Thyroid extract

Abstract: An early case of oophorectomy for treatment of breast cancer is pres ented. A 33-year-old woman who had already had a cancerous breast removed came to the hospital with recurrence of the disease. The case was so advanced further surgery was considered hopeless. The author details how studies of sheep made for his M.D. thesis on lactation led him to believe that there were similarities between the lactation process and the growth of breast cancer. Both have no apparent local nerve control in both there is proliferation of epithelial cells and in lactation control is held by a remote organ the ovaries. The author operated on the woman again removing the Fallopian tubes and ovaries. 8 months later all vestiges of the cancer had disappeared. 20 grains of thyroid extract daily were given and the woman continued in good health.

Abstract: • An explanation of chronic thyroiditis in man was sought in observations made on rabbits, dogs, guinea pigs, and human subjects. The rabbits received injections of saline extracts of rabbit thyroid glands. The tests for circulating autoantibodies utilized the phenomena of precipitation, complement fixation, and tanned-cell hemagglutination. The third of these, based upon the principle of altering the surface of the red blood cells by dilute tannic acid so that they absorb proteins, was particularly sensitive. The three tests were applied to serums from 35 rabbits injected with rabbit thyroid extract, and thyroid autoantibodies were found in 32. Structural damage was found in the thyroid roughly in proportion to the autoantibody titer in the serum. Similar studies were carried out in dogs and guinea pigs with canine and guinea pig thyroid extracts respectively. The three tests were then applied to serums from patients with chronic thyroiditis. Twelve such patients were found whose serums contained circulating antibodies specifically directed against extracts of human thyroid glands. Three typical case histories are given, with histological findings on thyroid tissue removed during surgery. Six other patients with chronic thyroiditis, proved histologically, were not found to have autoantibodies in their serums at the time of study. These findings lead to the hypotheses that some types of chronic thyroiditis are related to an autoimmunization process within the patient against his own thyroid tissue, and that thyroid autoantibodies are at once indicators and links in the chain of pathological processes.

Abstract: Autoimmune thyroid disease is common and was the first autoimmune disease to be described, based on observations in animals immunized with thyroid extract and adjuvant. There are several different clinical presentations which, although being distinctive, share some common features in terms of genetic susceptibility, environmental factors that predispose to disease and pathogenic features such as the presence of autoantibodies against thyroglobulin and thyroid peroxidase. In autoimmune hypothyroidism, the thyroid is initially enlarged due to the presence of a marked lymphocytic infiltrate; this phase is followed by fibrosis, atrophy of the gland, and failure to synthesize normal levels of thyroid hormones. The main etiological factors in this process are cytotoxic T cells and an intrathyroidal proinflammatory state created by local cytokine release. Humoral autoimmunity may contribute through the action of thyroid-stimulating hormone (TSH) receptor-blocking autoantibodies or through the activation of complement and antibody-dependent NK cell-mediated cytotoxicity. In Graves' disease, thyroid overactivity is caused by autoantibodies which stimulate the TSH receptor. T cells which recognize the receptor also localize to the orbit in many of these patients, as a subpopulation of fibroblasts at this location also express the receptor; the cytokines produced by these T cells in turn leads to the clinical features of Graves' ophthalmopathy.

Abstract: Background: Approximately 15% more patients taking levothyroxine (LT4) report impaired quality of life compared to controls. This could be explained by additional diagnoses independently affecting quality of life and complicating assignment of causation. This study sought to investigate the underpinnings of reduced quality of life in hypothyroid patients and to provide data for discussion at a symposium addressing hypothyroidism. Methods: An online survey for hypothyroid patients was posted on the American Thyroid Association Web site and forwarded to multiple groups. Respondents were asked to rank satisfaction with their treatment for hypothyroidism and their treating physician. They also ranked their perception regarding physician knowledge about hypothyroidism treatments, need for new treatments, and life impact of hypothyroidism on a scale of 1–10. Respondents reported the therapy they were taking, categorized as LT4, LT4 and liothyronine (LT4 + LT3), or desiccated thyroid extract (DTE). They also reported sex, age, cause of hypothyroidism, duration of treatment, additional diagnoses, and prevalence of symptoms. Results: A total of 12,146 individuals completed the survey. The overall degree of satisfaction was 5 (interquartile range [IQR] = 3–8). Among respondents without self-reported depression, stressors, or medical conditions (n = 3670), individuals taking DTE reported a higher median treatment satisfaction of 7 (IQR = 5–9) compared to other treatments. At the same time, the LT4 treatment group exhibited the lowest satisfaction of 5 (IQR = 3–7), and for the LT4 + LT3 treatment group, satisfaction was 6 (IQR = 3–8). Respondents taking DTE were also less likely to report problems with weight management, fatigue/energy levels, mood, and memory compared to those taking LT4 or LT4 + LT3. Conclusions: A subset of patients with hypothyroidism are not satisfied with their current therapy or their physicians. Higher satisfaction with both treatment and physicians is reported by those patients on DTE. While the study design does not provide a mechanistic explanation for this observation, future studies should investigate whether preference for DTE is related to triiodothyronine levels or other unidentified causes.