The impact of vitamin D status and supplementation on thyroid autoimmunity

Main Article Content

I. Pankiv

Abstract

Background. In spite of large volume of data linking vitamin D (VD) with cardiovascular morbidity, autoimmunity, cancer, and virtually every organ system, VD and thyroid is a lesser-known aspect of VD in clinical practice. The reason for this almost ubiquitous role of VD is perhaps because VD receptor (VDR) is virtually expressed in every tissue and organ system of the body. This review intends to highlight the current literature on the impact of VD status and supplementation on thyroid autoimmunity. Materials and methods. References for this review were identified through searches of PubMed for articles published to from 2015 to September 2020 using the terms “thyroid” and “Vitamin D”. Results. Significant inverse correlation was documented between anti-thyroid peroxidase antibody (TPO Ab) and serum 25-hydroxyvitamin D 25(OH)D. TPO Ab positivity is more prevalent in VD deficient individuals. A large volume of medical literature is available from observational studies linking VD with thyroid autoimmunity. Data from interventional studies documenting beneficial effects of VD on thyroid autoimmunity is also available, but lesser than that from observational studies. Short-term high dose oral VD supplementation reduces TPO Ab titers. Certain VDR gene polymorphism has been linked to increased occurrence of autoimmune thyroid disorders (AITD). Data on whether correction of Vitamin D deficiency in AITD results in reduction in the requirement of levothyroxine or carbimazole in hypothyroidism or Graves’ disease respectively is not available. Conclusions. In spite of large volume of medical literature from observational studies linking VD with thyroid autoimmunity, meaningful concrete clinical data on impact of VD supplementation on hard clinical end points in these disorders is lacking, and should be the primary area of research in the next decade.

Article Details

How to Cite
Pankiv, I. “The Impact of Vitamin D Status and Supplementation on Thyroid Autoimmunity”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 8, Apr. 2021, pp. 681-5, doi:10.22141/2224-0721.16.8.2020.222889.
Section
Literature Review

References

Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020 Nov;74(11):1498-1513. doi: 10.1038/s41430-020-0558-y.

Charoenngam N, Holick MF. Immunologic Effects of Vitamin D on Human Health and Disease. Nutrients. 2020 Jul 15;12(7):2097. doi: 10.3390/nu12072097.

Liyanage P, Lekamwasam S, Weerarathna TP, Liyanage C. Effect of Vitamin D therapy on urinary albumin excretion, renal functions, and plasma renin among patients with diabetic nephropathy: A randomized, double-blind clinical trial. J Postgrad Med. 2018 Jan-Mar;64(1):10-15. doi: 10.4103/jpgm.JPGM_598_16.

Nitsa A, Toutouza M, Machairas N, Mariolis A, Philippou A, Koutsilieris M. Vitamin D in Cardiovascular Disease. In Vivo. 2018 Sep-Oct;32(5):977-981. doi: 10.21873/invivo.11338.

Pankiv VI, Yuzvenko TYu, Pashkovska NV, Pankiv IV. Effect of vitamin D on insulin resistance and anthropometric parameters in patients with type 2 diabetes mellitus. Clinical Endocrinology and Endocrine Surgery. 2019;1(65):53-58. doi: 10.30978/CEES-2019-1-53.

Gröber U, Holick MF. Diabetes Prevention: Vitamin D Supplementation May Not Provide Any Protection If There Is No Evidence of Deficiency! Nutrients. 2019 Nov 4;11(11):2651. doi: 10.3390/nu11112651.

Aibana O, Huang CC, Aboud S, et al. Vitamin D status and risk of incident tuberculosis disease: A nested case-control study, systematic review, and individual-participant data meta-analysis. PLoS Med. 2019 Sep 11;16(9):e1002907. doi: 10.1371/journal.pmed.1002907.

Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity. J Nat Sci Biol Med. 2018 Jan-Jun;9(1):54-58. doi: 10.4103/jnsbm.JNSBM_128_17.

Feige J, Moser T, Bieler L, Schwenker K, Hauer L, Sellner J. Vitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and Threats. Nutrients. 2020 Mar 16;12(3):783. doi: 10.3390/nu12030783.

Karras S, Anagnostis P, Kotsa K, Goulis DG. Vitamin D and gonadal function in men: a potential inverse U-shaped association? Andrology. 2016 May;4(3):542-4. doi: 10.1111/andr.12173.

Bass JJ, Nakhuda A, Deane CS, et al. Overexpression of the vitamin D receptor (VDR) induces skeletal muscle hypertrophy. Mol Metab. 2020 Dec;42:101059. doi: 10.1016/j.molmet.2020.101059.

Quesada-Gomez JM, Entrenas-Castillo M, Bouillon R. Vitamin D receptor stimulation to reduce acute respiratory distress syndrome (ARDS) in patients with coronavirus SARS-CoV-2 infections: Revised Ms SBMB 2020_166. J Steroid Biochem Mol Biol. 2020 Sep;202:105719. doi: 10.1016/j.jsbmb.2020.105719.

Kyritsi EM, Kanaka-Gantenbein C. Autoimmune Thyroid Disease in Specific Genetic Syndromes in Childhood and Adolescence. Front Endocrinol (Lausanne). 2020 Aug 19;11:543. doi: 10.3389/fendo.2020.00543.

Hirota S, Marui S, Migliari D. Does autoimmune thyroid disorder act as a predisposing factor in the development of oral lichen planus? Oral Dis. 2020 Apr 4. doi: 10.1111/odi.13339.

Martens PJ, Gysemans C, Verstuyf A, Mathieu AC. Vitamin D's Effect on Immune Function. Nutrients. 2020 Apr 28;12(5):1248. doi: 10.3390/nu12051248.

Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020 Jan 16;12(1):236. doi: 10.3390/nu12010236.

Dutta D, Sharma M, Aggarwal S, Mohindra R, Bhattacharya S, Kalra S. Vitamin D, Thyroid Autoimmunity and Cancer: An Interplay of Different Factors. Indian J Endocrinol Metab. 2019 Sep-Oct;23(5):507-513. doi: 10.4103/ijem.IJEM_526_19.

Kim D. The Role of Vitamin D in Thyroid Diseases. Int J Mol Sci. 2017 Sep 12;18(9):1949. doi: 10.3390/ijms18091949.

Vanherwegen AS, Gysemans C, Mathieu C. Regulation of Immune Function by Vitamin D and Its Use in Diseases of Immunity. Endocrinol Metab Clin North Am. 2017 Dec;46(4):1061-1094. doi: 10.1016/j.ecl.2017.07.010.

Alrefaie Z, Awad H. Effect of vitamin D3 on thyroid function and de-iodinase 2 expression in diabetic rats. Arch Physiol Biochem. 2015;121(5):206-9. doi: 10.3109/13813455.2015.1107101.

Lowry MB, Guo C, Zhang Y, et al. A mouse model for vitamin D-induced human cathelicidin antimicrobial peptide gene expression. J Steroid Biochem Mol Biol. 2020 Apr;198:105552. doi: 10.1016/j.jsbmb.2019.105552.

Muscogiuri G, Mari D, Prolo S, et al. 25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly. Int J Environ Res Public Health. 2016 Aug 26;13(9):850. doi: 10.3390/ijerph13090850.

Botelho IMB, Moura Neto A, Silva CA, Tambascia MA, Alegre SM, Zantut-Wittmann DE. Vitamin D in Hashimoto's thyroiditis and its relationship with thyroid function and inflammatory status. Endocr J. 2018 Oct 29;65(10):1029-1037. doi: 10.1507/endocrj.EJ18-0166.

D'Aurizio F, Villalta D, Metus P, Doretto P, Tozzoli R. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases? Autoimmun Rev. 2015 May;14(5):363-9. doi: 10.1016/j.autrev.2014.10.008.

Kim S, Kwon YS, Kim JY, Hong KH, Park YK. Association between Iodine Nutrition Status and Thyroid Disease-Related Hormone in Korean Adults: Korean National Health and Nutrition Examination Survey VI (2013-2015). Nutrients. 2019 Nov 13;11(11):2757. doi: 10.3390/nu11112757.

Miao CY, Fang XJ, Chen Y, Zhang Q. Effect of vitamin D supplementation on polycystic ovary syndrome: A meta-analysis. Exp Ther Med. 2020 Apr;19(4):2641-2649. doi: 10.3892/etm.2020.8525.

Wang J, Lv S, Chen G, Gao C, He J, Zhong H, Xu Y. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015 Apr 3;7(4):2485-98. doi: 10.3390/nu7042485.

Feng M, Li H, Chen SF, Li WF, Zhang FB. Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: a meta-analysis. Endocrine. 2013 Apr;43(2):318-26. doi: 10.1007/s12020-012-9812-y.

Răcătăianu N, Leach NV, Bolboacă SD, et al. Vitamin D deficiency, insulin resistance and thyroid dysfunction in obese patients: is inflammation the common link? Scand J Clin Lab Invest. 2018 Nov-Dec;78(7-8):560-565. doi: 10.1080/00365513.2018.1517420.

Bozdag H, Akdeniz E. Does severe vitamin D deficiency impact obstetric outcomes in pregnant women with thyroid autoimmunity? J Matern Fetal Neonatal Med. 2020 Apr;33(8):1359-1369. doi: 10.1080/14767058.2018.1519017.

Krysiak R, Szkróbka W, Okopień B. The Relationship Between Statin Action On Thyroid Autoimmunity And Vitamin D Status: A Pilot Study. Exp Clin Endocrinol Diabetes. 2019 Jan;127(1):23-28. doi: 10.1055/a-0669-9309.

Gao XR, Yu YG. Meta-Analysis of the Association between Vitamin D Receptor Polymorphisms and the Risk of Autoimmune Thyroid Disease. Int J Endocrinol. 2018 Mar 22;2018:2846943. doi: 10.1155/2018/2846943.

Simsek Y, Cakır I, Yetmis M, Dizdar OS, Baspinar O, Gokay F. Effects of Vitamin D treatment on thyroid autoimmunity. J Res Med Sci. 2016 Oct 18;21:85. doi: 10.4103/1735-1995.192501.

Chaudhary S, Dutta D, Kumar M, Saha S, Mondal SA, Kumar A, Mukhopadhyay S. Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. Indian J Endocrinol Metab. 2016 May-Jun;20(3):391-8. doi: 10.4103/2230-8210.179997.

Pankiv I. Impact of cholecalciferol supplementation on thyroid peroxidase antibody titers in patients with hypothyroidism. In: World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2017): Poster Abstracts. Osteoporos Int. 2017 Jul;28(Suppl 1):127-636. doi: 10.1007/s00198-017-3950-2.

Chahardoli R, Saboor-Yaraghi AA, Amouzegar A, Khalili D, Vakili AZ, Azizi F. Can Supplementation with Vitamin D Modify Thyroid Autoantibodies (Anti-TPO Ab, Anti-Tg Ab) and Thyroid Profile (T3, T4, TSH) in Hashimoto's Thyroiditis? A Double Blind, Randomized Clinical Trial. Horm Metab Res. 2019 May;51(5):296-301. doi: 10.1055/a-0856-1044.

Wang S, Wu Y, Zuo Z, Zhao Y, Wang K. The effect of vitamin D supplementation on thyroid autoantibody levels in the treatment of autoimmune thyroiditis: a systematic review and a meta-analysis. Endocrine. 2018 Mar;59(3):499-505. doi: 10.1007/s12020-018-1532-5.

Knutsen KV, Madar AA, Brekke M, et al. Effect of Vitamin D on Thyroid Autoimmunity: A Randomized, Double-Blind, Controlled Trial Among Ethnic Minorities. J Endocr Soc. 2017 Apr 11;1(5):470-479. doi: 10.1210/js.2017-00037.

Talaei A, Ghorbani F, Asemi Z. The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double-blind, Placebo-controlled Trial. Indian J Endocrinol Metab. 2018 Sep-Oct;22(5):584-588. doi: 10.4103/ijem.IJEM_603_17.

Hu MJ, Zhang Q, Liang L, et al. Association between vitamin D deficiency and risk of thyroid cancer: a case-control study and a meta-analysis. J Endocrinol Invest. 2018 Oct;41(10):1199-1210. doi: 10.1007/s40618-018-0853-9.

Díaz L, Díaz-Muñoz M, García-Gaytán AC, Méndez I. Mechanistic Effects of Calcitriol in Cancer Biology. Nutrients. 2015 Jun 19;7(6):5020-50. doi: 10.3390/nu7065020.

Sulibhavi A, Rohlfing ML, Jalisi SM, et al. Vitamin D deficiency and its relationship to cancer stage in patients who underwent thyroidectomy for papillary thyroid carcinoma. Am J Otolaryngol. 2019 Jul-Aug;40(4):536-541. doi: 10.1016/j.amjoto.2019.04.013.

Yildiz S, Ekinci O, Ucler R. The relationship between 25 hydroxy Vitamin D3 and thyroid antibodies with thyroid benign-malign neoplasms. Niger J Clin Pract. 2019 Sep;22(9):1224-1228. doi: 10.4103/njcp.njcp_440_18.

Peng W, Wang K, Zheng R, Derwahl M. 1,25 dihydroxyvitamin D3 inhibits the proliferation of thyroid cancer stem-like cells via cell cycle arrest. Endocr Res. 2016 May;41(2):71-80. doi: 10.3109/07435800.2015.1037048.

Yavropoulou MP, Panagiotou G, Topouridou K, et al. Vitamin D receptor and progesterone receptor protein and gene expression in papillary thyroid carcinomas: associations with histological features. J Endocrinol Invest. 2017 Dec;40(12):1327-1335. doi: 10.1007/s40618-017-0700-4.

Izkhakov E, Somjen D, Sharon O, et al. Vitamin D receptor expression is linked to potential markers of human thyroid papillary carcinoma. J Steroid Biochem Mol Biol. 2016 May;159:26-30. doi: 10.1016/j.jsbmb.2016.02.016.

Danilovic DL, Ferraz-de-Souza B, Fabri AW, Santana NO, Kulcsar MA, Cernea CR, Marui S, Hoff AO. 25-Hydroxyvitamin D and TSH as Risk Factors or Prognostic Markers in Thyroid Carcinoma. PLoS One. 2016 Oct 13;11(10):e0164550. doi: 10.1371/journal.pone.0164550.