January is Thyroid Awareness Month, so we are investigating the latest research studies in the two autoimmune thyroid conditions: Hashimoto’s and Graves’ Disease (learn about the latest in Graves’ disease research here). The focus of this post is about Hashimoto’s thyroiditis, also known as chronic autoimmune thyroiditis. In Hashimoto’s, the body’s immune cells mistakenly attack the thyroid gland, resulting in destruction of tissue and a hypothyroid state. Because of its prevalence and impact, this disease attracts researchers interested in elucidating its mechanisms, finding new therapies, or both. Below we discuss some of these research efforts, and what they might mean for you as a patient.
What are the latest results of research studies or clinical trials seeking better therapies for Hashimoto’s?
Yes there are, although a brief review online revealed that Hashimoto’s studies might occur with less frequency than those examining other autoimmune disorders, simply based on availability of information. Research reports available online indicate an ongoing interest in finding the precise genetic and immune mechanisms involved in the disease, as well as potential new treatment options.
The National Endocrine and Metabolic Disease Information Service notes that it is only through research that patients and their families continue to remain hopeful for improvements. Their website offers some good basic information on how to learn more about such research activities, and the NIH provides an overview of their autoimmune disease research plan, which contains general information on the directions they plan to take in the future regarding studies. In addition, the International Scleroderma Network provides a very nice collection of various research involving Hashimoto’s, organized by medical category.
One specific area of interest is selenium supplementation, which has been shown to increase the conversion of T4 to T3 while simultaneously reducing thyroid antibody levels responsible for the autoimmune attack. While initial work appears promising, the research is far from conclusive, and this approach needs considerably more study, according to write-ups of different studies in the European Journal of Endocrinology, the Journal of Endocrinology, Thyroid and the Journal of Clinical Endocrinology and Metabolism. Still, these investigations are good news for those patients seeking different treatment options.
Other work has focused on whether total thyroidectomy, where all thyroid tissue antigens (the proteins that trigger an immune response) are eliminated, results in permanent disappearance of corresponding antibodies. Researchers have found this to be the case, which may have future implications for treatment decisions. A related retrospective study reviewed thyroidectomy as a treatment option, and found that Hashimoto’s thyroid patients tended to have more complications during the procedure, which might impact therapeutic decisions.
And more recently, a plant alkaloid known as anatabine has been shown to be quite effective in reducing the inflammatory response seen in thyroiditis, via inhibition of immune response, though this research has yet to be peer reviewed according to research published in Endocrinology and via Reuters.
Some studies aim to examine the effects of other specific substances on thyroid function during Hashimoto’s thyroiditis, though these tend to be quite technical, are not yet testing on people and many are still in very experimental stages; for example this 2011 Japanese study on the onset of autoimmune thyroiditis in mice. While some have disproved certain hypotheses, others have shed light on possible mechanisms and treatments. There are also studies involving genetics that seek further illumination into the pathology of Hashimoto’s, as well as potential future treatments.
How can I find out about Hashimoto’s thyroiditis clinical trials?
As for ongoing or future clinical trials, there are two reputable websites that serve as clearinghouses: CenterWatch and ClinicalTrials. ClinicalTrials is a national listing of studies available or taking place throughout the country and you can search for Hashimoto’s trials where current participants are needed. Together with CenterWatch, the two are invaluable resources in this pursuit. A brief online search revealed a past study examining laser treatment, as one example, and new research is being conducted all the time. Another excellent resource is your local or regional major academic medical center. Even if they aren’t running trials at the moment, chances are they can point you in the right direction.
Questions for your doctor:
- Is there any new research being conducted to find alternative therapies for Hashimoto’s?
- Can you recommend a good starting point if I’m interested in learning more about clinical trials (other than those above)?
- Are there any therapies not approved in the U.S. but available elsewhere that are safe and effective? Do you suggest looking into them?
- Can I take selenium in over-the-counter preparations, or does this supplementation need to be prescribed by a doctor? Do you recommend trying it?
- Is there active research being conducted in the area of immunotherapy for Hashimoto’s hypothyroid? Why or why not? Where can I find more information?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at grothbard[email protected].