1.
Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease.
Rayman, MP
The Proceedings of the Nutrition Society. 2019;(1):34-44
Abstract
Hashimoto's thyroiditis (HT) and Graves' disease (GD) are examples of autoimmune thyroid disease (AITD), the commonest autoimmune condition. Antibodies to thyroid peroxidase (TPO), the enzyme that catalyses thyroid-hormone production and antibodies to the receptor for the thyroid-stimulating hormone, are characteristic of HT and GD, respectively. It is presently accepted that genetic susceptibility, environmental factors, including nutritional factors and immune disorders contribute to the development of AITD. Aiming to investigate the effect of iodine, iron and selenium in the risk, pathogenesis and treatment of thyroid disease, PubMed and the Cochrane Library were searched for relevant publications to provide a narrative review. Iodine: chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly-iodinated thyroglobulin (Tg) is more immunogenic. The recent introduction of universal salt iodisation can have a similar, although transient, effect. Iron: iron deficiency impairs thyroid metabolism. TPO is a haem enzyme that becomes active only after binding haem. AITD patients are frequently iron-deficient since autoimmune gastritis, which reduces iron absorption and coeliac disease which causes iron loss, are frequent co-morbidities. In two-thirds of women with persistent symptoms of hypothyroidism despite appropriate levothyroxine therapy, restoration of serum ferritin above 100 µg/l ameliorated symptoms. Selenium: selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases remove excessive hydrogen peroxide produced there for the iodination of Tg to form thyroid hormones. There is evidence from observational studies and randomised controlled trials that selenium, probably as selenoproteins, can reduce TPO-antibody concentration, hypothyroidism and postpartum thyroiditis. Appropriate status of iodine, iron and selenium is crucial to thyroid health.
2.
Adjuvant Effect of Molecular Iodine in Conventional Chemotherapy for Breast Cancer. Randomized Pilot Study.
Moreno-Vega, A, Vega-Riveroll, L, Ayala, T, Peralta, G, Torres-Martel, JM, Rojas, J, Mondragón, P, Domínguez, A, De Obaldía, R, Avecilla-Guerrero, C, et al
Nutrients. 2019;(7)
Abstract
This study analyzes an oral supplement of molecular iodine (I2), alone and in combination with the neoadjuvant therapy 5-fluorouracil/epirubicin/cyclophosphamide or taxotere/epirubicin (FEC/TE) in women with Early (stage II) and Advanced (stage III) breast cancer. In the Early group, 30 women were treated with I2 (5 mg/day) or placebo (colored water) for 7-35 days before surgery. For the Advanced group, 30 patients received I2 or placebo, along with FEC/TE treatment. After surgery, all patients received FEC/TE + I2 for 170 days. I2 supplementation showed a significant attenuation of the side effects and an absence of tumor chemoresistance. The control, I2, FEC/TE, and FEC/TE + I2 groups exhibited response rates of 0, 33%, 73%, and 100%, respectively, and a pathologic complete response of 18%, and 36% in the last two groups. Five-year disease-free survival rate was significantly higher in patients treated with the I2 supplement before and after surgery compared to those receiving the supplement only after surgery (82% versus 46%). I2-treated tumors exhibit less invasive potential, and significant increases in apoptosis, estrogen receptor expression, and immune cell infiltration. Transcriptomic analysis indicated activation of the antitumoral immune response. The results led us to register a phase III clinical trial to analyze chemotherapy + I2 treatment for advanced breast cancer.
3.
On the importance of selenium and iodine metabolism for thyroid hormone biosynthesis and human health.
Schomburg, L, Köhrle, J
Molecular nutrition & food research. 2008;(11):1235-46
Abstract
The trace elements iodine and selenium (Se) are essential for thyroid gland functioning and thyroid hormone biosynthesis and metabolism. While iodine is needed as the eponymous constituent of the two major thyroid hormones triiodo-L-thyronine (T3), and tetraiodo-L-thyronine (T4), Se is essential for the biosynthesis and function of a small number of selenocysteine (Sec)-containing selenoproteins implicated in thyroid hormone metabolism and gland function. The Se-dependent iodothyronine deiodinases control thyroid hormone turnover, while both intracellular and secreted Se-dependent glutathione peroxidases are implicated in gland protection. Recently, a number of clinical supplementation trials have indicated positive effects of increasing the Se status of the participants in a variety of pathologies. These findings enforce the notion that many people might profit from improving their Se status, both as a means to reduce the individual health risk as well as to balance a Se deficiency which often develops during the course of illness. Even though the underlying mechanisms are still largely uncharacterised, the effects of Se appear to be exerted via multiple different mechanisms that impact most pronounced on the endocrine and the immune systems.
4.
Impact of pilot project of Rural Maintenance Programme (RMP) on destitute women: CARE, Bangladesh.
Roy, SK, Bilkes, F, Islam, K, Ara, G, Tanner, P, Wosk, I, Rahman, AS, Chakraborty, B, Jolly, SP, Khatun, W
Food and nutrition bulletin. 2008;(1):67-75
Abstract
BACKGROUND The rate of malnutrition among women in Bangladesh is high, but historically there has not been a specific program focusing on the improvement of the nutritional status of Bangladeshi women. OBJECTIVE To observe changes in the nutritional status of destitute women of the Rural Maintenance Programme (RMP) by incorporating a health and nutrition intervention package with RMP ongoing activities. METHODS An intervention study involving 1,275 poor destitute women was conducted from July 2004 to June 2005 in 17 districts in Bangladesh under two field offices, Mymensingh and Jessore, covering 8 and 9 districts, respectively. The respondents were divided into intervention, comparison, and control groups. All participants in the intervention and comparison groups were paid as part of the RMP and received weekly 30-minute nutrition interventions for 7 weeks in addition to routine training. The comparison group also received RMP training. The control group consisted of women with similar demographic characteristics to the intervention and comparison groups who did not receive pay or any intervention. The intervention was a unique combination of the three components of the UNICEF triangle model (food security, caring practices, and disease control). Data on socioeconomic and anthropometric characteristics, immunization, and vitamin A capsule intake were also collected with the use of a structured questionnaire. RESULTS After the intervention, the mean body weight had significantly increased by 1,333 g in the intervention group and had decreased by 277 g in the control group and 147 g in the comparison group. The body mass index of women in the intervention group had also significantly increased at the end of the study (p < .001). There was a significant increase in the intake of iodized salt in the intervention group as well as increased immunization coverage in all groups. Intake of the first vitamin A capsule by children increased (from 60% to 97%) in the intervention group only. CONCLUSIONS The nutrition pilot intervention was highly effective in improving the nutritional status of women in the RMP.