Hashimoto's autoimmune thyroiditis and vitamin D deficiency

[helvella]

In Marz' home of Crete, with boundless sunshine and wonderful weather, at least two medics have decided that research into vitamin D is needed - and have published the paper abstracted below.

What is the situation for the rest of us in dark, cloudy and rainy northern Europe?

Hell J Nucl Med. 2014 Feb 21. pii: s002449910120. [Epub ahead of print]

Hashimoto's autoimmune thyroiditis and vitamin D deficiency. Current aspects.

Mazokopakis EE, Kotsiris DA.

Author information

Iroon Polytechniu 38A, Chania, 73 132, Crete, Greece.

Abstract

Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroid disease caused by an interaction between genetic factors and environmental conditions, both of which are not yet completely understood. The significant association between vitamin D deficiency and HT has been investigated regarding the immune role of this hormone. In HT, an immunologic reaction is triggered when thyrocytes express major histocompatibility complex (MHC) class II surface HLA-DR antigens, a process induced by the production from T helper (Th)1 type lymphocytes, of inflammatory cytokines (especially IFN-γ), which may be inhibited by 1,25[OH]2D. Genetic polymorphism of vitamin D receptor (VDR), binding protein (DBP) and of 1α-hydroxylase (CYP1α) may also predispose to the development of HT. Considering current evidence, presented in this review, screening for vitamin D deficiency and careful vitamin D supplementation, when required, may be recommended for patients with HT. Further research is needed in patients with HT in order to investigate the mechanisms by which vitamin D affects autoimmunity and also to evaluate the cost-effectiveness of vitamin D supplementation and to suggest the possible optimal dose treatment.

PMID:

24563883

[PubMed - as supplied by publisher]

Rod

[Moggie]

Can't honestly say that I understood much of the above Rod, apart from further research is needed, can you simplify.

Didn't like the "cost effective" bit, lets hope their research doesn't conclude that it isn't cost effective to test or treat for vitd deficiency. Not many of us are given further treatment after an initial loading dose, which then raises out levels out of the NHS deficient range and so forfeit any further treatment, but surely the amount you supplement after that is unique to each person. If I were Marz's next door neighbour maybe I wouldn't need to supplement 3,000iu daily.

Moggie x

[helvella in reply to Moggie]

People who have a genetic factor that affects their vitamin D levels may also be predisposed to get Hashimoto's. That is, there is a link such that those with Hashimoto's may be more likely to need vitamin D supplementation.

Hope someone else agrees! Or tells me that is wrong.

Rod

[Moggie in reply to helvella]

Wonder if Marz would sign up for the study.lol.

Thanks for the explanation, its was just too scientific for poor little old me. If they do find a genetic link I wonder how long that will take to filter through to our GP's and would they then automatically test for vitd deficiency as soon as they found hashi's seeing as some GP's, mine included, refused to test for hashi's as "it really doesn't make a difference to the outcome".

Moggie x

[helvella in reply to Moggie]

Maybe they would test for Hashimoto's in all those with low vitamin D?

Rod

[Moggie in reply to helvella]

Did that purple pig with green spots just fly past your window as well Rod!!!!!! LOL

Moggie x

[Marz in reply to helvella]

Am sure you saw the letter that was sent out in 2012 from the Chief Medical Officer of Health - indicating to all Health Workers that vulnerable people should be tested for VitD. I do not think there should have been a list of people to be tested - EVERYONE should be.

[Glenys in reply to helvella]

I wish!

[Glenys in reply to Glenys]

I had to ASK for my vitD test, then when I was daignosed very low, I asked (a different) GP if I would have had other vit D tests before, and she replied that the only request it when they think its needed! I told her tha I have had the symptoms years and it was me that requested it. The next (different) GP then had the cheek to tell me there was no point in teating for vit D as everyone in the UK is deficient, And so on.....#

[Marz in reply to helvella]

Thanks for posting Rod. I have written to the researchers and offered to be a lab-rat. I would like to know if I have this problem with VitD as that could well have been the cause of the Ileo-caecal TB as well. I have been taking 10,000 IU's daily as it has helped the Crohns too - as learnt from the Vitamin D Council - which was posted on this forum.

My health has improved greatly in the last two years - which I also attribute to increased B12 VitD and T3.... so in my book you are NOT wrong. Have read Michael Holicks book - The Vitamin D Solution - which does promote thoughts that LOW VitD is connected to so many conditions. The list is endless.

It is not an expensive treatment so can't imagine why they should mention costs - perhaps they are expecting millions to need the treatment. Also being PC as Greece is bust ! Thyroid issues certainly abound here - is it the environment/soil - Nato base ?? - or is it just they test more thoroughly in the beginning ? Yes lots of Greeks think that the American base pollutes the sea with the subs coming in and out of Souda !!

[helvella in reply to Marz]

Thanks Marz,

According to my stab-in-the-air calculation, testing once costs about twice as much as a one year supply of 5000 IU D3 capsules. Agreed not intrinsically expensive (though the testing costs have dropped markedly over the past few years), but the scale is a problem - unless universal approaches are adopted.

Rod

[Marz in reply to helvella]

Yes - I did not think of testing costs - was merely thinking of the cost of the treatment. See below my comment to Moggie about the researchers reply....

[Moggie in reply to helvella]

I wonder if that gene also effects iron as so many of us also have trouble with, firstly increasing our iron levels, and then maintaining them at an acceptable level.

Just a thought.

Moggie x

[Marz in reply to Moggie]

...our bodies are complex computers - and the connections just keep on appearing. Go with your gut reactions..... M x

[TSH110 in reply to helvella]

I wonder if my hypo is HT. I only ever heard thyroiditis mentioned as the cause. Would the findings above still be of possible relevance?

[helvella in reply to TSH110]

Most hypothyroid people here have Hashimoto's (autoimmune thyroid disease). Something like 80% in the UK and USA.

I do not - so far as I know. My Thyroid Peroxidase antibodies test was negative.

[Marz in reply to TSH110]

Best to have your thyroid anti-bodies tested - Anti-TPO and Anti-Tg. Then you will know for sure. Doctors have this misplaced conception that the treatment is the same for Hypothyroidism and Hashimotos. The latter is auto-immune in which case healing the gut is important along with an awareness that other auto-immune issues may creep in. Also supplements are much needed. Often with Hahsi's there are conversion issues - t4 tablet into the ACTIVE T3 hormone that is needed in every cell of you body - TRILLIONS ! Also important for the FT3 to be tested too....

Hashimotos is the most common of thyroid conditions throughout the world....my anti-bodies were high and TFT's in range - so thankfully I live in Crete and received treatment. Now T3 only....

[TSH110 in reply to Marz]

I was told that my immune system had attacked my thyroid, and it had shrivelled away. I had a short period of hyper when my thyroid dumped its store of thyroxine, then I went hypo for good and was started on levothyroxine. I will ask my GP if it is HT or something else.

[Marz in reply to TSH110]

Sounds as if you have Hashimotos. Hope your Doc has some answers. Maybe ask for copies of all your blood test results going back to the initial diagnosis. They are yours by right. There should be some anti-body results there Otherwise how would he know your thyroid has shrivelled away. Have you had a scan to demonstrate this ? They sometime make things up to fit the criteria....

[TSH110 in reply to Marz]

My Endo did a scan on the thyroid because of the family history of lymphoma/

thyroid cancer. So it deffo is very small and shrivelled and probably does not make any thyroxine - they told me they can't know for sure if there is any function left but my Levo dosage suggests little or nothing is going on.. I have all the blood tests from the Endo (bar the first two) and have started asking for copies at the new practice ( I moved about a year ago my previous GP in London was fantastic), and will ask for the missing ones they have done. I was told everything was being tested because of my ongoing health problems - many hypo symptoms yet 'optimised' - but was dismayed to discover the last test was just TSH and T4 - about as minimal and useless as it can get - and I had asked the practice nurse to include for iron due to breathlessness - that all seems ok. I have swapped GP's. Already he is going to sort out a really troublesome Bakers Cyst that I was told was completely untreatable. He is going to talk to me about the thyroid problems - seems sympathetic but suspect conservative. At least he listens. I will dig out old tests and post the one with antibodies etc

Thanks

[Marz in reply to TSH110]

Glad you are being cared for....

[Glenys in reply to helvella]

Wierdly enough I am just looking into the possibilty of my having hashimoto's and last year I was extremely deficient in vit D. The only time I was pain free was when my vit D initial very high supplementation put me with a blood test reading of 120, then it dropped to a more "respectable level" of around 60 when I was put on a standard daily dose, and the pain returned.

[Marz in reply to Moggie]

Oh yes you would - after moving here in 2004 hubby and I tested insufficient a couple of years ago. I take 10,000 IU's daily as it helps Crohns as well. vitamindcouncil.org Hubby takes 5000IU's. It's possible we have an issue with the VDR as mentioned in the abstract.

I think it is the auto-immune component or the aging process - or BOTH

Anyway I have written to the dear man by e-mail offering to be a lab rat !! Have also printed off copies to deliver to the GP and the Haematology Clinic down the road....

Had my annual blood checks last week and collect results tomorrow. Had anti-bodies tested for the first time since 2011 - as I wanted to see if there was an improvement. Both of us have Hashi's and both our Mums died with Non-Hodgkins Lymphoma - I am suspecting a connection. Rubbish blood and all that.....due to the low absorption of goodies....

Cost - well I think they are being PC as Greece is bust. They probably paid for the research themselves - as Docs here are sometimes not paid and they give their time for free. All is not lost - will keep you informed.

M x

[Moggie in reply to Marz]

Morning Marz,

Would love you to get picked as one of the lab rats as you seem to have a lot of questions surrounding this issue plus we would have our own excellent source of first hand info.

Cant believe that with all the sunshine you get you are still on such a high dose of vitd daily, that has suprised me. So when the docs in this country tell you that to cure your vitd deficiency you just require 15 mins of sunshine daily they are totally misleading you - wouldn't be the first time I suppose.

Are you expecting your antibodies to have dropped Marz - Have you been doing anything different to warrant a drop (diet?) is that why you asked for the test?

Have a lovely, restful Sunday Marz.

Moggie x

[Marz in reply to Moggie]

Hi Moggie - just been down to the beach for a doggie walk - and to soak up some D !! On the way home I came across a field of wild blue lupins - wow quite spectacular.

Yes I am on a high dose because of the Crohns. A colonoscopy last year revealed that I still do have Crohns lesions and the Gastro man wanted more tests and prescribed a nasty drug. Well I decided VitD would serve me better. Before being on this forum I had not realised the importance of D so have been educating myself and want to know if it has impacted the anti-bodies. Started T3 at the same time. It seems that D affects as many conditions as the thyroid - so there could well be a big connection.

I think sitting in the sun - as prescribed in the UK is fine - is the best way of getting adequate D into the system. However it has to be midday sun and at least 40% of your body needs to be exposed. Not really practical in your lunch hour Then of course we forget for all those poor people on statins - their cholesterol is blocked - and will not work in the skin with the UVB to create the D. Another reason so many people are becoming sick - could be those who take statins ? How many in the UK ? - somewhere around 5 million is it ?

Just had an e-mail from the researchers - Thank you for your message and your comments. Seems as if my offer to be a lab-rat have been refused....although it is Carnival Day today everywhere - with Clean Monday tomorrow. Beginning of Lent and they don't eat anything with bones until Easter.... I will write back to them and ask how I get tested for Th1 and for the defects in the VDR's...

Have a lovely day Moggie - and feel free to hop on a plane and come for some Cretan sunshine - we have plenty to spare....

M x

[Moggie in reply to Marz]

They don't know what they have refused as I think you would have made a good lab rat.lol.

Looked at that link you kindly posted and found that low vitd caused anaemia, so if you have one the you'll more than likely have the other, so why didn't my GP automatically test my iron (she refused numerous requests) when she found my vitd was on the floor.

You really do have to do your homework to keep on top of the treatment you are not being offered and to join the dots yourself. Makes me mad that people suffer unnecessarily because doctors ignore what is right in front of their noses.

The walk sounds lovely (then again your whole life out their sounds idyllic) and thanks for the offer of a sun filled holiday but I don't even own a passport, and don't suppose I ever will, as I have a fear of flying.

Moggie x

[Marz in reply to Moggie]

I'll have to send you some pictures then. Possibly when you are OPTIMAL with all your treatments you will overcome your fears. I was once that person. Irrational fears have been mentioned in some lists of Signs and Symptoms - but I cannot remember where !

M x

[TSH110 in reply to Marz]

That is interesting, Marz. My mother and brother both died of non Hodgkins lymphomas. A sister had her thyroid removed because of cancerous lumps which I presume were likely to be lymphoma. My mother's was in the thyroid. Brother's was Burkitts in the guts. Maternal Grandma had a goitre and died of cancer of the spleen (lymphoma?) and my mother's sister had hypothyroidism - my cousin found her thyroxine tablets when she died but had no idea she even suffered from it . I am hypo but no cancer thank god. Seems too coincidental for there not to be a hereditary factor involved.

[Marz in reply to TSH110]

So sorry to hear about all your family. As you say there must be a pre-disposition somewhere along the line. We have in the past thought it could be to do with copied practices - like eating and lifestyle. More and more there seem to be other factors at play.... Still think that food is our medicine though

[TSH110 in reply to Marz]

Thanks Marz. I still do miss them as I am sure you appreciate with the sad loss of your mother.

We grew up on the Wirral where there is a huge petrochemical industry and higher rates of cancer than the national average. Lever Brothers were forever discharging weird stuff into the air some days it smelt like farted custard! God knows what we were breathing in. But only my generation so it can't explain earlier generations thyroid problems, they were based in Hyde Cheshire.

I have always believed you are what you eat. Prior to becoming ill I ate a very heathy Mediterranean type diet (veggie) but as I got ill I started to crave really awful calorie fat laden stuff and never felt satiated. I am trying hard to get back to a better quality of diet now (I still get those dreadful cravings but can override them a bit better now) it has to be the key to better health and is totally within my control.

[Marz in reply to TSH110]

...so understand your feelings. My youngest daughter remained in Birmingham when I moved to Cornwall - way back in 1987. Sadly she had thyroid cancer and was there when Chenobyl happened and those winds carried the toxic clouds into the Welsh mountains....via Birmingham the day after. They still test the sheep before they go into the food chain - sadly not the humans... She is also struggling with another rare cancer too ....

[TSH110 in reply to Marz]

So sorry to hear that Marz. I hope your daughter can defeat it or keep it in check.

My sister who had the thyroidectomy got endometrial cancer but it was nipped in the bud thanks to an article she read in Woman's Realm at her dentists - so lucky. I love Cornwall. I used to live in Portreath

[Marz in reply to TSH110]

...thanks.... Crete is a bit like Cornwall in some ways...

Keep well.... M

[helvella in reply to Marz]

The other week in a program on BBC4, Michael Mosley (I think) mentioned over-bite. Seems this is near-universal now (consider The Simpsons) - but only since the adoption of the fork for eating. Something about the way we use our mouths when hand-to-mouth feeding as against using a fork results in the lower jaw not growing quite the same. I was totally amazed that such a cultural change could have that sort of impact.

Could something like that (or even that itself) have an impact on thyroid development?

Rod

[Marz in reply to helvella]

...now that is strange as I saw a Bowen Therapist when I was in the UK. He did a movement which he thought would benefit the thyroid - it was the TMJ - something to do with the jaw !! Synchronicity at play as so often happens on this forum.....

[crimple]

The research sound very interesting and would certainly like to hear more. I have always craved sunshine, I don't mean lying on a beach, but just bright skies make me feel better! My Vit D was low last year at 50 but I got it up to 80 after taking the tablets and some sunshine holidays. I wonder what it is now? Hopefully not as low as 50 as the winter hasn't been as grey as last year. Will get full tests done soon after paying for my thyroid scan which showed the thyroid was severely atrophied and I have antibodies.In the meantime I will continue with Vit D tabs.

[Hidden]

Well, it's all Greek to me! Perhaps it's a good thing that I'm having more tests tomorrow. Being one of the many undiagnosed, and very much in the dark, having just read this it's made me feel hopeful that at last i have a doc who knows what he's doing. I'm being tested for vit D and B12 amongst other things. Thanks for sharing. Xx

[Marz]

Just don't let him tell you are 'normal ' when you are low in the range - needs to be towards the TOP for optimal health.

Good Luck tomorrow.... and beyond...