The Hypothyroid Nutrition Study

• Do you, or someone you know, suffer from hypothyroidism?
• Do you feel fatigued, have reduced wellbeing, or struggle to control your weight, despite thyroid hormone treatment and normal blood tests?
  
• Would you be happy taking supplements from natural sources, with a long history of use, and suitable for vegetarians and vegans?
  

Do nutritional supplements to enhance glucose metabolism help relieve persistent symptoms in treated hypothyroid patients?

The background to the study

• Incidence of treated hypothyroid disease is reported at over 1% in the UK (Saravanan, et al, 2002)
• Patients treated for hypothyroidism with thyroid replacement hormones often have persistent symptoms despite blood levels being in normal range
  
• Symptoms include fatigue, depression, palpitations, & difficulty losing weight
  
• A review study showed 62% of patients undergoing long-term treatment report impaired overall quality of life, with fatigue (78-81%), reduced emotional wellbeing (46-87%), palpitations, & weight problems (31-75%), (Watt, et al, 2006)
  
• This has led to debate over the most appropriate replacement therapy with combined thyroxine (T4) & triiodothyronine (T3) supplementation remaining controversial
  
• Treatment of persistent symptoms in hypothyroid patients represents a challenging area of medicine
  
• Glucose metabolism has been shown to be impaired in clinical hypothyroidism (Dimitriadis, et al, 2006) & sub-clinical hypothyroidism (Alsayed, Ali, Abbas, Alfadhli, 2006) (Tuzku, Bahceci, Goklap, Tuzun, Gunes, 2005)
  
• Variations of thyroid function tests in people without thyroid disease are linked to variables of insulin resistance (Fernandez-Real, et al, 2006)
  
• Treated autoimmune thyroiditis patients show more Insulin resistance than controls without autoimmune thyroiditis (Lethagen, et al, 2002)
  
• Nutritional supplement Chromium has previously been demonstrated to improve glucose metabolism in Type 2 Diabetes Mellitus (Martin, et al, 2006) (Jain, Patel, Rogier, & Jain, 2006) (Vladeva, Terzieva, & Arabadjiiska, 2005) (Rabinovitz, et al, 2004)
  
• Nutritional supplement Cinnamon has previously been demonstrated to improve glucose metabolism in Type 2 Diabetes Mellitus (Khan, et al, 2003) (Mang, et al, 2006)
  
• Improving glucose metabolism with Chromium Polynicotinate or Cinnamon may help relieve persistent symptoms in treated hypothyroidism

The study involves

• A 30 minute pre-treatment consultation. This includes measurement of well-being, fatigue, mood, palpitations, & waist to hip ratio
  
• 6 weeks of taking a supplement or placebo capsule once a day. The supplements are from natural sources, have a long history of use, & are suitable for vegetarians & vegans
  
• A 30 minute post-treatment consultation. This includes measurement of well-being, fatigue, mood, palpitations, & waist to hip ratio
  
• The study is designed to determine whether supplements may provide additional benefit to treated hypothyroid patients. It is not intended to constitute treatment for the participants during the study.

In appreciation of time donated

• All participants are entitled to a no charge 45 minute consultation or
  treatment of their choice
  
• This is available at the end of the study, from April 2007, at
  the complementary medicine practice or
  Ivinghoe Natural Health
  
• Alternatively an individual report with treatment recommendations can be sent to you

The research will take place at
the complementary medicine practice, Room 402, 1 Harley St. London W1G 9QD
alternatively patients can be seen at
Ivinghoe Natural Health, 32 Wellcroft, Ivinghoe, Bucks. LU7 9EF

For more information contact liz@tcmspace.com

The Hypothyroid Nutrition Study Registration Form

• can be downloaded, completed & emailed to liz@tcmspace.com
  
• can be posted to Ivinghoe Natural Health, 32 Wellcroft, Ivinghoe, Beds. LU7 9EF
  
• on receipt of your completed registration form your pre-treatment consultation will be booked

Principal researcher
Liz Jeannet, BSc (1st class Hons), PGDip Nutrition

Supporting organisations
the complementary medicine practice
London College of Traditional Acupuncture & Oriental Medicine
Dept. of Health & Biosciences, University of East London

References
Alsayed, A., Ali, N.A., Bo Abbas, Y., Alfadhli, E., 2006, Subclinical Hypothyroidism is associated with Early Insulin Resistance in Kuwaiti Women. Endocr J. Aug 11

Dimitriadis, G., Panayota, M., Lambadiari, V., Boutati, E., Maratou, E., Panagiotakos, D.B., Koukkou, E., Tzanela, M., Thalassinos, N., Raptis, S.A., 2006, Insulin action in adipose tissue and muscle in hypothyroidism, Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc,2006-0478

Fernandez-Real, J-M, Lopez-Bermejo, A., Castro, A., Casamitjana, R., Ricart, W., 2006, Thyroid Function is Intrinsically Linked to Insulin Sensitivity and Epithelium-Dependent Vasodilation in Healthy Euthyroid Subjects, Journal of Clinical Endocrinology & Metabolism 91;9:3337-3343

Jain, S.K., Patel, P., Rogier, K., Jain, S.K., 2006, Trivalent chromium inhibits protein glycosylation and lipid peroxidation in high glucose treated erythrocytes, Antioxid Redox Signal, Jan-Feb;8(1-2):238-41

Khan, A., Safdar, M., Ali Khan, M.M., Khattak, K.N. Anderson, R.A., 2003, Cinnamon improves glucose and lipids of people with type 2 diabetes, Diabetes Care, Dec;26(12):3215-8

Lethagen, A.L., Ericsson, U-B, Hallengren, B., Groop, L., Tuomi, T., 2002, Glutamic Acid Decarboxylase Antibody Positivity is associated with an Impaired Glucose Response and Arginine in Nondiabetic Patients with Autoimmune Thyroiditis, Journal of Clinical Endocrinology & Metabolism 87;3:1177-1183

Mang, B., Wolters, M., Schmiddt, B., Kelb, K., Lichtinghagen, R., Stichtenoth, D.O., Hahn, A., 2006, Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in Diabetes Mellitus type 2, Eur J Clin Invest, May;36(5):340-4

Martin, J., Wang, Z.Q, Zhang, X.H., Watchel, D., Volaufova, J., Matthews, D.E., Cefalu, W.T., 2006, Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes, Diabetes Care, Aug;29(8):1826-32

Rabinovitz, H., Friedensohn, A., Leibovitz, A., Gabay, G., Rocas, C., Habot, B, 2004, Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients, Int J Vitam Nutr Res, May;74(3):178-82

Saravanan, P., Chau, W.F., Roberts, N., Vedhara, K., Greenwood, R., Dayan, C.M., 2002, Psychological well-being in patients on 'adequate' doses of l-thyroxine: results of a large, controlled community-based questionnaire study, Nov;57(5):577-85

Tuzku, A., Bahceci, M., Gokalp, D., Tuzun, Y., Gunes, K., 2005, Subclinical hypothyroidism may be associated with elevated high-sensitivity C-reactive protein (low grade inflammation) and fasting hyperinsulinaemia, Endocr J. Feb;52(1):89-94

Vladeva, S.V., Terzieva, D.D., Arabadjiiska, D.T., 2005, Effect of chromium on the insulin resistance in patients with type II Diabetes Mellitus, Folia Med. 47(3-4):59-62

Watt, T., Groenvold, M., Rasmussen, A.S., Bonnema, S.J., Hegedus, L., Bjorner, J.B., Feldt-Rasmussen, U., 2006, Quality of life in patients with benign thyroid disorders. A review. European Journal of Endocrinology 154;4:501-510