Azezli Adil Dogan, Bayraktaroglu Taner, Orhan Yusuf
Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology Metabolism and Nutrition, Fatih-Istanbul, Turkey.
J Am Coll Nutr. 2007 Dec;26(6):663-8. doi: 10.1080/07315724.2007.10719645.
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.
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.
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.
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.
甲状腺功能亢进症患者有时需要迅速恢复到甲状腺功能正常状态。鉴于甲状腺毒症时甲状腺素(T4)和三碘甲状腺原氨酸(T3)的肠肝循环增加,以及魔芋葡甘聚糖在胃肠道系统的代谢作用,我们旨在确定葡甘聚糖治疗甲状腺功能亢进症的活性。
采用前瞻性、随机、安慰剂对照、单盲研究设计,纳入48例新诊断的甲状腺功能亢进症患者(30例格雷夫斯病患者和12例多结节性甲状腺肿患者)。他们被分配到以下治疗组之一:I)甲巯咪唑2×10mg、普萘洛尔2×20mg和葡甘聚糖(Propol)2×1.3g,每日服用两个月;II)甲巯咪唑2×10mg、普萘洛尔2×20mg和安慰剂粉末,每日服用两个月。
从基线甲状腺激素水平来看,两组之间未检测到差异(p>0.05)。进一步分析显示,在研究的第二、第四和第六周结束时接受葡甘聚糖治疗的患者,其血清T3、T4、FT3和FT4水平显著低于接受安慰剂治疗的患者(p<0.05)。两组在任何特定时间的促甲状腺激素水平均无差异(p>0.05)。在第8周,甲状腺激素水平未显示出任何差异。葡甘聚糖治疗组的所有四项血清甲状腺激素水平下降速度均比安慰剂治疗组更快。
我们认为我们的初步结果表明,葡甘聚糖可能是治疗甲状腺毒症的一种安全且易于耐受的辅助治疗药物。这种联合治疗在甲状腺功能亢进症患者治疗的最初几周似乎效果最佳。