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Hashimoto's thyroiditis (HT) is the most common cause of chronic hypothyroidism in areas with sufficient iodine, stemming from an autoimmune response against thyroid peroxidase and/or thyroglobulin. It is the most prevalent autoimmune thyroid disease and a leading cause of overall hypothyroidism. Even when they reach euthyroidism, 82% of treated women with HT still have excess body weight, and 35% of them are obese. Thyroid dysfunction can affect the function of adipose tissue and lead to metabolic disturbances. Leptin can stimulate thyroid-stimulating hormone secretion, while thyroid-stimulating hormone can influence leptin release from adipose tissue. Additionally, HT patients often exhibit high levels of C-reactive protein and interleukin-6, suggesting an association between increased thyroid-stimulating hormone levels and the inflammatory process, which may contribute to comorbid disease risk in individuals with HT. Nutrition can serve as a complementary treatment for HT by affecting thyroid functions and having anti-inflammatory properties. Dietary interventions may involve eliminating gluten, lactose, or certain food components, or focusing on an anti-inflammatory dietary pattern while preventing nutritional deficiencies. Therefore, this study is a randomized controlled, single-blind trial designed to evaluate the effects of a gluten-free, lactose-free diet and a diet enriched with Aronia Melanocarpa, both individually and in combination, as well as healthy dietary protocols, on autoantibody levels, leptin, ghrelin, oxidative response, and weight loss in patients with Hashimoto's thyroiditis. The study aims to recruit a minimum of 80 participants aged 18-65 years, diagnosed with Hashimoto's thyroiditis at Istanbul Medical Faculty Hospital. In the initial face-to-face interview, participants will provide sociodemographic information, dietary habits, anthropometric measurements, and dietary intake records through a questionnaire. The study involves the inclusion of Aronia Melanocarpa in the diet (high anthocyanin content, 69.24 mg/100 ml), a gluten-free and lactose-free diet, both interventions being applied together, and the application of only healthy nutrition protocols to patients over an 8-week period, with serum assessments of thyroid-stimulating hormon, free T4, free T3, anti-thyroid peroxidase, anti-Tg, interleukin-6,anti tumor necrosis factor alpha, C-reactive protein and leptin-ghrelin levels at the beginning and end of the study. The goal is to create recommendations for patients, improve their quality of life, and establish sustainable nutritional interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gluten- lactose free diet | Experimental | People will be given a healthy diet by eliminating gluten-free lactose-containing foods from their diet. It will continue for 8 weeks. |
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| Aronia Melanocarpa added and Gluten- lactose free diet | Experimental | In addition to a healthy diet, people will be given aronia melanocarpa fruit juice daily (high in anthocyanins, 69.24 mg/100 mL cyanidin-3-glucoside) and a gluten-free-lactose-free diet.It will continue for 8 weeks. |
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| Aronia Melanocarpa added diet | Experimental | People will be given aronia melanocarpa fruit juice daily (high in anthocyanins, 69.24 mg/100 mL cyanidin-3-glucoside).It will continue for 8 weeks. |
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| Healthy eating group | Experimental | Healthy diet patterns with an average macronutrient content of 10-20% protein, 20-35% fat and 45-60% carbohydrate will be followed for 8 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dietary intervention | Other | Four different dietary interventions are planned.
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| Measure | Description | Time Frame |
|---|---|---|
| Effect of diet on weight loss | The effect of diets on weight loss will be evaluated. Body composition analyzes of individuals (body weight (kg), body fat ratio (%), body water ratio (%), visceral fat ratio) will be performed using handheld device. | Start and end of study (8 weeks) |
| Effect of diet on hormone level | The effects of diets on leptin and ghrelin levels will be examined with venous blood samples. | Start and end of study (8 weeks) |
| Effect of diet on inflammatory parameters | To evaluate oxidative stress parameters, two 5 mL venous blood samples will be taken from each patient in yellow tubes after an overnight fast of at least eight hours between 08:00 and 09:00 in the morning. The blood sample will be kept at room temperature for 10-20 minutes and after being centrifuged at 2000-3000 rpm for 20 minutes, it will be transferred to Eppendorf tubes with the help of a sterile pipette and will be stored in 2 separate refrigerators at -20 °C. IL-6, TNF-alpha, CRP levels will be measured with commercial kits, following the company protocol. | Start and end of study (8 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Effect of diet on routine hashimoto thyroid parameters | Thyroid Stimulating Hormone, free thyroxine, free triiodothyronine, thyroid peroxidase antibodies and anti-thyroglobulin biochemical parameters of the participants will be requested by the doctor with institutional permission and patient approval. | Start and end of study (8 weeks) |
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Inclusion Criteria:
Exclusion Criteria:
Since the prevalence of the disease is high in female individuals, it will be conducted with female individuals.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Berrak Basturk, Lecturer | Contact | 05465088090 | berrakerguden@halic.edu.tr | |
| Ayse Kubat Uzum, Profesor | Contact | akubatuzum@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Berrak Basturk, Lecturer | Halic University | Principal Investigator |
| Zeynep Ozerson, Assoc. prof. | Halic University | Study Director |
| Ayse Kubat Uzum, Profesor |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Halic University | Istanbul | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D050031 | Hashimoto Disease |
| ID | Term |
|---|---|
| D013967 | Thyroiditis, Autoimmune |
| D013966 | Thyroiditis |
| D013959 | Thyroid Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D004035 | Diet Therapy |
| ID | Term |
|---|---|
| D044623 | Nutrition Therapy |
| D013812 | Therapeutics |
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| Istanbul University |
| Study Director |
| Melike Cevikdizici, Nurse | Istanbul University | Study Director |
| Yusuf Celik, Profesor | Biruni University | Study Director |
| D001327 |
| Autoimmune Diseases |
| D007154 | Immune System Diseases |