BackgroundOne of the most common causes of hypothyroidism is Hashimoto´s Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren´s syndrome.Material and MethodsHT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected.
A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute.ResultsXerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant.ConclusionsThe patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions.
Key words:Thyroid, salivary gland, xerostomia.
Objective: Several lines of evidence suggest that the symptoms of hypothyroidism, including psychological symptoms and metabolic effects, persist in a significant percentage of patients treated with levothyroxine (L-T4). A hypothesis to explain this phenomenon is that the triiodothyronine (L-T3) serum levels may not be completely normalized. This study aimed to compare the level of serum free T3 (FT3) in patients who are biochemically euthyroid after L-T4 monotherapy with different underlying causes of hypothyroidism. Material and Methods: This cross-sectional study was conducted on patients with hypothyroidism who received L-T4 monotherapy and were biochemically euthyroid. The serum levels of thyroid-stimulating hormone (TSH), free T4 (FT4), FT3, and FT3/FT4 ratio were measured in these patients. Patients were divided into three groups based on the cause of hypothyroidism (radioiodine therapy, thyroidectomy and Hashimoto), and the results of biochemical tests of the thyroid were compared in three groups. Results: Of the 78 patients studied, 12 (15.4%) cases were male, and 66 (84.6%) cases were female. Among the variables studied, only the mean value of FT3 was significantly different in the three groups (p=0.006), where the highest mean value was seen in the Hashimoto group, and the lowest mean value was seen in the radioiodine therapy group. Conclusion: The results of this study showed that although hypothyroidism patients can be optimally treated with L-T4 alone, in many of these patients, the level of FT3 will not be in therapeutic range, and the mean serum FT3 levels in these patients could be related to their hypothyroidism causes.
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