The effect of vitamin D on thyroid autoimmunity in euthyroid men with autoimmune thyroiditis and testosterone deficiency

Pharmacol Rep. 2019 Oct;71(5):798-803. doi: 10.1016/j.pharep.2019.04.010. Epub 2019 Apr 15.

Abstract

Background: Autoimmune (Hashimoto's thyroiditis) is characterized by a strong female preponderance, which may suggest that sex hormones have an impact on thyroid autoimmunity. The aim of this study was to investigate whether testosterone determines vitamin D action on thyroid antibody titers and thyroid function tests in men with autoimmune thyroiditis and low testosterone levels.

Methods: The study included 36 men with testosterone deficiency, 17 of whom had been treated for at least 26 weeks with oral testosterone undecanoate (120 mg daily). Because of coexistent euthyroid Hashimoto's thyroiditis, all participants were then treated with vitamin D (100 μg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin, free thyroid hormones, testosterone and 25-hydroxyvitamin D, as well as Jostel's thyrotropin index, SPINA-GT and SPINA-GD were assessed before vitamin D treatment and 26 weeks later.

Results: With the exception of testosterone levels, there were no significant differences between both study groups in serum hormone levels, antibody titers and thyroid function tests. All participants completed the study. In addition to increasing 25-hydroxyvitamin D levels, vitamin D increased SPINA-GT and reduced thyroid peroxidase and thyroglobulin antibody titers. In testosterone-treated men, vitamin D increased testosterone levels. Vitamin D did not affect serum levels of thyrotropin, free thyroid hormones, Jostel's thyrotropin index and SPINA-GD. Treatment-induced changes in thyroid antibody titers and SPINA-GT were more pronounced in testosterone-treated than testosterone-naïve men.

Conclusions: The obtained results suggest that the beneficial effect on thyroid autoimmunity and thyroid secretory function is stronger in men receiving testosterone therapy.

Keywords: Testosterone deficiency; Thyroid autoimmunity; Thyroid function tests; Vitamin D.

MeSH terms

  • Adult
  • Aged
  • Autoantigens / blood
  • Autoimmunity / drug effects*
  • Case-Control Studies
  • Cholecalciferol / administration & dosage
  • Cholecalciferol / pharmacology*
  • Hashimoto Disease / blood
  • Hashimoto Disease / drug therapy*
  • Humans
  • Iodide Peroxidase / blood
  • Iron-Binding Proteins / blood
  • Male
  • Middle Aged
  • Testosterone / administration & dosage
  • Testosterone / blood
  • Testosterone / pharmacology*
  • Thyroglobulin / blood
  • Thyroid Function Tests
  • Thyroid Gland / drug effects*
  • Thyroid Gland / metabolism
  • Thyroid Hormones / blood
  • Vitamins / administration & dosage
  • Vitamins / pharmacology*

Substances

  • Autoantigens
  • Iron-Binding Proteins
  • Thyroid Hormones
  • Vitamins
  • Cholecalciferol
  • Testosterone
  • Thyroglobulin
  • TPO protein, human
  • Iodide Peroxidase