Dietary factors and thyroid dysfunction

Abstract

Besides iodine deficiency, autoimmune Hashimoto thyroiditis is the leading cause of hypothyroidism globally, characterized by the increased titer of thyroid autoantibodies and destruction of thyroid cells. Graves' disease is the most common etiology of hyperthyroidism worldwide. Patients with thyroid dysfunction often require dietary modifications. Popular interventions include supplementation with certain vitamins and minerals, as well as trace elements such as iodine and selenium. The intake of food containing goitrogens should be limited. Goitrogens are substances of plant origin that interfere with the production of thyroid hormones, increasing the risk for goiter and hypothyroidism. The primary dietary sources of goitrogens are cruciferous vegetables, soy products, starchy plants, and some fruits. Beyond essential nutrients, there has been an increasing interest in using specific nutraceuticals, including myoinositol, L- carnitine, melatonin, and resveratrol, as potential preventive and therapeutic agents in thyroid diseases. Even though current evidence promotes some beneficial outcomes of these nutraceuticals, further investigations are needed to clarify dose-dependent effects, duration of supplementation, combination in different clinical settings, and the exact mechanism of their action in thyroid disorders.

Pored nedostatka joda, najčešća etiologija hipotireoze u razvijenim zemljama je Hašimoto tireoiditis, koji karakteriše povišen nivo serum autoantitela i limfocitna infiltracija štitaste žlezde. Grejvsova bolest je vodeći uzrok hipertireoza na globalnom nivou. Pacijenti sa oboljenjem štitaste žlezde često zahtevaju modifikaciju dijetarnog režima. Popularne intervencije uključuju suplementaciju određenim vitaminima, mineralima i mikroelementima kao što su jod i selen. Preporučuje se ograničen unos namirnica koje sadrže goitrogene supstance jer ometaju normalnu sintezu tiroidnih hormona, povećavajući rizik za nastanak strume i hipotireoze. Primarni izvori goitrogena u ishrani su kruciferno povrće, proizvodi od soje, skrobne biljke i pojedine vrste voća. Osim esencijalnih nutrijenata, postoji sve veće interesovanje za primenu specifičnih nutraceutika u prevenciji i koterapiji bolesti štitaste žlezde, kao što su mioinozitol, L-karnitin, melatonin i rezveratrol. Trenutni dokazi ukazuju na moguće promotivne efekte ovih jedinjenja u oboljenjima štitaste žlezde. Potrebna su dalja ispitivanja koja bi pratila uticaj doze i dužine suplementacije nutraceutika i potvrdila tačne mehanizme njihovog delovanja u poremećajima funkcije štitaste žlezde.