الفهرس 
THYROID GLAND AND HASHIMOTO THYROIDITISOnly 14 pages are availabe for public view
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Abstract
Hashimoto’s thyroiditis (HT) is the most frequent autoimmune thyroid disorder. It is the leading cause of hypothyroidism in the iodine-sufficient areas of the world (Ragusa et al., 2019). Euthyroid individuals with HT continue to suffer from symptoms, such as chronic fatigue, dry skin, hair loss, chronic irritability, and nervousness, impairing quality of life (Abbott et al., 2019). There is still no specific diet recommended for patients with HT, but an anti-inflammatory diet may help HT patients to reduce the need for medicines, slow down the course of the disease, and avoid relapses (Ihnatowicz et al., 2020).
Our aim was to study the impact of anti-inflammatory modified Mediterranean diet in patients with Ht. Disease activity was assessed by measuring levels of anti-TPO and anti-TG levels pre and post intervention, as well as TSH, free T3, and free T4. Impact of diet on HRQL was assessed using ThyPRO questionnaire. We used ESR to evaluate the inflammatory state in the patients. The patients’ metabolic profile was assessed using BMI and lipid profile. Correlations between the changes seen in thyroid profile and autoantibodies compared to different parameters (BMI, lipid profile, ESR, and ThyPRO scores) were also assessed.
We conducted an open label single arm interventional study in which 40 female patients with HT. Patients were recruited from Ain Shams University hospital outpatient endocrinology clinic. Study participants were provided with educational sessions and meal plans with exchange lists to carry out the MD for 3 months. Baseline evaluation was done at initial visit, with a follow up evaluation after 3 months.
Willcoxon rank test was used to evaluate the difference in autoantibodies levels, changes in TSH, changes in ESR, and changes in ThyPRO scale items. Paired t-test was used to evaluate differences in Free T3, Free T4, BMI, and lipid profile parameters. Spearman correlation test was used to assess the correlations between different study parameters with autoantibodies level and thyroid profile changes.
In both study 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 the Levothyroxine group the observed changes were statistically more significant. We also observed statistically highly significant reductions in levels of thyroid stimulating hormone in the Levothyroxine group (-39.09%, p<0.01), however, the changes in the No Levothyroxine group were statistically non-significant.