Dear Thyroid Folks,

The primary caution I would like to provide with this
bibliography is that, in my opinion, western allopathic
medical "science" has little clue about differential
diagnosis and/or differential treatment of the various
"diseases" called Inflammatory Bowel Disease (IBD),
such as Irritable Bowel Syndrome, Crohn's Disease,
Ulcerative colitis, etc.

Also, I have tried to explain some of the abbreviations,
but I don't have time to explain them all. Ask if you
are stumped, please.

If your thyroid doctor, or your gut doctor, can't or won't
talk to you about this stuff, find a new one or educate
the old one.

If anyone obtains paper or digital copies of the papers
behind these mere abstracts, I would be delighted to
pay postage an copying costs to receive them, please.

As always, thank you for your support.

 Pax,
Ballew Kinnaman <[log in to unmask]> 206/463-2322
Discussion list owner: Allergy, Arthritis, Rubber, Thyroid

Thyroid
Discussion Group http://www.Emissary.Net/thyroid/index.html

=== ===

Brief Quotes - Thyroid and Inflammatory Bowel Disease (IBD):

2001: The concurrent presentation has implications for the diagnosis and
treatment of both diseases. At the time of suspected initial presentation
or exacerbation or preexisting IBD, we emphasize the need to consider both
IBD and thyroid disease in the differential diagnosis for optimal patient
management.

1999: Abnormal thyroid-stimulating hormone levels were detected in 6%
(67/1209) of patients, of whom half were hypothyroid and half were
hyperthyroid.

1999: A statistically significant increase of thyroid volume was found in
IBD compared to control subjects, more frequently in [Crohn's Disease] CD
(70.4%) than in [Ulcerative Colitis] UC (14.3%). Hormone assays demonstrated
increased [Free T4] FT4 values in UC (64.3%) and decreased T4 values in CD
(51.8%). Patients affected with IBD showed an increased frequency of
anti-thyroglobulin and anti-thyroid peroxidase antibodies. Such abnormalities
subsided only partially after therapy. Our data suggest that in IBD there is
a frequent thyroid involvement with morphological, hormonal, and immunological
abnormalities.

1999: The hypothesis that autoimmunity is important in the pathogenesis of
UC and thyroid disease continues to stimulate interest. Further investigation
is warranted to clarify the exact relationships between UC and thyroid disease.

1998: We review the pertinent literature on thyroid disease in inflammatory
bowel disease (IBD) and suggest that this association supports the hypothesis
that autoimmunity is involved in the pathogenesis of IBD. Early diagnosis and
treatment of thyroid dysfunction in patients with IBD is desirable because
thyroid dysfunction worsens the symptoms and course of IBD.

1995: In patients with IBD, thyroid volume was increased on average by 35%,
and the prevalence of thyroid enlargements (antero-posterior diameter
> 20 mm) was 3 times higher (45% vs 16%). Free thyroxine was increased by
nearly 50%, but only 10% of patients had anti-thyroid antibodies. Alterations
of thyroid volume and function are present in IBD, even in the absence of
clinically-detectable thyroid disease.

1989: The results indicate that the immune response of autoimmune thyroid
disease and inflammatory bowel disease is of polyclonal origin.

1975: It is concluded that the T4 metabolism is disturbed in UC and Crohn's
disease and that excessive losses of T4 iodine can be a cause of iodine
depletion in some patients with longstanding and severe disease.

1975: It is also concluded that in UC and Crohn's disease sometimes both the
T(4) and the T(3)-test values can be abnormal so that misdiagnosis of
hyperthyroidism is easy to make.

1975: These results are compatible with an increased occurrence of iodine
deficiency in patients with chronic inflammatory bowel disease.

1975: A history of thyrotoxicosis was obtained in 3.7 percent of the UC
patients compared with 0.8 percent of the controls (p greater than 0.01).
In more than half of the UC patients with a history of hyperthyroidism,
the hyperthyroidism occurred years before the onset of the colitis. It
is therefore highly unlikely that hyperthyroidism is a complication of
the colitis.

1975: These findings indicate that the metabolism of T4 and T3 are
influenced differently by corticosteroids.

= begin PUBMed Search 04 June 2002 =

Am J Gastroenterol  2001 Jun;96(6):1925-6

Simultaneous occurrence of inflammatory bowel disease and thyroid disease.

Bonapace ES, Srinivasan R.

Department of Medicine, Temple University School of Medicine, Philadelphia,
Pennsylvania 19140, USA.

We report a case of simultaneous occurrence of inflammatory bowel disease (IBD)
and Graves' disease. A review of reported cases of simultaneous onset of
ulcerative colitis (UC) and autoimmune hyperthyroidism is presented. A
discussion of the prevalence of thyroid disease in patients with UC and
possible common autoimmune etiology is entertained. The concurrent presentation
has implications for the diagnosis and treatment of both diseases. At the time
of suspected initial presentation or exacerbation or preexisting IBD, we
emphasize the need to consider both IBD and thyroid disease in the differential
diagnosis for optimal patient management.
Publication Types:ReviewReview of Reported Cases
PMID: 11419852 [PubMed - indexed for MEDLINE]

==

Klin Khir  2000 Nov;(11):18-9

[The neuro-endocrinal system status in patients with severe inflammatory colonic
diseases][Article in Russian]

Volkov VI.

There were examined 27 patients with inflammatory diseases of colon. In cases of
the nonspecific ulcerative colitis and Crohn's disease of colon the thyroid
gland insufficiency occurs in variant of the thriiodinethyronine low contents
syndrome, causing the necessity of the substitution therapy conduction in
postoperative period.
PMID: 11247446 [PubMed - indexed for MEDLINE]

==

Am J Gastroenterol  1999 May;94(5):1279-82

Additional investigations fail to alter the diagnosis of irritable bowel
syndrome in subjects fulfilling the Rome criteria.

Hamm LR, Sorrells SC, Harding JP, Northcutt AR, Heath AT, Kapke GF, Hunt CM,
Mangel AW.

Department of Gastroenterology, Glaxo Wellcome Inc., Research Triangle Park,
North Carolina, USA.

OBJECTIVE: Irritable bowel syndrome (IBS) is diagnosed by the presence of a
constellation of symptoms fulfilling the Manning or Rome Criteria, after
exclusion of organic disease. To exclude other diagnoses that might contribute
to the abdominal pain or bowel symptoms experienced by subjects with IBS,
numerous screening algorithms have been advocated, incorporating lactose
hydrogen breath tests, thyroid function tests, fecal ova and parasite
determination, and colonic endoscopy/radiography. The utility of these tests in
uncovering alternative diagnoses, other than IBS, was examined in 1452 patients.
METHODS: Data were combined from two large multinational studies of IBS
patients. All patients exhibited symptoms meeting the Rome criteria for IBS for
at least 6 months before study entry. If prior evaluation had been > 2 yr
previously, patients underwent colonic endoscopy/radiography at study entry. In
addition, thyroid function tests, fecal ova and parasite determination, and a
lactose hydrogen breath test were performed. RESULTS: Lactose malabsorption was
diagnosed in 23% (256/1122) of patients. Colonic abnormalities were detected in
2% (7/306) of patients; in four patients, colonic inflammation (n = 3) or
obstruction (n = 1) may have contributed to symptoms of abdominal pain or
altered bowel habits. Abnormal thyroid-stimulating hormone levels were detected
in 6% (67/1209) of patients, of whom half were hypothyroid and half were
hyperthyroid. Positive fecal ova and parasite tests were noted in 2% (19/1154)
of patients. CONCLUSIONS: Examination of screening tests in 1452 patients with
an established history of IBS revealed an incidence of lactose malabsorption
comparable to that in the general U.S. population and a low incidence of thyroid
dysfunction, ova and parasite infestation, or colonic pathology. The limited
detection rates, added costs, and inconvenience of these tests suggest that
their routine use in the diagnostic evaluation of established IBS patients
should be scrutinized.
PMID: 10235207 [PubMed - indexed for MEDLINE]

==

Recenti Prog Med  1999 Jan;90(1):13-6

[The clinical and echographic assessment of thyroid function and structure in
patients with a chronic inflammatory intestinal disease][Article in Italian]

Messina G, Viceconti N, Trinti B.
Servizio di Ecotomografia e Color Doppler, Ospedale Madre G. Vannini, Roma.
[log in to unmask]

In Crohn's disease (CD) and in ulcerative colitis (UC) data about possible
thyroid involvement are lacking. We studied thyroid morphology and function in
41 patients affected by active inflammatory bowel disease (IBD) (14 UC; 27 CD)
before (all) and 45 and 90 days after onset of therapy (23/41), and in 60 normal
control subjects. At each time, the following tests were performed: thyroid
sonography, hormonal and immunological assays. A statistically significant
increase of thyroid volume was found in IBD compared to control subjects, more
frequently in CD (70.4%) than in UC (14.3%). Parenchymal structure was
inhomogeneous (88.4% CD; 15.4% UC) with increased frequency compared to control
subjects (12.7%). Hormone assays demonstrated increased FT4 values in UC (64.3%)
and decreased T4 values in CD (51.8%). Patients affected with IBD showed an
increased frequency of anti-thyroglobulin and anti-thyroid peroxidase
antibodies. Such abnormalities subsided only partially after therapy. Our data
suggest that in IBD there is a frequent thyroid involvement with morphological,
hormonal, and immunological abnormalities.
PMID: 10193158 [PubMed - indexed for MEDLINE]

==

Nippon Rinsho  1999 Nov;57(11):2536-9

[Complications of extraintestinal endocrine disease associated with ulcerative
colitis--association of ulcerative colitis and autoimmune thyroid disease]
[Article in Japanese]

Okai K, Machida K, Nishi M, Nanjo K.Kokuho Susami Hospital.

We experienced a rare case of Basedow's disease followed by ulcerative colitis
(UC). The association of UC and autoimmune thyroid disease was reviewed and
discussed. A high frequency of endocrine autoimmunity, especially autoimmune
thyroid disease, was reported in patients with UC. But prevalence of autoimmune
thyroid disease associated with UC varies widely in different studies. Some
authors described that it was impossible to say that the observed numbers of UC
associated with thyroid disease exceed to those to be expected in a random
sample of the general populations. The hypothesis that autoimmunity is important
in the pathogenesis of UC and thyroid disease continues to stimulate interest.
But the evidence for autoimmunity acting in these diseases is not quite as
convinced. Further investigation is warranted to clarify the exact relationships
between UC and thyroid disease.
Publication Types:ReviewReview of Reported Cases, Review, Tutorial
PMID: 10572426 [PubMed - indexed for MEDLINE]

==

J Clin Gastroenterol  1998 Mar;26(2):117-20

Autoimmune (Hashimoto's) thyroiditis associated with Crohn's disease.

Shah SA, Peppercorn MA, Pallotta JA.

Division of Gastroenterology, Brown University School of Medicine, Providence,
Rhode Island, USA.

We report the occurrence of autoimmune (Hashimoto's) thyroiditis in three
patients with Crohn's disease. Previously, thyroid disease has been described
only in association with ulcerative colitis. We review the pertinent literature
on thyroid disease in inflammatory bowel disease (IBD) and suggest that this
association supports the hypothesis that autoimmunity is involved in the
pathogenesis of IBD. Early diagnosis and treatment of thyroid dysfunction in
patients with IBD is desirable because thyroid dysfunction worsens the symptoms
and course of IBD.
Publication Types:ReviewReview of Reported Cases
PMID: 9563922 [PubMed - indexed for MEDLINE]

==

Radiol Med (Torino)  1996 Sep;92(3):257-60

[Clinico-ultrasonographic assessment of the thyroid volume and function in
chronic enteritis and colitis: preliminary data][Article in Italian]

Gimondo P, Mirk P, Pizzi C, Messina G, Gimondo S, Iafrancesco G.
Servizio di Diagnostica per Immagini, Ospedale S. Sebastiano M., Azienda RM/H,
Frascati, Roma.

Inflammatory bowel diseases (IBD) such as Crohn's disease (CD) and ulcerative
colitis (UC) have frequent extraintestinal (hepatobiliary, cutaneous, ocular,
articular, urinary) complications. On the contrary, no data are available about
possible thyroid involvement. We studied thyroid morphology and function in 39
patients affected with active IBD (13 UC; 26 CD) before (all) and 45 and 90 days
after onset of therapy (21/39), and in 55 normal control subjects. Every time,
the following exams were performed: thyroid US (parenchymal assessment, thyroid
volume calculation), hormone and immunologic assays (T3, T4, FT3, FT4, TSH;
antithyroglobulin and antithyroid microsomal/peroxidase antibodies). A
statistically significant increase in thyroid volume was found in IBD (mean:
22.1 ml) compared to control subjects (mean: 15.6 ml), more frequently in CD
(18/26 patients; 69.2%) than in UC (2/13 patients; 15.4%). Parenchymal structure
was inhomogeneous in the two groups of patients (88.4% CD; 15.4% UC) more
frequently than in control subjects (12.7%). Hormone assays demonstrated
increased FT4 values in UC (9/13 patients; 69.2%) and decreased T4 values in CD
(14/26 patients; 53.8%). IBD patients increased frequency of antithyroglobulin
and antithyroid microsomal/peroxidase antibodies. Such abnormalities subsided
only partially after therapy. Our data suggest that in IBD there is a frequent
thyroid involvement with morphological, hormone, and immunologic abnormalities.
PMID: 8975312 [PubMed - indexed for MEDLINE]

==

Ital J Gastroenterol  1995 Jul-Aug;27(6):291-5

Thyroid involvement in patients with active inflammatory bowel diseases.

Bianchi GP, Marchesini G, Gueli C, Zoli M.

Istituto di Clinica Medica Generale e Terapia Medica, Universita di Bologna,
Italy.

Previous studies have documented an association between systemic diseases and
disorders of the thyroid gland, expressed by an enlargement of the thyroid and
by the presence of anti-thyroid antibodies. Chronic inflammatory bowel diseases
(IBD, ulcerative colitis and Crohn's disease) may also present a multi-organ
involvement, including the biliary tree, joints and uvea. To detect a possible
subclinical thyroid involvement, thyroid volume and function were assessed in
31 patients with IBD in active phase and in 50 control subjects. Thyroid volume
was calculated by ultrasonography on the basis of the three maximum diameters
of the 2 lobes. A blood sample was taken to determine free thyroid hormones,
TSH, and anti-thyroid antibodies. In patients with IBD, thyroid volume was
increased on average by 35%, and the prevalence of thyroid enlargements
(antero-posterior diameter > 20 mm) was 3 times higher (45% vs 16%). Free
thyroxine was increased by nearly 50%, but only 10% of patients had
anti-thyroid antibodies. Alterations of thyroid volume and function are present
in IBD, even in the absence of clinically-detectable thyroid disease. The
association of IBD with thyroid disorders, as well as the involvement of
various organs, confirms the view that IBD is a systemic disease.
PMID: 8562993 [PubMed - indexed for MEDLINE]

==

Am J Med  1990 Mar;88(3):312-3

Hypothyroidism and functional bowel disease.

Lake-Bakaar G.

State University of New York Health Service Center, Brooklyn 11203.
PMID: 2309747 [PubMed - indexed for MEDLINE]

==

Monatsschr Kinderheilkd  1989 Sep;137(9):610-5

[Molecular genetic detection of polyclonal immune response in autoimmune
thyroiditis and inflammatory bowel diseases][Article in German]

Kaulfersch W, Baker JR, Burman KD, Fiocchi C, Ahmann AJ, D'Avis JC,
Waldmann TA. Universitats-Kinderklinik Graz.

Southern blot hybridization techniques were used to analyze the arrangements of
the immunoglobulin and the T cell antigen receptor genes in lymphocytes of
patients with Graves disease and Hashimoto's thyroiditis as well as in patients
with Crohn's disease, chronic ulcerative colitis, and with other
gastrointestinal disease. The results indicate that the immune response of
autoimmune thyroid disease and inflammatory bowel disease is of polyclonal
origin.
PMID: 2554127 [PubMed - indexed for MEDLINE]

==

Acta Med Scand  1975 Jan-Feb;197(1-2):89-94

The thyroid in ulcreative colitis and Crohn's disease.

III. The daily fractional turnover of thyroxine.

Jarnerot G, Truelove SC, Warner GT.

The daily fractional turnover of thyroxine (T4) labelled with 131 I has been
determined in 11 patients with ulcerative colitis (uC) of Crohn's disease and 8
controls. The daily fractional turnover of 131I-T4 was significantly increased
in the patient group. The daily total disposal of T4 iodine was not
significantly different although it was excessive in 3 of the 11 patients. The
amount of T4 in plasma did not differ significantly between the patients and the
controls. It is concluded that the T4 metabolism is disturbed in UC and Crohn's
disease and that excessive losses of T4 iodine can be a cause of iodine
depletion in some patients with longstanding and severe disease.
PMID: 47700 [PubMed - indexed for MEDLINE]

==

Acta Med Scand  1975 Jan-Feb;197(1-2):95-8

The thyroid in ulcerative colitis and Crohn's disease.

IV. Thyroid hormone binding proteins.

Jarnerot G, Truelove SC, von Schenck H.

The thyroxine binding globulin (TBG), thyroxine binding prealbumin (TBPA),
albumin, thyroxine (T(4)) and the triiodothyronine uptake test (T(3)-test)
values have been estimated in serum of twenty patients with ulcerative colitis
(UC) or Crohn's disease. The patient group was compared with twenty healthy
control subjects matched for sex and age. The T(4) and the T(3)-test values were
similar in the two groups. TBPA and albumin in serum were significantly lower,
while the TBG values were significantly higher in the patients than in the
controls. Treatment with corticosteroids influenced the results significantly.
It is also concluded that in UC and Crohn's disease sometimes both the T(4) and
the T(3)-test values can be abnormal so that misdiagnosis of hyperthyroidism is
easy to make.
PMID: 47701 [PubMed - indexed for MEDLINE]

==

Acta Med Scand  1975 Jan-Feb;197(1-2):77-81

The thyroid in ulcerative colitis and Crohn's disease. I. Thyroid radioiodide
uptake and urinary iodine excretion.

Jarnerot G.

In order to investigate the prevalence of iodine depletion in chronic
inflammatory bowel disease two separate studies have been performed. One was
devoted to the 24-hour urinary iodine excretion and 50 patients with ulcerative
colitis or Crohn's disease were examined and compared with 102 controls. In the
other study the thyroid 131I uptake was compared in 38 patients and 36 controls.
Ten of the 50 patients with chronic inflammatory bowel disease had a 24-hour
urinary iodine excretion less than 40 mug, compared with 5 of the 102 controls
(p greater than 0.01). Sixteen of the 38 patients had a 24-hour thyroid 131I
uptake of 50% or more of the administered test does, compared with 4 of the 36
controls (p smaller than 0.01). These results are compatible with an increased
occurrence of iodine deficiency in patients with chronic inflammatory bowel
disease. Treatment with corticosteroids or Salazopyrin or a milk-free diet did
not influence these findings. No evidence was found of an impaired absorption of
inorganic iodide from the gut.
PMID: 235826 [PubMed - indexed for MEDLINE]

==

Acta Med Scand  1975 Jan-Feb;197(1-2):83-7

The thyroid in ulverative colitis and Crohn's disease. II. Thyroid enlargement
and hyperthyroidism in ulcerative colitis.

Jarnerot G, Azad Khan AK, Truelove SC.

The frequency of thyroid disease has been surveyed in 300 patients with
ulcerative colitis (UC) and 600 controls. The controls were drawn from visitors
to the general medical wards of the Radcliffe Infirmary and were matched for age
and sex with the UC patients. Two observers independently assessed all these
subjects for thyroid enlargement of the simple goitre type. Although there were
minor variations between the results obtained by the two observers, they found
simple goitre in 8.7-6.3 percent among the UC patients compared with 4.3-3.3%
percent among the controls; a difference which is significant. A history of
thyrotoxicosis was obtained in 3.7 percent of the UC patients compared with 0.8
percent of the controls (p greater than 0.01). In more than half of the UC
patients with a history of hyperthyroidism, the hyperthyroidism occurred years
before the onset of the colitis. It is therefore highly unlikely that
hyperthyroidism is a complication of the colitis [] mpossible reasons for the
association of the two diseases are discussed but it is concluded that no
satisfactory explanation exists at present.
PMID: 1124663 [PubMed - indexed for MEDLINE]

==

Acta Med Scand  1976;199(3):229-32

The thyroid in ulcerative colitis and Crohn's disease. V. Triiodothyronine.
Effect of corticosteroids and influence of severe disease.

Jarnerot G, Kagedal B, von Schenck H, Truelove SC.
The concentrations of triiodothyronine (T3), thyroxine (T4) and thyroxine
binding globulin (TBG) have been measured in serum of 20 patients with
ulcerative colitis or Crohn's disease. The patient group was compared with 20
healthy control subjects matched for sex and age. The concentration of T3 and T4
were similar in the two groups but TBG in serum was higher in the patient group,
mainly due to the high TBG levels in the female patients. The concentration of
T3 in serum was lower in the severely ill patients than in those who were
mildly-moderately ill, while T4 and TBG were not affected by the severity of the
disease. The concentration of T3 was lower in the corticosteroid-treated
patients than in those who did not have such treatment, just like the TBG level.
However, TBG was not subnormal in the corticosteroid-treated patients, whereas
the serum concentration of T3 was. T4 in serum was not affected by treatment
with corticosteroids. These findings indicate that the metabolism of T4 and T3
are influenced differently by corticosteroids.
PMID: 816175 [PubMed - indexed for MEDLINE]

= end PUBMed Search 04 June 2002 =



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