Homeopathy 2014; 103(04): 224-231
DOI: 10.1016/j.homp.2014.08.004
Original Paper
Copyright © The Faculty of Homeopathy 2014

Efficacy of homeopathic intervention in subclinical hypothyroidism with or without autoimmune thyroiditis in children: an exploratory randomized control study

Vijay K. Chauhan
1   Dr. B. R. Sur Homoeopathic Medical College, Hospital & Research Centre, New Delhi, India
,
Raj K. Manchanda
2   Central Council for Research in Homoeopathy, Department of AYUSH, Ministry of Health & Family Welfare, Government of India, India
,
Archana Narang
1   Dr. B. R. Sur Homoeopathic Medical College, Hospital & Research Centre, New Delhi, India
,
Raman K. Marwaha
3   Institute of Nuclear Medicine and Allied Sciences, New Delhi, India
,
Saurav Arora
2   Central Council for Research in Homoeopathy, Department of AYUSH, Ministry of Health & Family Welfare, Government of India, India
,
Latika Nagpal
1   Dr. B. R. Sur Homoeopathic Medical College, Hospital & Research Centre, New Delhi, India
,
Surender K. Verma
4   Directorate of Indian System of Medicine & Homeopathy, Government of NCT of Delhi, New Delhi, India
,
V. Sreenivas
5   All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

Received12 February 2014
revised14 August 2014

accepted26 August 2014

Publication Date:
02 January 2018 (online)

Introduction: The decision to treat subclinical hypothyroidism (SCH) with or without autoimmune thyroiditis (AIT) in children, presents a clinical dilemma. This study was undertaken to evaluate the efficacy of individualized homeopathy in these cases.

Methods: The study is an exploratory, randomized, placebo controlled, single blind trial. Out of 5059 school children (06–18 years) screened for thyroid disorders, 537 children had SCH/AIT and 194 consented to participate. Based on primary outcome measures (TSH and/or antiTPOab) three major groups were formed: Group A – SCH + AIT (n = 38; high TSH with antiTPOab+), Group B – AIT (n = 47; normal TSH with antiTPOab+) and Group C – SCH (n = 109; only high TSH) and were further randomized to two subgroups-verum and control. Individualized homeopathy or identical placebo was given to respective subgroup. 162 patients completed 18 months of study.

Results: Baseline characteristics were similar in all the subgroups. The post treatment serum TSH (Group A and C) returned to normal limits in 85.94% of verum and 64.29% of controls (p < 0.006), while serum AntiTPOab titers (Group A and B) returned within normal limits in 70.27%of verum and 27.02%controls (p < 0.05). Eight children (10.5%) progressed to overt hypothyroidism (OH) from control group.

Conclusion: A statistically significant decline in serum TSH values and antiTPOab titers indicates that the homeopathic intervention has not only the potential to treat SCH with or without antiTPOab but may also prevent progression to OH.

 
  • References

  • 1 Marwaha R.K., Tandon N., Garg M.K. et al. Thyroid status two decades after salt iodisation: country-wide data in school children from India. Clin Endocrinol (Oxf). 76 (06) 2012; Jun 905-910.
  • 2 Dabbaghmanesh M.H., Sadegholvaad A., Ejtehadi F., Omrani G.R. Persistence of goitre in children post-salt iodization in Islamic Republic of Iran: autoimmune status. East Mediterr Health J 15 (03) 2009; 584-590.
  • 3 Hashemipour M., Amini M., Aminorroaya A. et al. High prevalence of goiter in an iodine replete area: do thyroid auto-antibodies play a role?. Asia Pac J Clin Nutr 16 (03) 2007; 403-410.
  • 4 Kabelitz M., Liesenkotter K.P., Stach B. et al. The prevalence of anti-thyroid peroxidase antibodies and autoimmune thyroiditis in children and adolescents in an iodine replete area. Eur J Endocrinol 148 (03) 2003; 301-307.
  • 5 Zois C., Stavrou I., Kalogera C. et al. High prevalence of autoimmune thyroiditis in schoolchildren after elimination of iodine deficiency in northwestern Greece. Thyroid 13 (05) 2003; 485-489.
  • 6 Gopalakrishnan S., Chugh P.K., Chhillar M. et al. Goitrous AIT in a pediatric population: a longitudinal study. Pediatrics 122 (03) 2008; sep 670-674.
  • 7 Jaruratana sirikul S., Leethanaporn K., Khuntigij P., Sriplung H. The clinical course of Hashimoto's Thyroiditis in children and adolescents: 6 years longitudinal follow up. J Pediatr Endocrinol Meta 14 (02) 2001; feb 177-184.
  • 8 Hak A.E., Pols H.A., Visser T.J. et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam study. Ann Intern Med 2000; 132: 270-278.
  • 9 Imaizumi M., Akahoshi M., Ichimaru S. et al. Risk of ischaemic heart disease and all-cause mortality in subclinical hypothyroidism. J Clin Endocrinol Metab 2004; 89: 3365-3370.
  • 10 Walsh J.P., Bremner A.P., Bulsara M.E. et al. Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med 2005; 165: 2467-2472.
  • 11 Stangnaro Green A., Chen X., Bogelen J.D. et al. The thyroid and pregnancy: a novel risk factor for very preterm delivery. Thyroid 15 (04) 2005; 3-357.
  • 12 Prumel M.F., Wiersinga W.M. Thyroid autoimmunity and miscarriages. Eur J Endocrinol 150 (06) 2004; 7-755.
  • 13 Pratt D., Novotny M., Kaberlein G. et al. Antithyroid antibodies and the association with non-organ specific antibodies in recurrent pregnancy loss. Am J Obstet Gynecol 1993; 168: 837-841.
  • 14 Cetinkaya E., Aslan A., Vindinlisan S., Ocal G. Height improvement by l-thyroxine treatment in Subclinical hypothyroidism. Pediatr Int Off J Jpn Pediatric Soc 45 (05) 2003; Oct 534-537.
  • 15 Svensson J., Erricsson U.B., Nilsson P., Olsson C., Jonsson B., Ivarsson S.A. Levothyroxine treatment reduces thyroid size in children and adolescents with chronic autoimmune thyroiditis. J Clin Endocrinol Metabolism 91 (05) 2006; May 1729-1734.
  • 16 Cerbone M., Capalbo D., Wasniewska M. et al. Cardiovascular risk factors in children with long standing untreated idiopathic subclinical hypothyroidism. J Clin Endocrinol Metabolism 99 (08) 2014; Aug 2697-2703.
  • 17 Brenta G., Vaisman M., Sgarbi J.A. et al. Task Force on Hypothyroidism of the Latin American Thyroid Society Clinical practice guidelines for the management of hypothyroidism. Arq Bras Endocrinol Metabol 57 (04) 2013; Jun 265-291.
  • 18 WHO/UNICEF/ICCIDD Assessment of iodine deficiency disorders and monitoring their elimination. WHO/NHD/01.1; 2001.
  • 19 Random Allocation Software, Version 1.0.0 (developed and distributed for Institutional, educational and research purposes by University of Isfahan).
  • 20 Karmisholt Jesper, Anderson S., Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism. Thyroid 18 (03) 2008; 303-308.
  • 21 Meier C., Staub J.J., Roth C.B. et al. TSH controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: A dobule blind, placebo controlled trial (Basel thyroid study). J Clin Endocrinol Metab 2001; 86: 4860-4866.
  • 22 Cooper D.S. Subclinical hypothyroidism. N Engl J Med 2001; 345: 260-265.
  • 23 Cooper D.S., Halpern R., Wood L.C. et al. Supression of cell mediated immunity in hypothyroidism. South Med J 1995; 88: 347-349.
  • 24 Bianchi G.P., Zaccheroni V., Solaroli E. et al. Health related quality of life in patients with thyroid disorders. Qual Life Res 2004; 13: 45.
  • 25 Carani C., Isoidori A.M., Granata A. et al. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. J Clin Endocrinol Metab 2005; 90: 6472-6479.
  • 26 Samuels M.H., Schuff K.G., Carlson N.E. et al. Health status, mood and cognition in experimentally induced subclinical hypothyroidism. J Clin Endocrinol Metab 2007; 92: 25-25.
  • 27 Biondi B., Cooper D.S. The clinical significance of subclinical thyroid dysfunction. Endocr Rev 2008; 29: 76-131.
  • 28 Radetti Giorgio. The natural history of the normal/mild elevated TSH serum levels in children and adolescents with Hashimoto's thyroiditis and isolated hyperthyrotropinaemia: a three year follow-up. Clin Endocrinol (Oxf). 2011; Oct 10 DOI: 10.1111/j.1365-2265.2011.042.
  • 29 Fava A., Oliverio R., Giuliano S. et al. Clinical evolution of autoimmune thyroiditis in children and adolescence. Thyroid 19 (04) 2009; 361-367.
  • 30 Moore D.C. Natural course of subclinical hypothyroidism in childhood and adolescence. Archives Pediatrics Adolesc Med 150 (03) 1996; 293-297.
  • 31 Lazar L., Frumkin R.B.D., Battat E., Lebenthal Y., Phillip M., Meyerovitch J. Natural history of thyroid function tests over five years in large pediatric cohort. J Clin Endocrinol Metab 94 (05) 2009; 1678-1682.
  • 32 Radetti Giorgio, Gottardi E., Bona G., Corrias A., Salardi S., Loche S. The natural history of euthyroid hashimoto thyroiditis in children. J Pediatrics 149 (06) 2006; 827-832.
  • 33 Wasniewska M., Salerno M., Cassio A. et al. Prospective evaluation of the natural course of idiopathic subclinical hypothyroidism in childhood and adolescence. Eup J Endocrinol 160 (03) 2009; 417-421.
  • 34 Vanderpump M.P., Tunbridge W.M., French J.M. et al. The incidence of thyroid disorders in the community: A 20 year follow up of the Whickham survey. Clin Endocrinol (Oxf) 1995; 43: 55-68.
  • 35 Ross D.S. Subclinical hypothyroidism. Braverman L.E., Utiger R.D. Werner and Ingbar's the thyroid. 7th ed. Philadelphia, PA: Lippencott-Raven; 1996: 1010-1015.
  • 36 Tunbridge F., Brewis M., French J.M. et al. Natural history of autoimmune thyroiditis. Br Med J 1981; 282: 258-262.
  • 37 Kabadi U.M. Subclinical hypothyroidism. Natural course of the syndrome during a prolonged follow up study. Arch Intern Med 1993; 153: 957-961.
  • 38 Huber G., Staub J.J., Meier C. et al. Prospective study of the spontaneous course of SCH: prognostic value of thyrotropin, thyroid reserve and thyroid antibodies. J Clin Endocrinol Metab 2002; 87: 3221-3226.
  • 39 Diez J.J., Iglesias P. Spontaneous subclinical hypothyroidism in patients older than 55 years: An analysis of natural course of and risk factors for the development of overt thyroid failure. J Clin Endocrinol Metab 2004; 89: 4890-4897.
  • 40 Bagachi N., Brown T.R., Parish R.F. Thyroid dysfunction in adults over age 55 years. A study in an urban US community. Arch Intern Med 1990; 150: 785-787.