Clinical Curative Effect Observation Of Selenium Yeast On Treating Autoimmune Thyroiditis And Hypothyroidism

Objective: Autoimmune Thyroiditis(AIT) is a kind of organ specific autoimmune disease, characterized by goiter, elevated thyroid peroxidase antibodies(TPOAb) and/or thyroid globulin(Tg Ab) levels[1]. AIT pathogenesis remains unclear, may be related to immune factors, oxidative damage, genetic factors, free radical induced apoptosis and so on. Researches show that there are infiltrated lymphocytes in thyroid tissues of AIT patients. The infiltrated lymphocytes initiate autoimmune reaction, destroy the thyroid gland, increase the levels of blood thyroid peroxidase antibody(TPOAb) and/or thyroglobulin antibody(Tg Ab). The elevated antibody further damage thyroid tissue,then cause hypothyroidism further. Due to the pathogenesis of autoimmune thyroiditis remains unclear, it is difficult to treat the disease etiologically at present, symptomatic treatment is the main method, such as using levothyroxine sodium orally to regulate the thyroid function. No specific treatment on the destruction of the thyroid gland caused by autoimmune response is used in clinics.Thyroid tissue contains very high levels of selenium, selenium lack may aggravate inflammation and immune reaction progress. A certain dose of selenium element increases the activities of plasma glutathione peroxidase and thioredoxin reductase, reduces the toxic concentration of hydrogen peroxide and lipid peroxides in the synthesis process of thyroid hormone, and alleviates inflammation and immune response. So supplementation of selenium is beneficial for the treatment of autoimmune thyroiditis. So how to use selenium element is becoming a new research hotspot on treating autoimmune thyroiditis and hypothyroidism. The effects of selenium yeast on thyroid morphology, function, thyroid peroxidase antibody, and thyroglobulin antibody were observed in patients with autoimmune thyroiditis and hypothyroidism in this experiment. The hyroid size, shape and function change were also observed.Methods: 50 patients aged from 18 to 70 years old who was initially diagnosed as autoimmune thyroiditis and hypothyroidism were selected in this experiment. The patients were divided into two groups randomly including control group and observation group, each group 25 cases. The patients in control group were given levothyroxine sodium 50-100 ug as the maintenance dose, once a day. The patients in observation group were given both levothyroxine sodium 50-100 ug by daily and selenium yeast 100 ug twice a day. The size and echo characteristics of thyroid gland were measured by ultrasound techniques, levels of FT3, FT4, TSH, Tg Ab, and TPOAb were measured before and after 3 months treatment both in control group and observation group.Results: Comparison of the size and echo characteristics of thyroid gland. The ultrasound diagnosis results showed that the sizes of thyroid gland were decreased after 3 months treatment both in control group and observation group(P<0.05 or 0.01 respectively), the alleviation effects were more obvious in observation group than those in control group(P<0.01). The abnormal echo mainly expressed as grade I both in control group and observation group after 3 months treatment. Both of them were better than before treatment which mainly expressed as grade II. There was no obvious difference between the two groups after 3 months treatment.Comparison of serum levels of FT3, FT4, and TSH. Levels of FT3 and FT4 were increased both in control group and observation group after 3 months treatment compared with before treatment(P<0.01 respectively). However, levels of TSH in both groups were decreased after 3 months treatment(P<0.01 respectively vs before treatment). There were no obvious differences in FT3 and FT4 levels between observation group and control group after 3 months medication(P> 0.05), but the TSH level in observation group was higher than that in control group(P<0.01).Comparison of the levels of thyroid antibody in serum: The level of Tg Ab was not changed( P>0.05) while the level of TPOAb was increased(P<0.01)in control group after 3 months treatment. Levels of Tg Ab and TPOAb were decreased obviously in observation group after 3 months treatment(P<0.01 respectively). Levels of Tg Ab and TPOAb were decreased significantly in observation group compared with those in control group(P<0.01 respectively).Conclusion: Selenium Supplementation in patients with autoimmune thyroiditis and hypothyroidism reduces the thyroid volume and the serum levels of TSH, TPOAb and Tg Ab, and has no obvious effect on internal echo of thyroid and serum levels of FT3 and FT4.