ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P626 | DOI: 10.1530/endoabs.63.P626

Autoimmune thyroiditis (AIT) and diet - the patients' and medical professionals' view

Małgorzata Trofimiuk-Muldner1, Ewa Czubek2, Jan Sztorc2, Anna Skalniak1 & Alicja Hubalewska-Dydejczyk1

1Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland; 2Medical Faculty, Jagiellonian University Medical College, Kraków, Poland.

An increasing interest in improving the quality of life of patients with autoimmune thyroid disorders has been noted during recent years. Although there is little scientific evidence, many patient-oriented publications, websites and support groups recommend changes in diet as well as nutritional supplement use as a cure for thyroid disease and the mean for ailments reduction. The presented survey aimed to explore the patients’ and medical professionals’ approach to nutritional treatments of AIT.

Material and methods: (1) Medical professionals: 30 physicians, 32 nutritionists, 35 medical students and 27 dietetics students responded to an internet questionnaire on the recommendations for a nutritional approach in AIT (gluten-free and lactose-free diet, selenium, vitamin D, and iodine supplementation). (2) AIT patients: 150 subjects aged 18 to 70 years (146 females, 4 males) responded to an internet questionnaire on the nutritional approach in their disease. Questions concerned: gluten-free and lactose-free diet, as well as vitamins and microelements use, the source of the patients’ knowledge, and the recommending body behind their decision on changes in nutrition.

Results: (1) Medical professionals. 54% of the surveyed subjects recommended their patients the use of selenium supplements (9.7% in Graves’ ophthalmopathy), 41.3% - iodine supplements, 92.3% -vitamin D supplements. 6.4% of responders advised a gluten-free diet regardless of the coexistence of gluten-related disorders, and 4.8% - a lactose-free diet even in the absence of lactose intolerance. There were discrepancies in recommendations between professionals: physicians advised iodine and selenium least often. (2) AIT patients. 44.3% of responders were on a lactose-free, and 37.3% - on a gluten-free diet. Only 2% of responders were diagnosed with celiac disease. 38% of responders who had modified their diet, have decided to do so following the recommendation of a medical professional, the remaining 62% - without any advice. 36.7% of responders were using selenium supplements (27.3% following a physician’s recommendation), 8% - iodine supplements (all advised by a physician), 74.7% - vitamin D supplements (48.7% of them have obtained recommendations). Websites (80.7%) and patients-oriented publications (50.7%) were the main sources of AIT patients’ knowledge and opinions on the role of nutrition in AIT management.

Conclusions: AIT patients commonly decide to implement a nutrition-based approach to their disease, even without any professional advice. Although the results of the survey are biased by internet methodology, it is worrying that many medical professionals advise introduction of diets and supplements against guidelines of medical societies.

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