Search Results (193)

Polycystic ovary syndrome (PCOS) is a complex condition affecting women of reproductive age, characterized by menstrual irregularities, hyperandrogenism, polycystic ovarian morphology, and low-grade inflammation accompanied by oxidative stress and increased autoimmune risk, particularly Hashimoto’s thyroiditis. Many studies have examined thyroid autoantibodies—anti-thyroid peroxidase antibodies (anti-TPO) and anti-thyroglobulin antibodies (anti-TG)—in PCOS; however, observed differences in baseline thyroid-stimulating hormone (TSH) levels and body mass indices (BMIs) impede a direct interpretation of the results. This systematic review and meta-analysis aimed to summarize the available evidence on the prevalence and levels of anti-TPO and anti-TG in women with PCOS. We conducted a systematic search of PubMed, Scopus, and Embase, which yielded 40 eligible, observational studies including 6045 women with PCOS and 4527 controls. Subgroup analyses were conducted separately for TSH- and BMI-matched populations. Anti-TPO prevalence (odds ratio [OR] = 2.03; 95% confidence interval [CI]: 1.35–3.04; p = 0.0006) and levels (standardized mean difference [SMD] = 0.63; 95% CI: 0.37–0.88; p < 0.00001) were significantly higher in PCOS patients. Anti-TG prevalence (OR = 1.92; 95% CI: 1.23–3.01; p = 0.004) and levels (SMD = 0.41; 95% CI: 0.18–0.64; p = 0.0004) were also significantly elevated. In matched subgroups, prevalence differences were no longer significant, though anti-TPO levels remained significantly elevated and anti-TG levels were borderline significant in the TSH-matched subgroup of PCOS women. Although differences in thyroid autoantibody prevalence in women with PCOS appear to be driven by elevated TSH levels and BMIs, the persistently increased antibody levels in the majority of matched subgroups suggest that PCOS itself may contribute independently to heightened autoimmune activation. Full article

Thyroid hormones play a crucial role in regulating metabolism and cardiovascular function, with even mild dysfunction—such as subclinical hypothyroidism—negatively impacting heart health. While previous studies have confirmed the effects of iodine, selenium, and vitamin D on thyroid regulation and inflammation, the combined role of these nutrients in reducing cardiovascular disease (CVD) risk in autoimmune thyroid disorders remains insufficiently understood. This review explores the influence of specific micronutrients—including selenium, iodine, and zinc—and dietary patterns, particularly the Mediterranean diet, on the pathophysiology of hypothyroidism and Hashimoto’s thyroiditis. We introduce a novel framework that integrates emerging data on sex-specific micronutrient interactions and nutritional immunomodulation. Unlike the existing literature, this review introduces original hypotheses related to sex-specific nutritional immunomodulation and proposes a novel framework for micronutrient-driven dietary intervention in Hashimoto’s thyroiditis. Full article

Objectives: Thyroid dysfunction, particularly hypothyroidism, has been associated with endometrial cancer in observational studies; however, these findings may be confounded by obesity, an endometrial cancer risk factor. To clarify these associations, we performed Mendelian randomisation analysis, a genetic approach that mitigates confounding and reverse causation analyses. Methods: We accessed European-ancestry GWAS summary statistics for endometrial cancer (12,270 cases; 46,126 controls), endometrioid (8758 cases), and non-endometrioid (1230 cases) subtypes. Thyroid dysfunction phenotype and BMI GWAS data were predominantly from individuals of European descent. We used these datasets to conduct univariable and multivariable Mendelian randomisation analyses incorporating body mass index (BMI). Results: Our main finding was a causal association between hypothyroidism and decreased risk of endometrial cancer (OR = 0.93; 95% CI 0.89–0.97; p = 3.96 × 10⁻⁴). Subtype analysis revealed a decreased risk of the most common histological subtype, endometrioid endometrial cancer, and a similar protective association for Hashimoto’s thyroiditis, an autoimmune disease and common cause of hypothyroidism. Sensitivity analyses confirmed the robustness of the associations. Further analyses revealed that while BMI was causally associated with hypothyroidism risk, both BMI and hypothyroidism independently influenced endometrial cancer risk. Conclusions: Our study has identified hypothyroidism as a protective factor for endometrial cancer, challenging previous observational associations and highlighting potential confounding by obesity. Further investigation into immune mechanisms, particularly those linked to Hashimoto’s thyroiditis, may provide insights into the biological pathways underlying endometrial cancer development. Full article

The incidence of Hashimoto’s disease (HD) increases with age and in people who have other autoimmune diseases. It is characterized by lymphocytic infiltration, fibrosis, and atrophy of the thyroid parenchyma with the simultaneous presence of thyroid peroxidase antibodies (ATPO) and/or thyroglobulin antibodies (ATG). Eicosanoids are formed via the cyclooxygenase (COX), lipoxygenase (LOX), and monooxygenase (CYP450) pathways with arachidonic acid (ARA), resulting in the production of epoxyeicosatrienoic acids (EETs) or hydroxyeicosatetraenoic acids (HETEs). These eicosanoids can act in an autocrine or paracrine manner on target cells. This study aimed to examine whether a gluten-free diet (GFD) can modulate the enzymatic pathways of the pro-inflammatory ARA cascade. The study material consisted of serum samples from Caucasian female patients with HD aged 18–55 years. Participants were enrolled in the study based on the presence of an ultrasound characteristic of HD, and elevated serum levels of anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies. Patients with confirmed celiac disease did not participate in the study. A total of 78 samples were analyzed, with 39 collected after 3 months of following a GFD. Eicosanoids (thromboxane B2, prostaglandin E2, leukotriene B4, and 16R-hydroxy-5Z,8Z,11Z,14Z-eicosatetraenoic acid (16-RS HETE)) were extracted using high-performance liquid chromatography. The contribution of leukotriene (LTB) was analyzed in the LOX pathway, prostaglandins (PGE2) and thromboxane (TXB2) were selected for the involvement of the COX pathway, and 16RS HETE was used for the CYP450 pathway. All parameters were analyzed before and after a 3-month dietary intervention that included a gluten-free diet. In the obtained results, only one mediator, leukotriene B4, was significant (p < 0.05). The mean level on the initial visit was 0.202 ± 0.11 (SD), while it was 0.421 ± 0.27 (SD) on the subsequent visit, indicating a significant increase in its level after implementing a GFD. Although there was a trend in the CYP 450 pathway of decreased 16-RS HETE, the presented correlations show that thromboxane B4 and 16RS-HETE were positively correlated with the body mass and body fat mass of the examined patients. There was a trend in the CYP 450 pathway of decreased 16-RS HETE after GFD. Thromboxane B4 and 16RS-HETE levels before GFD were positively correlated with the body mass and body fat mass of the examined patients. A gluten-free diet in HD does not suppress the synthetic pathways of LOX, COX, or cytochrome P450 (CYP450). The level of adipose tissue has a greater impact on the inflammatory processes in HD than a gluten-free diet. This study does not confirm the suppressive effect of a gluten-free diet on the pro-inflammatory arachidonic acid cascade in any of the three analyzed mediator synthesis LOX, COX, CYP450 pathways. Full article

Background: Hashimoto’s thyroiditis (HT), the most prevalent autoimmune thyroid disorder in reproductive-age women, has been linked to diminished ovarian reserve and subfertility. This study aimed to evaluate the relationship between HT and key fertility parameters, including hormonal markers and reproductive outcomes, while also exploring the potential impact of thyroid hormone replacement therapy. Methods: A retrospective observational study was conducted on 86 women undergoing fertility evaluation. Participants were divided into two groups based on anti-thyroid peroxidase antibodies (ATPO): the HT group (n = 49) and the control group (n = 37). Among women with HT, 57% were receiving levothyroxine (Euthyrox^®) at the time of assessment. Variables analyzed included serum levels of anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), insulin resistance index (HOMA-IR), number of oocytes retrieved, blastocysts formed, pregnancies achieved, and live births. Statistical methods included t-tests, Mann–Whitney U tests, Pearson/Spearman correlations, and linear regression models. Results: Women in the HT group had slightly lower AMH levels and oocyte counts compared to controls, though these differences did not reach statistical significance. TSH values were higher in the HT group and showed a significant negative correlation with blastocyst formation (p = 0.03). Although TSH also showed negative trends with oocyte count, pregnancies, and live births, these correlations did not reach statistical significance. A post-hoc subgroup analysis revealed that HT patients receiving levothyroxine tended to have higher numbers of oocytes retrieved and blastocysts formed compared to untreated HT patients, suggesting a possible beneficial effect of thyroid hormone replacement, although the differences were not statistically significant. Conclusions: HT is associated with subtle but clinically relevant impairments in ovarian reserve and reproductive potential. Thyroid hormone replacement may offer modest benefits and should be considered in the individualized management of fertility in women with thyroid autoimmunity. Full article

Background: Hypothyroidism is defined as a deficiency of thyroid hormones and is further classified into primary, secondary, and tertiary types, based on the root cause of the deficiency. Migraine is a primary headache disorder, characterized by unilateral, pulsating pain, lasting from 4 to 72 h, accompanied by symptoms such as photophobia, phonophobia, nausea, and emesis and sometimes preceded by specific aura phenomena. Both diseases are more prevalent in women than in men. While the primary focus of this systematic review was on the relationship between hypothyroidism and migraine, we also included relevant data on headaches in general when they provided valuable context or mechanistic insight. Methods: This systematic review aimed to summarize the current knowledge about the relationship between migraine and hypothyroidism. The Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were applied. Screening of two databases led to including 29 relevant studies in the review. Results: Studies demonstrated that migraine and disturbed thyroid function may influence one another. The positive correlation between migraine and hypothyroidism, mainly Hashimoto’s disease, was presented in several studies. Moreover, some research identified this correlation in pediatric populations. Finally, the effects of levothyroxine use, a treatment applied in hypothyroidism, on migraine course were presented. Conclusions: A better understanding of the correlation between migraine and hypothyroidism may lead to an increase in the understanding of the pathogenesis of both disorders and positively impact clinical practice. Full article

Background/Objectives: Hashimoto thyroiditis (HT) is an autoimmune disease affecting the thyroid, often leading to hypothyroidism, even in individuals with adequate iodine intake. Despite achieving biochemical euthyroidism through levothyroxine (LT4) therapy, many patients continue to experience persistent symptoms, likely due to ongoing thyroid autoimmunity. Photobiomodulation (PBM) has shown promise in treating autoimmune conditions, but its effect on thyroid volume (TV) remains unclear. This study aimed to assess the efficacy of PBM combined with supplements in restoring thyroid function and normalising TV compared to the use of supplements alone. Methods: Ninety-eight females aged 20–50 years old were divided into two groups: Group 1 received PBM and supplements and Group 2 received supplements only. The PBM parameters were as follows: 820 nm wavelength, 200 mW power, continuous mode, 20 s per point at 8 points (32 J/cm² per point), twice weekly for three weeks. Both groups received vitamin D3 supplementation (if serum < 40 ng/dL) and 100 µg of oral selenium daily. Results: Ninety-seven participants completed the study (51 in Group 1, 46 in Group 2). Group 1 showed significantly greater improvements in TV normalisation and weight loss and reductions in BMI, waist/hip circumference, waist-to-hip ratio, TSH, anti-TPO, anti-TG, and LT4 dosage (p < 0.05). Conclusions: This study demonstrates that low-fluence PBM combined with supplements can effectively improve thyroid function, reduce TV, and enhance anthropometric and clinical outcomes in HT patients. The protocol holds potential for broader application and further validation in larger trials. Full article

Bone metabolism is a dynamic process involving continuous bone formation and resorption, orchestrated by the interplay between osteoblasts and osteoclasts. Osteoporosis (Op), the most prevalent osteo-metabolic disorder globally, results from an imbalance in this remodeling cycle. Hashimoto’s thyroiditis (HT), a chronic autoimmune thyroid disorder, has been increasingly recognized as a contributor to bone loss, even in euthyroid individuals. HT is marked by immune dysregulation, autoantibody production, and chronic inflammation, factors that can alter bone remodeling. Furthermore, both thyroid-stimulating hormone (TSH) and thyroid hormones (THs) independently influence bone health. Low TSH and elevated TH levels, including in subclinical states, have been linked to reduced bone mineral density (BMD) and increased fracture risk. Nutritional factors, particularly selenium and iodine intake, modulate both thyroid and bone function, and can be considered as a link between HT and Op. In particular, antioxidant-rich diets such as the Mediterranean diet may confer protective effects. This review integrates current clinical and experimental evidence linking HT with bone metabolism disorders, emphasizing the multifactorial nature of bone fragility in autoimmune thyroid disease and the potential role of diet in mitigating its impact. Full article

Background: Lifestyle is one of the important factors determining health and quality of life. The aim of the study was to analyse relationships between pro-health behaviours, depression and quality of life among women with Hashimoto’s thyroiditis. Material and methods: The study was conducted among 219 women aged 20–50 from southern Poland, using (i) Juczyński’s Healthy Behaviour Inventory (HBI); (ii) Beck’s Depression Inventory (BDI); (iii) satisfaction with life scale (SWLS) and (iv) WHOQoL-Bref (Quality of Life-BREFF). In the statistical analysis, Spearman’s R correlation coefficient and multiple regression analysis were applied, assuming a significance level of α = 0.05. Results: It was shown that with the increase in the general indicator of pro-health behaviours, the level of depressive symptoms decreased, while the level of satisfaction with life and all four aspects of quality of life on the WHOQoL scale increased (p < 0.001). Regression analysis demonstrated that the model consisting of all analysed pro-health behaviours explains a high percentage of variance in depressive symptoms (38%), life satisfaction (31%) and all aspects of quality of life, including those somatic and social (19%), psychological (28%) and environmental (12%). Conclusions: The noted correlations between pro-health behaviours, the intensity of depressive symptoms as well as the level of life satisfaction and quality of life indicate justification for promoting a pro-health lifestyle as a significant factor contributing to mental health and better quality of life among women with hypothyroidism. Full article

Thyroid organoids, three-dimensional in vitro models derived from stem cells, have emerged as a powerful tool for studying thyroid development, function, and disease mechanisms. These organoids recapitulate the key aspects of the thyroid gland, including the follicular structure, hormone production, and response to stimuli such as to the thyroid-stimulating hormone (TSH). Recent advances in thyroid organoid technology have established the basis for the modeling of development and thyroid diseases, including congenital hypothyroidism (CH), autoimmune conditions like Graves’ disease and Hashimoto’s thyroiditis, and other thyroid-related disorders. By utilizing pluripotent stem cells (PSCs) and adult tissue, researchers have generated organoid models suitable for dissecting the mechanisms associated with thyroid development while mimicking the genetic, functional, and inflammatory characteristics of thyroid diseases. Additionally, thyroid organoids offer the potential for personalized medicine by providing a platform to test therapies in a more clinically relevant context. This review highlights the recent progress in thyroid organoid generation, discusses their applications in dissecting the thyroid development mechanisms and disease modeling, and explores their potential for advancing our understanding of the thyroid physiology and pathology. Furthermore, we address the challenges and future directions in the optimization and use of thyroid organoids in translational research. Full article

Background: The anti-inflammatory effects of omega-3 fatty acids and their derivatives are of considerable interest as a potential therapeutic agent in many diseases characterized by inflammation. Methods: This study aimed to measure the concentration of mediators derived from eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids. We included 33 women suffering from Hashimoto’s disease, with an average age of 37.58 ± 8.41 kg, in the study. The levels of EPA and DHA acids were examined using gas chromatography, and their derivatives were studied with liquid chromatography (HPLC). Patients were assessed after being put on a healthy and balanced diet supplemented with omega-3 fatty acids. Results: The results showed statistically significant correlations between the C-reactive protein (CRP) level and derivatives: resolvins E1 and D1 (RvE1, RvD1), 10S17R DiHDHA (Protectin DX), and 18RS HEPE (18-hydro(peroxy)-eicosapentaenoic acid) following the diet. There was also a significant correlation observed between Maresin 1 and free thyroxine (fT4). Moreover, a dependency between the RvD1 level and some anthropometric parameters was observed. Conclusions: The findings suggest that the chronic inflammatory state occurring in the course of Hashimoto’s thyroiditis (HT) is associated with increased synthesis of anti-inflammatory mediators of omega-3 fatty acids, particularly DHA derivatives. Consequently, these may affect the level of thyroid hormone synthesis, which should be considered in future research on biological drugs in Hashimoto’s therapy. Full article

Although the inner ear is considered an immune-privileged organ because of the blood–labyrinth barrier, accumulating evidence has revealed an unexpected relation between Hashimoto’s disease and inner ear damage manifesting as audiovestibular dysfunction. Hashimoto’s disease can simultaneously affect both the auditory and vestibular systems, either through direct autoantibody attacks or through metabolic dysfunction associated with hypothyroidism. Currently, there is no consensus regarding tests or treatments for audiovestibular dysfunction related to Hashimoto’s disease. In this review, we summarize the currently available evidence regarding the characteristics, pathophysiology, diagnostic approaches, and treatment of audiovestibular dysfunction in patients with Hashimoto’s disease. Furthermore, we propose a specific steroid-plus-thyroxine treatment protocol to manage audiovestibular dysfunction associated with Hashimoto’s disease. This condition may respond to adequate treatment, potentially allowing reversibility if it is recognized and managed in a timely manner. Conversely, delayed diagnosis or failure to recognize the subtle presentation of audiovestibular dysfunction in patients with Hashimoto’s disease may lead to progressive hearing loss, immobility, and reduced quality of life. Based on the updated evidence in our review and our modified treatment protocol, we aim to provide new insights and therapeutic directions for clinicians managing audiovestibular dysfunction in patients with Hashimoto’s disease. Trial registration: PROSPERO CRD420250652982. Full article

Background/Objectives: Chronic idiopathic thrombocytopenic purpura (chITP) is an autoimmune disease which develops in 10–30% of patients with newly diagnosed idiopathic thrombocytopenic purpura (ndITP). It is defined as thrombocytopenia which lasts longer than 12 months, with extremely diverse clinical expressions. The aim is to present the most significant clinical and laboratory characteristics of children with chITP. Methods: This is retrospective, observational research, which included children between 2–18 years with chITP who were treated in the Republic of Serbia for 25 years. We analyzed clinical data from personal and family medical histories and different laboratory analyses. Results: The total number of respondents was 152, with female predominance (F:M = 1.27:1) and mild predominance of adolescents. Of the patients, 15% were asymptomatic, but 15% had periodically life-threatening bleeding. Transfusion was not required for 70% of patients. Thirty-five percent of patients had chITP alone, and 45% had high titer levels of autoantibodies. The most frequent comorbidity was Hashimoto thyroiditis (15%). The same percentage (45%) of family members were reported with and without autoimmune diseases. Twenty-five percent of patients were resistant to initial therapy. Helicobacter pylori was detected in 20%, 70% had higher levels of lactate dehydrogenase (LDH), three patients had sufficient serum vitamin D levels, splenomegaly was found in 25%, and accessory spleen in 14% of patients. Around 50% of patients had a platelet count between 20–50 × 10⁹/L, and 40% below 20 × 10⁹/L. Mean platelet volume (MPV) was 10.6 ± 1.4 fL. No dysplastic changes were noted in bone marrow aspirate. Initial first-line therapy was sufficient for 45% of patients, second-line therapy was administered in 25%, splenectomy was performed in 20%, and 10% received all available treatments. Conclusions: The severe clinical form of pediatric chITP is accompanied by a low platelet count, the presence of autoimmune comorbidities, a positive family medical history, resistance to initial therapy, hypovitaminosis D, and rare megakaryocytes in the bone marrow. Full article

Background/Objectives: Osteoporosis is a skeletal disorder characterized by reduced bone mineral density (BMD) and increased fracture risk. Chronic inflammation is implicated in osteoporosis pathogenesis, with inflammatory mediators promoting bone resorption. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of systemic inflammation and have emerged as potential indicators of bone health. This study’s aim was to highlight the potential role of the NLR and PLR as markers of bone health in postmenopausal women affected by osteoporosis or osteopenia and to evaluate the possible influence of autoimmune disease in this context. Methods: This cross-sectional study included 124 postmenopausal women diagnosed with osteopenia or osteoporosis at the Orthopedic Unit of the Policlinico G. Rodolico in Catania, Italy. Demographic, clinical, laboratory, and diagnostic imaging data were collected. The NLR and PLR were calculated from complete blood counts, and BMD was measured using dual-energy X-ray absorptiometry (DEXA). Statistical analyses included correlations, group comparisons, and multiple and logistic regressions. Results: The NLR and PLR did not directly correlate with BMD or fracture incidence. However, the PLR weakly correlated with vitamin D levels. Notably, women without Hashimoto’s thyroiditis exhibited higher NLR values than those with the condition. Hypertensive women had a lower PLR than non-hypertensive women, while euthyroid women had a higher PLR than hyperthyroid or hypothyroid women. Multiple regression analysis revealed that age, BMI, CKD stage, vitamin D levels, NLR, PLR, diabetes, and autoimmune diseases significantly predicted BMD at the femur neck, with the PLR contributing significantly. Logistic regression confirmed these predictors for osteoporosis or osteopenia, with an increased PLR being associated with a higher likelihood of osteoporosis. Conclusions: While the NLR and PLR may not independently predict bone health, their inclusion in a multifactorial assessment considering age, BMI, vitamin D, and comorbidities could enhance osteoporosis management. Full article

Background/Objectives: Concerns about the occurrence of autoimmune diseases are one of the main reasons influencing the uptake of the human papillomavirus (HPV) vaccine. Limited evidence exists regarding the relationship between HPV vaccination and the risk of Hashimoto’s thyroiditis (HT). Therefore, the purpose of this study was to examine the association between HPV vaccination and the risk of HT development in American women. Methods: Using the National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2012, we conducted a cross-sectional study of 2717 women aged 18–59 with comprehensive data on relevant HPV vaccination status, HPV DNA vaginal swab results, and thyroid function. The relationship between HPV vaccination and the risk of HT development was explored by weighted logistic regression, while the association between HPV vaccination and thyroid peroxidase antibodies (TPOAb)/thyroglobulin antibodies (TGAb) levels was analyzed by weighted linear regression. Results: In the fully adjusted model, HPV vaccination was associated with an 87% decrease in the risk of developing HT (OR 0.13; 95% CI 0.02, 0.76). Furthermore, weighted linear regression demonstrated significant negative associations between HPV vaccination and TPOAb levels (−22.27 (−34.86, −9.68), p = 0.001) and TGAb levels (−7.53 (−14.88, −0.18), p = 0.045). HPV vaccination was significantly negatively correlated with the risk of HT development and TPOAb/TGAb levels. Conclusions: We advocate for adherence to vaccination guidelines, which could confer dual protective benefits against HPV and potentially reduce the risk of HT development. Full article