Impact of Methimazole Treatment on Magnesium Concentration and Lymphocytes Activation in Adolescents with Graves’ Disease

Abstract

The aim of this research was to assess plasma magnesium (Mg) concentration, the frequencies of activated T CD4+ and T CD8+ lymphocytes and B lymphocytes in adolescents with hyperthyroidism due to Graves’ disease (GD), and to assess changes in the above-mentioned parameters during methimazole (MMI) treatment. The frequencies of activated T and B cells were measured by flow cytometry method and plasma Mg concentration was determined by spectrophotometry method in 60 adolescents at the time of GD diagnosis and after receiving the normalisation of the thyroid hormones levels. The control group consisted of 20 healthy volunteers. We observed lower plasma Mg concentration, and higher frequencies of activated T and B lymphocytes in the study group before the treatment in comparison with healthy controls, and with study group in MMI-induced euthyreosis (p < 0.01).Statistically significant negative correlations between the percentages of activated T CD3+, T CD4+, T CD8+ and B CD19+ lymphocytes, and plasma Mg concentration before the treatment were found (r < −0.335, p < 0.002). After the treatment no vital differences in plasma Mg concentration, and in percentages of activated cells between GD patients and controls were found, except CD8+CD25+ cells (p = 0.03). The present study demonstrates that both activated T and B cells might play an important role in the pathogenesis of GD, and activation is related to Mg plasma level. The use of MMI in treatment of hyperthyroidism due to GD leads to decrease the frequencies of activated lymphocytes and normalisation of Mg levels.

Thyroid Function in 35 Patients with Gitelman Syndrome

“…Studies have shown that patients with hyperthyroidism had lower levels of serum Mg 2+ than patients with euthyroid function [17,18]. The use of methimazole for the treatment of hyperthyroidism due to GD leads to an increase in serum Mg 2+ concentration [18]. In our study, 30 (85.7%) GS patients exhibited hypomagnesemia.…”

“…In animal experiments, thyroid-deficient animals conserved magnesium much more efficiently than rats with either euthyroidism or hyperthyroidism, although the serum magnesium levels in thyroid-deficient rats were similar to those in euthyroid rats [16]. Studies have shown that patients with hyperthyroidism had lower levels of serum Mg 2+ than patients with euthyroid function [17,18]. The use of methimazole for the treatment of hyperthyroidism due to GD leads to an increase in serum Mg 2+ concentration [18].…”

Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectional study

“…A study on patients with Graves’ disease found that their serum magnesium concentrations were lower than in normal individuals, and that the serum magnesium concentration was inversely related to the activation levels of CD3 + , CD4 + , CD8 + T, and CD19 + B cells. It was speculated that low serum magnesium might lead to decreased immune tolerance and abnormal activation of immune cells 26 . Second, given its function as a coenzyme, magnesium is involved in a variety of antioxidant metabolism pathways, such as glutathione synthesis; low serum magnesium could therefore reduce the antioxidant response capacity in cells and allow the accumulation of free radicals, resulting in oxidative stress and tissue damage 21 , 38 , 39 .…”

“…There are few studies on the relationship between magnesium and thyroid disease. For example, a study on patients with Graves’ disease found that they exhibited a lower serum magnesium concentration than normal control participants, and that the serum magnesium concentration was negatively correlated with lymphocyte activation 26 . An Austrian study found that low serum magnesium was associated with abnormal thyroid function, which was improved after supplemental magnesium therapy 27 .…”

Complicated Gitelman syndrome and autoimmune thyroid disease: a case report with a new homozygous mutation in the SLC12A3 gene and literature review

“…One study showed that long-term high dietary magnesium can lead to abnormal thyroid function. Another study suggested that hypomagnesemia may lead to rapid relapse of GD [ 22 ]. In contrast, increasing magnesium supplementation has also been shown to promote normalization of thyroid morphology and function [ 23 ].…”