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      The Influence of Reducing Diets on Changes in Thyroid Parameters in Women Suffering from Obesity and Hashimoto’s Disease

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      1 , 2 , 1 , *
      Nutrients
      MDPI
      Hashimoto, obesity, elimination diet, thyroid gland, adults

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          Abstract

          Hashimoto’s disease is listed among the most common endocrine causes of obesity. As treatment of obesity in women with Hashimoto’s disease is frequently unsuccessful, the aim of this study was to evaluate the effectiveness of two different reducing diets and their influence on changes in thyroid parameters in female patients. A six-month observational/interventional study was performed on 100 women aged 18–65 years, previously diagnosed with Hashimoto’s disease and obesity and receiving L-thyroxine. The women were randomly assigned to the test group (group A, n = 50) following elimination/reducing diets, and the control group (group B, n = 50) following reducing diets with the same caloric content (without elimination). Anthropometric and thyroid parameters were evaluated at the beginning, after 3 months and after 6 months of treatment. In both groups a significant decrease in BMI and body fat percentage was achieved, but in test group A the decrease in BMI and body fat percentage was significantly greater than in control group B ( p < 0.002 and p = 0.026, respectively). Serum TSH (thyroid stimulating hormon) levels decreased significantly more in group A than in group B ( p < 0.001). Group A exhibited significantly greater increases in fT4 and fT3 levels than the control group ( p < 0.001) as well as significantly greater decreases in the levels anti-TPO (thyroid peroxidase) ( p < 0.001) and anti-TG (thyreoglobulin) antibodies ( p = 0.048). The application of reducing diets with product elimination was found to be a more beneficial tool for changing anthropometric and thyroid parameters in women suffering from obesity and Hashimoto’s disease than classic reducing diets with the same energy values and macronutrient content.

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          Hashimoto thyroiditis: clinical and diagnostic criteria.

          Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related variant, juvenile form, Hashitoxicosis, and painless thyroiditis (sporadic or post-partum). All forms are characterized pathologically by the infiltration of hematopoietic mononuclear cells, mainly lymphocytes, in the interstitium among the thyroid follicles, although specific features can be recognized in each variant. Thyroid cells undergo atrophy or transform into a bolder type of follicular cell rich in mitochondria called Hürthle cell. Most HT forms ultimately evolve into hypothyroidism, although at presentation patients can be euthyroid or even hyperthyroid. The diagnosis of HT relies on the demonstration of circulating antibodies to thyroid antigens (mainly thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid sonogram in a patient with proper clinical features. The treatment remains symptomatic and based on the administration of synthetic thyroid hormones to correct the hypothyroidism as needed. Surgery is performed when the goiter is large enough to cause significant compression of the surrounding cervical structures, or when some areas of the thyroid gland mimic the features of a nodule whose cytology cannot be ascertained as benign. HT remains a complex and ever expanding disease of unknown pathogenesis that awaits prevention or novel forms of treatment.
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            The incidence and prevalence of thyroid autoimmunity.

            The thyroid gland is the most common organ affected by autoimmune disease. Other autoimmune diseases, most notably type 1 diabetes mellitus, are increasing in incidence. It is unknown whether autoimmune thyroid diseases are following the same pattern. This review summarizes studies of autoimmune thyroid disease incidence and prevalence since 1950, not only for these measures of occurrences, but also for commenting on identified risk factors for thyroid autoimmunity. We find that incidence of autoimmune thyroid disease is currently higher than in historic series although the studies are so variable in design, patient population, disease definition, and laboratory methods that it is impossible to tell whether this difference is real. Further research is required to assess the possibility of changing disease patterns of autoimmune thyroid disease as opposed to simple changes in diagnostic thresholds.
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              The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation.

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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                05 March 2021
                March 2021
                : 13
                : 3
                : 862
                Affiliations
                [1 ]Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, ul. Mieszka I 4 B, 15-054 Bialystok, Poland; lucyna.ostrowska@ 123456umb.edu.pl
                [2 ]Faculty of Physiotherapy and Health Sciences, Gdansk College of Health, ul. Pelplińska 7, 80-335 Gdańsk, Poland; dominika.gier@ 123456gmail.com
                Author notes
                [* ]Correspondence: beata.zysk@ 123456umb.edu.pl ; Tel.: +48-857-328-244
                Author information
                https://orcid.org/0000-0002-0543-1817
                https://orcid.org/0000-0002-9821-9347
                Article
                nutrients-13-00862
                10.3390/nu13030862
                8000220
                33808030
                6e65f70e-e75c-4c0f-ac6e-ad503a304e91
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 January 2021
                : 01 March 2021
                Categories
                Article

                Nutrition & Dietetics
                hashimoto,obesity,elimination diet,thyroid gland,adults
                Nutrition & Dietetics
                hashimoto, obesity, elimination diet, thyroid gland, adults

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