Impact of dehydroepiandrosterone on thyroid autoimmunity and function in men with autoimmune hypothyroidism
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RESEARCH ARTICLE
Impact of dehydroepiandrosterone on thyroid autoimmunity and function in men with autoimmune hypothyroidism Robert Krysiak1 · Witold Szkróbka1 · Bogusław Okopień1 Received: 15 June 2020 / Accepted: 18 November 2020 © Springer Nature Switzerland AG 2020
Abstract Background Testosterone administration was found to have a protective effect on thyroid autoimmunity in men with autoimmune (Hashimoto’s) thyroiditis. Objective The present study was aimed at assessing whether oral dehydroepiandrosterone affects thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in men with subclinical hypothyroidism induced by Hashimoto’s thyroiditis. Setting The study was conducted at Medical University of Silesia, Katowice, Poland. Method The study enrolled 32 elderly men with autoimmune hypothyroidism and low dehydroepiandrosterone-sulfate levels. Based on patient preference, the participants either received oral dehydroepiandrosterone (50 mg daily; n = 16) or remained untreated (n = 16). Apart from measuring antibody titers and hormone levels, we calculated baseline and post-treatment values of three structure parameters of thyroid homeostasis. Main outcome measure Serum titers of thyroid peroxidase and thyroglobulin antibodies. Results At baseline, there were no significant differences in the investigated parameters between both groups of men. All participants completed the study. Oral dehydroepiandrosterone increased dehydroepiandrosteronesulfate and testosterone levels, as well as had a neutral effect on estradiol levels. The increase in dehydroepiandrosteronesulfate correlated with treatment-induced changes in serum testosterone. Moreover, dehydroepiandrosterone reduced titers of thyroid peroxidase and thyroglobulin antibodies, decreased serum thyrotropin levels, reduced Jostel’s thyrotropin index as well as increased thyroid’s secretory capacity. Treatment-induced changes in thyroid antibody titers, thyrotropin levels, Jostel’s thyrotropin index and thyroid’s secretory capacity correlated with the increase in dehydroepiandrosterone-sulfate and testosterone levels. Conclusion The obtained results show that exogenous dehydroepiandrosterone may exert a beneficial effect on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in men with autoimmune thyroiditis and subclinical hypothyroidism. Keywords Adrenal androgens · Hypothalamic-pituitary-thyroid axis · Thyroid autoimmunity · Thyroid function tests Abbreviations CI Confidence interval DHEA Dehydroepiandrosterone DHEA-S Dehydroepiandrosterone-sulfate IU International unit SD Standard deviation SPINA Structure parameter inference approach TgAb Thyroglobulin antibodies TPOAb Thyroid peroxidase antibodies
Impacts on practice • Exogenous dehydroepiandrosterone reduces thyroid anti-
body titers in men with Hashimoto’s thyroiditis
• The beneficial effect on thyroid autoimmunity is accom-
panied by the improvement in thyroid function
• Dehydroepiandrosterone treatment may bring benefits to
men with autoimmune hypothyro
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