More on Vitamin D deficiency in Hashimoto’s thyroiditis

The need for high dose steroid treatment or even IVIG seems to be called into question based on these results. One ounce of prevention?

1.    J Pediatr Endocrinol Metab. 2012;25(5-6):467-70.
Vitamin D status in children with Hashimoto thyroiditis.

Camurdan OM, Döğer E, Bideci A, Celik N, Cinaz P.
Department of Pediatric Endocrinology, School of Medicine, Gazi University, Ankara, Turkey.


To investigate vitamin D status in children with Hashimoto thyroiditis.


The study group consisted of 78 children recently diagnosed as Hashimoto thyroiditis and 74 subjects as the control group. Parameters of calcium metabolism, thyroid function tests, and 25-hydroxyvitamin D [25(OH)D] levels were measured.


Vitamin D deficiency rate was significantly higher in the Hashimoto group compared with the control subjects (73.1% vs. 17.6%, p < 0.0001). In the Hashimoto group, mean 25(OH)D levels were significantly lower compared with the control group (31.2 +/- 11.5 versus 57.9 +/- 19.7 nmol/L, p < 0.001) and was inversely correlated with the anti-thyroid peroxidase (anti-TPO) levels (r = -0.30, p = 0.007).


The higher vitamin D deficiency rates besides lower vitamin D levels in the Hashimoto group together with the inverse correlation between vitamin D and anti-TPO suggest that vitamin D deficiency may have a role in the autoimmune process in Hashimoto thyroiditis in children.

PMID: 22876540 [PubMed – indexed for MEDLINE]
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2.    Thyroid. 2011 Aug;21(8):891-6. doi: 10.1089/thy.2009.0200. Epub 2011 Jul 13.
Relative vitamin D insufficiency in Hashimoto’s thyroiditis.

Tamer G, Arik S, Tamer I, Coksert D.
Department of Endocrinology and Metabolism, Goztepe Education and Research Hospital, Istanbul, Turkey.


Vitamin D insufficiency, defined as serum levels of 25-hydroxyvitamin D [25(OH)D3] lower than 30 ng/mL, has been reported to be prevalent in several autoimmune diseases such as multiple sclerosis and type 1 diabetes mellitus. The goal of the present study was to assess whether vitamin D insufficiency is also a feature of Hashimoto’s thyroiditis (HT).


We performed a prevalence case-control study that included 161 cases with HT and 162 healthy controls. Serum levels of 25(OH)D3, calcium, phosphorus, and parathyroid hormone were measured in all 323 subjects.


The prevalence of vitamin D insufficiency in HT cases (148 of 161, 92%) was significantly higher than that observed in healthy controls (102 of 162, 63%, p < 0.0001). Among HT cases, the prevalence rate of vitamin D insufficiency showed a trend to be higher in patients with overt hypothyroidism (47 of 50, 94%) or subclinical hypothyroidism (44 of 45, 98%) than in those with euthyroidism (57 of 66, 86%), but the differences were not significant (p = 0.083).


Vitamin D insufficiency is associated with HT. Further studies are needed to determine whether vitamin D insufficiency is a casual factor in the pathogenesis of HT or rather a consequence of the disease.

PMID: 21751884 [PubMed – indexed for MEDLINE]
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3.    Diabetologia. 2009 Dec;52(12):2542-50. doi: 10.1007/s00125-009-1554-x. Epub 2009 Oct 13.
Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort.

Kirii K, Mizoue T, Iso H, Takahashi Y, Kato M, Inoue M, Noda M, Tsugane S; Japan Public Health Center-based Prospective Study Group.
Collaborators: Tsugane S, Inoue M, Sobue T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, Kokubo Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Matsui K, Abe T, Katagiri M, Suzuki M, Doi M, Terao A, Ishikawa Y, Tagami T, Sueta H, Doi M, Urata M, Okamoto N, Ide F, Sakiyama H, Onga N, Takaesu H, Uehara M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Tsubono Y, Suzuki K, Honda Y, Yamagishi K, Sakurai S, Tsuchiya N, Kabuto M, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Akabane M, Kadowaki T, Noda M, Mizoue T, Kawaguchi Y, Takashima Y, Yoshida M, Nakamura K, Matsushima S, Natsukawa S, Shimizu H, Sugimura H, Tominaga S, Iso H, Iida M, Ajiki W, Ioka A, Sato S, Maruyama E, Konishi M, Okada K, Saito I, Yasuda N, Kono S.

Department of Epidemiology and International Health, Research Institute, International Medical Center of Japan, Tokyo, Japan.



Calcium and vitamin D have been implicated in the development of type 2 diabetes, but epidemiological evidence is limited. We examined prospectively the relation of calcium and vitamin D intake to type 2 diabetes risk in a Japanese cohort.


Participants were 59,796 middle-aged and older men and women, who participated in the Japan Public Health Center-based Prospective Study and had no history of type 2 diabetes or other serious diseases. Dietary intake of calcium and vitamin D were estimated using a validated food frequency questionnaire. Logistic regression was used to assess the association between intake of these nutrients and self-reported newly diagnosed type 2 diabetes.


During a 5 year follow-up, 1,114 cases of type 2 diabetes were documented. Overall, calcium intake was not associated with a significantly lower risk of type 2 diabetes; the multivariable odds ratio for the highest vs lowest quartiles was 0.93 (95% CI 0.71-1.22) in men and 0.76 (95% CI 0.56-1.03) in women. However, among participants with a higher vitamin D intake, calcium intake was inversely associated with diabetes risk; the odds ratio for the highest vs lowest intake categories was 0.62 (95% CI 0.41-0.94) in men and 0.59 (95% CI 0.38-0.91) in women. Dairy food intake was significantly associated with a lower risk of type 2 diabetes in women only.


Calcium and vitamin D may not be independently associated with type 2 diabetes risk. Our finding suggesting a joint action of these nutrients against type 2 diabetes warrants further investigation.

PMID: 19823801 [PubMed – indexed for MEDLINE]
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4.    Int J Immunogenet. 2008 Apr;35(2):125-31. doi: 10.1111/j.1744-313X.2008.00748.x. Epub 2008 Feb 11.
Association of vitamin D receptor gene 3′-variants with Hashimoto’s thyroiditis in the Croatian population.

Stefanić M, Papić S, Suver M, Glavas-Obrovac L, Karner I.
Department of Nuclear Medicine, Radiation Protection and Pathophysiology, Clinical Hospital Osijek, Osijek, Croatia.


Hashimoto’s thyroiditis (HT) is the most frequent autoimmune thyroid disease with strong genetic background. Vitamin D receptor (VDR) endocrine system affects immunosuppressive, regulatory and tolerogenic decisions required for induction and maintenance of peripheral immune tolerance. With respect to the biological function of the VDR and functionally plausible gene-expression data, we sought to test whether particular 3′-restriction fragment length polymorphisms (RFLP) and haplotypes previously directly or indirectly associated with VDR mRNA 3′-allelic imbalance phenotype and differences in total VDR mRNA expression are implicated in HT susceptibility. Thus, 145 Croatian HT patients and 145 age-, sex- and ethnically matched euthyroid controls were genotyped for VDR rs1544410 (BsmI), rs7975232 (ApaI) and rs731236 (TaqI) polymorphisms by polymerase chain reaction-RFLP method. Covariate-adjusted single-locus and haplotype-phenotype regression analyses were performed. Permutation corrections (P(c)) and Akaike Information Criteria were used for model comparisons. The best-fit [global P(c) = 7.2 x 10(-4)]BsmI-TaqI BT haplotype was found significantly more often in subjects without HT [12.2% vs. 3.7%; odds ratio (OR, 95% confidence intervals) = 0.28 (0.14-0.56), P(c) = 8 x 10(-4)], whereas the bT haplotype was significantly more frequent in individuals with HT [45.7% vs. 61.8%; OR = 1.91 (1.37-2.65), P(c) = 4 x 10(-4)]. Two extended BsmI-ApaI-TaqI RFLP haplotypes, the common baT [35.7 vs. 47.3%, OR = 1.63 (1.17-2.27), P(c) = 0.012] and rare BaT variants [6.5 vs. 1.2%, OR = 0.17 (0.06-0.55), P(c) = 1.2 x 10(-3)] were associated with HT, representing predisposing and protective haplotypes, respectively. In single-RFLP association analyses, only rs1544410 polymorphism was associated with HT phenotype (allelic P(c) = 0.0078) and appeared to function under the recessive model, with decreased risk of HT among the BB homozygotes [OR = 0.39 (0.21-0.7), P(c) = 0.0052] when compared to the reference b(+)-genotypes. These data suggest that common haplotypic variants within the VDR gene 3′-region previously linked to VDR mRNA expression and allelic imbalance could be associated with HT in the general population, and thus, may be involved in the pathogenesis of HT.

PMID: 18279374 [PubMed – indexed for MEDLINE]
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5.    J Clin Lab Anal. 2006;20(3):109-12.
Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto’s thyroiditis in Chinese patients in Taiwan.

Lin WY, Wan L, Tsai CH, Chen RH, Lee CC, Tsai FJ.
Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan.


The etiology of the autoimmune thyroid, Hashimoto’s thyroiditis (HT) is not very clear. However, genetic susceptibility is thought to play a critical role. The vitamin D receptor (VDR)-related endocrine system has been demonstrated to be able to carry out modulation of the immune response. Here, we investigated whether single nucleotide polymorphisms (SNPs) of VDR are associated with HT patients. VDR SNP was detected by polymerase chain reaction (PCR)-based restriction analysis in 109 patients with HT and 90 normal controls. Significant differences were found in the genotype distribution of VDR SNP between Hashimoto’s thyroiditis patients and controls (P=0.0458). Allelic frequency of the VDR gene distinguished HT patients from controls (P=0.0089). The results revealed a significant difference between HT patients and normal controls in VDR SNP and a statistic correlation between VDR-FokI polymorphisms and HT formation. It could be concluded that patients who carry the C/C homozygote of the VDR-FokI gene polymorphism in exon 2 may have a higher risk of developing HT in Chinese patients in Taiwan.

(c) 2006 Wiley-Liss, Inc.

PMID: 16721822 [PubMed – indexed for MEDLINE]
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