The use of konjac glucomannan to lower serum thyroid hormones in hyperthyroidism.

OBJECTIVE: Patients with hyperthyroidism occasionally need rapid restoration to the euthyroid state. In view of the increased enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) in thyrotoxicosis, and metabolic effects of konjac glucomannan in gastrointestinal system, we aimed to determine the activity of glucomannan in treatment of hyperthyroidism. METHODS: A prospective, randomized, placebo-controlled, one-blind study design was used with newly diagnosed 48 hyperthyroid patients (30 patients with Graves' disease and 12 with multinodulary goitre). They were assigned to one of the following treatment groups: I) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and glucomannan (Propol) 2 x 1.3 gr daily for two months; II) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and placebo powder daily for two months. RESULTS: No differences were detected from the point of view of the baseline thyroid hormone levels between groups (p > 0.05). Further analyses revealed that the patients receiving glucomannan at the end of the second, fourth and sixth weeks of the study had significantly lower serum T3, T4, FT3 and FT4 levels than the patients who received placebo (p < 0.05). TSH was not different between the two groups at any specific time (p > 0.05). At week 8, thyroid hormone levels were not shown any differences. The glucomannan-treated group had a more rapid decline in all four serum thyroid hormone levels than the placebo-treated group. CONCLUSIONS: We believe our preliminary results indicate that glucomannan may be a safe and easily tolerated adjunctive therapeutic agent in the treatment of thyrotoxicosis. This combination therapy seems most effect during first weeks of treatment of a hyperthyroid patient.

The alarm and action levels of waist circumference in overweight and obese Turkish women.

OBJECTIVE: To determine 'alarm and action levels' of waist circumference (WC) in overweight and obese Turkish women and investigate the relationship with cardiovascular risk factors.Research subjects and methods: Four thousand three hundred and seventy-five women aged 18-81 years selected from Istanbul Faculty of Medicine Obesity outpatient clinic. WC, waist-to-hip ratio (WHR), body mass index [(BMI) (weight (kg)/height (m(2)))], blood pressure, and biochemical parameters were analyzed. RESULTS: There was strong correlation between BMI and WC levels (r: 0.852). The regression equation which describes this correlation [WC = 1.68 × BMI (kg/m(2)) + 39.2 ± 1.6] was applied to 500 random samples in order to define alarm and action levels for WC. Our results indicated that alarm level of WC at BMI 25 kg/m(2) is 81 cm and action level of WC at BMI 30 kg/m(2) is 90 cm. Validating samples were divided into three groups: group I (WC levels below 81 cm, n: 421), group II (WC levels between 81 and 90 cm, n: 718), group III (WC levels above 90 cm, n: 2736) and further correlative analyses were performed. Strong differences within alarm and action groups in terms of cardiovascular risk factors were identified. The prevalence and mean values of cardiovascular risk factors significantly increased with WC. In group 1 one or more risk factor prevalence was 64.8%, whereas in groups 2 and 3 prevalence was increased to 76.8 and 89%, respectively. CONCLUSION: Turkish women with WC greater than 81 cm should gain no further weight and those greater than 90 cm should reduce their weight.