Effect of a polyherbal formulation on L-thyroxine induced hyperthyroidism in a rat model: In vitro and in vivo analysis and identification of bioactive phytochemicals.

An excess of thyroid hormones in the blood characterizes hyperthyroidism. Long-term use of prescription medications to treat hyperthyroidism has substantial adverse effects and when discontinued, the symptoms frequently recur. Several plant species have been utilized to cure hyperthyroidism. In the present work, we investigated the impact of polyherbal extract (POH) of four medicinal plants to treat hyperthyroidism. Biochemical analysis revealed the presence of a high concentration of phytochemicals in the POHs. The in vitro antioxidant study revealed their antioxidant and free radical scavenging capacity. The gas chromatography coupled mass spectrometry analysis of the POHs showed the presence of 13 bioactive phytochemical compounds. The effect of various concentrations of POHs on L-thyroxine-induced hyperthyroidism in Wistar albino rats was evaluated for 18 days. The TSH, T3 and T4 levels increased significantly and reduced the increase of liver enzymes caused by hyperthyroidism in POH-treated rats. The data showed that POH therapy could restore thyroid function to normal. The injection of POH increased the size comprising vacuolated cells, columnar follicular cells and highly coloured nuclei with increasing POH content and the number of normal thyroid follicles rose. The findings indicate that polyherbal formulations of these medicinal plants include credible antithyroid compounds that may offer a protective and an effective alternative treatment to synthetic thyroid medications.

Thyroid storm due to inappropriate administration of a compounded thyroid hormone preparation successfully treated with plasmapheresis.

BACKGROUND: Thyroid storm (TS) is a rare life-threatening condition that is characterized by fever and altered mental status precipitated by endogenous or exogenous critical events, illness/injury, acute iodine load, and thyroid or non thyroid surgery. A large number of thyroid extracts are available and extensively used, even though they are not recommended clinically in hypothyroid or euthyroid patients. Consumption of such products can be dangerous and result in life-threatening TS. Here, we report a case of TS caused by inadvertent intake of very high dosages of triiodothyronine (T3) and thyroxine (T4) in compounded thyroid extracts. Plasmapheresis may be considered an option for the management of exogenous TS. PATIENT FINDINGS: A 62-year-old woman with no significant past medical history presented with severe myalgia, fever, tachycardia, and blood pressure of 170/80 mmHg, which precipitated to an altered mental state within 24 hours. Neurological examination did not reveal any focal deficit or any signs of meningeal irritation. Further investigation revealed that she had been taking thyroid supplements. The patient had accidentally been supplied with a batch of thyroid extract pills that had an inadvertently high content of T4. Her free T3 (FT3) and free T4 (FT4) levels were found to be very high beyond the laboratory readable range (FT3>30 pg/mL; FT4>6.06 ng/dL; thyrotropin [TSH]=0.07 IU/mL). SUMMARY: Three days post commencement of standard conservative management of TS, the patient developed posterior reversible encephalopathy syndrome, resulting in a seizure. She remained unresponsive and in a poor mental state. The confirmed exogenous etiology for TS led to a decision to conduct plasmapheresis. Plasmapheresis conducted for two consecutive days proved successful as a therapeutic measure for TS and improved her thyroid profile as well as her mental state. CONCLUSIONS: The inappropriate use of thyroid extracts in euthyroid and hypothyroid patients can result in life-threatening TS. Plasmapheresis is probably a life-saving treatment in patients who are exposed to amounts of thyroid hormone far in excess of that usually produced by the thyroid gland.

Sub-laboratory hypothyroidism and the empirical use of Armour thyroid.

Evidence is presented that many people have hypothyroidism undetected by conventional laboratory thyroid-function tests, and cases are reported to support the empirical use of Armour thyroid. Clinical evaluation can identify individuals with sub-laboratory hypothyroidism who are likely to benefit from thyroid-replacement therapy. In a significant proportion of cases, treatment with thyroid hormone has resulted in marked improvement in chronic symptoms that had failed to respond to a wide array of conventional and alternative treatments. In some cases, treatment with desiccated thyroid has produced better clinical results than levothyroxine. Research supporting the existence of sub-laboratory hypothyroidism is reviewed, and the author's clinical approach to the diagnosis and treatment of this condition is described.

Life span extension and cancer risk: myths and reality.

A significant increase in the number of old people in the populations of developed countries was followed by an increase in morbidity and mortality resulting from main age-related diseases -- cardiovascular, cancer, neurodegenerative, diabetes mellitus, decrease in resistance to infections. Obviously, the development of the means of prevention of the premature aging of humans is crucial for the realization of this program. However, data available on such kind of means are rather scarce, contradictory and are often not reliable from the points of view of the adequacy of the experiments to current scientific requirements as well as the interpretation of the results and safety. Data available on the increase in life span and the adverse effects of the following geroprotectors were critically analyzed: antioxidants, chelate agents and lathyrogens, succinate, adaptogens and herbs, neurotropic drugs, inhibitors of monoamine oxidase, glucocorticoids, dehydroepiandrosterone, sex and growth hormones, melatonin, pineal peptide preparations, protein inhibitors, antidiabetic biguanides, thymic hormones and peptides, immunomodulators, enteroadsorbents, lypofuscin inhibitors, as well as calorie intake restriction and special diets. Most of the available results were insufficient and could not provide convincing evidence for the life span extension and the safety of the suggested geroprotectors. Drugs and means prolonging the life span could be subdivided into three groups: (a) geroprotectors prolonging the life span equally in all the members of the population: these postponed the beginning of the population's aging; (b) geroprotectors decreasing the mortality rate in a long-lived subpopulation, which raised their maximal life span: these slowed down the population's aging rate; (c) geroprotectors increasing the survival rate in a short-lived subpopulation without changes in the maximal life span: in this case, the aging rate increased. There was a high positive correlation between the type of geroprotector-induced aging delay and the pattern of tumour development in the same population of animals. The first type of geroprotectors did not influence the incidence of tumour but increased tumour latency. The second type of geroprotectors was effective both in the inhibition of spontaneous carcinogenesis and the increase in tumour latency. Certain drugs of the third type raised tumour incidence in the exposed populations. According to the multistage model, geroprotectors either inhibit or accelerate the passage of carcinogen-exposed cells form one stage to another. Thus, the efficacy of geroprotectors as preventive means of cancer development will decrease with respect to the age of exposure onset. Recommendations of the available drugs and means of life span increase should be carefully reconsidered under the international scientific control.

Thyroid hormone therapy in patients infected with human immunodeficiency virus: a clinical approach to treatment.

Clinical, biochemical and immunological evidence suggests that thyroid hormones would be helpful in human immunodeficiency virus disease either by itself or as an adjuvant to present-day therapies. During prolonged non-thyroidal illnesses such as human immunodeficiency virus disease, thyroid function tests could be misleading or difficult to interpret. Human immunodeficiency virus disease could mask a hypothyroid state which might be intracellular. Thyroid hormones are the only consistent natural stimulator of both the primary lymphoid tissue (thymus and bone marrow) and secondary lymphoid tissue (circulating lymphocytes, spleen and lymph nodes). There is abundant historical precedent for using thyroid hormone as a safe pharmacological agent against human immunodeficiency virus disease.

[Pregnancy and the thyroid gland]. / Grossesse et thyroïde.

During pregnancy the thyroid should adapt itself to the availability of the least quantities of iodides necessary to synthesis hormones and to several other possible modifications such as a rise in the thyroxine-binding globulin and the thyroid stimulating effect of beta-hCG. An increase in size of the thyroid gland is very common. The interpretation of the parameters used to diagnose abnormalities of thyroid function can be carried out. Although the development of the fetal thyroid can take place independently of the maternal thyroid behaviour, an abnormal thyroid function in the mother can not occur without affecting the pregnancy. Grave's disease can cause either fetal or neonatal hyperthyroidism due to a transplacental transfer of thyroid stimulating immunoglobulins or hypothyroidism secondary to the use of too large doses of synthetic antithyroid products. Pregnancy itself favours hyperthyroidism. Maternal hypothyroidism which has not been treated is rarer because of a lack of fertility. It can cause repercussions on the fetus that have probably been over estimated. When pregnancy occurs in a hypothyroid woman who is being treated the dosages of drugs that she is being given should be increased by 20-30%. Providing a good knowledge of the thyroid parameters and keeping the patient preferably euthyroid in cases where thyroid dysfunction can occur, the pregnancy can continue normally whatever the state of the mother thyroid function was. The risks to the fetus are minimal. In women who are at risk it is very important to keep controlling the thyroid state after delivery when there is an immunological rebound which may lead to a relapse in Grave's disease and to post-partum thyroiditis.

Hypopituitarism who had undergone prolonged treatment with thyroid hormones alone for primary hypothyroidism.

A patient with hypopituitarism which is believed to have developed immediately after birth had been treated with thyroid hormones alone for a prolonged year of seven years until the time of the initial examination by the author. The subject has severe emaciation and lack of secondary sexual characteristics, but no past history of adrenocortical crisis was present, and, in fact, she manifested hyperthyroidism. It is questionable whether the preceding administration of thyroid hormones on the case with hypopituitarism should have been contraindicated. The two major complaints were improved through proper supplementary hormone treatment.