Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes – Role of Early Life Adversity

Fischer, Susanne; Markert, Charlotte; Strahler, Jana; Doerr, Johanna M.; Skoluda, Nadine; Kappert, Mattes B.; Nater, Urs M.

doi:10.3389/fphys.2018.00564

Cited by 12 publications

(11 citation statements)

References 40 publications

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“…Altogether, they emphasize the complex interaction of various environmental and physiological factors such as neonatal stress, nutrition, and sex in the regulation of the HPT axis activity, underlining the importance of studying sex differences, confirming that neuroendocrine responses to stress and nutrition are sexually dimorphic. Finally, our results are in line with clinical studies that report that different adult or adolescent psychopathologies due to childhood trauma are associated with alterations in thyroid function (29–31, 95, 96). The HPT axis is a dynamic and adaptive system; however, in this context, if adaptability is not met, psychological or metabolic pathologies may arise as observed in obese patients (97).…”

Section: Discussionsupporting

confidence: 92%

“…Chronic and some forms of acute stress inhibit various elements of the HPT axis in rats (24, 25, 27–29), and stress during critical periods of development may program its function. A history of physical/emotional abuse or neglect has been linked with reduced plasma levels of T3 in adolescents (30) and low plasma levels of TSH in adult women (31).…”

Section: Introductionmentioning

confidence: 99%

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Sex Dimorphic Responses of the Hypothalamus–Pituitary–Thyroid Axis to Maternal Separation and Palatable Diet

et al. 2019

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Neonatal stress contributes to the development of obesity and has long-lasting effects on elements of the hypothalamus–pituitary–thyroid (HPT) axis. Given the importance of thyroid hormones in metabolic regulation, we studied the effects of maternal separation and a high-fat/high-carbohydrate diet (HFC), offered from puberty or adulthood, on HPT axis activity of adult male and female Wistar rats. Pups were non-handled (NH) or maternally separated (MS) 3 h/day at postnatal days (Pd) 2–21. In a first experiment, at Pd60, rats had access to chow or an HFC diet (cookies, peanuts, chow) for 1 month. Male and female NH and MS rats that consumed the HFC diet increased their caloric intake, body weight, and serum insulin levels; fat weight increased in all groups except in MS males, and serum leptin concentration increased only in females. Mediobasal hypothalamus (MBH) Pomc expression increased in NH-HFC females and Npy decreased in NH-HFC males. MS males showed insulinemia and hypercortisolemia that was attenuated by the HFC diet. The HPT axis activity response to an HFC diet was sex-specific; expression of MBH thyrotropin-releasing hormone-degrading ectoenzyme ( Trhde ) increased in NH and MS males; serum TSH concentration decreased in NH males, and T4 increased in NH females. In a second experiment, rats were fed chow or an HFC diet from Pd30 or 60 until Pd160 and exposed to 1 h restraint before sacrifice. Regardless of neonatal stress, age of diet exposition, or sex, the HFC diet increased body and fat weight and serum leptin concentration; it induced insulinemia in males, but in females only in Pd30 rats. The HFC diet's capacity to curtail the hypothalamus–pituitary–adrenal axis response to restraint was impaired in MS males. In restrained rats, expression of Trh in the paraventricular nucleus of the hypothalamus, Dio2 and Trhde in MBH, and serum thyroid hormone concentration were altered differently depending on sex, age of diet exposition, and neonatal stress. In conclusion, metabolic alterations associated to an HFC-diet-induced obesity are affected by sex or time of exposition, while various parameters of the HPT axis activity are additionally altered by MS, pointing to the complex interplay that these developmental influences exert on HPT axis activity in adult rats.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Sex Dimorphic Responses of the Hypothalamus–Pituitary–Thyroid Axis to Maternal Separation and Palatable Diet

et al. 2019

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“…Overall, our data and those previously published emphasize the finding that lactose intolerance prevalence is not negligible in patients with HT, and its presence possible should be taken into account. In this regard, even though we observed a high prevalence of gastrointestinal symptoms in patients with HT, a finding consistent both with the prevalence of functional bowel disorders in the female general population and with the expected gastrointestinal complaints in patients with thyroid disease, we observed that a more detailed assessment of gastrointestinal symptoms showed that change in bowel habits was significantly more represented among patients with lactose intolerance, and this finding may guide selectively test patients who report this symptom, rather than screening for lactose intolerance all HT patients [ 31 , 32 ].…”

Section: Discussionsupporting

confidence: 73%

Prevalence of Lactose Intolerance in Patients with Hashimoto Thyroiditis and Impact on LT4 Replacement Dose

et al. 2022

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Purpose: to determine lactose intolerance (LI) prevalence in women with Hashimoto’s thyroiditis (HT) and assess the impact of LI on LT4 replacement dose. Methods. consecutive patients with HT underwent Lactose Breath Test and clinical/laboratory data collection. Unrelated gastrointestinal disorders were carefully ruled out. Lactose-free diet and shift to lactose-free LT4 were proposed to patients with LI. Results: we enrolled 58 females (age range, 23–72 years) with diagnosis of HT. In total, 15 patients were euthyroid without treatment, and 43 (74%) euthyroid under LT4 (30 of them with a LT4 formulation containing lactose). Gastrointestinal symptoms were present in 84.5% of patients, with a greater prevalence in change in bowel habits in lactose-intolerant patients (p < 0.0001). The cumulative LT4 dose required did not differ in patients with or without LI. No significant difference in both TSH values and LT4 dose were observed in patients shifted to lactose-free LT4 and diet at 3 and 6 months compared to baseline. Conclusion: the prevalence of LI in patients with HT was 58.6%, not different from global prevalence of LI. In the absence of other gastrointestinal disorders, LI seems not to be a major cause of LT4 malabsorption and does not affect the LT4 required dose in HT patients.

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“…It is thus possible that the depressive symptoms, rather than the early life stress, were the cause of the thermoregulatory alterations. Against this, emerging evidence in humans points to alterations in thermoregulatory mediators, such as the sympathetic nervous system [e.g., ( 9 )] or the hypothalamic-pituitary-thyroid axis [e.g., ( 18 )], in the aftermath of early life stress. Similarly, early life stress has been found to affect serotonergic signalling [e.g., ( 19 )], another system implicated in thermoregulation.…”

Section: Discussionmentioning

confidence: 99%

Altered Experienced Thermoregulation in Depression—No Evidence for an Effect of Early Life Stress

2021

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Objectives: Accumulating evidence suggests that individuals with depression are characterised by difficulties in thermoregulatory cooling. The aim of this study was to investigate, for the first time, whether depressed individuals are aware of these alterations, what their physical consequences are and whether they may be rooted in early life stress.Methods: A total of N = 672 medically healthy individuals from the general population were recruited to participate in an online survey. Participants were divided into depressed vs. non-depressed using the Patient Health Questionnaire. Experienced autonomic and behavioural thermoregulation as well as vigilance problems in response to temperature increases were assessed by the Experienced Temperature Sensitivity and Regulation Survey. The Childhood Trauma Questionnaire was administered to assess early life stress.Results: Controlling for age, sex, body mass index, and physical activity, depressed vs. non-depressed individuals did not differ in their experienced autonomic and behavioural responses to temperature increases. However, the depressed individuals reported comparably greater difficulties in concentrating and drowsiness/fatigue in warm environments (p = 0.029), during physical exertion (p = 0.029), and during stress (p < 0.001). There were no differences in the experienced thermoregulation between depressed individuals with vs. without early life stress.Conclusions: Depressed individuals experienced more severe physical impairments (i.e., greater vigilance problems) in response to intense warmth when compared to non-depressed individuals. These differences were not attributable to comorbid illnesses, the intake of medication, or physical deconditioning. Further enquiries in clinical populations are warranted to investigate to what extent the observed alterations map onto specific symptoms of depression (e.g., sleep disturbances).

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Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes – Role of Early Life Adversity

Cited by 12 publications

References 40 publications

Sex Dimorphic Responses of the Hypothalamus–Pituitary–Thyroid Axis to Maternal Separation and Palatable Diet

Sex Dimorphic Responses of the Hypothalamus–Pituitary–Thyroid Axis to Maternal Separation and Palatable Diet

Prevalence of Lactose Intolerance in Patients with Hashimoto Thyroiditis and Impact on LT4 Replacement Dose

Altered Experienced Thermoregulation in Depression—No Evidence for an Effect of Early Life Stress

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