Post by kickingfrog on Feb 1, 2011 19:47:23 GMT
Thyroid
Eur J Gastroenterol Hepatol 1998 Nov;10(11):927-31
Autoimmune thyroid diseases and coeliac disease.
Sategna-Guidetti C, Bruno M, Mazza E, Carlino A, Predebon S, Tagliabue M, Brossa C
Department of Internal Medicine, Cattedra di Gastroenterologia, Universita' di Torino, Italy.
BACKGROUND: Coeliac disease may be associated with a wide variety of diseases of known or suspected immunological aetiology. OBJECTIVE: To screen for both (a) the prevalence of coeliac disease in adults with autoimmune thyroid diseases, and (b) thyroid impairment among adults with coeliac disease, as compared to sex- and age-matched controls.
DESIGN: Prospective cohort study. SETTING: University teaching hospital.
PATIENTS: A total of 152 consecutive adults with autoimmune thyroid diseases, 185 consecutive coeliac disease patients (53 newly diagnosed and 132 already on a gluten-free diet) and 170 sex- and age-matched controls.
METHODS: Screening for coeliac disease was done by means of IgA anti-endomysium antibodies, detected by indirect immunofluorescence on monkey oesophagus. Patients with positive sera underwent duodenal biopsy for diagnostic confirmation. Thyroid function was assessed by measuring the levels of serum thyroid-stimulating hormone, free T3, free T4, thyroperoxidase and thyroid microsome antibodies. Autoimmune thyroid diseases were classified according to the American Thyroid Association guidelines.
RESULTS: Anti-endomysium antibodies were positive in five of 152 autoimmune thyroid disease patients (3.3%) and coeliac disease was histologically confirmed in all: this prevalence is 10-fold higher than expected. Only one patient presented with gastrointestinal complaints, but iron deficiency was found in three and alterations at bone mineralometry in all. The overall prevalence of autoimmune thyroid diseases was significantly higher (38/185, 20.5%) in coeliac patients than in controls (19/170, 11.2%). The prevalence of both hypo- and hyperthyroidism was not different from that of controls, while the prevalence of autoimmune thyroid disease with euthyroidism was 13% in patients and 4.7% in controls.
CONCLUSIONS: The association of coeliac disease with autoimmune thyroid disease is not surprising as they share common immunopathogenetic mechanisms. It is advisable to screen autoimmune thyroid disease patients for coeliac disease as there is an increased risk for gluten intolerance. In contrast, thyroid function assessment in coeliac disease patients is probably less justified, although the need for a strict clinical follow-up of those patients with euthyroidism and autoimmune thyroid disease, who could develop overt thyroid impairment, remains an open question.
PMID: 9872614, UI: 99087649
*************
Hashimoto's Disease
What is Hashimoto's disease?
Hashimoto's disease is a problem with your thyroid gland. The thyroid gland is located in the front of your neck, just below your Adam's apple. It makes hormones that control metabolism, the pace of your body's processes. Metabolism includes things like your heart rate and how quickly you burn calories. When you have Hashimoto's disease, your immune system begins to attack your thyroid gland, causing it to become swollen and irritated. When this happens, your thyroid can't make hormones as it normally does.
What causes Hashimoto's disease?
Hashimoto's disease is an autoimmune disease. Normally, antibodies produced by the immune system help protect the body against viruses, bacteria and other foreign substances. An autoimmune disease is when your immune system produces antibodies that attack your body's tissues and/or organs. With Hashimoto's disease, antibodies attack the thyroid.
What are the symptoms of Hashimoto's disease?
Many people who have Hashimoto's disease have no symptoms at all. The disease progresses over time and symptoms are similar to hypothyroidism (underactive thyroid disease). This is because the attack on the thyroid causes the gland to produce fewer hormones. Symptoms of Hashimoto's disease include:
Fatigue
Unexpected weight gain
Increased sensitivity to cold
Muscle aches, cramps, tenderness or stiffness
Pain, stiffness or swelling in your joints
Pale, dry skin
Puffy face
Hoarse voice
Constipation
Heavier than normal periods in women
Elevated blood cholesterol
Depression
Visibly enlarged thyroid
Forgetfulness
How does my doctor know I have Hashimoto's disease?
A blood test can tell if your thyroid gland is not working properly. It measures hormone levels to check for Hashimoto's disease.
Who gets Hashimoto's disease?
Although Hashimoto's disease can affect people of all ages, it's most common in women who are between 30 and 50 years of age. If someone in your family has had thyroid disease, you may have an increased risk for Hashimoto's disease. Doctors are not sure why people get this disease.
How is Hashimoto's disease treated?
Hashimoto's disease has no cure. However, your doctor can treat low thyroid function to minimize any long-term effects.
Treatment for Hashimoto's disease is synthetic thyroid hormone taken daily in pill form. This medicine will regulate hormone levels and shift your metabolism back to normal. It will also lower your low-density lipoprotein (LDL) cholesterol and may help reverse weight gain. The thyroid medicine can replace the hormones your thyroid gland usually makes. How long you need to take the medicine will depend on the results of your blood tests. For most people, taking thyroid hormone medicine causes no problems.
Taking your thyroid medicine and having regular blood tests to see how your thyroid gland is working can help prevent symptoms. Some medicines, supplements and foods may affect your body's ability to absorb the synthetic thyroid hormone. Tell your doctor if you eat large amounts of soy products, are on a high-fiber diet or take other medicines such as iron supplements, calcium supplements, cholestyramine or aluminum hydroxide (found in some antacids).
familydoctor.org/online/famdocen/home/common/hormone/548.html#ArticleParsysMiddleColumn0001
*********************
Thyroid Disease Main Forum
Welcome to the Main Thyroid Disease Forum, hosted by Mary Shomon, your About.com Guide to Thyroid Disease. This is one of a number of forums you can visit for thyroid-related support and information. Here at the main Thyroid Disease Forum, you'll find support, information, camaraderie, and people who understand what you're going through. Whether you're newly diagnosed and want to know what questions to ask your doctor, or you've been living with thyroid disease for years and simply want ideas on how to feel and live better, these boards can be an important part of your wellness.
forums.about.com/ab-thyroid/start
*****************
Thyroid
Endocrinologists Say TSH Normal Range is Now 0.3 to 3
thyroid.about.com/cs/testsforthyroid/a/newrange.htm
***************************
From Jackie MOT on GF Board
Coeliac disease and autoimmune thyroid disease share common immunopathogenetic mechanisms.
See link at the very bottom.
Also interesting is this
www.ithyroid.com/celiac_disease1.htm
A gluten-free diet started early may prevent the other autoimmune diseases frequently associated with celiac disease," Dr. Ventura and colleagues hypothesize. However, further studies will be needed to determine the clinical significance of the organ-specific autoantibodies in these patients and to confirm this hypothesis.
J Pediatr 2000;137:263-265.
I have not heard whether this hypothesis has been followed up.
www.ncbi.nlm.nih.gov/pubmed/9872614?dopt=Abstract
*****************************************************
Autoimmune thyroid disease and celiac disease in children.
(From Charlotte on GF board)
J Pediatr Gastroenterol Nutr. 2003 Jul ;37 (1):63-6 12827007
Autoimmune thyroid disease and celiac disease in children.
Nicoletta Ansaldi , Tiziana Palmas , Andrea Corrias , Maria Barbato , Mario Rocco D'Altiglia , Angelo Campanozzi , Mariella Baldassarre , Francesco Rea , Rosanna Pluvio , Margherita Bonamico , Rosanna Lazzari , Giovanni Corrao
BACKGROUND: Celiac disease (CD) may be associated with other immunologic disorders in adults and children. Previous studies linking CD and autoimmune thyroid disease in children have included very few patients with limited biochemical and immunologic screening tests. The aim of this multicenter study was to establish the prevalence of autoimmune thyroid involvement in a large series of pediatric patients with CD.
METHODS: Five hundred seventy-three consecutive pediatric patients were enrolled from clinics in Torino, Bologna, Foggia, Rome (two clinics), Naples, and Bari. Three hundred forty-three patients with CD were studied, 230 girls and 113 boys (median age, 8.5 years). Two hundred fifty-six of the patients with CD (median age, 9 years) had been following a gluten-free diet for 3 months to 16 years; 87 patients were untreated (median age, 6.2 years). The diagnosis of CD was made using the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. A control group of 230 subjects (median age, 8.3 years) was enrolled. Serum free triiodothyronine, free thyroxine, and thyroid-stimulating hormone (TSH), antithyroperoxidase, antithyroglobulin, anti-TSH receptor antibodies, and thyroid echographic pattern were considered.
RESULTS: Autoimmune thyroid disease was found in 90 of 343 (26.2%) patients with CD (62 on a gluten-free diet) and in 20 (10%) of the control subjects (P = 0.001). Fifty-four (15.7%) patients with CD and autoimmune markers had normal thyroid function (euthyroidism) as did 12 (6.0%) of the control subjects; hypothyroidism was observed in 28 (8.1%) patients with CD and in 7 (3.5%) of the control subjects. Hyperthyroidism was diagnosed in four patients with CD and in none of the control subjects with autoimmune markers. An abnormal echographic pattern was seen in 37 patients with CD (16.8%) and only in 1 (1.6%) of the control subjects (P = 0.002).
CONCLUSIONS: The high frequency of autoimmune thyroid disease found among patients with CD, even those on a gluten-free diet, may justify a thyroid status assessment at diagnosis and at follow-up evaluation of children with CD.
lib.bioinfo.pl/pmid:12827007
*******************
Thyroid function, autoimmune thyroiditis and coeliac disease in juvenile idiopathic arthritis
S. Stagi, T. Giani, G. Simonini and F. Falcini
Department of Paediatrics, Paediatric Rheumatology Unit, University of Florence, Italy.
Correspondence to: F. Falcini, Dipartimento di Pediatria, Via Pico della Mirandola 24, 50132, Firenze, Italy. E-mail: falcini@unifi.it
Objectives. Autoimmune diseases have been associated with some organ non-specific rheumatological disorders such as rheumatoid arthritis and systemic lupus erythematosus; however, few studies have been performed in an extensive cohort of children with juvenile idiopathic arthritis (JIA). Our objective was to evaluate the thyroid function and the prevalence of antithyroid antibodies, autoimmune thyroiditis and coeliac disease in children with JIA.
Methods. One hundred and fifty-one children (120 female, 31 male, median age 8.3 yr, range 2.4–16.9 yr) with JIA were evaluated. All patients underwent thyroid function tests (u-TSH, free T4 and free T3), antithyroglobulin (TgA) and antiperoxidase (TPOA) antibodies, antigliadin, anti-endomysium and antitransglutaminase antibodies. All patients with raised thyroid stimulating hormone levels, low thyroid hormone levels or positive TPOA and/or TgA values had a thyroid high-resolution sonography examination. Coeliac disease was confirmed by jejunal biopsy if the specific antibodies profile was positive. One hundred and fifty-eight age- and sex-matched Caucasian children from the same geographical area acted as controls.
Results. Fourteen (9.3%) patients showed subclinical hypothyroidism, 17 (11.9%) patients showed autoimmune thyroiditis with nine patients also showing a non-homogeneous thyroid parenchyma at ultrasound evaluation. Coeliac disease was demonstrated in 10 (6.6%) patients. Compared with controls, JIA patients had higher prevalence of subclinical hypothyroidism (P<0.01), autoimmune thyroiditis (P<0.0001) and coeliac disease (P<0.005).
Conclusions. JIA children have an increased prevalence of autoimmune thyroiditis, subclinical hypothyroidism and coeliac disease. These data seem to suggest careful monitoring of thyroid function, thyroid autoantibodies and coeliac disease in JIA children.
***************************
Calcium supplements and thyroxine
Most women now know that taking calcium is a cheap and easy way to protect against bone loss, but such supplementation may be tricky in those being treated for an underactive thyroid.
Researchers report that calcium may interfere with the absorption of the most widely used therapy for this condition, and they raise a red flag that the two should not be taken together.
my.webmd.com/content/article/25/1728_58215?
***********************
Eur J Gastroenterol Hepatol 1998 Nov;10(11):927-31
Autoimmune thyroid diseases and coeliac disease.
Sategna-Guidetti C, Bruno M, Mazza E, Carlino A, Predebon S, Tagliabue M, Brossa C
Department of Internal Medicine, Cattedra di Gastroenterologia, Universita' di Torino, Italy.
BACKGROUND: Coeliac disease may be associated with a wide variety of diseases of known or suspected immunological aetiology. OBJECTIVE: To screen for both (a) the prevalence of coeliac disease in adults with autoimmune thyroid diseases, and (b) thyroid impairment among adults with coeliac disease, as compared to sex- and age-matched controls.
DESIGN: Prospective cohort study. SETTING: University teaching hospital.
PATIENTS: A total of 152 consecutive adults with autoimmune thyroid diseases, 185 consecutive coeliac disease patients (53 newly diagnosed and 132 already on a gluten-free diet) and 170 sex- and age-matched controls.
METHODS: Screening for coeliac disease was done by means of IgA anti-endomysium antibodies, detected by indirect immunofluorescence on monkey oesophagus. Patients with positive sera underwent duodenal biopsy for diagnostic confirmation. Thyroid function was assessed by measuring the levels of serum thyroid-stimulating hormone, free T3, free T4, thyroperoxidase and thyroid microsome antibodies. Autoimmune thyroid diseases were classified according to the American Thyroid Association guidelines.
RESULTS: Anti-endomysium antibodies were positive in five of 152 autoimmune thyroid disease patients (3.3%) and coeliac disease was histologically confirmed in all: this prevalence is 10-fold higher than expected. Only one patient presented with gastrointestinal complaints, but iron deficiency was found in three and alterations at bone mineralometry in all. The overall prevalence of autoimmune thyroid diseases was significantly higher (38/185, 20.5%) in coeliac patients than in controls (19/170, 11.2%). The prevalence of both hypo- and hyperthyroidism was not different from that of controls, while the prevalence of autoimmune thyroid disease with euthyroidism was 13% in patients and 4.7% in controls.
CONCLUSIONS: The association of coeliac disease with autoimmune thyroid disease is not surprising as they share common immunopathogenetic mechanisms. It is advisable to screen autoimmune thyroid disease patients for coeliac disease as there is an increased risk for gluten intolerance. In contrast, thyroid function assessment in coeliac disease patients is probably less justified, although the need for a strict clinical follow-up of those patients with euthyroidism and autoimmune thyroid disease, who could develop overt thyroid impairment, remains an open question.
PMID: 9872614, UI: 99087649
*************
Hashimoto's Disease
What is Hashimoto's disease?
Hashimoto's disease is a problem with your thyroid gland. The thyroid gland is located in the front of your neck, just below your Adam's apple. It makes hormones that control metabolism, the pace of your body's processes. Metabolism includes things like your heart rate and how quickly you burn calories. When you have Hashimoto's disease, your immune system begins to attack your thyroid gland, causing it to become swollen and irritated. When this happens, your thyroid can't make hormones as it normally does.
What causes Hashimoto's disease?
Hashimoto's disease is an autoimmune disease. Normally, antibodies produced by the immune system help protect the body against viruses, bacteria and other foreign substances. An autoimmune disease is when your immune system produces antibodies that attack your body's tissues and/or organs. With Hashimoto's disease, antibodies attack the thyroid.
What are the symptoms of Hashimoto's disease?
Many people who have Hashimoto's disease have no symptoms at all. The disease progresses over time and symptoms are similar to hypothyroidism (underactive thyroid disease). This is because the attack on the thyroid causes the gland to produce fewer hormones. Symptoms of Hashimoto's disease include:
Fatigue
Unexpected weight gain
Increased sensitivity to cold
Muscle aches, cramps, tenderness or stiffness
Pain, stiffness or swelling in your joints
Pale, dry skin
Puffy face
Hoarse voice
Constipation
Heavier than normal periods in women
Elevated blood cholesterol
Depression
Visibly enlarged thyroid
Forgetfulness
How does my doctor know I have Hashimoto's disease?
A blood test can tell if your thyroid gland is not working properly. It measures hormone levels to check for Hashimoto's disease.
Who gets Hashimoto's disease?
Although Hashimoto's disease can affect people of all ages, it's most common in women who are between 30 and 50 years of age. If someone in your family has had thyroid disease, you may have an increased risk for Hashimoto's disease. Doctors are not sure why people get this disease.
How is Hashimoto's disease treated?
Hashimoto's disease has no cure. However, your doctor can treat low thyroid function to minimize any long-term effects.
Treatment for Hashimoto's disease is synthetic thyroid hormone taken daily in pill form. This medicine will regulate hormone levels and shift your metabolism back to normal. It will also lower your low-density lipoprotein (LDL) cholesterol and may help reverse weight gain. The thyroid medicine can replace the hormones your thyroid gland usually makes. How long you need to take the medicine will depend on the results of your blood tests. For most people, taking thyroid hormone medicine causes no problems.
Taking your thyroid medicine and having regular blood tests to see how your thyroid gland is working can help prevent symptoms. Some medicines, supplements and foods may affect your body's ability to absorb the synthetic thyroid hormone. Tell your doctor if you eat large amounts of soy products, are on a high-fiber diet or take other medicines such as iron supplements, calcium supplements, cholestyramine or aluminum hydroxide (found in some antacids).
familydoctor.org/online/famdocen/home/common/hormone/548.html#ArticleParsysMiddleColumn0001
*********************
Thyroid Disease Main Forum
Welcome to the Main Thyroid Disease Forum, hosted by Mary Shomon, your About.com Guide to Thyroid Disease. This is one of a number of forums you can visit for thyroid-related support and information. Here at the main Thyroid Disease Forum, you'll find support, information, camaraderie, and people who understand what you're going through. Whether you're newly diagnosed and want to know what questions to ask your doctor, or you've been living with thyroid disease for years and simply want ideas on how to feel and live better, these boards can be an important part of your wellness.
forums.about.com/ab-thyroid/start
*****************
Thyroid
Endocrinologists Say TSH Normal Range is Now 0.3 to 3
thyroid.about.com/cs/testsforthyroid/a/newrange.htm
***************************
From Jackie MOT on GF Board
Coeliac disease and autoimmune thyroid disease share common immunopathogenetic mechanisms.
See link at the very bottom.
Also interesting is this
www.ithyroid.com/celiac_disease1.htm
A gluten-free diet started early may prevent the other autoimmune diseases frequently associated with celiac disease," Dr. Ventura and colleagues hypothesize. However, further studies will be needed to determine the clinical significance of the organ-specific autoantibodies in these patients and to confirm this hypothesis.
J Pediatr 2000;137:263-265.
I have not heard whether this hypothesis has been followed up.
www.ncbi.nlm.nih.gov/pubmed/9872614?dopt=Abstract
*****************************************************
Autoimmune thyroid disease and celiac disease in children.
(From Charlotte on GF board)
J Pediatr Gastroenterol Nutr. 2003 Jul ;37 (1):63-6 12827007
Autoimmune thyroid disease and celiac disease in children.
Nicoletta Ansaldi , Tiziana Palmas , Andrea Corrias , Maria Barbato , Mario Rocco D'Altiglia , Angelo Campanozzi , Mariella Baldassarre , Francesco Rea , Rosanna Pluvio , Margherita Bonamico , Rosanna Lazzari , Giovanni Corrao
BACKGROUND: Celiac disease (CD) may be associated with other immunologic disorders in adults and children. Previous studies linking CD and autoimmune thyroid disease in children have included very few patients with limited biochemical and immunologic screening tests. The aim of this multicenter study was to establish the prevalence of autoimmune thyroid involvement in a large series of pediatric patients with CD.
METHODS: Five hundred seventy-three consecutive pediatric patients were enrolled from clinics in Torino, Bologna, Foggia, Rome (two clinics), Naples, and Bari. Three hundred forty-three patients with CD were studied, 230 girls and 113 boys (median age, 8.5 years). Two hundred fifty-six of the patients with CD (median age, 9 years) had been following a gluten-free diet for 3 months to 16 years; 87 patients were untreated (median age, 6.2 years). The diagnosis of CD was made using the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. A control group of 230 subjects (median age, 8.3 years) was enrolled. Serum free triiodothyronine, free thyroxine, and thyroid-stimulating hormone (TSH), antithyroperoxidase, antithyroglobulin, anti-TSH receptor antibodies, and thyroid echographic pattern were considered.
RESULTS: Autoimmune thyroid disease was found in 90 of 343 (26.2%) patients with CD (62 on a gluten-free diet) and in 20 (10%) of the control subjects (P = 0.001). Fifty-four (15.7%) patients with CD and autoimmune markers had normal thyroid function (euthyroidism) as did 12 (6.0%) of the control subjects; hypothyroidism was observed in 28 (8.1%) patients with CD and in 7 (3.5%) of the control subjects. Hyperthyroidism was diagnosed in four patients with CD and in none of the control subjects with autoimmune markers. An abnormal echographic pattern was seen in 37 patients with CD (16.8%) and only in 1 (1.6%) of the control subjects (P = 0.002).
CONCLUSIONS: The high frequency of autoimmune thyroid disease found among patients with CD, even those on a gluten-free diet, may justify a thyroid status assessment at diagnosis and at follow-up evaluation of children with CD.
lib.bioinfo.pl/pmid:12827007
*******************
Thyroid function, autoimmune thyroiditis and coeliac disease in juvenile idiopathic arthritis
S. Stagi, T. Giani, G. Simonini and F. Falcini
Department of Paediatrics, Paediatric Rheumatology Unit, University of Florence, Italy.
Correspondence to: F. Falcini, Dipartimento di Pediatria, Via Pico della Mirandola 24, 50132, Firenze, Italy. E-mail: falcini@unifi.it
Objectives. Autoimmune diseases have been associated with some organ non-specific rheumatological disorders such as rheumatoid arthritis and systemic lupus erythematosus; however, few studies have been performed in an extensive cohort of children with juvenile idiopathic arthritis (JIA). Our objective was to evaluate the thyroid function and the prevalence of antithyroid antibodies, autoimmune thyroiditis and coeliac disease in children with JIA.
Methods. One hundred and fifty-one children (120 female, 31 male, median age 8.3 yr, range 2.4–16.9 yr) with JIA were evaluated. All patients underwent thyroid function tests (u-TSH, free T4 and free T3), antithyroglobulin (TgA) and antiperoxidase (TPOA) antibodies, antigliadin, anti-endomysium and antitransglutaminase antibodies. All patients with raised thyroid stimulating hormone levels, low thyroid hormone levels or positive TPOA and/or TgA values had a thyroid high-resolution sonography examination. Coeliac disease was confirmed by jejunal biopsy if the specific antibodies profile was positive. One hundred and fifty-eight age- and sex-matched Caucasian children from the same geographical area acted as controls.
Results. Fourteen (9.3%) patients showed subclinical hypothyroidism, 17 (11.9%) patients showed autoimmune thyroiditis with nine patients also showing a non-homogeneous thyroid parenchyma at ultrasound evaluation. Coeliac disease was demonstrated in 10 (6.6%) patients. Compared with controls, JIA patients had higher prevalence of subclinical hypothyroidism (P<0.01), autoimmune thyroiditis (P<0.0001) and coeliac disease (P<0.005).
Conclusions. JIA children have an increased prevalence of autoimmune thyroiditis, subclinical hypothyroidism and coeliac disease. These data seem to suggest careful monitoring of thyroid function, thyroid autoantibodies and coeliac disease in JIA children.
***************************
Calcium supplements and thyroxine
Most women now know that taking calcium is a cheap and easy way to protect against bone loss, but such supplementation may be tricky in those being treated for an underactive thyroid.
Researchers report that calcium may interfere with the absorption of the most widely used therapy for this condition, and they raise a red flag that the two should not be taken together.
my.webmd.com/content/article/25/1728_58215?
***********************