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Hashimoto's Thyroiditis and Vitamin D - multiple studies

Most studies agree: Hashimoto's Thyroiditis is associated with low Vitamin D

H vs H

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HASHIMOTO'S: IS IT A THYROID PROBLEM OR AN IMMUNE PROBLEM?
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See also Vitamin D Life

Thyroid and parathyroid category starts with the following


Vitamin D supplementation (1200-4000 IU) reduced HT - Sept 2015

Is vitamin D related to pathogenesis and treatment of Hashimoto's thyroiditis?
Hell J Nucl Med. 2015 Sep-Dec;18(3):222-7.
Mazokopakis EE1, Papadomanolaki MG, Tsekouras KC, Evangelopoulos AD, Kotsiris DA, Tzortzinis AA.
1Department of Internal Medicine, Naval Hospital of Crete, K. Mitsotaki 36, Chania 73 132,Crete, Greece. emazokopakis at yahoo.gr.

OBJECTIVE:
The aim of this study was to investigate vitamin D status by measuring serum 25(OH)D levels in euthyroid patients with Hashimoto's thyroiditis (HT) who lived and worked on the sunny island of Crete, Greece, and to evaluate whether vitamin D3 supplementation is beneficial for the management of HT patients with vitamin D deficiency.
SUBJECTS AND METHODS:
We studied 218 HT patients, euthyroid Caucasian Cretan Greek citizens: 180 females and 38 males. Among these patients, 186 (85.3%) had vitamin D deficiency defined as serum 25(OH)D levels < 30 ng/mL. The mean age of all these 218 HT patients was 35.3 ± 8.5 years. The mean age of the 186 vitamin D deficient HT patients (173 females and 13 males) was 37.3 ± 5.6 years. The 186 vitamin D deficient HT patients received vitamin D3 (cholecalciferol, CF) orally, 1200-4000 IU, every day for 4 months aiming to maintain serum 25(OH)D levels ≥ 40 ng/mL. Anthropometric characteristics (height, weight, waist circumference), systolic and diastolic blood pressure, serum concentration of 25(OH)D, thyrotropin (TSH), free thyroxine (FT4), anti-thyroid peroxidase (anti-TPO), antithyroglobulin (anti-TG), calcium and phosphorus levels and thyroid and kidney sonographic findings were recorded and measured before and after CF administration.
RESULTS:
There was a significant negative correlation only between serum 25(OH)D levels and anti-TPO levels among all 218 HT patients. Also, anti-TPO levels were significantly higher in 186/218 vitamin D deficient HT patients compared to 32/218 HT patients with no vitamin D deficiency (364 ± 181IU/mL versus 115.8 ± 37.1IU/mL, P<0.0001).
Supplementation of CF in 186 vitamin D deficient HT patients caused a significant decrease (20.3%) in serum anti-TPO levels.
Although at the end of the 4 months period of the study body mass index (BMI), serum anti-TG and TSH levels decreased by 2.2%, 5.3% and 4% respectively, these differences were not significant.
No changes in the sonographic findings were observed.
CONCLUSION:
The majority (85.3%) of the Greek Caucasian patients with HT studied who lived and worked in Crete had low serum 25(OH)D levels inversely correlated with serum anti-TPO thyroid antibodies. After 4 months of CF supplementation in the 186 HT patients with vitamin D deficiency, a significant decrease (20.3%) of serum anti-TPO levels was found. These findings suggest that vitamin D deficiency may be related to pathogenesis of HT and that its supplementation could contribute to the treatment of patients with HT.
PMID: 26637501
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Hashimoto's Thyroiditis 2.3X more likely if low vitamin D - June 2015

J Clin Res Pediatr Endocrinol. 2015 Jun 5;7(2):128-33. doi: 10.4274/jcrpe.2011.
Vitamin D Deficiency and Hashimoto's Thyroiditis in Children and Adolescents: a Critical Vitamin D Level for This Association?
Evliyaoğlu O1, Acar M, Özcabı B, Erginöz E, Bucak F, Ercan O, Kucur M.
Author information
1İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 533 633 15 64 E-mail: olcayevliyaoglu at hotmail.com.

OBJECTIVE: Vitamin D has been suggested to be active as an immunomodulator in autoimmune diseases such as Hashimoto's thyroiditis (HT). The goal of the present study was to investigate the vitamin D status in HT patients.

METHODS: This prevalence case-control study was conducted on 90 patients with HT (of ages 12.32±2.87 years) and 79 age-matched healthy controls (11.85±2.28 years). Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured in all 169 subjects.

RESULTS: The prevalence of vitamin D deficiency in HT patients (64 of 90; 71.1%) was significantly higher than that in the control group (41 of 79; 51.9%) (p=0.025). Mean serum 25(OH)D3 level in the HT group was significantly lower compared to the control group (16.67±11.65 vs. 20.99±9.86 ng/mL, p=0.001). HT was observed 2.28 times more frequently in individuals with 25(OH)D3 levels <20 ng/mL (OR: 2.28, CI: 1.21-4.3).

CONCLUSION: Vitamin D deficiency is associated with HT in children and adolescents.
Levels lower than 20 ng/mL seem to be critical.
The mechanism for this association is not clear.

PMID: 26316435


92% of Hashimoto’s patients had Vitamin D deficiency - Jan 2015

hypothyroidmom


Relative Vitamin D Insufficiency in Hashimoto's Thyroiditis (2011)

Gonca Tamer,1; Safiye Arik,2; Ismet Tamer,3 and Damla Coksert2
1 Department of Endocrinology and Metabolism, Goztepe Education and Research Hospital, Istanbul, Turkey. hgtamer at yahoo.com
2 Department of Internal Medicine, Goztepe Education and Research Hospital, Istanbul, Turkey.
3 Department of Family Medicine, Kartal Education and Research Hospital, Istanbul, Turkey.

Background: Vitamin D insufficiency, defined as serum levels of 25-hydroxyvitamin D [25(OH)D3] lower than 30?ng/mL, has been reported to be prevalent in several autoimmune diseases such as multiple sclerosis and type 1 diabetes mellitus. The goal of the present study was to assess whether vitamin D insufficiency is also a feature of Hashimoto's thyroiditis (HT).

Methods: We performed a prevalence case–control study that included 161 cases with HT and 162 healthy controls.
Serum levels of 25(OH)D3, calcium, phosphorus, and parathyroid hormone were measured in all 323 subjects.

Results: The prevalence of vitamin D insufficiency in HT cases (148 of 161, 92%) was significantly higher than that observed in healthy controls (102 of 162, 63%, p?<?0.0001). Among HT cases, the prevalence rate of vitamin D insufficiency showed a trend to be higher in patients with overt hypothyroidism (47 of 50, 94%) or subclinical hypothyroidism (44 of 45, 98%) than in those with euthyroidism (57 of 66, 86%), but the differences were not significant (p?=?0.083).

Conclusion: Vitamin D insufficiency is associated with HT. Further studies are needed to determine whether vitamin D insufficiency is a casual factor in the pathogenesis of HT or rather a consequence of the disease.


Hashimoto's autoimmune thyroiditis and vitamin D deficiency. Current aspects. (Feb 2014)

Hell J Nucl Med. 2014 Feb 21. pii: s002449910120.
Mazokopakis EE1, Kotsiris DA.
Iroon Polytechniu 38A, Chania, 73 132, Crete, Greece. emazokopakis at yahoo.gr.

Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroid disease caused by an interaction between genetic factors and environmental conditions, both of which are not yet completely understood. The significant association between vitamin D deficiency and HT has been investigated regarding the immune role of this hormone. In HT, an immunologic reaction is triggered when thyrocytes express major histocompatibility complex (MHC) class II surface HLA-DR antigens, a process induced by the production from T helper (Th)1 type lymphocytes, of inflammatory cytokines (especially IFN-γ), which may be inhibited by 1,25[OH]2D. Genetic polymorphism of vitamin D receptor (VDR), binding protein (DBP) and of 1α-hydroxylase (CYP1α) may also predispose to the development of HT.

Considering current evidence, presented in this review, screening for vitamin D deficiency and careful vitamin D supplementation, when required, may be recommended for patients with HT.

Further research is needed in patients with HT in order to investigate the mechanisms by which vitamin D affects autoimmunity and also to evaluate the cost-effectiveness of vitamin D supplementation and to suggest the possible optimal dose treatment.
PMID: 24563883
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Risk of Hashimoto's Thyroiditis reduced 19 percent for each 5 ng increase in vitamin D – March 2014

The association between serum 25OHD levels and hypothyroid Hashimoto’s thyroiditis
Journal of Endocrinological Investigation, March 2014
Nasrin Mansournia, Mohammad Ali Mansournia, Sandra Saeedi, Jafar Dehghan

Background
Vitamin D is shown to be a potent immunomodulator. Considering the potential role of low serum vitamin D levels in autoimmune disorder, we evaluated the association between Hashimoto’s thyroiditis (HT) (with subclinical or overt hypothyroidism) and serum 25-hydroxyvitamin D (25OHD) levels in an Iranian population.
Methods
A total number of 86 individuals were enrolled. The case group included 41 patients with hypothyroid HT (overt or subclinical). The control group comprised 45 healthy euthyroid persons. Serum 25OHD levels were measured in all subjects.
Results
The case:control ratio of geometric means of 25OHD levels was 0.66 (95 % CI: 0.49–0.90; P = 0.008). There was a significant inverse association between serum 25OHD levels and HT (OR: 0.81 for 5 ng/ml increase in 25OHD level, 95 % CI: 0.68–0.96; P = 0.018). This association remained significant after adjustment for potential confounding factors including age, sex and BMI.
Conclusions
Our study suggested that higher serum 25OHD levels was associated with decreased risk of HT so that each 5 ng/ml increase in the serum 25OHD levels results in 19 % decrease in odds of HT.
References

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No difference in Frequency of Hashimoto's thyroiditis with Vitamin D level in Turkey - 2014

Note: perhaps no difference because very few people in Turkey have enough vitamin D
Frequency of Hashimoto's thyroiditis in women with vitamin D deficiency: A cross sectional study
American Journal of Internal Medicine, 2014; 2(3): 44-48
Published online May 20, 2014 (http://www.sciencepublishinggroup.eom/j/ajim) doi: 10.11648/j.ajim.20140203.12
Tayyibe Saler , §akir Ozgiir Keskek ' , Suleyman Ahbab , Sedat Cakir , Giilay Ortoglu , Mehmet Bankir , Omer Arif Pamuk
department of Internal Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey 2Department of Internal Medicine, Numune Training and Research Hospital Hospital, Adana, Turkey 3Department of Internal Medicine, Haseki Training and Research Hospital Hospital, Istanbul, Turkey drkeskek at yahoo.com (§. O. Keskek)

Objective: Vitamin D deficiency has been reported to be associated with different autoimmune diseases such as type 1 diabetes, rheumatoid arthritis and Crohn's disease. The aim of this study was to evaluate the association between Hashimoto's thyroiditis and vitamin D deficiency.
Material and Methods: This case-control study was carried out in tertiary hospitals from 2011 to 2012. A total of 198 female subjects were included, of whom 84 and 114 participants were healthy or had vitamin D deficiency, respectively. Serum vitamin D levels, parathyroid hormone concentrations thyroid hormone levels and thyroid auto-antibodies were measured in all subjects.
Results: Demographic characteristics of participants were not significantly different between the control and study groups (p > 0,05). Frequency of Hashimoto's thyroiditis was similar in both groups (p = 0.958). Thyroid auto-antibodies did not correlate with vitamin D levels (p > 0.05).

Conclusion: Although vitamin D deficiency is associated with some of autoimmune diseases, Hashimoto's thyroiditis was not found to be associated with vitamin D deficiency in female patients in this study.
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Hypothyroidism And Hashimoto's Thyroiditis - book 2013 - includes Vitamin D

A Groundbreaking, Scientific And Practical Treatment Approach
Amazon Dr. Zaidi
Note: I have not read this book, but his other books on Vitamin D are great


5 free videos on Hashimoto's Thyroiditis - June 2016

Unknown if Vitamin D will be discussed
22 million people in the US have Hashimoto’s disease
Symptoms of Hashimoto’s don’t often show early, and can take 8-10 years to be detected, but may include:
Adrenal exhaustion, Weight gain, Cold hands and feet, Fatigue, Dry skin, Brittle nails
Bloating, Anxiety, Thinning, brittle hair, Muscle aches, Joint pain, Heavy menstrual periods
Panic attacks, Short term memory loss, Constipation, Depression, Insomnia
http://healinghashimotossummit.com/ 5 are free, all 21 videos cost $99


Low vitamin D status is associated with hypothyroid Hashimoto's thyroiditis. - July 2016

Hormones (Athens). 2016 Jul 11. doi: 10.14310/horm.2002.1681. [Epub ahead of print]
Kim D Department of Internal Medicine, Dankook University College of Medicine, Department of Kinesiologic Medical Science, Graduate, Dankook University, Cheonan, 330-714, Republic of Korea.

OBJECTIVE:
The association of low vitamin D status with autoimmune thyroid disease (AITD), which includes Hashimoto's thyroiditis (HT) and Graves' disease (GD), is controversial. The aim of this study was to investigate the correlation between vitamin D insufficiency and AITD, HT, and GD.
DESIGN:
Our cross-sectional study included patients who visited a tertiary hospital for thyroid evaluation or follow-up. A total of 776 patients in whom serum 25-hydroxyvitamin D [25(OH)D], thyroid function, and anti-thyroid antibodies had been measured were analyzed retrospectively. Vitamin D insufficiency was defined as serum 25(OH)D level <75 nmol/L.
RESULTS:
The prevalence of vitamin D insufficiency was significantly higher in the 369 patients with AITD than in the 407 without AITD (46.1% vs. 37.1%, p=0.011), and higher in the 221 patients with HT than in those with GD or non-AITD (48.9% vs. 41.9%, 37.1%, p=0.017). Among HT cases, patients with overt hypothyroidism had a significantly higher prevalence of vitamin D insufficiency (60.4% vs. 44.1%, 21.7%, 37.1%, respectively, p <0.001) and lower 25(OH)D levels (80.1 ± 47.7 vs. 99.34 ± 61.2, 110.3 ± 69.9, 99.6 ± 53.7 nmol/L, respectively, p=0.009) compared with those with euthyroidism and subclinical hypothyroidism or those without AITD. Serum 25(OH)D levels were significantly negatively correlated with serum thyroid stimulating hormone (TSH) levels after adjustment for age, sex, body mass index, and sampling season (r= -0.127, p=0.013).
CONCLUSION:
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
Image
Figure 2. The mean serum 25(OH)D levels (A) and the prevalence of vitamin D insufficiency (B) according to the presence of Hashimoto’s thyroiditis and thyroid function state in patients with

  • Hashimoto’s thyroiditis. HT,
  • Hashimoto’s thyroiditis; ET, euthyroidism;
  • SCH, subclinical hypothyroidism;
  • OH, overt hypothyroidism.

* p<0.05 vs. non-AITD, p=0.009 between groups (A), p<0.001 between groups (B).

PMID: 27394703
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HASHIMOTO'S THYROIDITIS NOT ASSOCIATED WITH VITAMIN-D DEFICIENCY - March 2016

Endocr Pract. 2016 Mar 28. [Epub ahead of print]
Yasmeh J1, Farpour F1, Rizzo V1, Kheradnam S1, Sachmechi I1.
1From: Department of Medicine, Queens Hospital Center, Icahn School of Medicine at Mount Sinai.

OBJECTIVE:
Vitamin-D deficiency is associated with several autoimmune diseases. This study assessed whether vitamin-D deficiency is associated with Hashimoto's thyroiditis (HT).
METHODS:
Two groups of patients were selected in which serum 25(OH)D levels had been measured: (I) a study group of patients diagnosed with HT as indicated by thyroid antibodies, and (II) a healthy control group. Each group was separated by sex and then controlled for age and BMI. Groups' mean 25(OH)D levels were compared by ANOVA, and percent frequencies of vitamin-D sufficiency, insufficiency, and deficiency were compared with a Z-test. The correlation between 25(OH)D levels and TgAb, TPO, or TSH levels was also tested using Spearman's correlation test.
RESULTS:
The mean 25(OH)D levels for the HT and control groups were significantly different in females (30.75 vs. 27.56 ng/mL respectively) but not in males (14.24 vs. 13.26). HT females had a higher rate of vitamin-D sufficiency (51.7% vs. 31.1%) and a lower rate of insufficiency (48.3% vs. 68.9%) relative to control females. No such differences were found in the male groups. None of the females were vitamin-D deficient, but almost all males were. In the males, a significant (p=.016) positive correlation (rs=.436) between 25(OH)D and TgAb was observed.
CONCLUSION:
HT is not associated with higher rates of vitamin-D deficiency relative to in a control group.

PMID: 27018618
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Vitamin D levels of Autoimmune Thyroiditis are low in winter increaase over the years - Nov 2019

Vitamin D Status and Thyroid Autoantibodies in Autoimmune Thyroiditis
Horm Metab Res. 2019 Nov 25. doi: 10.1055/a-1023-4181. Epub ahead of print
Koehler VF1,2, Filmann N3, Mann WA1.

A lack of vitamin D seems to be related to autoimmune diseases including autoimmune thyroiditis (AIT). This study intends to determine the correlation between improvement of 25-hydroxyvitamin D 25(OH)D levels and AIT in patients from an outpatient endocrine clinic in Frankfurt, Germany. This study included 933 patients with thyroid peroxidase antibodies (anti-TPO-Ab) ≥34 kIU/l, including most patients with clear AIT due to a concurrent sonographic evidence of reduced echogenicity. We performed clinical evaluation and laboratory analysis at five points in time within two years retrospectively. Due to a high dropout rate within the observation period, we excluded the last two time points from analysis. Data from 933 AIT patients revealed 89% having vitamin D deficiency or insufficiency [25(OH)D <75 nmol/l] with a median 25(OH)D level of 39.7 nmol/l. At baseline, a weak inverse correlation between 25(OH)D and anti-TPO-Ab was observed during winter (rs=-0.09, p=0.048*), but not during summer time (p>0.2).
We discovered 58 patients having initially a 25(OH)D level < 75 nmol/l (median: 40.2 nmol/l), which improved over time to a 25(OH)D level ≥ 75 nmol/l (median: 83.2 nmol/l, p<0.0005***).
Simultaneously, the median anti-TPO-Ab level showed a significant decrease of 25% from 245.8 to 181.3 kIU/l (p=0.036*). A significant reduction of the median anti-TPO-Ab level of 9% was also observed in the control group, which consisted of patients having constantly a 25(OH)D level <75 nmol/l.
The result may suggest that in particular patients with 25(OH)D levels < 75 nmol/l benefit from an increase of 25(OH)D levels ≥ 75 nmol/l. Further prospective randomized controlled clinical trials are needed to finally evaluate if vitamin D has immunmodulatory effects in AIT.


HT: Importance of Vitamin D, Iodine, Selenium, and Gluten - April 2017

A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients.Points that need more investigation
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Attached files

ID Name Comment Uploaded Size Downloads
8127 Hashimoto thyroiditis I, Se, Vit D.pdf PDF 2017 admin 23 Jun, 2017 19:59 1.46 Mb 640
7829 Hashimoto’s autoimmune thyroiditis and vitamin D - 2014.pdf PDF 2014 admin 13 Mar, 2017 12:53 305.17 Kb 643
6877 H triggers.jpg admin 11 Jul, 2016 17:38 30.63 Kb 7900
6876 H vs H.jpg admin 11 Jul, 2016 17:37 42.88 Kb 8892
6875 HT treated by Vitamin D.pdf PDF 2015 admin 11 Jul, 2016 14:40 1.49 Mb 693
6874 HT Not.pdf PDF 2016 admin 11 Jul, 2016 14:28 206.80 Kb 909
6873 Kim F2.jpg admin 11 Jul, 2016 13:58 12.19 Kb 3270
6872 Kim HT July 2016.pdf PDF 2016 admin 11 Jul, 2016 13:58 517.82 Kb 728
3923 Hashimoto’s thyroiditis.pdf PDF 2014 admin 20 May, 2014 11:17 208.43 Kb 1104
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