An autoimmune disease is a condition when the immune system malfunctions and the body produces antibodies which attack its own organs or tissues and causes inflammation. Scientists can measure systemic inflammation in the body by measuring the inflammatory chemicals secreted by immune cells such as monocytes, macrophages and lymphocytes. The degree of inflammation can correlate with the progress of an autoimmune disease.
Hashimoto’s is an autoimmune disease which leads to hypothyroidism, but can show symptoms long before thyroid tests go outside the “normal” range. This condition is known as “euthyroid” Hashimoto’s disease. Typically doctors don’t prescribe thyroid treatment until thyroid-specific tests, such as TSH and T4, become abnormal.
A group of researchers wanted to experiment to see what happens when they treated patients earlier than usual, before they were classified as hypothyroid. They gathered a group of women who were newly diagnosed with Hashimoto’s disease, but were still considered euthyroid. The patients were divided into 4 groups and were given either levothyroxine, selenium, levothyroxine + selenium, or placebo. The study also monitored and compared the Hashimoto’s patients to a similar group of healthy women.
All participants were monitored with tests for inflammation at the beginning of the study, at 3 months and at 6 months. At the start of the study, all groups of the Hashimoto’s patients had higher inflammatory markers than the group of healthy women.
The group that took levothyroxine or levothyroxine + selenium had a reduction in TSH levels and increase in thyroid hormone levels, as desired. All three treatment groups of women, including those taking levothyroxine, levothyroxine + selenium or selenium-only, had the positive benefit of reduced TPOAb (an autoimmune antibody). They also had a reduction in hsCRP, an inflammatory marker. Overall, selenium and levothyroxine both helped reduce inflammation, but the combination of levothyroxine + selenium was the best for reducing specific inflammatory chemicals that are released by immune cells. The researchers discovered that each treatment worked on different inflammatory chemicals, therefore, combining them together was the most effective way to reduce inflammation.
Although this study was small, it helped demonstrate that patients with Hashimoto’s disease might benefit from being treated with a combination of thyroid hormone plus selenium, even before their thyroid tests indicate hypothyroidism. This study showed that the combination treatment effectively reduced several inflammatory parameters, therefore might possibly prevent the autoimmune disease from progressing to hypothyroidism in the long term.
J Clin Endocrinol Metab. 2011 Jul;96(7):2206-15. doi: 10.1210/jc.2010-2986. Epub 2011 Apr 20.