Hyperthyroidism during refeeding in anorexia nervosa

Rayment, Dane; Asfaha, Eden Asmerom; Babiker, Amir; Jaffa, Tony

doi:10.1002/eat.20964

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…However, studies of the risk of T1D in individuals with eating disorders are, according to our knowledge, lacking. Abnormal thyroid values occur in eating disorders [17], and starvation as well as re-feeding are associated with altered thyroid function [18]. Crohn's disease and celiac disease have been suggested to act as triggers for the development of eating pathology [19]–[20], and individuals with celiac disease are reported to be at increased risk for eating disorders [3].…”

Section: Introductionmentioning

confidence: 99%

The Increased Risk for Autoimmune Diseases in Patients with Eating Disorders

et al. 2014

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ObjectiveResearch suggests autoimmune processes to be involved in psychiatric disorders. We aimed to address the prevalence and incidence of autoimmune diseases in a large Finnish patient cohort with anorexia nervosa, bulimia nervosa, and binge eating disorder.MethodsPatients (N = 2342) treated at the Eating Disorder Unit of Helsinki University Central Hospital between 1995 and 2010 were compared with general population controls (N = 9368) matched for age, sex, and place of residence. Data of 30 autoimmune diseases from the Hospital Discharge Register from 1969 to 2010 were analyzed using conditional and Poisson regression models.ResultsOf patients, 8.9% vs. 5.4% of control individuals had been diagnosed with one or more autoimmune disease (OR 1.7, 95% CI 1.5–2.0, P<0.001). The increase in endocrinological diseases (OR 2.4, 95% CI 1.8–3.2, P<0.001) was explained by type 1 diabetes, whereas Crohn's disease contributed most to the risk of gastroenterological diseases (OR 1.8, 95% CI 1.4–2.5, P<0.001). Higher prevalence of autoimmune diseases among patients with eating disorders was not exclusively due to endocrinological and gastroenterological diseases; when the two categories were excluded, the increase in prevalence was seen in the patients both before the onset of the eating disorder treatment (OR 1.5, 95% CI 1.1–2.1, P = 0.02) and at the end of the follow-up (OR 1.4, 95% CI 1.1–1.8, P = 0.01).ConclusionsWe observed an association between eating disorders and several autoimmune diseases with different genetic backgrounds. Our findings support the link between immune-mediated mechanisms and development of eating disorders. Future studies are needed to further explore the risk of autoimmune diseases and immunological mechanisms in individuals with eating disorders and their family members.

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Section: Introductionmentioning

confidence: 99%

The Increased Risk for Autoimmune Diseases in Patients with Eating Disorders

et al. 2014

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“…Hashimoto thyroiditis could also disrupt the management of AN by causing hyperthyroidism. The literature contains many reports on hyperthyroidism, mostly due to Graves’ disease, worsening AN either by leading to weight loss itself or by increasing the psychological distress by causing hyperphagia, weight gain, and a fear of losing self-control over eating ( 10 , 11 , 12 ). In the clinical course of our patient, Hashimoto thyroiditis disrupted the management of AN first by causing hyperthyroidism and then by leading to hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis

Kızılkan¹,

Kanbur

Akgül³

et al. 2016

Jcrpe

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Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis.

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“…Pro-oxidant effects of starvation status lasted for several days after resumption of refeeding status; it may be because of tissue oxidative injury or enhanced levels of T3, and hyper metabolic state [9]. Hyperthyroidism during refeeding was reported in anorexia nervosa by Rayment et al [22]. T3 decreased significantly by starvation status (P<0.001).…”

Section: Group T3 (Nmol/l) T4 (Nmol/l)mentioning

confidence: 92%

“…A decrease in serum T3 levels can be seen in mild illness, and when the severity and length of the illness increases, both serum T3 and T4 will decrease. Anorexia Nervosa in human is associated with lower levels of thyroid hormones due to the effects of starvation status on metabolism [22]. In fact, starvation status results in a decrease in the serum T3 concentration due to decreased peripheral generation of T3 from T4 [24,25].…”

Section: Group T3 (Nmol/l) T4 (Nmol/l)mentioning

confidence: 99%

The Effects of Starvation and Refeeding on Oxidative Stress Parameters (MDA, SOD, GPx), Lipid Profile, Thyroid Hormones and Thyroid Histopathology in Male Wistar Rats

et al. 2016

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Objective: This study aimed to investigate the effect of starvation and re-feeding on oxidative stress markers, lipid profile, thyroid hormones, and changes in thyroid tissue and in male Wistar rats.Method: Fifty-six male Wistar rats were divided into 6 groups. After 3 months of feeding animals with specific diet, the first group was used without fasting (day zero). Other rats were exposed to fasting for 14 days. The second group was considered as a group after fasting (day 14). In groups 3 to 6, replenishment was done and then these groups were euthanized on days 16 to 22, and blood and tissue samples were taken.Results: Significant increase was observed in MDA, triglycerides, and VLDL cholesterol. The concentrations of SOD, GPx and T3 were decreased significantly. By re-feeding, SOD, GPx, triglycerides, total cholesterol, and VLDL cholesterol increased. T3 concentration was significantly increased in all groups after re-feeding. In thyroid tissue, the diameter of follicles and the amount of colloid decreased and the number of parafollicular cells increased during starvation. By days 2 and 4 post-refeeding there were follicles with different sizes and the numbers of parafollicular cells were increased.

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Hyperthyroidism during refeeding in anorexia nervosa

Cited by 5 publications

References 14 publications

The Increased Risk for Autoimmune Diseases in Patients with Eating Disorders

The Increased Risk for Autoimmune Diseases in Patients with Eating Disorders

An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis

The Effects of Starvation and Refeeding on Oxidative Stress Parameters (MDA, SOD, GPx), Lipid Profile, Thyroid Hormones and Thyroid Histopathology in Male Wistar Rats

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