Relationship Between Vitamin D and Autoimmune Condition and Thyroid Function with Newly Onset Grave’s Disease

Abstract

Vitamin due to the presence of the receptor (VDR), which is found in almost all nuclear cells is an important regulator in the pathogenesis of many diseases. The question of the causal relationship between vitamin D deficiency and Graves 'disease and the importance of this vitamin for thyroid function in the treatment of Graves' disease deserves special attention. The aim of the study was to investigate the level of 25-(OH) D in the body in Graves' disease and its relationship with thyroid function. We examined 143 patients who were first diagnosed with moderate Graves' disease (GD). All patients studied by us, residents of Ukraine, 67% of them live in Kyiv, 19% in Kyiv region, 14% in other regions of Ukraine. The average age of the subjects was 43.8 ± 0.95, among whom were men 22.4%, women -77.6%. The analysis of immune parameters and thyroid function depending on the age of patients, the content of vitamin D in the serum, and its quartile distribution before treatment. Subsequently, all patients were divided into two groups depending on the therapy. The first group included 73 subjects, whose average age was 44.69 ± 1.39, patients in this group received tyrosol at a dose of 5 -10 mg per day. The second group consisted of 70 patients. whose average age was 42.93 ± 1.29, they took tyrosol at a dose of 5-10 mg per day and vitamin D preparations -2000 MO/day. In patients with Graves' disease. the highest content of 25-(OH) D in serum was observed in the age group of 19-30 years -59.1 nmol/l and a low level of antibodies to the TSH receptor -9.0 mUi/l. A significant decrease in the immune index was observed only in the 3 rd and 4 th quartiles, when the content of 25-(OH) D in the serum reached 47.5 nmol/l and above, i.e. approached a moderate deficit. At a slight increase to 34 nmol/l, such changes were insignificant. After 3 months of treatment, the level of AbrTSH in the serum during treatment with vitamin D was twice lower than when treated with tyrosol alone. After 6 months, compared with the treatment with tyrosol, the effect of treatment was 2 times better. In contrast to TPOAbs in Graves' disease without treatment with vitamin D, where it did not differ depending on the level of 25 (OH) D, in the second group after 6 months of treatment there was a significant decrease in this indicator (p = 0.009). Compared to tyrosol treatment alone, there was a significant increase in TSH levels and a decrease in thyroid volume after 6 months. Data on the dependence of thyroid function on the level of 25 (OH) D were indicative. In each of the quartiles, the level of TSH after treatment with vitamin D was 4-5 times higher than in the group of patients treated only with tyrosol. Convincing data on the positive effect of vitamin D on autoimmune parameters, thyroid function and the need for its inclusion in the treatment of Graves' disease.

Vitamin D Level in Graves’ Disease and Effect of Vitamin D Supplements on Associated Autoimmunity

“…TSH levels also increased and FT4 decreased, but the differences weren't statistically significant (p=0.328 & 0.267 respectively). These results are similar to Kravchenko et al (24) who found that taking vitamin D supplement seems to improve thyroid function (increase in serum TSH values and a decline in thyroid volume) in Graves' patients. Also, Sheriba and his colleagues (29) studied 60 individuals with GD; 40 received a 30 mg of methimazole and 200000IU of vitamin D per month for 3 months, while the remaining 20 received methimazole alone and reported that Vitamin D administration has favorable effects on the degree of exophthalmos as well as on thyroid volume.…”

“…We found that Graves' cases with VDI had a significant decrease in TRAB, anti-TPO, and anti-Tg titers after taking VD supplements for six months (p<0.001, 0.039, and 0.007, respectively). These results are in accordance with Kravchenko and his colleagues (24) who reported a significant decrease in TRAB titers in Graves' cases after vitamin D intake and came to the conclusion that, autoimmune thyroid illnesses can be prevented, or their clinical symptoms can be diminished by using vitamin D in optimal dose. There are a limited number of research on the actions of VD supplementation in GD, but those that are available seem to indicate that it has a positive impact.…”

Елементне Забезпечення Населення України Та Його Значення При Тиреоїдній Патології

“…У 51,7% обстежених спостерігали знижений рівень се лену -<60 мкг/л. При ХГ рівень селену в си роватці крові був майже вдвічі нижчим, ніж у контрольній групі та становив 29,35 мкг/л (р<0,001) [61]. У межах нормальних значень було тільки 26,6% проб.…”

“…Суттєві позитивні зміни реєструвалися в рівні АТрТТГ в крові, причому з подовженням лі кування до 6 місяців ця позитивна тенденція зберігалася (р<0,005). Порівнюючи з показни ком у контрольній групі титр АТрТТГ все ж залишався підвищеним [61].…”

Основні Етапи Становлення Та Вагомі Досягнення Відділу Епідеміології Ендокринних Захворювань ДУ «Інститут Ендокринології Та Обміну Речовин Ім. В.П. Комісаренка НАМН України»

“…Через 3 місяці лікування рівень антитіл до рецептора тиреотропого гормону в сироватці крові при лікуванні додатково вітаміном Д був вдвічі нижчим, ніж при лікуванні тільки тирозолом. Через 6 місяців порівняно з лікуванням тирозолом ефект лікування був ще у 2 рази кращим [36].…”