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Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease

Rayman, Margaret (2018) Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease Proceedings of the Nutrition Society.

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Hashimoto’s Thyroiditis (HT) and Graves’ Disease (GD) are examples of autoimmune thyroid disease (AITD), the commonest autoimmune condition. Antibodies to thyroid peroxidase (TPO), the enzyme that catalyses thyroid-hormone production, and antibodies to the receptor for the thyroid-stimulating hormone (TSHR), are characteristic of HT and GD, respectively. It is currently accepted that genetic susceptibility, environmental factors, including nutritional factors, and immune disorders contribute to the development of AITD. Aiming to investigate the effect of iodine, iron and selenium in the risk, pathogenesis and treatment of thyroid disease, PubMed and the Cochrane Library were searched for relevant publications to provide a narrative review. Iodine: Chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly-iodinated thyroglobulin is more immunogenic. Recent introduction of universal salt iodisation can have a similar, though transient, effect. Iron: Iron deficiency impairs thyroid metabolism. TPO is a haem enzyme that becomes active only after binding haem. AITD patients are frequently iron-deficient since autoimmune gastritis, which reduces iron absorption, and coeliac disease which causes iron loss, are frequent co-morbidities. In two-thirds of women with persistent symptoms of hypothyroidism despite appropriate levothyroxine therapy, restoration of serum ferritin above 100 µg/L ameliorated symptoms. Selenium: Selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases remove excessive hydrogen peroxide produced there for the iodination of thyroglobulin to form thyroid hormones. There is evidence from observational studies and randomised controlled trials that selenium, probably as selenoproteins, can reduce TPO-antibody concentration, hypothyroidism and postpartum thyroiditis. Appropriate status of iodine, iron and selenium is crucial to thyroid health.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
Date : 13 September 2018
DOI : 10.1017/S0029665118001192
Copyright Disclaimer : Copyright 2017 Cambridge University Press. This article has been accepted for publication and will appear in the Proceedings of the Nutrition Society, published by Cambridge University Press.
Uncontrolled Keywords : Autoimmune thyroid disease; Autoimmune thyroiditis; Nutrition; Iodine; Iron; Selenium; Autoimmune thyroid disease; Deiodinases; Graves’ disease; Glutathione peroxidases; Hashimoto's thyroiditis; Iron deficiency; Levothyroxine; Randomised controlled trial; Tri-iodothyronine; T4; Thyroxine
Related URLs :
Depositing User : Clive Harris
Date Deposited : 30 Aug 2018 09:47
Last Modified : 08 Nov 2018 14:32

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