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Sivakumar RR, Chinnaiah Govindareddy D, Sahoo J, Bobby Z, Chinnakali P. Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis - a randomized controlled trial. J Pediatr Endocrinol Metab 2024; 37:137-143. [PMID: 38154030 DOI: 10.1515/jpem-2023-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/07/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES To assess the effect of daily zinc supplementation for 12 weeks on thyroid auto-antibodies - thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb), and oxidative stress in children with autoimmune thyroid disease (AITD) compared to standard therapy. METHODS This open-labeled, parallel, randomized controlled trial was done in a tertiary care teaching institute in south India. Children aged 3-18 years with AITD were randomized to receive 25 mg elemental zinc daily for 12 weeks or standard therapy alone. The change in thyroid function tests (thyroid stimulating hormone, free T3, free T4), thyroid auto-antibody (TPOAb, TgAb) titers, oxidative stress markers (glutathione peroxidase, malondialdehyde, superoxide dismutase, and total antioxidant capacity) were compared. RESULTS Forty children, 20 in each arm, were recruited in the study. We observed a female-to-male ratio of 7:1. Median duration of disease was 2 (0.25, 4.25) years. A total of 37 (92.5 %) children were hypothyroid, two hyperthyroid, and one euthyroid at enrolment. A total of 13 children (32.5 %) had associated co-morbidities, most commonly type 1 diabetes mellitus and systemic lupus erythematosus, three (7.5 %) each. We did not find any significant change in thyroid function tests, thyroid auto-antibody titers, and oxidative stress markers. However, the requirement of levothyroxine dose was significantly increased in the control arm, compared to the zinc group (p=0.03). Only four (20 %) children had minor adverse effects like nausea, metallic taste, and body ache. CONCLUSIONS Zinc supplementation did not have any effect on thyroid auto-antibodies and oxidative stress. Zinc-supplemented children did not require escalation in levothyroxine dose.
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Affiliation(s)
- Ramachandran Ramge Sivakumar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | | | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Zachariah Bobby
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Palanivel Chinnakali
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Ruggeri RM, Barbalace MC, Croce L, Malaguti M, Campennì A, Rotondi M, Cannavò S, Hrelia S. Autoimmune Thyroid Disorders: The Mediterranean Diet as a Protective Choice. Nutrients 2023; 15:3953. [PMID: 37764737 PMCID: PMC10535745 DOI: 10.3390/nu15183953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Autoimmune thyroid diseases are on the rise worldwide, and such a rapid increase is mainly driven by environmental factors related to changed lifestyles in "modern" societies. In this context, diet seems to play a crucial role. An unhealthy high-energy diet, rich in animal fat and proteins, salt and refined sugars (the so-called "Western diet") negatively influences the risk of autoimmunity by altering the immune balance and the gut microbiota composition, enhancing oxidative stress and promoting inflammation. In contrast, the Mediterranean diet represents a unique model of healthy eating, characterized by a high intake of food from vegetable sources, a low consumption of saturated fats in favor of unsaturated fats (mainly, olive oil), a moderate consumption of fish (typically, the small oily fishes) and dairy products, as well as a moderate consumption of wine at meals, and a low intake of meat. Thanks to its nutritional components, the Mediterranean Diet positively influences immune system function, gut microbiota composition, and redox homeostasis, exerting anti-oxidants, anti-inflammatory, and immunomodulatory effects. The present review was aimed at exploring the existing knowledge on the correlations between dietary habits and thyroid autoimmunity, to evaluate the role of the Mediterranean diet as a protective model.
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Affiliation(s)
- Rosaria Maddalena Ruggeri
- Department of Human Pathology of Adulthood and Childhood DETEV “G. Barresi”, Endocrinology Unit, University of Messina, 98125 Messina, Italy;
| | - Maria Cristina Barbalace
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Laura Croce
- Department of Internal Medicine and Therapeutics, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) University of Pavia, 27100 Pavia, Italy; (L.C.); (M.R.)
| | - Marco Malaguti
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Alfredo Campennì
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Unit of Nuclear Medicine, University of Messina, 98125 Messina, Italy;
| | - Mario Rotondi
- Department of Internal Medicine and Therapeutics, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) University of Pavia, 27100 Pavia, Italy; (L.C.); (M.R.)
| | - Salvatore Cannavò
- Department of Human Pathology of Adulthood and Childhood DETEV “G. Barresi”, Endocrinology Unit, University of Messina, 98125 Messina, Italy;
| | - Silvana Hrelia
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
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3
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Larsen D, Singh S, Brito M. Thyroid, Diet, and Alternative Approaches. J Clin Endocrinol Metab 2022; 107:2973-2981. [PMID: 35952387 DOI: 10.1210/clinem/dgac473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Increasingly, patients are asking their physicians about the benefits of dietary and alternative approaches to manage their diseases, including thyroid disease. We seek to review the evidence behind several of the vitamins, minerals, complementary medicines, and elimination diets that patients are most commonly using for the treatment of thyroid disorders. SUMMARY Several trace elements are essential to normal thyroid function, and their supplementation has been studied in various capacities. Iodine supplementation has been implemented on national scales through universal salt iodization with great success in preventing severe thyroid disease, but can conversely cause thyroid disorders when given in excess. Selenium and zinc supplementation has been found to be beneficial in specific populations with otherwise limited generalizability. Other minerals, such as vitamin B12, low-dose naltrexone, and ashwagandha root extract, have little to no evidence of any impact on thyroid disorders. Avoidance of gluten and dairy has positive impacts only in patients with concomitant sensitivities to those substances, likely by improving absorption of levothyroxine. Avoidance of cruciferous vegetables and soy has little proven benefit in patients with thyroid disorders. CONCLUSION While many patients are seeking to avoid conventional therapy and instead turn to alternative and dietary approaches to thyroid disease management, many of the most popular approaches have no proven benefit or have not been well studied. It is our responsibility to educate our patients about the evidence for or against benefit, potential harms, or dearth of knowledge behind these strategies.
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Affiliation(s)
- Dana Larsen
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Sargun Singh
- Government Medical College Amritsar, Amritsar, Punjab, India
| | - Maria Brito
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
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4
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Beserra JB, Morais JBS, Severo JS, Cruz KJC, de Oliveira ARS, Henriques GS, do Nascimento Marreiro D. Relation Between Zinc and Thyroid Hormones in Humans: a Systematic Review. Biol Trace Elem Res 2021; 199:4092-4100. [PMID: 33409921 DOI: 10.1007/s12011-020-02562-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to systematically evaluate the relation between zinc and the thyroid hormones in humans. The search for articles was conducted using the Pubmed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and ScienceDirect databases on October 21 and 22, 2019, by two authors independently. The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed in the conduct of this review. The Cochrane Collaboration tool was used to assess the risk of bias of the trials included in this review. After the screening of the articles, eight studies that assessed the effects of zinc supplementation on thyroid hormone concentrations and ten studies that assessed the relationship between blood zinc concentrations and thyroid hormones were included in this systematic review. Although cross-sectional and case-control studies have shown a relationship between zinc deficiency and thyroid, the data from this systematic review provides inconclusive evidence with respect to the effects of zinc supplementation on thyroid hormone concentrations due to the divergence of the research found by the authors that only reports findings in patients suffering from some kind of disease, which cannot be generalized to the average human population.
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Affiliation(s)
- Jéssica Batista Beserra
- Department of Nutrition, Federal University of Piauí, Campus Minister Petrônio Portela, Teresina, Piauí, Brazil
| | | | - Juliana Soares Severo
- Department of Nutrition, Federal University of Piauí, Campus Minister Petrônio Portela, Teresina, Piauí, Brazil
| | - Kyria Jayanne Clímaco Cruz
- Department of Nutrition, Federal University of Piauí, Campus Minister Petrônio Portela, Teresina, Piauí, Brazil
| | | | | | - Dilina do Nascimento Marreiro
- Department of Nutrition, Federal University of Piauí, Campus Minister Petrônio Portela, Teresina, Piauí, Brazil.
- Departamento de Nutrição, Universidade Federal do Piauí, Campus Ministro Petrônio Portela, Bairro Ininga, Teresina, Piauí, 64049550, Brazil.
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Khan SZA, Lungba RM, Ajibawo-Aganbi U, Veliginti S, Perez Bastidas MV, Saleem S, Cancarevic I. Minerals: An Untapped Remedy for Autoimmune Hypothyroidism? Cureus 2020; 12:e11008. [PMID: 33094039 PMCID: PMC7574993 DOI: 10.7759/cureus.11008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For decades, the focus of managing autoimmune hypothyroidism has been on thyroxine replacement. Correcting lab parameters such as thyroid stimulating hormone (TSH) has been a primary goal. The increasing prevalence of Hashimoto’s thyroiditis (HT) continues to impact the quality of life in patients. We believe a holistic approach to this disease entity, considering its underlying complex etiopathogenesis, would benefit patients. Nutraceuticals are combinations of essential nutrients and are becoming a part of novel medical treatments despite the lack of regulation. This review aims to present a concise summary of recent developments regarding minerals such as zinc, selenium, magnesium, iron, and their potential clinical benefit as nutraceuticals in patients with HT. We have explored the potential benefits and associations of these minerals in HT and thyroid function. We reviewed relevant articles, metanalyses, and clinical trials in literature platforms such as PubMed, PubMed Central, and Google Scholar. Significant data found in the literature suggesting a potential health benefit of these minerals in HT though there were many studies to the contrary. Many trials demonstrated the restoration of residual symptoms, reversal of HT-associated thyroid morphological changes, and improvement in thyroid functions. Many of these trials lack statistical power due to the small sample sizes, and their external validity may be questionable due to unaccounted confounding factors. In our opinion, to support an evidence-based holistic clinical approach, further scientific evidence is needed. The association of these elements in thyroid function necessitates more large scale pragmatic trials to elucidate the benefits of nutraceuticals in HT.
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Affiliation(s)
- Seyad Zulficar Ali Khan
- Research and Development, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Primary Care & Emergency, Ministry of Health Oman, Salalah, OMN
| | - Rayan M Lungba
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Uvie Ajibawo-Aganbi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Swathi Veliginti
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maria V Perez Bastidas
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sania Saleem
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Kanamori T, Suzuki M, Kaneko Y, Yamada K, Kubo H, Uchiyama M. Severe fatigue due to valproate-induced hypothyroidism in a case of bipolar disorder. Ann Gen Psychiatry 2020; 19:49. [PMID: 32944056 PMCID: PMC7487638 DOI: 10.1186/s12991-020-00299-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Valproate-induced hypothyroidism is a rare condition and has been considered asymptomatic. Here, we report a case of bipolar I disorder who developed symptomatic valproate-induced hypothyroidism. CASE PRESENTATION A 44-year-old woman with bipolar I disorder complained of severe fatigue after starting valproate. She showed a hormonal pattern of central hypothyroidism. Thyroid autoantibodies were negative, and no pituitary abnormality was seen on magnetic resonance imaging. After stopping valproate, her severe fatigue rapidly improved with normalizing thyroid function. CONCLUSIONS Our case suggests that valproate-induced hypothyroidism should be considered when patients complain of excessive fatigue under treatment with valproate.
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Affiliation(s)
- Tadashi Kanamori
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan.,Kunpukai Yamada Hospital, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan
| | - Yoshiyuki Kaneko
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan
| | - Kouju Yamada
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan.,Kunpukai Yamada Hospital, Tokyo, Japan
| | - Hideyuki Kubo
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610 Japan.,Tokyoadachi Hospital, Tokyo, Japan
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7
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Paulazo MA, Klecha AJ, Sterle HA, Valli E, Torti H, Cayrol F, Barreiro Arcos ML, Cremaschi GA. Hypothyroidism-related zinc deficiency leads to suppression of T lymphocyte activity. Endocrine 2019; 66:266-277. [PMID: 31056723 DOI: 10.1007/s12020-019-01936-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/11/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Hypothyroidism has been shown to induce immunosuppression and both the thyroid status and immunity are affected by zinc deficiency. However, the impact of hypothyroidism on zinc metabolism and its possible relationship with the immune status has not yet been deeply explored. Here, our aim was to study whether hypothyroidism may alter zinc metabolism and thus lead to the impairment of T lymphocyte activity. METHODS Variations in the distribution of zinc in the body were evaluated in PTU-treated hypothyroid mice. The effects of hypothyroidism and zinc deficiency were studied on T lymphocyte proliferation after stimulation both in vitro and in vivo. For in vitro assays, thyroid hormone-free or zinc chelator (TPEN or DTPA)-supplemented media were used. For in vivo assays, lymphocyte activity was evaluated in cells from hypothyroid, T3-treated, and zinc-supplemented mice. RESULTS Hypothyroid mice showed lower levels of zinc in femur and lymph nodes than controls. T3 and zinc supplementation reversed these effects. In vitro, both thyroid hormone and zinc deficiency led to a decreased response to mitogen stimulation. However, only zinc deficiency was able to induce lymphocyte apoptosis. Mitogen-stimulated T cells from hypothyroid mice showed impaired proliferation, accompanied by decreased activation of PKC and lower levels of p-ERK, effects that were reversed by T3 replacement or zinc supplementation. CONCLUSIONS Our results show an important role of zinc deficiency in hypothyroid-mediated T-cell suppression and suggest the importance of evaluating zinc levels and restoring them when necessary to maintain an efficient immune response in hypothyroid patients.
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Affiliation(s)
- María Alejandra Paulazo
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
| | - Alicia Juana Klecha
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
- Cátedra de Física, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Helena Andrea Sterle
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
| | - Eduardo Valli
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
| | - Horacio Torti
- Cátedra de Física, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Florencia Cayrol
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
| | - María Laura Barreiro Arcos
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina
| | - Graciela Alicia Cremaschi
- Instituto de Investigaciones Biomédicas (BIOMED), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina (UCA), Av. Alicia Moreau de Justo 1600, 3er piso (1107 AAZ), Buenos Aires, Argentina.
- Cátedra de Física, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
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Temple LM, Saigal P. Hypothyroidism. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Intrauterine Zn Deficiency Favors Thyrotropin-Releasing Hormone-Increasing Effects on Thyrotropin Serum Levels and Induces Subclinical Hypothyroidism in Weaned Rats. Nutrients 2017; 9:nu9101139. [PMID: 29057835 PMCID: PMC5691755 DOI: 10.3390/nu9101139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/29/2017] [Accepted: 10/11/2017] [Indexed: 11/17/2022] Open
Abstract
Individuals who consume a diet deficient in zinc (Zn-deficient) develop alterations in hypothalamic-pituitary-thyroid axis function, i.e., a low metabolic rate and cold insensitivity. Although those disturbances are related to primary hypothyroidism, intrauterine or postnatal Zn-deficient adults have an increased thyrotropin (TSH) concentration, but unchanged thyroid hormone (TH) levels and decreased body weight. This does not support the view that the hypothyroidism develops due to a low Zn intake. In addition, intrauterine or postnatal Zn-deficiency in weaned and adult rats reduces the activity of pyroglutamyl aminopeptidase II (PPII) in the medial-basal hypothalamus (MBH). PPII is an enzyme that degrades thyrotropin-releasing hormone (TRH). This hypothalamic peptide stimulates its receptor in adenohypophysis, thereby increasing TSH release. We analyzed whether earlier low TH is responsible for the high TSH levels reported in adults, or if TRH release is enhanced by Zn deficiency at weaning. Dams were fed a 2 ppm Zn-deficient diet in the period from one week prior to gestation and up to three weeks after delivery. We found a high release of hypothalamic TRH, which along with reduced MBH PPII activity, increased TSH levels in Zn-deficient pups independently of changes in TH concentration. We found that primary hypothyroidism did not develop in intrauterine Zn-deficient weaned rats and we confirmed that metal deficiency enhances TSH levels since early-life, favoring subclinical hypothyroidism development which remains into adulthood.
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10
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Saghazadeh A, Mahmoudi M, Dehghani Ashkezari A, Oliaie Rezaie N, Rezaei N. Systematic review and meta-analysis shows a specific micronutrient profile in people with Down Syndrome: Lower blood calcium, selenium and zinc, higher red blood cell copper and zinc, and higher salivary calcium and sodium. PLoS One 2017; 12:e0175437. [PMID: 28422987 PMCID: PMC5396920 DOI: 10.1371/journal.pone.0175437] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 03/27/2017] [Indexed: 12/12/2022] Open
Abstract
Different metabolic profiles as well as comorbidities are common in people with Down Syndrome (DS). Therefore it is relevant to know whether micronutrient levels in people with DS are also different. This systematic review was designed to review the literature on micronutrient levels in people with DS compared to age and sex-matched controls without DS. We identified sixty nine studies from January 1967 to April 2016 through main electronic medical databases PubMed, Scopus, and Web of knowledge. We carried out meta-analysis of the data on four essential trace elements (Cu, Fe, Se, and Zn), six minerals (Ca, Cl, K, Mg, Na, and P), and five vitamins (vitamin A, B9, B12, D, and E). People with DS showed lower blood levels of Ca (standard mean difference (SMD) = -0.63; 95% confidence interval (CI): -1.16 to -0.09), Se (SMD = -0.99; 95% CI: -1.55 to -0.43), and Zn (SMD = -1.30; 95% CI: -1.75 to -0.84), while red cell levels of Zn (SMD = 1.88; 95% CI: 0.48 to 3.28) and Cu (SMD = 2.77; 95% CI: 1.96 to 3.57) were higher. They had also higher salivary levels of Ca (SMD = 0.85; 95% CI: 0.38 to 1.33) and Na (SMD = 1.04; 95% CI: 0.39 to 1.69). Our findings that micronutrient levels are different in people with DS raise the question whether these differences are related to the different metabolic profiles, the common comorbidities or merely reflect DS.
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Affiliation(s)
- Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Mahmoudi
- Department of Cellular and Molecular Nutrition, School of Nutrition and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Dietitians and Nutrition Experts Team (DiNET), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Atefeh Dehghani Ashkezari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nooshin Oliaie Rezaie
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Boston, MA, United States of America
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Boston, MA, United States of America
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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11
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Applying a systems approach to thyroid physiology: Looking at the whole with a mitochondrial perspective instead of judging single TSH values or why we should know more about mitochondria to understand metabolism. BBA CLINICAL 2017; 7:127-140. [PMID: 28417080 PMCID: PMC5390562 DOI: 10.1016/j.bbacli.2017.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/20/2017] [Accepted: 03/28/2017] [Indexed: 12/17/2022]
Abstract
Classical thinking in endocrine physiology squeezes our diagnostic handling into a simple negative feedback mechanism with a controller and a controlled variable. In the case of the thyroid this is reduced to TSH and fT3 and fT4, respectively. The setting of this tight notion has no free space for any additions. In this paper we want to challenge this model of limited application by proposing a construct based on a systems approach departing from two basic considerations. In first place since the majority of cases of thyroid disease develop and appear during life it has to be considered as an acquired condition. In the second place, our experience with the reversibility of morphological changes makes the autoimmune theory inconsistent. While medical complexity can expand into the era of OMICS as well as into one where manipulations with the use of knock-outs and -ins are common in science, we have preferred to maintain a simple and practical approach. We will describe the interactions of iron, magnesium, zinc, selenium and coenzyme Q10 with the thyroid axis. The discourse will be then brought into the context of ovarian function, i.e. steroid hormone production. Finally the same elemental players will be presented in relation to the basic mitochondrial machinery that supports the endocrine. We propose that an intact mitochondrial function can guard the normal endocrine function of both the thyroid as well as of the ovarian axis. The basic elements required for this function appear to be magnesium and iron. In the case of the thyroid, magnesium-ATP acts in iodine uptake and the heme protein peroxidase in thyroid hormone synthesis. A similar biochemical process is found in steroid synthesis with cholesterol uptake being the initial energy-dependent step and later the heme protein ferredoxin 1 which is required for steroid synthesis. Magnesium plays a central role in determining the clinical picture associated with thyroid disease and is also involved in maintaining fertility. With the aid of 3D sonography patients needing selenium and/or coenzyme Q10 can be easily identified. By this we firmly believe that physicians should know more about basic biochemistry and the way it fits into mitochondrial function in order to understand metabolism. Contemplating only TSH is highly reductionistic. Outline Author's profiles and motivation for this analysis The philosophical alternatives in science and medicine Reductionism vs. systems approach in clinical thyroid disease guidelines The entry into complexity: the involvement of the musculoskeletal system Integrating East and West: teachings from Chinese Medicine and from evidence based medicine (EBM) Can a mathematical model represent complexity in the daily thyroid practice? How effective is thyroxine treatment? Resolving the situation of residual symptoms in treated patients with thyroid disease Importance of iron, zinc and magnesium in relation to thyroid function Putting together new concepts related to thyroid function for a systems approach Expanding our model into general aspects of medicine
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Raza N, Raza W, Zafar ZI, Kumar RV. Beneficiation of zinc from electric arc furnace dust using hydrometallurgical approach. RUSS J APPL CHEM+ 2016. [DOI: 10.1134/s1070427216050244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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Soria M, Anson M, Escanero JF. Correlation Analysis of Exercise-Induced Changes in Plasma Trace Element and Hormone Levels During Incremental Exercise in Well-Trained Athletes. Biol Trace Elem Res 2016; 170:55-64. [PMID: 26271307 DOI: 10.1007/s12011-015-0466-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/03/2015] [Indexed: 11/25/2022]
Abstract
This study analyzes the relationship between hormonal changes induced by exercise and variations in trace elements associated with oxidative stress during incremental exercise. Nineteen well-trained endurance athletes performed a cycle ergometer test: after a warm-up of 10 min at 2.0 W kg(-1), workload increased by 0.5 W kg(-1) every 10 min until exhaustion. The analysis was controlled for prior diet and activity patterns, levels of exercise training, and time of day (circadian rhythms). Whole blood lactate concentration and plasma concentrations of ions (Zn, Se, Mn, and Co), insulin, glucagon, aldosterone, thyroid stimulating hormone (TSH), calcitonin, and parathyroid hormone (PTH) were measured at rest; at the end of each stage; and 3, 5, and 7 min post-exercise. The statistical analysis involved paired non-parametric tests and correlation coefficients. No significant differences were found in Mn or Co levels as a function of exercise intensity. Zn and Se levels at the end of the exercise protocol and over the recovery time were significantly different to baseline. Further, Zn levels were significantly correlated with aldosterone, calcitonin, and PTH levels, while Se levels were associated with aldosterone, calcitonin, and TSH levels. Our results indicate several different patterns of association between acute changes in hormone concentrations and variations in trace element concentrations related to oxidative stress during submaximal exercise.
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Affiliation(s)
- Marisol Soria
- Department of Pharmacology and Physiology, School of Medicine, University of Zaragoza, Spain, C/ Domingo Miral, s/n. 50.009, Zaragoza, Spain.
| | - Miguel Anson
- Department of Pharmacology and Physiology, School of Medicine, University of Zaragoza, Spain, C/ Domingo Miral, s/n. 50.009, Zaragoza, Spain
| | - Jesús F Escanero
- Department of Pharmacology and Physiology, School of Medicine, University of Zaragoza, Spain, C/ Domingo Miral, s/n. 50.009, Zaragoza, Spain.
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Abstract
Down syndrome is the most commonly encountered human chromosomal disorder. Down syndrome is associated with thyroid dysfunction including: hypothyroidism, both congenital and acquired, and hyperthyroidism. A genetic predisposition and a propensity to acquire autoimmune disorders seem to be possible factors, though their causal relation remains unclear. The aim of the review is to describe what is currently known about the association between Down syndrome and thyroid dysfunction.
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Affiliation(s)
- Lorenzo Iughetti
- a 1 Department of Medical and Surgical sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, via del Pozzo no 71, 41124, Modena, Italy
| | - Laura Lucaccioni
- a 1 Department of Medical and Surgical sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, via del Pozzo no 71, 41124, Modena, Italy
| | - Francesco Fugetto
- a 1 Department of Medical and Surgical sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, via del Pozzo no 71, 41124, Modena, Italy
| | - Avril Mason
- b 2 Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Sick Children, G3 8SJ, UK
| | - Barbara Predieri
- a 1 Department of Medical and Surgical sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, via del Pozzo no 71, 41124, Modena, Italy
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Alvarez‐Salas E, Alcántara‐Alonso V, Matamoros‐Trejo G, Vargas MA, Morales‐Mulia M, Gortari P. Mediobasal hypothalamic and adenohypophyseal TRH‐degrading enzyme (PPII) is down‐regulated by zinc deficiency. Int J Dev Neurosci 2015; 46:115-24. [DOI: 10.1016/j.ijdevneu.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/30/2015] [Accepted: 08/03/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Elena Alvarez‐Salas
- Department of Neurosciences ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico
- ISSSTE School of Dietetics and NutritionMexico
| | - Viridiana Alcántara‐Alonso
- Department of Neurosciences ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico
- ISSSTE School of Dietetics and NutritionMexico
| | - Gilberto Matamoros‐Trejo
- Department of Neurosciences ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico
| | - Miguel Angel Vargas
- Instituto de BiotecnologíaUniversidad Nacional Autónoma de MéxicoCuernavacaMor 62271Mexico
| | - Marcela Morales‐Mulia
- Department of Neurosciences ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico
| | - Patricia Gortari
- Department of Neurosciences ResearchNational Institute of Psychiatry Ramón de la Fuente MuñizMexico
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16
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Biswas UK, Kumar A. Does assessment of carbonic anhydrase activity support the diagnosis of various thyroid disorders. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60467-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Betsy A, Binitha M, Sarita S. Zinc deficiency associated with hypothyroidism: an overlooked cause of severe alopecia. Int J Trichology 2013; 5:40-2. [PMID: 23960398 PMCID: PMC3746228 DOI: 10.4103/0974-7753.114714] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hypothyroidism is a common and well recognized cause of diffuse hair loss. Zinc and other trace elements such as copper and selenium are required for the synthesis of thyroid hormones, and deficiency of these can result in hypothyroidism. Conversely, thyroid hormones are essential for the absorption of zinc, and hence hypothyroidism can result in acquired zinc deficiency. The hair loss attributed to hypothyroidism may not improve with thyroxine unless zinc supplements are added, as demonstrated in our case.
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Affiliation(s)
- Ambooken Betsy
- Department of Dermatology and Venereology, Government Medical College, Calicut, Kerala, India
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18
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Noaparast Z, Hosseinimehr SJ. Radioprotective agents for the prevention of side effects induced by radioiodine-131 therapy. Future Oncol 2013; 9:1145-59. [DOI: 10.2217/fon.13.79] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Radioiodine 131 (131I) has been used worldwide for the ablation of remnant thyroidal tissue after surgery or as the first-line treatment for Graves’ disease. Although the use of 131I is becoming increasingly prevalent, there is evidence suggesting that this treatment is associated with side effects such as salivary gland dysfunction and an increased risk of leukemia. This article aims to review the potential use of radioprotective agents and the side effects induced by 131I therapy. Several synthetic and natural compounds have been investigated in preclinical and clinical studies. The protective agents reduced the toxicity of 131I, mainly in the salivary glands, and mitigated the genetic damage through different mechanisms. There are limited clinical studies evaluating the use of radioprotective agents in patients undergoing radioiodine therapy. However, lemon candies, lemon juice and sugarless chewing gum have been proposed to be beneficial for minimizing the side effects of radioiodine within the salivary glands.
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Affiliation(s)
- Zohreh Noaparast
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Pharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Abstract
AIM Assisted reproduction technology is used widely all over the world. There is a great concern about the morbidity of in vitro fertilization (IVF) babies, but investigations are mostly related to mechanical conditions that are attributed to multiparity. This paper aimed to investigate the effect of IVF on thyroid functions in newborns. METHODS A total of 98 healthy, term IVF newborns were evaluated between postnatal 2-4 weeks of age by screening of thyroid functions between July 2006 and April 2008. Ten subjects were assessed as a study group whose thyroid-stimulating hormone (TSH) levels were higher than 6.5 mU/L. Control group consisted of randomly selected 10 naturally conceived infants with hyperthyrotropinemia (whose TSH levels were higher than 6.5 mU/L but under 15 mU/L) with the same age. All children were thoroughly examined, and serum fT4, TSH, anti-thyroid peroxidase and anti-thyroglobulin antibodies were measured, and a thyrotropin-releasing hormone (TRH) test was performed in all subjects in both groups. RESULTS Euthyroid hyperthyrotropinemia was diagnosed in approximately 10% of IVF babies. Exaggerated TSH levels to TRH were obtained in all IVF babies (subclinical hypothyroidism) but in none of the controls. A significant difference was noted in the concentration of TSH at the 20th min between the two groups (p < 0.001). Besides, sustained and delayed TSH responses were observed in IVF babies. Neonatal screening tests were negative in both of the groups. CONCLUSION In IVF babies, despite normal neonatal screening tests, subclinical hypothyroidism might be observed that suggests the need for screening in this respect.
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Affiliation(s)
- Hasan Onal
- Division of Metabolic Diseases, Department of Pediatrics, Ministry of Health Bakirkoy Maternity and Children Education Hospital, Istanbul, Turkey.
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20
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Tomilova IK, Gromova OA, Grishina OV. Macro- and microelements in the brains of fetuses and newborns in normal and pathological states: A review. NEUROCHEM J+ 2012. [DOI: 10.1134/s1819712412010084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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Hypothyroidism. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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22
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Barollo M, Medici V, D’Incà R, Banerjee A, Ingravallo G, Scarpa M, Patak S, Ruffolo C, Cardin R, Sturniolo GC. Antioxidative potential of a combined therapy of anti TNFα and Zn acetate in experimental colitis. World J Gastroenterol 2011; 17:4099-103. [PMID: 22039323 PMCID: PMC3203360 DOI: 10.3748/wjg.v17.i36.4099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 02/19/2011] [Accepted: 02/26/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate whether combination therapy with anti-tumour necrosis factor α (TNFα) antibody and Zn acetate is beneficial in dextran sodium sulphate (DSS) colitis.
METHODS: Colitis was induced in CD1-Swiss mice with 5% DSS for 7 d. The experimental mice were then randomised into the following subgroups: standard diet + DSS treated (induced colitis group); standard diet + DSS + subcutaneous 25 μg anti-TNFα treated group; Zn acetate treated group + DSS + subcutaneous 25 μg anti-TNFα; standard diet + DSS + subcutaneous 6.25 μg anti-TNFα treated group and Zn acetate treated group + DSS + subcutaneous 6.25 μg anti-TNFα. Each group of mice was matched with a similar group of sham control animals. Macroscopic and histological features were scored blindly. Homogenates of the colonic mucosa were assessed for myeloperoxidase activity as a biochemical marker of inflammation and DNA adducts (8OH-dG) as a measure of oxidative damage.
RESULTS: DSS produced submucosal erosions, ulcers, inflammatory cell infiltration and cryptic abscesses which were reduced in both groups of mice receiving either anti-TNFα alone or combined with zinc. The effect was more pronounced in the latter group (vs Zn diet, P < 0.02). Myeloperoxidase activity (vs controls, P < 0.02) and DNA adducts, greatly elevated in the DSS fed colitis group (vs controls, P < 0.05), were significantly reduced in the treated groups, with a more remarkable effect in the group receiving combined therapy (vs standard diet, P < 0.04).
CONCLUSION: DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity.
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23
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Pathak R, Dhawan D, Pathak A. Effect of zinc supplementation on the status of thyroid hormones and Na, K, And Ca levels in blood following ethanol feeding. Biol Trace Elem Res 2011; 140:208-14. [PMID: 20405336 DOI: 10.1007/s12011-010-8691-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
Abstract
The influence of zinc (Zn) on the serum levels of triiodothyronine (T(3)), thyroxine (T(4)), thyroid-stimulating hormone (TSH) and sodium (Na), potassium (K), and calcium (Ca) was evaluated following ethanol toxicity to the rats. To achieve this, male Wistar rats (150-195 g) were given 3 ml of 30% ethanol orally, and zinc was given in the form of zinc sulfate (227 mg/l) in their drinking water daily for 8 weeks. Ethanol feeding resulted in a slight decrease in T(3) and T(4) levels and a significant increase in thyroid-stimulating hormone concentration, which may be due to the direct stimulatory effect of ethanol on thyroid. Interestingly, when zinc was given to these rats, all the above levels were brought quite close to their normal levels, thus indicating the positive role of zinc in thyroid hormone metabolism. Serum Zn and Ca levels were found to be reduced, but Na levels were raised upon ethanol feeding. Restoration of normal levels of these metals upon zinc supplementation to ethanol fed rats confirms that zinc has potential in alleviating some of the altered thyroid functions following ethanol administration.
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Affiliation(s)
- R Pathak
- Department of Physiology, Bhojia Dental College, Baddi, India.
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24
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Park YM, Kang SG, Lee BH, Lee HJ. Decreased thyroid function in Korean women with bipolar disorder receiving valproic acid. Gen Hosp Psychiatry 2011; 33:200.e13-5. [PMID: 21596216 DOI: 10.1016/j.genhosppsych.2010.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 11/14/2010] [Accepted: 11/15/2010] [Indexed: 12/26/2022]
Abstract
We report here two adult female patients with bipolar disorder who developed abnormal thyroid function after short-or long-term administration of valproic acid (VPA). The first patient developed sick euthyroid syndrome (relative to her pretreatment thyroid levels) after only 2 months of treatment with VPA and quetiapine. The second patient, who had no pretreatment medical history including thyroid disease, developed hypothyroidism after several years of treatment with VPA and quetiapine.
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Affiliation(s)
- Young-Min Park
- Department of Neuropsychiatry, Ilsanpaik Hospital, Inje University College of Medicine, Goyang 411-706, South Korea.
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Lima AS, Cardoso BR, Cozzolino SF. Nutritional status of zinc in children with Down syndrome. Biol Trace Elem Res 2010; 133:20-8. [PMID: 19468695 DOI: 10.1007/s12011-009-8408-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 05/12/2009] [Indexed: 11/25/2022]
Abstract
Experimental and clinical studies have established that zinc metabolism is altered in individuals with Down syndrome (DS). The present study intends to evaluate the nutritional status of zinc in children with DS by determining their biochemical and dietary parameters. The investigation was carried out on a group of children with DS (n = 35) and compared with a control group (n = 33), both aging between 4 and 11 years. Weight-for-age, height-for-age, and weight-for-height indexes and diet were evaluated by using a 3-day dietary record. Zinc was evaluated in plasma, erythrocytes, and 24-h urine collection by using the method of atomic absorption spectroscopy. The frequency of short stature was higher in children with DS. Both groups presented high protein content, adequate concentrations of lipids and carbohydrates, and deficit in calories. Adequate zinc intake was observed in 40% of children with DS and in 67% of the control group. Zinc concentrations were significantly lower in plasma and urine and higher in erythrocytes of children with DS. The results allowed us to conclude that the altered zinc nutritional status of individuals with Down syndrome contributes to clinical disturbances that usually appear with aging in these patients.
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Affiliation(s)
- Adriana S Lima
- Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
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26
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Kandhro GA, Kazi TG, Afridi HI, Kazi N, Baig JA, Arain MB, Sirajuddin, Shah AQ, Sarfraz RA, Jamali MK, Syed N. Effect of zinc supplementation on the zinc level in serum and urine and their relation to thyroid hormone profile in male and female goitrous patients. Clin Nutr 2009; 28:162-8. [PMID: 19250719 DOI: 10.1016/j.clnu.2009.01.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 12/23/2008] [Accepted: 01/26/2009] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS Zinc (Zn) is an essential element involved in many basic biochemical reactions in thyroid. The aims of present study is to evaluate the Zn status in biological samples and thyroid hormones levels in 60 goitrous male (GMPs) and 72 female patients (GFPs), before and after 6 months treatment with Zn supplementation and compared with non-goitrous subjects of both genders (M=106, F=120) of age range 16-30 years. METHODS The biological samples were analyzed for Zn concentration using flame atomic absorption spectrophotometer, following their microwave assisted acid digestion. Quality control for the methodology was established with certified samples and with those obtained by conventional wet acid digestion method on the same CRMs and real samples. RESULTS The results showed that the significantly lower mean values of Zn in serum, while high level urine samples of GMPs and GFPs were observed as compared to control subjects (p<0.005 and 0.007) respectively. The mean values of free triiodothyronine and thyroxin were found to be lower in goitrous patients of both genders than in the age matched healthy control (p<0.006 and 0.002) respectively, in contrast high mean values of thyroid stimulating hormone were detected in GMPs and GFPs (p<0.009). CONCLUSION It was observed that Zn status and serum thyroid hormone levels were improved in goitrous patients after six months treatment with Zn supplementation.
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Affiliation(s)
- Ghulam Abbas Kandhro
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro 76080, Sindh, Pakistan.
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Marreiro DDN, de Sousa AF, Nogueira NDN, Oliveira FE. Effect of zinc supplementation on thyroid hormone metabolism of adolescents with Down syndrome. Biol Trace Elem Res 2009; 129:20-7. [PMID: 19050829 DOI: 10.1007/s12011-008-8280-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Accepted: 11/11/2008] [Indexed: 11/24/2022]
Abstract
Studies have evidenced that zinc metabolism is altered in the presence of Down syndrome, and zinc seems to have a relationship with the metabolic alterations usually present in this syndrome. In this work, the effect of zinc supplementation on thyroid hormone metabolism was evaluated in adolescents with Down syndrome. A prospective study was carried out on 16 adolescents with Down syndrome (age: 10-19 years) who were randomized for treatment with 30 mg zinc daily for 4 weeks. Diet evaluation was accomplished y using a 3-day dietary record, and the analysis was performed by the NutWin program, version 1.5. Anthropometric measurements were performed for evaluation of body composition. The Zn-related nutritional status of the groups was evaluated by means of zinc concentration determinations in plasma and erythrocytes using the method of atomic absorption spectroscopy, and the thyroid hormone was obtained by radioimmunoassay. The diet of patients with Down syndrome, before and after the intervention presented reduced energy level and adequate zinc concentrations. Mean plasma zinc values were 59.2 +/- 13.2 and 71.0 +/- 21.9 microg/dL before and after the intervention, respectively. Erythrocyte concentrations of the mineral before supplementation, instead, were 51.5 microg/dL +/- 11.1 microg Zn/gHb, and at the end of the experiment, they were 42.9 +/- 8/5 microg Zn/gHb, with a significant statistical difference (p < 0.05). Serum concentrations of T(4) hormone before and after zinc supplementation were 1.26 +/- 0.20 and 1.54 +/- 0.63 pg/mL, respectively. Mean T(3) values before intervention were 2.47 +/- 037 pg/mL and, after supplementation, 2.25 +/- 0.67 pg/mL, without significant statistical difference (p > 0.05). Intervention with zinc showed to be effective in the stabilization of the concentrations of this mineral in plasma and erythrocytes, but had no influence on the metabolism of thyroid hormones.
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Katzen-Luchenta J. The declaration of nutrition, health, and intelligence for the child-to-be. Nutr Health 2008; 19:85-102. [PMID: 18309769 DOI: 10.1177/026010600701900212] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Declaration of Nutrition, Health, and Intelligence for the Child-to-be is an urgent cry from the unborn child for a life-span of nutrients for physical and mental wellness. It is a proclamation of paramount importance for everyone involved in child development: parents, health professionals, teachers, government agencies, all producers of food--and children, so they may learn how to feed themselves well. The Declaration of Olympia on Nutrition and Fitness, 1996, came from a group pf nutritional scientists and medical doctors to commemorate the Olympic Games' 100th anniversary. They based it on the health principles of Hippocrates: genetics, the age of the individual, the powers of various foods, and exercise. Following today's vast wealth of nutritional research and expressing it with my teaching experience, I have revitalized the Declaration of Olympia by writing from the heart of the little learner and the hope of the child-to-be. The nutrients implicated in healthy reproduction and lifelong health include B vitamins, particularly B1, B6, folate, B1312 antioxidants, particularly vitamins C and E: minerals such as iron, zinc, magnesium, selenium, iodine, and copper; and essential fatty acids, particularly DHA. These nutrients also lower the risk of neural tube defects: autism, dyslexia, Down's syndrome: childhood cancers, obesity, and defective fetal cell membranes associated with maternal diabetes. Our metabolism is hugely influenced also by activity and by affection. Today's foods are often processed beyond the cells' recognition and can result in neurological and physical morbidity and mortality. A diet of unprocessed free-range animals and seafood: legumes, deep-colored vegetables and fruits: nuts, seeds, and whole grains, germ and bran, reinstates nutritional potency.
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Haase H, Overbeck S, Rink L. Zinc supplementation for the treatment or prevention of disease: current status and future perspectives. Exp Gerontol 2007; 43:394-408. [PMID: 18221847 DOI: 10.1016/j.exger.2007.12.002] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 10/25/2007] [Accepted: 12/04/2007] [Indexed: 11/15/2022]
Abstract
Zinc is a nutritionally essential trace element, and thus zinc deficiency may severely affect human health. Many studies were published in which the effect of nutritional zinc supplementation on the incidence or severity of a certain disease was investigated. This review summarizes the main observations and aims to evaluate the use of nutritional zinc supplementation for prevention and treatment of human disease.
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Affiliation(s)
- Hajo Haase
- Institute of Immunology, University Hospital, RWTH Aachen University, Germany
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30
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Risk factors for development of subclinical hypothyroidism during valproic acid therapy. J Pediatr 2007; 151:178-81. [PMID: 17643774 DOI: 10.1016/j.jpeds.2007.02.046] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Revised: 11/07/2006] [Accepted: 02/15/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify risk factors for subclinical hypothyroidism (SCH) (thyroid-stimulating hormone levels >5 mIU/mL) in patients receiving valproate (VPA) therapy. STUDY DESIGN During a period of 2 years, consecutive patients with epilepsy receiving VPA and a control group of patients with diseases other than epilepsy attending a tertiary care neurology clinic were screened for SCH. The 2 groups were compared. The association between SCH and specific risk factors was investigated with bivariate and multivariate analyses. RESULTS Thirty-six of 143 patients receiving VPA (25.2%, mean age +/- SD: 8.5 +/- 6.6 years) and none of the 35 control subjects had SCH (P < .001). Predictors of SCH were younger age (OR: 1.15, cutoff age 3.9 years); duration of treatment between 6 and 24 months versus <6 months (OR: 2.98) and >24 months (OR: 2.66); VPA polytherapy with enzyme-inducing agents (OR: 6.08), or polytherapy with non-enzyme-inducing agents (OR: 3.34) compared with VPA monotherapy. Most (88.2%) patients with duration of therapy >2 years were older than 3.9 years. CONCLUSION Risk factors for SCH were young age, co-medication with antiepileptic drugs, and duration of therapy between 6 and 24 months. Screening patients with these risk factors may be warranted.
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Temple LM. Hypothyroidism. Integr Med (Encinitas) 2007. [DOI: 10.1016/b978-1-4160-2954-0.50041-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Thiel R, Fowkes SW. Down syndrome and thyroid dysfunction: Should nutritional support be the first-line treatment? Med Hypotheses 2007; 69:809-15. [PMID: 17382480 DOI: 10.1016/j.mehy.2007.01.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Accepted: 01/27/2007] [Indexed: 10/23/2022]
Abstract
Individuals with Down syndrome (DS) not only have increased risk of hypothyroidism, they also tend to develop a relatively novel mild form of neonatal hypothyroidism. One problem that may predispose those with trisomy 21 to hypothyroidism is the overexpression of the gene DYRK1A, which may have an affect on the thyroid. While thyroxine supplementation (such as Synthroid) is increasingly being advised for those with DS, this treatment may have both positive and negative effects. Nutritional support for hypothyroidism offers some of the same benefits as drug therapy but without the likely negative long-term effects. Early 20th century practitioners used bovine glandulars for those with DS children, which were believed to help support thyroid function. Some doctors in more recent times have also included iodine, L-tyrosine, selenium, and zinc. As nutrition for those with DS has been safely used by some practitioners for many decades, it is suggested that nutritional thyroid support, and not necessarily thyroxine, should be considered for use as a first line treatment for those with trisomy 21. This paper also hypothesizes that nutritional interventions begun prenatally by the mother, may possibly also be of benefit.
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Affiliation(s)
- R Thiel
- Center for Natural Health Research, Down Syndrome-Epilepsy Foundation, 1248 E. Grand Avenue, Suite A, Arroyo Grande, CA 93420, USA.
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Abstract
Este estudo relata os aspectos funcionais do zinco, bem como a participação desse mineral nas alterações metabólicas presentes em indivíduos portadores de Síndrome de Down. A maioria dos trabalhos realizados observou que o estado nutricional relativo ao zinco nesses pacientes está inadequado, com alterações no sistema antioxidante, imunológico e no metabolismo dos hormônios da tireóide. Estudos in vitro apontam que o zinco participa como cofator da enzima deiodinase tipo II na conversão periférica de Tiroxina em Triiodotironina, e que essa reação está diminuída em indivíduos portadores de Síndrome de Down, o que contribui para a manifestação de distúrbios, como o hipotireoidismo subclínico. As alterações na compartimentalização do zinco no organismo desses indivíduos também favorecem a expressão excessiva da enzima cobre/zinco (Cu/Zn) superóxido dismutase, com aumento do estresse oxidativo, e ainda alterações no sistema imune. Na Síndrome de Down, tem sido demonstrada melhora no metabolismo dos hormônios tireoidianos e na função imune, após a suplementação com zinco. Portanto, o papel metabólico do zinco na Síndrome de Down deve ser mais pesquisado, tendo em vista que esse mineral pode contribuir no controle das alterações metabólicas comumente presentes em indivíduos portadores dessa síndrome.
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Dierssen M, Ortiz-Abalia J, Arqué G, de Lagrán MM, Fillat C. Pitfalls And Hopes in Down Syndrome Therapeutic Approaches: In the Search for Evidence-Based Treatments. Behav Genet 2006; 36:454-68. [PMID: 16520905 DOI: 10.1007/s10519-006-9050-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Accepted: 07/17/2005] [Indexed: 11/26/2022]
Abstract
Trisomy 21 or Down syndrome (DS) is a complex syndrome, of genetic origin with multiple and variable neurobiological and neuropsychological manifestations. DS patients have consistent signs of brain damage along their lives, but understanding the biology of DS is complicated due to the extraordinary heterogeneity of the phenotypic signs. Thus, treatment of DS mental retardation poses significant challenges for clinicians and scientists. The review addresses the classical pharmacological and environmental treatments and also critically reviews the new possibilities that are emerging from the exciting advances in gene or cell therapy. We describe some of the most recent developments in the field and give a sense of the prospects for future prevention and therapy.
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Affiliation(s)
- Mara Dierssen
- Genes and Disease Program, Genomic Regulation Center, (CRG-UPF), Barcelona Biomedical Research Park, Spain
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Abstract
Non-Asian individuals with Down syndrome are much more likely to develop epileptic seizure disorders than individuals without Down syndrome. Examination of nutrient and metabolite levels in patients with these two seemingly disparate disorders reveals numerous similarities. Compared to individuals without these disorders, individuals with Down syndrome and individuals with seizures may have lower levels of vitamin A, vitamin B1, folate, vitamin B12, vitamin C, magnesium, manganese, selenium, zinc, carnitine, carnosine, choline, and possibly serine. Excesses of copper, cysteine, phenylalanine, and superoxide dismutase are also sometimes encountered in both disorders. In addition to common nutritional lower levels and excesses, disorders of metabolism involving vitamin B6, vitamin D, calcium, and tryptophan may play a common role. This paper hypothesizes that nutritional factors may account for the high joint occurrence of these conditions. Further examination of these data may provide insights into nutritional, metabolic and pharmacological treatments for both conditions.
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Affiliation(s)
- R J Thiel
- Technical Research Department, First National University, 2 Forrest Road, Fort Oglethorpe, GA 30742, USA.
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Ai J, Leonhardt JM, Heymann WR. Autoimmune thyroid diseases: etiology, pathogenesis, and dermatologic manifestations. J Am Acad Dermatol 2003; 48:641-59; quiz 660-2. [PMID: 12734493 DOI: 10.1067/mjd.2003.257] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Autoimmune thyroid disease (AITD) including Graves' disease, Hashimoto's thyroiditis, and idiopathic hypothyroidism (atrophic Hashimoto's thyroiditis) is of vital concern to the dermatologist. This article reviews the cutaneous manifestations of Graves' disease and Hashimoto's thyroiditis. Recognition of dermatologic manifestations of AITD may alert practitioners to investigate for these disorders. The immune response involved in the pathogenesis of AITD is detailed. Current understanding of the role of genetic and environmental factors, antigens, and apoptosis are elaborated. The future holds exciting insight into the etiology, pathogenesis, and treatment of AITD.
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Affiliation(s)
- Julia Ai
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, USA
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