Endocrine Abstracts

Background: Hashimoto’s thyroiditis is one of the leading causes of hypothyroidism worldwide. Currently the only available treatment is Levothyroxine. Even though symptoms improve with treatment, many patients continue to suffer from a lower quality of life and inability to lose weight. The role of nutritional therapy in managing patients with Hashimoto’s disease has been of interest lately.

Aim: The aim of our study was to assess the effects of Mediterranean diet on quality of life in Hashimoto’s thyroiditis patients using ThyPRO questionnaire, as well as thyroid autoantibodies and thyroid profile parameters.

Methods: We performed a dietary interventional study on 40 female patients previously diagnosed with Hashimoto’s disease over 3 months. The study participants were divided into two groups, Group 1 (n=17) were hypothyroid patients on Levothyroxine, while Group 2 (n=23) were euthyroid patients and not on levothyroxine. Both groups were started on a modified Mediterranean dietary plan with reduction of goitrogenic foods. Baseline evaluation of anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, thyroid profile parameters, body mass index, total cholesterol, triglycerides, HDL, LDL, ESR, and ThyPRO questionnaire (for assessment of disease specific health-related quality of life) was done and reassessed at the end of the study.

Results: In both groups a statistically significant reduction was seen in levels of anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, BMI, LDL, total cholesterol and triglycerides (P<0.01). Statistically significant improvement in all items of the ThyPRO scale were observed in both groups (P<0.05), except for eye symptoms, which were statistically non-significant in both groups. Regarding free T3 and free T4, statistically significant increases in their levels were seen in both groups, however in group 1 the observed changes were statistically more significant. Changes in free T3 and free T4 were (+41.2%, P<0.01) and (+54.32, P<0.05) respectively. We also observed statistically highly significant reductions in levels of thyroid stimulating hormone in group 1 (-39.09%, P<0.01), however, the changes in group 2 were statistically non-significant.

Conclusion: The disease burden of Hashimoto’s disease is not only related to hormone levels, but could also be related to an underlying inflammatory state. A modified Mediterranean diet could have beneficial effects on symptoms burden, quality of life, lipid state, as well as autoantibodies levels and hence can be used as an adjuvant to levothyroxine treatment.