4 and insulin.Results: Both at baseline and at 6 months, the two groups were statistically similar for each of the considered indices. If percent changes (Δ%, 6 months over baseline) are contrasted in the two groups, serum TSH decreased in the myo-Ins group but increased in the latter, while serum insulin decreased in both groups.Conclusions: The combination of myo-Ins plus melatonin seems to affect positively glucose metabolism, while myo-Ins only seems to improve thyroid function.

Breed-specific reference intervals for assessing thyroid function in seven dog breeds.

Thyroxine (T4), free T4 (FT4), and thyrotropin (TSH) concentrations were measured in serum from 693 healthy representatives from 7 dog breeds (Alaskan Malamute, Collie, English Setter, Golden Retriever, Keeshond, Samoyed, or Siberian Husky) to determine whether breed-specific reference intervals (RIs) are warranted. Veterinarians reviewed the health history, performed a physical examination, and approved laboratory data for the enrolled dogs. Many purebred dogs had T4 and FT4 concentrations that were at, or below, the lower limits previously determined for non-breed-specific RIs. Mean concentrations of T4, FT4, and TSH varied significantly among breeds. The range of mean concentration of T4 (19.7 nmol/L [1.53 µg/dL] in English Setters to 29.0 nmol/L [2.25 µg/dL] in Keeshonds) and FT4 (12.6 pmol/L [0.98 ng/dL] in English Setters to 20.2 pmol/L [1.57 ng/dL] in Samoyeds) was considerable. Median TSH values ranged from 6.10 mIU/L (0.07 ng/mL; Alaskan Malamute and Golden Retriever) to 17.6 mIU/L (0.26 ng/mL; Collie). Mean T4 and FT4 concentrations were higher in females. Increasing age was associated with decreasing T4 and FT4, and increasing TSH concentration. The substantial ranges across breeds of measures of central tendency (mean, median) for all hormones indicate that breed-specific RIs are warranted. RIs encompassing the central 95% of reference values for all breeds combined, and for individual breeds, were calculated using nonparametric (TSH) and robust (T4, FT4) methods. Use of breed-specific RIs in combination with careful attention to the potential for pre-analytical and analytical variability in test results will improve thyroid function assessment in these breeds.

Phototherapeutic Effect of Low-Level Laser on Thyroid Gland of Gamma-Irradiated Rats.

One inescapable feature of life on the earth is exposure to ionizing radiation. The thyroid gland is one of the most sensitive organs to gamma-radiation and endocrine disrupters. Low-level laser therapy (LLLT) has been used to stimulate tissue repair, and reduce inflammation. The aim of this study was to gauge the value of using Helium-Neon laser to repair the damaged tissues of thyroid gland after gamma-irradiation. Albino rats were used in this study (144 rats), divided into control, gamma, laser, and gamma plus laser-irradiated groups, each group was divided into six subgroups according to time of treatment (total six sessions). Rats were irradiated once with gamma radiation (6 Gy), and an external dose of laser (Wavelength 632.8 nm, 12 mW, CW, Illuminated area 5.73 cm(2), 2.1 mW cm(-2) 120 s, 1.4 J, 0.252 J cm(-2)) twice weekly localized on thyroid region of the neck, for a total of six sessions. Animals were sacrificed after each session. Analysis included thyroid function, oxidative stress markers, liver function and blood picture. Results revealed improvement in thyroid function, liver function and antioxidant levels, and the blood cells count after LLLT.

Effect of Iodine Supplementation on Iodine Status, Thyroid Function, Body Composition, and Resting Metabolic Rate in Women

Decreased dietary iodine intake may predispose women to increased body weight and thyroid dysfunction. Purpose: to investigate efficacy of iodine supplementation in 18-45 year old women diagnosed with iodine deficiency in improving thyroid function, body composition and increasing resting metabolic rate (RMR) during a 6-month randomized, double-blind placebo-controlled trial. Study: non-pregnant women without a history of thyroid disease were randomized into two groups: iodine (IG, n=65, Iodoral® 12.5 mg iodine) or placebo (PG, n=38, glucose). Assessments included body mass index (BMI), RMR, body composition analysis (Dual Energy X-ray Absorptiometry-DXA), 24-hour urinary iodine (UI), % iodine saturation (IS), sodium iodide symporter (NIS) ratio, and concentrations of free thyroxine (T4), free triiodithyronine (T3), thyroid stimulating hormone (TSH) and thyroid-peroxidase antibody (TPOab). Baseline data (N=108) showed mean UI of 35.52mg/24hr vs >44 mg/24hr mean % IS 70.93% vs >90% and mean NIS ratio 27.86 vs 28-74, between study population and expected mean, respectively, indicating iodine deficiency. Of those completing study (n=35), UI increased from 34.1 to 37.7 mg/24hr (p=0.29) in IG (n=10) vs 32.0 to 34.8 mg/24hr (p=0.21) in PG (n=19), % IS increased from 67 to 75% (p=0.28) in IG (n=10) vs 63 to 70 (p=0.17) in PG (n=19), NIS ratio increased from 26.7 to 37.1 (p=0.16) in IG (n=10) vs 30.2 to 34.8 (p=0.34) in PG (n=18), and RMR increased from 1541 to 1595.5 Kcals (p=0.04) in IG (n=14) vs 1594-1643 Kcals (p=0.62) in PG (n=21). Iodine supplementation may improve iodine status, thyroid function and RMR in young women.

Selenium Supplementation in Pregnancy Did Not Improve Thyroid Function or Thyroid Autoimmunity

Clinical ThyroidologyVol. 27, No. 2 SummariesSelenium Supplementation in Pregnancy Did Not Improve Thyroid Function or Thyroid AutoimmunityElizabeth N. PearceElizabeth N. PearceSearch for more papers by this authorPublished Online:15 Feb 2015https://doi.org/10.1089/ct.2015;27.30-31AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Selenium Supplementation in Pregnancy Did Not Improve Thyroid Function or Thyroid Autoimmunity." Clinical Thyroidology, 27(2), pp. 30–31FiguresReferencesRelatedDetailsCited bySelenium Supplementation in Pregnancy-Maternal and Newborn OutcomesJournal of Nutrition and Metabolism, Vol. 2022 Volume 27Issue 2Feb 2015 InformationCopyright 2015 American Thyroid Association, Inc.To cite this article:Elizabeth N. Pearce.Selenium Supplementation in Pregnancy Did Not Improve Thyroid Function or Thyroid Autoimmunity.Clinical Thyroidology.Feb 2015.30-31.http://doi.org/10.1089/ct.2015;27.30-31Published in Volume: 27 Issue 2: February 15, 2015PDF download

The effect of regular physical exercise on the thyroid function of treated hypothyroid patients: An interventional study at a tertiary care center in Bastar region of India

Background: Thyroid hormone is a key substance in normal homeostasis, having variable influence on cell metabolism on different organs. Hypothyroidism is common, potentially serious, often clinically overlooked, readily diagnosed by laboratory testing, and eminently treatable. Aim: This study was conducted with the aim of finding the effect of regular physical exercise of medium-intensity on thyroid function in patients already undergoing treatment for hypothyroidism. Materials and Methods: A total of 20 ambulatory treated hypothyroid patients were included in the study. Serum samples were collected and evaluated for triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) both before and after 3 months of daily 1 h physical exercise, from those patients doing exercise and from those who did not do any physical exercise. T-test was used to find a significant difference between the two groups. Results: Serum TSH was found to be significantly decreased in patients of regular exercise group postinterventionally (P < 0.001) when compared with nonexercise group (P = 0.43). Serum T3 and T4 were also found to be significantly raised in regular exercise group postinterventionally (P = 0.007 and P < 0.001 respectively) but not in nonexercise group (P = 0.92 and P = 0.73 respectively). On inter group comparison significant decrease in TSH was found in regular exercise group (P = 0.002) and significant increase was found in levels of T3 (P = 0.002) and T4 (P = 0.001) in regular exercise group. Mean weight was also found to be decreased in regular exercise group postinterventionally. Conclusion: Every hypothyroid patient should do regular physical exercise along with thyroxine replacement to improve thyroid function.

The WOMED model of benign thyroid disease: Acquired magnesium deficiency due to physical and psychological stressors relates to dysfunction of oxidative phosphorylation

BackgroundThe aim of this study was to discern whether a relation between biochemical parameters, sonography and musculoskeletal data exists in cases of hyperthyroidism and whether they are modifiable through supplementation with selenomethionine and magnesium citrate as well as by acupuncture and manual medicine methods. ResultsA direct correlation between whole blood selenium and serum magnesium was found in subjects without thyroid disease and in menopausal women while it was reversed in cases of thyroid diseases as well as in patients with depression, infection, and in infertile women. Vascularization indices were elevated in cases of newly diagnosed benign thyroid diseases. Musculoskeletal changes i.e. lateral tension and idiopathic moving toes, as well as situations of physical and psychological stress and minor trauma and infection led to an increase of vascularization. Magnesium levels correlated negatively with these two conditions. The supplementation brought a reduction of the vascularization indices and reduced the incidence of idiopathic moving toes. Treatment of lateral tension required manual medicine methods and acupuncture (gastrocnemius). A small subgroup of patients showed a further reduction of hyper-vascularization after receiving coenzyme Q10. ConclusionsWe interpret the elevated thyroid vascularization and low magnesium levels as signs of an inflammatory process related to the musculoskeletal changes. Improvement of thyroid function and morphology can be achieved after correcting the influence of stressors together with the supplementation regime. We hypothesize that the central biochemical event in thyroid disease is that of an acquired, altered mitochondrial function due to deficiency of magnesium, selenium, and coenzyme Q10.

Chinese herbal medicine for subacute thyroiditis: a systematic review of randomized controlled trials

ObjectiveTo evaluate the effectiveness and safety of Chinese herbal medicine (CHM) in the treatment of subacute thyroiditis. MethodsRandomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and graded the quality of evidence with GRADE profiler software. ResultsTwenty one studies were included. CHM was superior to Western Medicine (include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism (P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate. CHM plus Western Medicine were superior to Western Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate, while no statistical differences (P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group (relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias. ConclusionCHM (particularly CHM combined with Western Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs, reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.

Gamma-aminobutyric acid improves oxidative stress and function of the thyroid in high-fat diet fed mice

Redox status and thyroid functions of diet-induced obesity (DIO) and DIO-resistant (DIO-R) mice from 20-week high-fat diet-fed (HFD) mice were studied (study I). Whether antiobesity action of gamma-aminobutyric acid (GABA) in HFD mice was related to its antioxidative action or improvement in thyroid function was also examined (study II) by GABA in drinking water (0.2, 0.12 and 0.06%). In DIO mice, thyroid stimulating hormone (TSH) remarkably increased, free thyroid hormones (THs) decreased, thyroid structures deformed and expressions of THs synthesis-specific and thyroid antioxidative markers, THs receptors β and deiodinases in hypothalamus and liver decreased. DIO-R mice showed normalized TSH, increased THs and its functions. Three GABA treatments normalized TSH, while 0.2% and 0.12% GABA treatments restored redox status, raised THs excretions and functions. Consequently, Down-regulated thyroid and THs functions in DIO mice accounted for obesity. GABA could prevent obesity by ameliorating oxidative stress and HFD-disrupted functions of thyroid and THs.

Glucose variability before and after treatment of a patient with Graves’ disease complicated by diabetes mellitus: Assessment by continuous glucose monitoring

A 48-year-old woman was diagnosed and treated for Graves' disease (GD) in 1999 but she discontinued treatment at her own discretion. In 2011, she was admitted to a local hospital for management of thyrotoxic crisis. Treatment with propylthiouracil, iodide potassium (KI), and prednisolone (PSL) was started, which resulted in improvement of the general condition. PSL and KI were discontinued before she was transferred to our hospital. At the local hospital, fasting plasma glucose (FPG) was 212 mg/dL and hemoglobin A1c concentration was 11.2%; intensive insulin therapy had been instituted. Upon admission to our hospital, FPG level was 122 mg/dL, but insulin secretion was compromised, suggesting aggravation of thyroid function and deterioration of glycemic control. The FPG level increased to 173 mg/dL; continuous glucose monitoring (CGM) identified dawn phenomenon at approximately 0400 h. Resumption of KI resulted in improvement of FPG and disappearance of the dawn phenomenon, as assessed by CGM. These results indicate that in patients with compromised insulin secretion, hyperthyroidism can induce elevation of not only postprandial blood glucose, but also FPG level due to the dawn phenomenon and that the dawn phenomenon can be alleviated with improvement in thyroid function. To our knowledge, no studies have assessed glucose variability by CGM before and after treatment of Graves' disease. The observations made in this case shed light on the understanding of abnormal glucose metabolism associated with Graves' disease.

Alterations in thyroid function among the different polycystic ovary syndrome phenotypes

The study evaluates the prevalence of subclinical thyroid dysfunction in infertile PCOS patients, according to the different PCOS phenotypes and to examine whether insulin sensitizers in insulin resistant (IR) PCOS patients may improve thyroid function. The study population consisted of all PCOS patients, attending the infertility and IVF unit of Department of Pediatrics, Obstetrics and Reproductive Medicine of University of Siena, Italy, and compared them to regularly cycling, healthy, infertile controls. Upon admission, blood was drawn from all patients during the early follicular phase, for complete hormonal and metabolic profiles. In IR-PCOS patients treated with insulin sensitizers, blood was drawn again after 6 months. PCOS patients had a significantly higher prevalence of subclinical thyroid dysfunction compared to infertile controls. While no significant association was detected between TSH value and the presence of hyperandrogenism, overweight and obese PCOS patients, as well as IR PCOS patients showed significantly higher prevalence of subclinical thyroid dysfunction. Moreover, among IR PCOS patients, 6 months treatment with insulin sensitizers significantly reduces TSH levels. Infertile PCOS patients have a high prevalence of subclinical thyroid dysfunction, which may be successfully treated in IR PCOS patients by insulin sensitizers.

Use of Radiofrequency Ablation in Benign Thyroid Nodules: A Literature Review and Updates

Successful thermal ablation using radiofrequency has been reported in various tumors including liver or kidney tumors. Nonsurgical minimally invasive ablative therapy such as radiofrequency ablation (RFA) has been reported to be a safe and efficient treatment option in managing symptomatic cold thyroid nodules or hyperfunctioning thyroid nodules. Pressure and cosmetic symptoms have been shown to be significantly improved both in the short and long terms after RFA. For hyperfunctioning thyroid nodules, RFA is indicated for whom surgery or radioiodine are not indicated or ineffective or for those who refuse surgery or radio-iodine. Improvement of thyroid function with decreased need for antithyroid medications has been reported. Complication rate is relatively low. By reviewing the current literature, we reported its efficacy and complications and compared the efficacy of RFA relative to other ablative options such as ethanol ablation and laser ablation.

About the Evaluation of Liver Disease by the Monitoring of Mahalanobis Distance: Examination for Acute Hepatic Failure

Healthful aging with active participation in society are global public health priorities. Sender physique and high productivity levels absent clinical disease are widely recognized features of healthful aging. During studies of obesity in mice, we found that feeding of a purified probiotic microbe, Lactobacillus reuteri, forestalled typical old age-associated weight gain and lethargy, and instead conveyed physical features of much younger mice. We hypothesized that these retained features of youth may be related to increased thyroid gland activity. We subsequently discovered elevated levels of serum T4 and larger thyroid glands in slender one-year-old recipients of probiotic microbes, when compared with their age-matched obese control subjects. Oral L. reuteri treatment also preserved thyroid follicle epithelial height, a key histologic feature of thyroid gland activity, which relied mechanistically upon bacteria-triggered anti-inflammatory CD25+ regulatory T cells. These data from animal models suggest that probiotic microbe supplementation may be used to stimulate beneficial host immune interactions with improved thyroid function and more healthful aging.

P03.01. Acupuncture's Effectiveness at Treating Subclinical Hypothyroid Disease via the HPA/HPT Axis: A Multiple Case Series

Focus Area: Integrative Approaches to CarePurpose:Subclinical hypothyroid disease (SHypo) is defined as having serum thyroid-stimulating hormone (TSH) concentration above the normal reference range while serum free thyroxine (FT4) and free triiodothyronine (FT3) are within reference range. It is estimated that 4% to 10% of the general population has subclinical hypothyroidism, increasing to 20% in women over 60 years of age. The current treatment recommendation for SHypo with TSH levels between 3 MIU/L and 5 mIU/L is to monitor levels every 6 to 12 months. Studies have shown that levothyroxine is not effective for this TSH group. Based on Hans Selye's general adaption theory (GAS), it is known that acute and chronic stress can affect thyroid function via the hypothalamus-pituitary-adrenal (HPA) and the hypothalamus-pituitary-thyroid (HPT) axes. Acupuncture can reduce the body's stress response and therefore should improve thyroid function. This research was conducted to determine if acupuncture is a viable treatment option for SHypo.Methods:Two cases were studied for replication. The female patients, aged 34 and 44 years, received 12 Japanese Meridian acupuncture constitutional treatments and moxibustion once per week. Serum TSH, FT4, FT3, salivary cortisol, Perceived Stress Scale–10 (PSS-10) were measured at pretreatment, mid-treatment, and posttreatment. Number of hypothyroid symptoms present (Zulewski index) were assessed prior to each treatment. All measurements were analyzed for changes over time and cross-case comparison.Results:Both patients had decreases in TSH and number of hypothyroid symptoms present and increases in total cortisol load and morning diurnal cortisol rhythm. Both patients reported improvements in bowel movements and menstruation.Conclusion:From this study, it can be theorized that acupuncture is a viable treatment option for SHypo; however, more rigorous larger-scale research studies need to be conducted to validate and extend these findings.

Low-level laser in the treatment of patients with hypothyroidism induced by chronic autoimmune thyroiditis: a randomized, placebo-controlled clinical trial

Chronic autoimmune thyroiditis (CAT) is the most common cause of acquired hypothyroidism, which requires lifelong levothyroxine replacement therapy. Currently, no effective therapy is available for CAT. Thus, the objective of this study was to evaluate the efficacy of low-level laser therapy (LLLT) in patients with CAT-induced hypothyroidism by testing thyroid function, thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), and ultrasonographic echogenicity. A randomized, placebo-controlled trial with a 9-month follow-up was conducted from 2006 to 2009. Forty-three patients with a history of levothyroxine therapy for CAT-induced hypothyroidism were randomly assigned to receive either 10 sessions of LLLT (830 nm, output power of 50 mW, and fluence of 707 J/cm(2); L group, n=23) or 10 sessions of a placebo treatment (P group, n=20). The levothyroxine was suspended 30 days after the LLLT or placebo procedures. Thyroid function was estimated by the levothyroxine dose required to achieve normal concentrations of T3, T4, free-T4 (fT4), and thyrotropin after 9 months of postlevothyroxine withdrawal. Autoimmunity was assessed by measuring the TPOAb and TgAb levels. A quantitative computerized echogenicity analysis was performed pre- and 30 days postintervention. The results showed a significant difference in the mean levothyroxine dose required to treat the hypothyroidism between the L group (38.59 ± 20.22 μg/day) and the P group (106.88 ± 22.90 μg/day, P<0.001). Lower TPOAb (P=0.043) and greater echogenicity (P<0.001) were also noted in the L group. No TgAb difference was observed. These findings suggest that LLLT was effective at improving thyroid function, promoting reduced TPOAb-mediated autoimmunity and increasing thyroid echogenicity in patients with CAT hypothyroidism.

Hürthle Cells Predict Hypothyroidism in Interferon-γ Transgenic Mice of Different Genetic Backgrounds

Hürthle cells have long been described in Hashimoto thyroiditis but remain of undetermined significance. We have previously shown that Hürthle cells and hypothyroidism develop in C57BL/6J mice expressing interferon-γ (IFNγ) in the thyroid. To assess the influence of genetic backgrounds on Hürthle cell development, we crossed C57BL/6J IFNγ transgenic mice to 14 strains and analyzed thyroid histopathology and function in a cohort of 389 mice (225 transgenic and 164 wild type) using a multiple linear regression model that also included strain, sex, genotype, and major histocompatibility complex haplotype. We then queried the Johns Hopkins surgical pathology electronic archive for "Hashimoto" and/or "thyroiditis" keywords, reviewed the reports, and reexamined the Hashimoto slides. Hürthle cells were markedly affected by the genetic background: they were prominent and associated with hypothyroidism in the C57BL/6J, C57BL/6ByJ, C57BL/10J, C57BLKS/J, C57L/J, C58/J, and BPN/3J IFNγ transgenic strains, whereas they are mild or absent in the BPH/2J, BPL/1J, LP/J, CBA/J, Balb/cJ, DBA/1J, and NOD/ShiLtJ strains. Hürthle cells were the strongest predictor of hypothyroidism after adjusting for all the other covariates in the regression model. Interestingly, transgenic mice of the BPL/1J, DBA/1J, and NOD/ShiLtJ strains developed a marked accumulation of intrathyroidal brown adipocytes that was significantly associated with improved thyroid function. Hürthle cells were mentioned in 23% of the Hashimoto reports but increased to 79% upon our slide review. This study reports a novel association of Hürhtle cells and brown adipocytes on thyroid function that should prompt a reconsideration of their significance and role in pathogenesis of autoimmune thyroiditis.

The potential dangers of supplements and herbal products marketed for improved thyroid function

The trend of using natural products has increased significantly in recent decades in the USA. A national health survey by the CDC in 2007 estimated that Americans spent US $34 billion on herbal sup...

Short-Term Effects of β-adrenergic Antagonists and Methimazole in New-Onset Thyrotoxicosis Caused by Graves' Disease

β-adrenergic antagonists (β-blockers) are often used to attenuate the hyperadrenergic symptoms of Graves' disease (GD), including palpitation. Although β-blockers reduce the heart rate, cardiac output and oxygen consumption, no firm evidence exists regarding the effects of combined therapy with β-blockers and anti-thyroid drugs. The objective is to elucidate the effects of β-blockers on anti-thyroid drug therapy in GD. Patients newly diagnosed with mild GD were randomly assigned to receive methimazole with or without β-blockers in a prospective multi-center survey. The heart rate and thyroid function were measured and the quality of life was assessed using original and SF-36 questionnaires at 0 and 4 weeks. A total of 28 patients were enrolled in the study. Fourteen patients (one man, 13 women) were randomly assigned to the group treated with β-blockers and 14 patients (one man, 13 women) were randomly assigned to the group not treated with β-blockers. Although no significant differences in the improvement of thyroid function were observed between the two groups, the heart rates improved more significantly in the group treated with β-blockers. Specific symptoms, such as easy fatigability and shortness of breath, also improved more significantly with the β-blocker treatment. In addition, 'physical functioning' assessed with the SF-36 questionnaires significantly improved only in the group treated with β-blockers. Although β-blockers may not reinforce the effects of anti-thyroid drugs on thyroid function, at least during the course of one month, they are effective in reducing heart rates and ameliorating specific symptoms in patients with mild GD.

Iodine intake in human nutrition: a systematic literature review

The present literature review is a part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. The main objective of the review is to assess the influence of different intakes of iodine at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation) in order to estimate the requirement for adequate growth, development, and maintenance of health. The literature search resulted in 1,504 abstracts. Out of those, 168 papers were identified as potentially relevant. Full paper selection resulted in 40 papers that were quality assessed (A, B, or C). The grade of evidence was classified as convincing, probable, suggestive, and no conclusion. We found suggestive evidence for improved maternal iodine status and thyroid function by iodine supplementation during pregnancy. Suggestive evidence was found for the relationship between improved thyroid function (used as an indicator of iodine status) during pregnancy and cognitive function in the offspring up to 18 months of age. Moderately to severely iodine-deficient children will probably benefit from iodine supplementation or improved iodine status in order to improve their cognitive function, while only one study showed improved cognitive function following iodine supplementation in children from a mildly iodine-deficient area (no conclusion). No conclusions can be drawn related to other outcomes included in our review. There are no new data supporting changes in dietary reference values for children or adults. The rationale for increasing the dietary reference values for pregnant and lactating women in the NNR5 needs to be discussed in a broader perspective, taking iodine status of pregnant women in the Nordic countries into account.