Hypothyroidism due to Hashimoto's thyroiditis masked by anorexia nervosa

Smalls‐Mantey, Adjoa; Steinglass, Joanna E.; Primack, Marshall P.; Clark‐Hamilton, Jill; Bongiovi, Mary

doi:10.1002/eat.22420

Cited by 7 publications

(8 citation statements)

References 31 publications

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“…Our study observed decreased TSH and fT4 levels in patients with AN (but still in the normal range defined for normal BMI subjects) that did not increase even after treatment (Table ). Our results are in accordance with previous studies that have described altered thyroid function in AN patients. , Endocrine dysregulation is considered to be an adaptation to long-term starvation followed by the slowdown of energy metabolism . As expected, these extensive hormonal changes were also projected in metabolism.…”

Section: Discussionsupporting

confidence: 93%

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NMR- and MS-Based Untargeted Metabolomic Study of Stool and Serum Samples from Patients with Anorexia Nervosa

et al. 2021

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Anorexia nervosa (AN), a pathological restriction of food intake, leads to metabolic dysregulation. We conducted a metabolomics study to reveal changes caused by AN and the effect of hospital realimentation on metabolism. Both stool and serum from patients with AN and healthy controls were analyzed by NMR and MS. Statistical analysis revealed several altered biochemical and anthropometric parameters and 50 changed metabolites, including phospholipids, acylcarnitines, amino acids, derivatives of nicotinic acid, nucleotides, and energy metabolism intermediates. Biochemical and anthropometric parameters were correlated with metabolomic data. Metabolic changes in patients with AN described in our study imply serious system disruption defects, such as the development of inflammation and oxidative stress, changed free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels, a deficit of vitamins, muscle mass breakdown, and a decrease in ketone bodies as an important source of energy for the brain and heart. Furthermore, our data indicate only a very slight improvement after treatment. However, correlations of metabolomic results with body weight, interleukin 6, tumor necrosis factor α, fT4, and TSH might entail better prognoses and treatment effectiveness in patients with better system parameter status. Data sets are deposited in MassIVE: MSV000087713,

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Section: Discussionsupporting

confidence: 93%

“…Our results are in accordance with previous studies that have described altered thyroid function in AN patients. 19,20 Endocrine dysregulation is considered to be an adaptation to long-term starvation followed by the slowdown of energy metabolism. 21 As expected, these extensive hormonal changes were also projected in metabolism.…”

Section: ■ Discussionmentioning

confidence: 99%

NMR- and MS-Based Untargeted Metabolomic Study of Stool and Serum Samples from Patients with Anorexia Nervosa

et al. 2021

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“…The elevated TSH that would be expected in Hashimoto's thyroiditis was blunted by weight loss associated with Anxiety Neurosis was reported early (9). Consequences of untreated subclinical hypothyroidism are dyslipidemia, coronary artery disease, CHF, cognitive dysfunction and neuropsychiatric symptoms and progression to overt symptomatic hypothyroidism.…”

Section: Resultsmentioning

confidence: 99%

Hashimoto’s Thyroiditis-Association with Eosinophillic Infiltration in FNAC

Bansal¹,

Gupta²,

Bharti³

et al. 2017

Int.J.Curr.Res.Aca.Rev.

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Article InfoTo assess whether an eosinophilic infiltration of the thyroid gland has a higher association with diffuse thyroid swellings especially Hashimoto's thyroiditis and search for more cytological clues to increase the sensitivity of diagnosis of diffuse swellings of thyroid gland on Fine needle aspiration cytology (FNAC). A total of 80 cases were studied. Aspirates from these cases were studied for cytomorphological features, all the cases were divided into two groups-cases and control. The cases diagnosed as Hashimoto's thyroiditis were included in the case group and cases diagnosed as other benign swellings except Hashimoto's thyroiditis were included in the control group. 40% of the cases showed an average of more than 1 eosinophil per HPF but none of the cases in the control group showed an average more than 1.Thus, we saw that number of eosinophils per HPF in the smears diagnosed as Hashimoto`s thyroiditis was found higher than in the smears from the control group. We also observed that the average ratio of eosinophils to neutrophils in the smears diagnosed as Hashimoto's thyroiditis was found to be significantly greater than in smears from the control group. Among the patients with Hashimoto's thyroiditis 80-90% have high titers of antithyroglobulin antibodies. Besides serological diagnosis presence of eosinophil per HPF increases the sensitivity of cytological diagnosis of Hashimoto thyroiditis.

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“…Review of the literature for the association of Hashimoto thyroiditis with EDs revealed only one recently published case report of a 16-year-old girl with a 4-year history of AN whose TSH levels had increased in response to weight gain and shown a decrease with weight loss. This unexpected pattern of TSH and markedly elevated levels of antithyroperoxidase antibodies suggested Hashimoto thyroiditis ( 17 ). The association between body weight and TSH levels observed in this case report was also present in our patient.…”

Section: Discussionmentioning

confidence: 98%

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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Hypothyroidism due to Hashimoto's thyroiditis masked by anorexia nervosa

Cited by 7 publications

References 31 publications

NMR- and MS-Based Untargeted Metabolomic Study of Stool and Serum Samples from Patients with Anorexia Nervosa

NMR- and MS-Based Untargeted Metabolomic Study of Stool and Serum Samples from Patients with Anorexia Nervosa

Hashimoto’s Thyroiditis-Association with Eosinophillic Infiltration in FNAC

An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis

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