Vitamin D in Hashimoto’s thyroiditis and its relationship with thyroid function and inflammatory status

Botelho, Ilka Mara Borges; Moura, Arnaldo Vieira; Silva, Conceição Aparecida; Tambascia, Marcos Antônio; Alegre, Sarah Monte; Zantut-Wittmann, Denise Engelbrecht

doi:10.1507/endocrj.ej18-0166

Cited by 55 publications

(52 citation statements)

References 43 publications

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“…Linear regression analysis showed that 25(OH)D increased by 1 ng/ml at the normal reference level, with an increase of 2.78 ng/dl in FT4 concentration and a decrease of 0.17 mIU/L in TSH. A study (18) found that the decrease of FT4 level is a predictor of vitamin D deficiency in HT patients, which is consistent with our findings, suggesting that thyroid hormone can play a role in regulating the autoimmune function of the thyroid when vitamin D is sufficient. Our study found a positive correlation between FT4 levels and 25(OH)D levels, suggesting that vitamin D supplementation or thyroid hormones may be used to regulate the balance between FT4 levels and 25(OH)D.…”

Section: Discussionsupporting

confidence: 92%

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Correlation Between Hashimoto's Thyroiditis–Related Thyroid Hormone Levels and 25-Hydroxyvitamin D

2020

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The purpose of this study was to further clarify the association of Hashimoto's thyroiditis (HT) and vitamin D deficiency, and to seek the connection between them and related influencing factors. Methods: Data were obtained from subjects who underwent health examinations from January 2018 to December 2018. The diagnosis of HT was based on: antithyroid peroxidase antibody (TPO-Ab) levels >35 IU/ml and/or antithyroglobulin antibody (Tg-Ab) levels >40 IU/ml. Based on the Endocrine Society guidelines, 25-hydroxyvitamin D [25(OH)D] levels ≥30.0 ng/ml were classified as a vitamin D sufficiency; those between 20 and 29.9 ng/ml, as an insufficiency; and those <20 ng/ml, as a deficiency. All statistical analysis was performed by software R. Results: Of a total of 75,436 individuals who were physically examined, 5,656 of them had 25(OH)D levels tested at the same time; 5,230 were enrolled. The level of 25(OH)D in the non-HT group was higher than that in the HT group. Multiple regression analysis showed that HT was statistically significantly correlated with being male, body mass index (BMI), waist circumference, and thyroid-stimulating hormone (TSH). TSH levels in the insufficiency group and deficiency group were higher than those in the sufficiency group. Free triiodothyronine (FT3) and thyroxine (FT4) levels in the insufficiency group and deficiency group were lower than those in the sufficiency group. 25(OH)D increased by 1 ng/ml at the normal reference level, with an increase of 2.78 ng/dl in FT4 concentration and a decrease of 0.17 mIU/L in TSH. Conclusions: Patients with HT present with a reduced 25(OH)D level, and TSH is an independent risk factor for HT. TSH is negatively correlated with 25(OH)D level. FT3 and FT4 levels were positively correlated with 25(OH)D levels.

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Section: Discussionsupporting

confidence: 92%

“…Studies in recent years have shown that the association between HT and vitamin D remains controversial. Recent studies have found no effect on vitamin D levels in the HT group compared with the control group (18). Another researcher suggested that vitamin D was not involved in the early stages of HT (19).…”

Section: Discussionmentioning

confidence: 98%

Correlation Between Hashimoto's Thyroiditis–Related Thyroid Hormone Levels and 25-Hydroxyvitamin D

2020

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“…Botello et al studied 88 patients with long-term HT and found a positive correlation between 25(OH)D levels, fT4, and (contrary to expectations) Th17 and TNFα. The authors hypothesized that low levels of fT4 are predictors of a deficiency of 25(OH)D and that the long evolution of the disease and treatment of hypothyroidism are related to a decrease in cytotoxic immune response, regardless of the levels of 25(OH)D [112]. The coexistence of AITD with other AID, such as celiac disease, also deserves consideration.…”

Section: What Is the Nature Of The Relationship Between Vitamin D Levmentioning

confidence: 99%

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Vieira¹,

Rodrigues

Paiva³

2020

Nutrients

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Vitamin D is a steroid hormone traditionally connected to phosphocalcium metabolism. The discovery of pleiotropic expression of its receptor and of the enzymes involved in its metabolism has led to the exploration of the other roles of this vitamin. The influence of vitamin D on autoimmune disease—namely, on autoimmune thyroid disease—has been widely studied. Most of the existing data support a relationship between vitamin D deficiency and a greater tendency for development and/or higher titers of antibodies linked to Hashimoto’s thyroiditis, Graves’ disease, and/or postpartum thyroiditis. However, there have also been some reports contradicting such relationships, thus making it difficult to establish a unanimous conclusion. Even if the existence of an association between vitamin D and autoimmune thyroid disease is assumed, it is still unclear whether it reflects a pathological mechanism, a causal relationship, or a consequence of the autoimmune process. The relationship between vitamin D’s polymorphisms and this group of diseases has also been the subject of study, often with divergent results. This text presents a review of the recent literature on the relationship between vitamin D and autoimmune thyroid disease, providing an analysis of the likely involved mechanisms. Our thesis is that, due to its immunoregulatory role, vitamin D plays a minor role in conjunction with myriad other factors. In some cases, a vicious cycle is generated, thus contributing to the deficiency and aggravating the autoimmune process.

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“…A total of 21 studies involving more than 3890 patients with AITD have been published till date evaluating the relationship between Vitamin D status and severity of thyroid autoimmunity as evaluated by autoantibody titers. [1819202122232425262728293031323334] These studies are often limited by small number of patients, different criteria used for defining Vitamin D deficiency/insufficiency and different criteria for AITD. Studies with more than 100 patients/controls have been elaborated in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Vitamin D, thyroid autoimmunity and cancer: An interplay of different factors

Dutta

Sharma

Aggarwal

et al. 2019

Indian J Endocr Metab

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Background and Aims:In spite of large volume of data linking Vitamin D with cardiovascular morbidity, autoimmunity, cancer, and virtually every organ system, Vitamin D and thyroid is a lesser-known aspect of Vitamin D in clinical practice. This article intends to highlight the current literature on the impact of Vitamin D status and supplementation on thyroid autoimmunity and cancer.Methods:References for this review were identified through searches of PubMed for articles published to from 1950 to August 2019 using the terms “thyroid” [MeSH Terms] AND “Vitamin D” [MeSH Terms] OR “thyroid” [All Fields] AND “Vitamin D” [All Fields].Results:Significant inverse correlation was documented between anti-thyroid peroxidase antibody (TPOAb) and serum 25-hydroxy-Vitamin D (25OHD). TPOAb positivity is more prevalent in Vitamin D deficient individuals. A large volume of medical literature is available from observational studies linking Vitamin D with thyroid autoimmunity. Data from interventional studies documenting beneficial effects of Vitamin D on thyroid autoimmunity is also available, but lesser than that from observational studies. Short-term high dose oral Vitamin D supplementation reduces TPOAb titers. Certain Vitamin D receptor (VDR) gene polymorphism have been linked to increased occurrence of autoimmune thyroid disorders (AITD). Vitamin D deficiency, decreased circulating calcitriol has been linked to increased thyroid cancer. Certain VDR gene polymorphisms have been linked with increased as well as decreased occurrence of thyroid cancer. Data is scant on use of Vitamin D and its analogues for treating thyroid cancer.Conclusion:In spite of large volume of medical literature from observational studies linking Vitamin D with thyroid autoimmunity and cancer, meaningful concrete clinical data on impact of Vitamin D supplementation on hard clinical end points in these disorders is lacking, and should be the primary area of research in the next decade.

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Vitamin D in Hashimoto’s thyroiditis and its relationship with thyroid function and inflammatory status

Cited by 55 publications

References 43 publications

Correlation Between Hashimoto's Thyroiditis–Related Thyroid Hormone Levels and 25-Hydroxyvitamin D

Correlation Between Hashimoto's Thyroiditis–Related Thyroid Hormone Levels and 25-Hydroxyvitamin D

Vitamin D and Autoimmune Thyroid Disease—Cause, Consequence, or a Vicious Cycle?

Vitamin D, thyroid autoimmunity and cancer: An interplay of different factors

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