A new hope for Hashimoto’s?

A new hope for Hashimoto’s?

Updates from European Congress of Endocrinology 2017

This year’s European Congress of Endocrinology offered a lot of topics on hormonal health and balance. Small proportion of these covered hypothyroidism and Hashimoto’s. Boost Health was a part of the scientific programme on Hashimoto’s, and we wanted to share some of the topics from that meeting, please keep in mind: these are all preliminary findings.

Selenium might be the real thing?

All of the research presented was done on a relatively small number of people, making it harder to predict how will it look when expanded to more and diverse people. Two most interesting findings about selenium:

1. It improves cognitive function

Selenium improved verbal divergent thinking, the process of thinking of many different possible solutions or answers to a problem or many different types of thinking. It also improves conceptual tracking, speed, attention and persistence in visually following any concept (e.g. connecting the numbers scattered on a big sheet of paper in ascending order). Selenium also lowered TPO antibody concentration. It was not shown whether the two were correlated. The study was small, done on 69 people only (1).

2. Selenium might have benefits for IVF pregnancy success rates

Several ongoing studies indicate Selenium is beneficial for management of autoimmune disorder. Carla Di Dato and team presented work on a “Serena Study” and have shown the benefits of taking selenium during pregnancy. It lowers Tg antibodies. They have followed a small number of women in natural pregnancies, as well as after in vitro fertilization. For IVF there were some striking results, although we should be cautious, since the numbers are small. They have measured pregnancy rate after embryo transfer. It happened in 3 out of 5 of persons taking selenium and in 1 out of 6 people on placebo (2).

Hypothyroid is not good for your heart

Several research groups reported an increased risk of heart diseases in people diagnosed with autoimmune thyroid disorders. Insulin resistance, changes in lipids, a combination of high levels of TSH and low T3 levels are contributing to the increased risk and worsening of heart diseases, while levothyroxine therapy seemingly improves the prognosis of patients with chronic heart failure (3–6).

Vitamin D story is still a mess

Vitamin D is a hormone that has an impact on many tissues in our body, and the thyroid gland is one of them. However, research data are still conflicting. One study used over 500 individuals and did not find any correlation between TSH, T3, T4 or vitamin D, the other study on 300 people, 155 of them non diagnosed showed there is a vitamin D deficiency in hypothyroid patients (7, 8). The differences in the results might come from different setup of experimentation, different geographic location or the way researchers included people in the study (sampling).

Hypothyroidism and pregnancy

In the past ten years clinical recommendations have improved awareness on pregnancy hypothyroidism prevalence has doubled, and is now at 2.4%, at the same time people that are not hypothyroid and receive thyroid treatment has also doubled, and is now 2.5% (9, 10).

Circadian rhythm break might lead to the autoimmune thyroid disease

Circadian rhythm, or our body’s internal clock, is connected to both hormones and the immune system and the onset of autoimmune diseases (11).

Therapy challenges

Researchers have asked themselves is a lifelong thyroid treatment really necessary for all? 9 in 10 patients that start with levothyroxine therapy continue for a long-term. But, if T4 treatment is discontinued 1 in 4 people relapses to hypothyroidism (12). Does that mean that 3 in 4 people currently taking medications are overrated? Probably it is very complicated to answer that question, and one needs to take in consideration the extent of functional thyroid that is left, demographics etc.

On the other hand, an increasing number of people demands (yes, the abstract mentioned word “aggressive” too) to be placed on T4+T3 combination. There are many logical benefits: this therapy will bring the levels of T3 and T4 to the most physiological levels, resembilng the average human body levels. Great news for the companies producing the drug, as they can scale up the production, and probably earn significantly more than with the same amount of T4. On the health benefit front, it seems that a combination of T3 and T4 therapy normalises cholesterol levels, but the data are still weak (13).

Hypothyroidism and teeth

Hypothyroidism seems to cause many teeth-related problems, such as periodontitis and lower quality of dentation. This problems might be due to a low amounts of calcium hormone produced by the thyroid.(14).

The future of hypothyroid therapy

The future of thyroid therapy is in stem cells, and in engineering tissue replacement for the destroyed thyroid (15).

Not much was said on the future of autoimmune part of the problem, but the research field is going strongly into the genetic modifications (CRISPR) and immune cell modifications, therefore I presume that is the next intended path.

In summary, there is hope. There is also a need for a more systematic approach in doing research on more patients, and trying to understand that our symptoms are best not to be ignored, but to be integrated in a wholesome image of our health.

 

One of our goals at BOOST Thyroid is to connect patients and research. We hope to be able to present on the next conference progress we have done.

Abstract references:

  1. Cognitive functions in primary hypothyroidism on selenium supplementation
  2. Selenium supplementation in the management of thyroid autoimmunity during pregnancy: results of the ‘Serena Study’ a randomized, double-blind, placebo-controlled trial
  3. Cardiovascular risk factors in patients with autoimmune thyroiditis
  4. Thyroid hormones deficiencies and poor outcome in chronic heart failure outpatients
  5. Hypothyroidism and heart failure outcome: a study with a long-term follow-up
  6. The correction of TSH with thyroid replacement therapy is associated with a better outcome in chronic heart failure patients
  7. Association of vitamin D levels with thyroid function and autoimmunity
  8. The assessment of influence vitamin D deficiency on the Hashimoto’s thyroiditis activity
  9. Improved diagnostics with increased treatment of hypothyroidism during pregnancy — a 10 year study of Finnish pregnant women
  10. Effect of subclinical hypothyroidism and autoimmunity on adverse pregnancy and neonatal outcome in our population
  11. Association of the Period3 clock gene polymorphism with autoimmune thyroid diseases
  12. Levothyroxine replacement therapy: once treatment is started, should it last indefinitely?
  13. T4/T3 combination therapy: is there a true effect?
  14. Primary underdosed hypothyroidism — parodontal implications
  15. Rebuilding your own thyroid from stem cells; the future therapy of hypothyroidism?