Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals : November 2014

Sunday, 30 November 2014

(Preview) Most common diseases of 50 plus - Thyroid Disease - Acute thyroiditis: Preventions, Managements and Treatments

Thyroid Disease : Acute thyroiditis

Acute thyroiditis is a condition of relatively high amount of iodine in the tissue caused by microbial inflammatory thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis. Acute infectious thyroiditis is very rare, accounted for about 0.1-0.7% of all thyroiditis.

A. Symptoms
1. Fever and swelling and tenderness in the neck
Patient with thyrotoxicosis may be experience symptoms of fever due to neck inflammatory changes, pus and with anterior neck tender swelling and odynophagia(1).

2. Infectious hip arthritis, spondylitis and Roth’s spots
Acute right-sided suppurative thyroiditis may enhance infectious hip arthritis, spondylitis and Roth’s spots(2).

3. Chills, dysuria and recent painful neck swelling
Patients with acute suppurative thyroiditis secondary to Escherichia coli (E. coli) infection are more likely presented with fevers, chills, dysuria(3).

4. Firm, livid, hardly mobile cervical swelling
Patient with acute suppurative thyroiditis and right lobe thyroid abscess caused by Klebsiella spp are shown to present with firm, livid, hardly mobile cervical swelling, due tosoft-tissue swelling, thyroid lobe and swelling of the thyroid gland(4).

5. Impaired vocal cord mobility
Although it is rare, acute suppurative thyroiditis also induces symptoms of unilateral vocal cord paralysis (5).

6. Swollen, red, hot, and tender, and limited neck movement
Fever, swollen, red, hot, and tender, and neck movement limited due to left lobe of the thyroid gland also are considered as symptoms of acute thyroiditis (6).

7. Severe odynophagia and dysphagia, fever, chills, sore throat and right ear pain
Suppurative thyroiditis caused by Salmonella enteritidis in patients with diabetes mellitus type 2 may present with severe odynophagia and dysphagia associated with fever, chills, sore throat and right ear pain(6a).

8. Dysphonia, myalgia, swelling of the small joints of the hands, weight loss, and erythematous malar rash
Acute suppurative thyroiditis associated with juvenile systemic lupus erythematosus (JSLE) onset may present with a painful voluminous swelling in the anterior cervical region with fever, myalgia, swelling of the small joints of the hands, weight loss, and erythematous malar rash(6b).

B. Causes and Risk Factors
B.1. Causes
According to Georgetown University, the most common anaerobic bacteria are Gram-negative bacilli and Peptostreptococcus spp. agents, including Streptococcus anginosus(8)(9), piriform sinus fistula with thyrotoxicosis(10), etc.
Viruses have also shown to associate with subacute thyroiditis, and include measles, mumps, influenza, enterovirus Epstein-barr, adenovirus, echovirus, and St Louis encephalitis(7).
Other causes of acute thyroiditis also include cervical thymic cyst(11) fungi and parasites(12).

B.2. Risk Factors
1. Immunocompromised patients
People who have weakened immune system are at increased risk of bacterial, virus and fungal causes of cute infectious thyroiditis.

2. Elderly
If you are elder, you are associated with increased risk of cute infectious thyroiditis.

3. Pre-existing thyroid diseases
Risk of acute thyroiditis increase for patient with hypothyroidism due to Hashimoto’s thyroiditis and mycobacterium avium intracellulare suppurative thyroiditis(13).

4. Congenital defect and infection
4.1. Complete congenital third branchial fistula
History of a small opening in the middle third of the anterior neck since birth, with recurrent surrounding swelling is associated to increased risk of infection of thyroid gland (14).
4.2. Fourth branchial arch anomalies
Fourth branchial arch anomalies represent <1% of all branchial anomalies may contribute to recurrent neck infections or suppurative thyroiditis(14a).
4.1. Persistent thyroglossal duct
Persistent thyroglossal duct infection may contribute to acute suppurative thyroiditis with abscess (15).
4.2. Piriform sinus fistula
Infected piriform sinus fistula with thyrotoxicosis is also associated to risk of acute suppurative thyroiditis(16).

C. Diseases associated to Acute thyroiditis
1. Tonsillitis
Patients with tonsillitis are shown to associate with the existence of suppurative thyroiditis complicated by thyrotoxicosis, in  causation of trachea deviation and compressed large vessels; associated with internal jugular vein thrombosis, and sepsis(17).

2. Bacterial throat infection
Thyroid abscesses are rare complications of neck infections, but it can occur in patients with acute thyroiditis, with symptoms of increased neck pain and swelling(18).

3. Thyroid papillary carcinoma
Suppurative thyroiditis, thyroid cancer and chronic thyroiditis combination have been observed in elderly(19).

4. Esophageal carcinoma
Right-sided thyroid abscess with fistulous connection to the upper of two oesophageal carcinomas hasbeen found in patients with acute thyroiditis, may cause dysphagia, weight loss and a neck swelling(20).

5. Laryngologic problem
Acute pharyngitis or laryngitis associated with acute suppurative thyroiditis could be life threatening, according to the Klinika Otolaryngologii CMKP w Warszawie(20a).

6. Diabetes mellitus
Diabetes mellitus (DM) patients showed to be a precipitating factor for acquiring unusual infectious thyroiditis(20b).

D. Complications
According to the study by the Universidade do Estado do Rio de Janeiro, acute suppurative thyroiditis is a rare disorder, most often caused by Staphylococcus aureus or Streptococcus pneumoniae, inducing complication of pyriform sinus fistula in children, infection in the oropharynx or respiratory tract in adult. Delays diagnosis also showed to increase the risk of complications(21). Sacroileitis is also a frequently rare complication of brucellosis, endocarditis, thyroiditis and pyelonephritis are among the rare complications(21a).

F. Misdiagnosis
1. Thyroid cancer
Patients with thyrotoxicosis presented with anterior neck tender swelling and odynophagia can be diagnosed as thyroid cancer due to the misleading computed tomography report, according to Fudan University(22).

2. Acute bacterial thyroiditis
Acute bacterial thyroiditis may be misdiagnosed if it is presented with absence of leucocytes and bacteria couple with initial borderline clinical and sonographic data(23).

3. Juvenile systemic lupus erythematosus
Although it is unusual, acute suppurative thyroiditis in at least one case is associated with juvenile systemic lupus erythematosus (JSLE) onset(24).

4. Hashimoto’s thyroiditis
Hashimoto’s thyroiditis has been misdiagnosed as thyroid abscess in cervical ultrasonograph
(25).

G. Diagnosis
If you are experience certain symptoms of the above and your doctor suspects that you have developed acute thyroiditis, after recording the past and present history and completing a physical exam, including assessing symptoms and complaints commonly seen including enlarged thyroid gland, heart rate, shaking hand etc., the tests ordered may include
1. Blood test
The aim of the test is to check for the elevation of white blood cell count, erythrocyte sedimentation(red blood cells/ hour) rate, abnormal thyroid hormone levels and alkaline phosphatase(measuring the amount of the enzyme transaminase(ALP) in the blood)26).

2. Needle aspiration
Needle aspiration of thyroid is a diagnostic procedure used to check for lumps or masses of thyroid gland. The procedure is safe, but in some cases, it can cause painful cervical swelling, fever, and chills due to infection, induced acute suppurative thyroiditis, according to Ankara University School of Medicine(27).

3. Ultrasound and oesophagography
The thyroid infection in children may induce abnormality of pyriform fossa sinus.
According to the Prince of Wales Hospital, ultrasound and oesophagography are helpful tools used to diagnose pyriform fossa sinus associated with suppurative thyroiditis(28).

4. CT scan
CT scan can be useful in identifying the location of the abscess, in unusual situations.

H. Prevention
H.1. Diet to prevent Acute infectious thyroiditis
1. Broccoli
Sulforaphane (SFN), a natural constituent of cruciferous vegetables such as broccoli, Brussels sprouts, etc. is considered as one of most potent anti-oxidant and anti-inflammatory agent and probably a promising reagent for intervention of multiple sclerosis and other autoimmune diseases through its anti-oxidant activity and antagonizing autoimmune inflammation(29).

2. Fresh ginger
Several chemical constituents of Zingiber officinale Rosc. (Zingiberaceae) showed to inhibit reactive oxygen species (ROS), immune system response to the inflammation)(30).

3. Catechu
Catechu, used as a food additive, astringent, tannin, and dye extracted from Acacia catechu
showed to exhibit a significantly strong anti inflammatory effect in vitro in study of rats, in concentration-depended manner(31).

4. Legume
20 g of soy protein with 160 mg of total isoflavones (64 mg genistein, 63 mg daidzein, and 34 mg glycitein) in 12 weeks enhanced serum adiponectin levels involved in regulating glucose levels as well as fatty acid breakdown, according to the study of 75 healthy postmenopausal women(32).

5. Turmeric
According to the study, curcumin (diferuloyl methane) was found effectively for treatment in patients with postoperative inflammation(33).

H.2. Phytochemicals and antioxidants to prevent Acute infectious thyroiditis
1. Alliin (S-allyl-L-cysteine-S-oxide)
Alliin (S-allyl-L-cysteine-S-oxide), an antimicrobial sulfur compound newly isolated from heated garlic extract, showed to exhibit its strong anti-yeast activity and rather weak antibacterial activity, similar to other antimicrobial compounds in garlic,(34).

2. Allyl sulfides
Antibacterial properties of Crushed garlic have been known for a long time for its anti bacterial activities including species of Escherichia, Salmonella, Staphylococcus, Streptococcus, Klebsiella, Proteus, Bacillus, and C!ostridium, according to “Allicin from fresh Garlic Nature’s Original Antimicrobial”, The Englishman’s Doctor (Harrington, 1609),

3. Triterpenoids
Triterpenoids, major chemical compound of several species showed a total antioxidant capacity of 42.94% as compared to ascorbic acid.

4. Lycopene
According to University of Milan, regular consumption of tomato drink, promoted DNA protection from oxidative stress, modulation of immune and inflammatory activity in young healthy volunteers(35).

5. Resveratrol
Resveratrol, a natural polyphenol with antioxidant, anti-inflammatory, and anticancer properties may be effectively in induced expression of microRNAs for prevention of cancer(36).

I. Treatments
I.1. In conventional medicine perspective
Drainage of the mass or lump and antibiotics and surgical resection
Administration of antibiotics has shown effectively for treatment of acute thyroiditis against the causative pathogen(s). Surgical drainage may be necessary in case of suppuration.  In treatment of an acute thyroiditis in children, surgical removal of the fistula combined with partial thyroidectomy may decrease the recurrence rate but it should be delayed until the inflammatory process is resolved, according to Georgetown University(36).

I.2. In herbal medicine perspective
1. Aloe Vera
Aloe Vera also is popular used in treating infection and inflammation(38) through its antioxidant property(38) and as immune system enhancer in regulating the immunological parameters in cellular immune response and phagocytosis(39).

2. Black Walnut
Tannins extract of phenolic compounds from several herbal plants, including black walnut not only  have exerted the relatively high level of anti bacterial activity (62.5 to 125 microg/ml) in fighting against Listeria monocytogenes(40) but also can fight the forming of free radical cause of DNA damage of irregular cells growth and enhance the immune system guarding our body from foreign invasion cause of inflammation and infection(41).

3. Cinnamon
3.1. Immunomodulatory effect
Cinnamon is a popular herb used in traditional medicine to treat various disorders such as chronic gastric symptoms, arthritis, and the common cold through its immunomodulatory effect(42)

3.2. Antimicrobial Activities
Cinnamon oil-chitosan film promotes better antimicrobial activity than the clove bud oil-chitosan film(43).

3.3. Anti-inflammatory activity
Myristicin (1-allyl-5-methoxy-3,4-methylenedioxybenzene) is an active aromatic compound found in nutmeg, carrot, basil,cinnamon, and parsley showed significantly in inhibition of the production of calcium, nitric oxide (NO), etc. through its anti-inflammatory effect.(44).

4. Garlic
Extracts of aged fresh garlic, aged over a prolonged period and its antioxidant effects showed the ability of AGE to protect against oxidant-induced disease, acute damage from aging, radiation and chemical exposure, and long-term toxic damage, etc.(45).

5. Kelp
5.1. Thyroid function
Short-term dietary supplementation with kelp significantly increases both basal and poststimulation TSH(46).

5.2. Antioxidants
Brown algae of the Laminariales (kelps) exhibits  strong antioxidant effect through iodide accumulation and impact of atmospheric chemistry(47).

I.3.Treatments in traditional Chinese medicine perspective
1. Ba Jiao Hui Xiang
Ba Jiao Hui Xiang also known Chinese Star Anise is a spice used in traditional Chinese cooking and in TCM an antibiotic agent and to for treatment of hernia, chronic lower back pain, vomiting due to coldness in stomach, pain and coldness in stomach. etc. for thousand of years from a small evergreen tree, native in southwest China.
Extract from Bai Jiao hui xiang has showb to exert its antibacterial activity against 67 clinical drug-resistant isolates, including 27 Acinetobacter baumannii, 20 Pseudomonas aeruginosa, and 20 methicillin-resistant Staphylococcus aureus(48). Its essential oil has also exhibited strong inhibitory effect against fungi(49).

2. Black pepper and cardamom
Black pepper (Piper nigrum) and cardamom (Elettaria cardamomum) extracts significantly enhance the cytotoxic activity of natural killer cells by exerting immunomodulatory roles and antitumor activities50).

3. Radix et Rhizoma Rhei and Rhizoma Polygoni Cuspidati
Processed products of Radix et Rhizoma Rhei and Rhizoma Polygoni Cuspidati showed to scavenge superoxide radical (O2-.) generated through hypoxanthine-oxidase system and (.OH) generated through Fenton action(52).

3. Long Kui
Solanum nigrum fruit extract (SNFEt), in ethanol-induced toxicity in rats improved the antioxidant status by decreasing the levels of TBARS( a byproduct of lipid peroxidation) and altering the lipid profiles to near normal(53). The methanol and chloroform extracts of Solanum nigrum (SN) seeds also exhibited more than 50% inhibition of HCV at non toxic concentration(54).

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References
(1) http://www.ncbi.nlm.nih.gov/pubmed/23435638
(2) http://www.ncbi.nlm.nih.gov/pubmed/22129504
(3) http://www.ncbi.nlm.nih.gov/pubmed/17259797
(4) http://www.ncbi.nlm.nih.gov/pubmed/19499695
(5) http://www.ncbi.nlm.nih.gov/pubmed/9142526
(6) http://www.ncbi.nlm.nih.gov/pubmed/20424880
(6a) http://www.ncbi.nlm.nih.gov/pubmed/22069108
(6b) http://www.ncbi.nlm.nih.gov/pubmed/19554814
(7) http://www.ncbi.nlm.nih.gov/pubmed/12697345
(8) http://www.ncbi.nlm.nih.gov/pubmed/23435638
(9) http://www.ncbi.nlm.nih.gov/pubmed/1298872
(10) http://www.ncbi.nlm.nih.gov/pubmed/11916288.
(11) http://www.ncbi.nlm.nih.gov/pubmed/2243452
(12) http://link.springer.com/article/10.1007%2Fs11908-000-0027-7
(13) http://www.ncbi.nlm.nih.gov/pubmed/8006334
(14) http://www.ncbi.nlm.nih.gov/pubmed/20156371
(14a) http://www.ncbi.nlm.nih.gov/pubmed/23478017
(15) http://www.ncbi.nlm.nih.gov/pubmed/8074961
(16) http://www.ncbi.nlm.nih.gov/pubmed/11916288
(17) http://www.ncbi.nlm.nih.gov/pubmed/22990644
(18) http://www.ncbi.nlm.nih.gov/pubmed/22470780
(19) http://www.ncbi.nlm.nih.gov/pubmed/8262271
(20) http://www.ncbi.nlm.nih.gov/pubmed/1437962
(20a) http://www.ncbi.nlm.nih.gov/pubmed/1652146 4
(21) http://www.ncbi.nlm.nih.gov/pubmed/22990644
(21a) http://www.ncbi.nlm.nih.gov/pubmed/19334391
(20b) http://www.ncbi.nlm.nih.gov/pubmed/9134826
(21) http://www.ncbi.nlm.nih.gov/pubmed/22990644
(21a) http://www.ncbi.nlm.nih.gov/pubmed/19334391
(22) http://www.ncbi.nlm.nih.gov/pubmed/23435638
(23) http://www.ncbi.nlm.nih.gov/pubmed/11251375
(24) http://www.ncbi.nlm.nih.gov/pubmed/19554814
(25) http://www.ncbi.nlm.nih.gov/pubmed/18604385
(29) http://www.ncbi.nlm.nih.gov/pubmed/24120440
(30) http://www.ncbi.nlm.nih.gov/pubmed/19833188
(31) http://www.ncbi.nlm.nih.gov/pubmed/22256752
(32) http://www.ncbi.nlm.nih.gov/pubmed/18981951
(33) http://www.ncbi.nlm.nih.gov/pubmed/20828317
(34) http://www.ncbi.nlm.nih.gov/pubmed/19105898
(35) http://www.ncbi.nlm.nih.gov/pubmed/16569044
(36) http://www.ncbi.nlm.nih.gov/pubmed/12697345
(37) http://www.thyroidmanager.org/chapter/acute-and-subacute-and-riedels-thyroiditis/
(38) http://www.ncbi.nlm.nih.gov/pubmed/21452374
(39) http://www.ncbi.nlm.nih.gov/pubmed/12687115
(40) http://www.ncbi.nlm.nih.gov/pubmed/18325686
(41) http://www.ncbi.nlm.nih.gov/pubmed/21925860
(42) http://www.ncbi.nlm.nih.gov/pubmed/22053946
(43) http://www.ncbi.nlm.nih.gov/pubmed/22034912
(44) http://www.ncbi.nlm.nih.gov/pubmed/21991618
(45) http://www.ncbi.nlm.nih.gov/pubmed/11238807
(46) http://www.ncbi.nlm.nih.gov/pubmed/14583417
(47) http://www.ncbi.nlm.nih.gov/pubmed/18458346
(48) http://www.ncbi.nlm.nih.gov/pubmed/20828316
(49) http://www.ncbi.nlm.nih.gov/pubmed/21030909
(50) http://www.ncbi.nlm.nih.gov/pubmed/20210607
(51) http://www.ncbi.nlm.nih.gov/pubmed/12528506
(52) http://www.ncbi.nlm.nih.gov/pubmed/20418062
(53) http://www.phcog.com/article.asp?issn=0973-1296;year=2010;volume=6;issue=21;spage=42;epage=50;aulast=Arulmozhi
(54) http://www.ncbi.nlm.nih.gov/pubmed/21247464

All rights reserved 2014. Any reproduction of this book in whole or parts are prohibited without permission of the writer. All articles and research papers written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying

Quick and #healthy #recipe: Health #nut Oatmeal

Posted By Kyle J. Norton Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Recipe contributed by Yum-O, the family cook book by Rachel Ray, Published by Clarkson Potter, New York.You can view her website at yum-o.org

Swap
1/2 cup honey for the brown sugar
1 cup craisins (dried cranberries) for the dates and currants

Add
1/4 cup flaxseeds meal
1/2 cup toasted, unsalted sunflower seeds
1/2 cup Grape-Nuts cereal

Instructions
Follow the directions for the original recipe, stirring in the flax seed meal and sunflower seeds along with the craisins. Serve with additional milk and sprinkle with a tablespoon of the Grape-Nuts cereal if desired.

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Saturday, 29 November 2014

(Preview) Most common diseases of 50 plus - Thyroid Disease - Silent thyroiditis: Preventions, Managements and Treatments

Thyroid Disease : Silent thyroiditis

Silent thyroiditis is the inflammation of the thyroid gland. Patients with silent thyroiditis are experience back and forth between hypothyroidism and hyperthyroidism. The disease classically present with a triphasic course: a brief period of hyperthyroidism due to release of preformed thyroid hormone that lasts for 1 to 3 months, followed by a more prolonged hypothyroid phase lasting up to 6 months, and eventually return to a euthyroid state. However, the types and degree of thyroid dysfunction, individual patients may present with mild or more severe cases of hyperthyroidism alone, hypothyroidism alone, or both types(a).

A. Symptoms
Symptoms are associated to the stage of the diseases and may include
1. Chronic fatigue
Chronic fatigue is associated to the presence of chronic lymphocytic thyroiditis, according to Bo Wikland and colleagues (March 24, p 956)1 report. Thyroxine, the primary medication may be used to relief the symptom(b).

In the phase of hyperthyroidism
2. Heat intolerance
Patient with silent thyroiditis may be experience the symptoms of heat intolerance, according to the Gifu Red Cross Hospital, Japan(c).

3. Hypertension
Hyperthyroidism is associated with unpleasant symptoms and hypertension due to increased adrenergic tone, according to the study by the Harran University Faculty of Medicine(d).

4. Tachycardia, fatigue, and weight loss, hyperactive reflexes, increased sweating, heat intolerance, tremor, nervousness, polydipsia, and increased appetite, anorexia, atrial fibrillation and goiter
Depending to the age, patients with Thyroid adenoma with the presence of hyperthyroidism may be experience certain above symptoms, according to the study by the Centre Hospitalier et Universitaire de Rouen(e).

In the phase of hypothyroidism

1. Weight gain and fatigue
Hyperthyroidism is associated to weight gain, especially in patients with co-existence of diabetes(1).
The comparable study of patients with thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH), also indicated a significantly higher levels of fatigue in hypothyroidism patients(1b). Statistics of study of 198 consecutive breast cancer patients receiving adjuvant chemotherapy, 22.2% of this patient population showed a significant and progressive weight gain of 6.7 lbs, and 94% of all patients reported fatigue, due to cytotoxic agents influence hypothyroidism in breast cancer patients(1a).

2. Vitiligo and alopecia areata
Vitiligo is associated with autoimmune endocrine disorders, especially withhypothyroidism(2). Primary hypothyroidism patients is at increased risk to develop vitiligo, depigmentation of parts of the skin and hair lost from some or all areas of the body, especially in the scalp(2a)

3. Chronic constipation(3a)
Hypothyroidism may induce the pathogenesis of constipation, according to the study by the University of California at Los Angele(3).

4. Hypothyroid women showed also significantly higher frequency of urticaria and puffiness of hands and feet, yellow ivory skin, coarse rough dry skin(4).

5. Depression
Patients with hypothyroidism have a higher occurrence of depressivesyndrome, these may be result of alterations in blood flow and glucose metabolism in the brain(5).

6. Mood and motor learning
Oral administration of usual dose l-T(4) (euthyroid arm) vs. higher dose l-T(4) (subclinical thyrotoxicosis arm) , showed to improve confusion, mood and motor learning in patients with hypothyroidism(6).

B. Causes and Risk factors
B.1. Causes
The cause of silent thyroiditis is unknown. The autoimmune thyroiditis processes progressively and slowly tinduce necrosis/apoptosis of thyroid cells, causing functional impairment of thyroid gland. Other forms of autoimmune thyroiditis includes postpartum thyroiditis and silent thyroiditis(11). Other researchers suggested that silent thyroiditis is an autoimmune disease characterized by lymphocytic(white blood cells) infiltration of the thyroid and by transient hyperthyroidism, followed occasionally by transient hypothyroidism and eventual recovery(12).

B.2. Risk factors
1. Gentic and environment factors
Genetic and/or environmental factors are important in the development of familial type of silent thyroiditis, according to the study by the Gifu Red Cross Hospital(14). Other study indicated that antecedent infection or exposure to antigen may cause the development of silent thyroiditis(15).

2. Adrenalectomy
Patients with unilateral adrenalectomy for treatment of Cushing’s syndrome are associated to increased risk of silent thyroiditis(16).

3. Lithium therapy
While hypothyroidism secondary to treatments by lithium are well known, cases of hyperthyroidism are less common. Lithium carbonate treatment in a long period of time without any auto-immunity biological markers, associated with a very low thyroid tracer uptake on scintigraphy(17).

4. Alpha-interferon therapy
Alpha-interferon therapy treatment in patients with chronic active hepatitis C develops may induce silent thyroiditis(18). Other study report indicated the development of a episode of silent thyroiditis in a patient with chronic thyroiditis and papillary adenocarcinoma following alpha interferon treatment for hepatitis C(19).

5. Thyroid-stimulation-blocking antibodies (TSBAb)
Thyroid-stimulation-blocking antibodies (TSBAb) showed to induce thyrotoxic symptoms with hypokalemic periodic paralysis, a disorder that causes occasional episodes of muscle weakness and sometimes a lower than normal level of potassium in the blood(20).

6. Infections
Viral infection such as rubella could cause the development of silent thyroiditis with synptoms of heat intolerance(21).

7. Gender
If you are women, you are associated to increased risk of silent thyroiditis.

8. Low level of selenium
Se levels were significantly decreased in cases of sub-acute and silent thyroiditis. according to WOMED(22).

9. Postpartum period
Silent or painless thyroiditis is a frequent cause of transient hyperthyroidism characterized by the onset of symptoms patient with a normal to modestly enlarged and firm thyroid gland, particularly in the postpartum patient(22a).

10. Autoimmune type 1 diabetes mellitus
Patients with autoimmune type 1 diabetes mellitus have often, besides immune diabetes markers, also other organ-specific antibodies, particularly thyroid autoantibodies(22b).

11. Thyroid peroxidase autoantibodies
Thyroid peroxidase (TPO) is a key enzyme in the formation of thyroid hormones and a major autoantigen in autoimmune thyroid diseases, depending to the degree of lymphocytic infiltration in euthyroid subjects, with prevalence rate of 12-26%(22c).

C. Complications
1. Sudden unexpected death
Silent (painless) thyroiditis, especially, is easily overlooked at autopsy as there are no macroscopic changes and often no prior symptoms or history of thyroid disease pointing towards this condition.
Extensive lymphocytic infiltration of the thyroid parenchyma has found to cause‘unknown cause of death’ in some patients with silent (painless) thyroiditis. (23).

2. Oncocytic follicular nodules
Oncocytic follicular (OF) cells, arising in multinodular goiter and chronic lymphocytic thyroiditis (CLT) has beed used as a prominent component of fine needle aspiration (FNA) specimens from neoplasms (adenomas and carcinomas) and nodules(24).

3. Recurrent Silent thyroiditis (ST)
Silent thyroiditis (ST) recurred with a high incidence (65%, 35/54), according to the study by the Department of Endocrinology and Metabolism, Toranomon Hospital(25).

4. Hashimoto’s thyroiditis and lymphoid follicles
Patient with silent thyroiditis, during the thyrotoxic phase, and 15 specimens during the early or late recovery phase are susceptible to develop chronic thyroiditis and lymphoid follicles(26).

D. Diseases associated to Silent thyroiditis
1. Hyperprolactinemia
Hyperprolactinemia may presents in patients with silent thyroiditis due to its influence in the active phase of some non organ-specific autoimmune diseases, including autoimmune thyroid diseases(29).

2. Graves’ disease
Graves’ disease, an autoimmune disease as a result of overproduction of thyroid hormones have associated to the presence of silent thyroiditis, according to the study by the Fourth Department of Internal Medicine, Saitama Medical School(30). The two diseases are closely linked because sequential development of GD followed by ST, or the reverse course of events(31).

3. Progressive systemic sclerosis (PSS)
Patients with progressive systemic sclerosis (PSS) with increased serum T3 and T4 and low 24-h thyroidal uptakeare more likle to be presence with silent thyroiditis(32).

4. Idiopathic thrombocytopenic purpura (I.T.P.)
Patients with diopathic thrombocytopenic purpura, a disorder of easy or excessive bruising and bleeding on the presence of symptoms of thyrotoxicosis. accompanied with the diagnosis of low uptake of radioactive iodine and technesium(chemical Tc) with may develop silent thyroiditis(33).

5. Thymoma
Thymoma often accompanies an autoimmune disease, is thought to be involved in the onset of silent thyroiditis(34).

6. Chronic adrenocortical insufficiency
chronic adrenocortical insufficiency (Addison’s disease), a autoimmune disorder is associated to the prevalence of silent thyrotoxic thyroiditis(35).

E. Misdiagnosis and diagnosis
E.1. Misdiagnosis
Silent thyroiditis in some cases has misdiagoesd as malignant lymphoma of the thyroid. Clinically and cytologically, it is difficult to make a distinction of diagnosis if immune response phenomena with invasion of lymphocyte and appearance of lymph follicle are the strongest(36).

E.2. Diagnosis
After recording the past and present history and completing a physical exam, including assessing symptoms and complaints commonly seen including enlarged thyroid gland, heart rate, shaking hand etc. The tests which your doctor orders may include
1. Radioactive iodine uptake test, or RAIU test
Radioactive iodine uptake (RAIU) test measures how much tracer the thyroid gland absorbs from the blood with radioactive tracer. In mast cases, patients with either Graves' diseases and silent thyroiditis are undergone iodine restriction before taking the test(37).

2. Blood test for blood levels of the thyroid hormones T3 and T4
The aim of the test is to the level of free T4 and thyroid stimulating hormone (TSH) levels to exclude thyroid dysfunction(38), if normal value of TSH is presented(38).

3. Thyroid scintigraphy
Thyroid scintigraphy, the test used to establish the functional characteristics of thyroid nodules (warm or cold) and to precise the origin of a thyrotoxicosis(hyperthroidism) of sub acute or silent thyroiditis(39).

4. Thyroid biopsy
In thyrroid biopsy, removed small sample of tissue from the thyroid gland is examined under a microscope for sign of unusual thyroid function(40).

F. Prevention
F.1. Diet to prevent silent thyroiditis
1. Broccoli
Sulforaphane (SFN), a natural constituent of cruciferous vegetables such as broccoli, Brussels sprouts, etc., exhibits its anti inflammatory effect against LPS-induced inflammation in RAW 264.7 cells(41).

2. Cherry
Anthocyanin-rich cherries, tested in the Zucker fatty rat model of obesity and metabolic syndrome, significantly attenuated the postprandial inflammatory response in a cross -over design of overweight adults consumed a high-carbohydrate, moderate-fat meal (HCFM) accompanied by either a strawberry or a placebo beverage(42).

3. Walnut
Walnut consumption showed to increase levels of apolipoprotein A, a protein played an important role in lipid metabolism with anti-inflammatory effects in adipocytes(fat cells) and adipose(fat) tissue similar in other cell types(43)

4. Garlic
1,2-vinyldithiin, a chemical ingredient from garlic inhibits differentiation and inflammation of human preadipocytes( precursor cells for the development of fat cells)(44).

F.2. Phytochemicals and antioxidants to prevent silent thyroiditis
1. Resveratrol
Resveratrol (trans-3,4′,5-trihydroxystilbene), a natural polyphenol with antioxidant, anti-inflammatory, and anticancer properties, showed to induce the expression of a tumor-suppressor and anti-inflammatory microRNA(44).

2. Pterostilbene
Pterostilbene showed to inhibit inflammatory effects in patients with colon cancer through controlling cellular responses to cytokines(45).

3. Phytofluene
Combination of CoQ10 and colorless carotenoids (phytoene and phytofluene, or to combinations of these antioxidants) treatment showed to enhance protection from inflammation and premature aging caused by sun exposure46).

4. Selenium
Se levels were significantly decreased in cases of sub-acute and silent thyroiditis as well as in follicular and papillary thyroid carcinoma(48).

G. Treatments
G.1. In conventional medicine perspective
Treatment of the disease is to relieve the symptoms and most of the patients show complete recovery and return of the thyroid gland to normal after 3 months as the disease rarely lead to permanent thyroid disease, although some loss of thyroid reserve may occur(49). Also, in some study thyroid suppression with thyroid hormone showed to be ineffective in preventing this disease(50).

G.2. In herbal medicine perspective
The below herbal medicine has been proven to be effective in treating inflammatory diseases
1. Myrrh
According to the study by the Shandong University, the resins of Commiphora species have emerged as a good source of the traditional medicines for the treatment of inflammation, arthritis, obesity, microbial infection, wound, pain, fractures, tumor and gastrointestinal diseases(54).

2. Desmodium gangeticum (L.) DC. and Desmodium adscendens (Sw.) DC.
Desmodium gangeticum is used as a tonic, febrifuge, digestive, anticatarrhal, antiemitic, in inflammatory conditions of chest and in various other inflammatory conditions in the Ayurvedic System of Medicine while Desmodium adscendens is widely used for the treatment of asthma in Ghana, Africa(55).

3. Senecio scandens
Senecio scandens is a medicinal plant with a climbing woody stem. Extracts and compounds isolated from Senecio scandens show a wide spectrum of pharmacological activities, including anti-inflammatory, antimicrobial and toxicological activities(56).

G.3. In traditional Chinese medicine perspective
The below TCM herbal medicine has been proven to be effective for treatment of inflammatory diseases
1. Deer antler
Deer antler base (Cervus, Lu Jiao Pan) has been recorded in the Chinese medical classics Shen Nong Ben Cao Jing 2000 years ago and has been extensively used in traditional Chinese medicine (TCM) to treat a variety of diseases including mammary hyperplasia, mastitis, uterine fibroids, malignant sores and children’s mumps. According to the study by the Dalian University of Technology, both in vitro and in vivo, deer antler base possess immunomodulatory, anti-cancer, anti-fatigue, anti-osteoporosis, anti-inflammatory, analgesic, anti-bacterial, anti-viral, anti-stress, anti-oxidant, etc.(51).

2. Brown seaweed Sargassum
According to the study by the Southern Cross University, Sargassum spp. showed to exhibit it anticancer, anti-inflammatory, antibacterial and antiviral activities in vivo and in vitro(52).

3. Callicarpa L. (Verbenaceae)
According to the study by the Second Military Medical University, isolates and crude extract containing Callicarpa species, exhibited anti-inflammatory, hemostatic, neuroprotective, anti-amnesic, antitubercular, antioxidant, antimicrobial, etc. effects in vitro and in vivo(53).

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References
(a) http://www.ncbi.nlm.nih.gov/pubmed/22443972

Quick and #healthy #recipe: #Apple #Cinnamon #Oatmeal

Posted By Kyle J. Norton Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Recipe contributed by Yum-O, the family cook book by Rachel Ray, Published by Clarkson Potter, New York.You can view her website at yum-o.org

Swap
2 Granny smith apples, peeled, cored, and chopped, for the dried fruit

Add 2 teaspoons ground cinnamon, plus more for serving

Instructions
Follow the directions for the original recipe(click here), adding the cinnamon along with the apples. Serve with additional milk and a sprinkle of cinnamon.

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Friday, 28 November 2014

Women's Health - Premenstrual syndrome(PMS): The Adverse effects of Salt(Revised edition with references)

Quick and #healthy #recipe: #Banana #nut oatmeal

Posted By Kyle J. Norton Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Recipe contributed by Yum-O, the family cook book by Rachel Ray, Published by Clarkson Potter, New York.You can view her website at yum-o.org

Swap
1/2 cup pure maple syrup for the brown sugar
2 bananas, chopped, for the dried fruit

Add
3/4 cup toasted walnut pieces, chopped

Instructions
Follow the directions for the original recipe(click here), stirring in the chopped nuts just before serving the oatmeal. Top with additional milk if desired.
Serves 8

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Thursday, 27 November 2014

Women's Health - Premenstrual syndrome(PMS): The Adverse effects of Smoking(Revised edition with references)

Ulvik A¹, Ebbing M, Hustad S, Midttun Ø, Nygård O, Vollset SE, Bønaa KH, Nordrehaug JE, Nilsen DW, Schirmer H, Ueland PM.(PubMed)

(14) Dietary B vitamin intake and incident premenstrual syndrome by Chocano-Bedoya PO¹, Manson JE, Hankinson SE, Willett WC, Johnson SR, Chasan-Taber L, Ronnenberg AG, Bigelow C, Bertone-Johnson ER.(PubMed)

Quick and #healthy #recipe: Dried #Fruit Oatmeal

Posted By Kyle J. Norton Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Recipe contributed by Yum-O, the family cook book by Rachel Ray, Published by Clarkson Potter, New York.You can view her website at yum-o.org

Ingredients
3 cups of old fashioned (not instant) oatmeal
3 cups skim milk, plus more for serving
1/2 half cup brown sugar
1/2 cup dried dates, chopped
1/2 cup currants or raisins
1/2 teaspoon salt

Instructions
Combine oatmeal, milk, and 4 cups water in large, deep saucepan and bring to a boil over medium-high heat. When it boils, quickly turn the heat down to very low. Stir in brown sugar, dried fruits and salt and cook at a low simmer for 15 to 20 minutes, or until very thick and creamy. Stir often to prevent the bottom from scorching.
Serve with additional milk, or cool and refrigerate to reheat later in the wee;.
Serves 8

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Wednesday, 26 November 2014

(Preview) Most common diseases of 50 plus - Thyroid Disease - Hashimoto’s thyroiditis : Preventions, Managements and Treatments

By Kyle J. Norton
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                                          Thyroid disease
          Thyroid disease is defined as a condition of malfunction of thyroid gland.

     Thyroid disease : Hashimoto’s thyroiditis

Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis) is an autoimmune disease in which the immune system attacks the thyroid gland, causing an underactive thyroid gland (hypothyroidism).
According to the study by the University of Pisa, Women with Hashimoto’s thyroiditis (HT) suffer from symptoms independently from hypothyroidism and regardless thyroid dysfunction(a).

A. Symptoms
1. Dysphagia, shortness of breath, voice changes, and odynophagia
According to the ata of patients who underwent thyroidectomy from 2005 through 2009, by the Medical University of South Carolina, 52%, 26% and 8% of patients experienced symptoms of dysphagia and shortness of breath; voice changes, and complained of odynophagia, respectively(1).

2. Anxiety, negative mood, depression, dry skin, cold intolerance, puffy eyes, muscle cramps and fatigue, deep voice, constipation, slow thinking and poor memory.
Hashimoto’s thyroiditis is a common auto-immune disorder. The most common presenting symptoms may include anxiety, negative mood, depression, dry skin, cold intolerance, puffy eyes, muscle cramps and fatigue, deep voice, constipation, slow thinking and poor memory, according to the study by the Leiden University Medical Center(2).

3. General health
Women with Hashimoto’s thyroiditis (HT) also with positive anti-thyroid autoantibodies(anti-TPO) are experience to a significantly higher prevalence of general health symptoms as compared to those without HT(2a).

4. Other symptoms
Swelling in front of the neck along with constipation, anorexia, weight gain and increasing pallor may also be symptoms of hypothyroid goiter (autoimmune thyroiditis, Hashimoto’s thyroidits), due to high level of thyroid stimulating hormone (TSH), low level of T4 with presence of thyroid specific antibodies in blood(2b).

B. Causes
1. Autoimmune disorder
The current knowledge on Hashimoto’s thyroiditis associated with concept of autoimmune thyroid disease is caused by autoimmune process in stimulation of abnormal production of antibodies, reacting with thyroglobulin and thyroid peroxidase(3a).

2. Primary hyperparathyroidism (PHPT)
Patients with primary hyperparathyroidism (PHPT) are susceptible to develop Hashimoto’s thyroiditis due to similar autoimmune inflammatory process with the rate ofoccurrenceof 1.89%(3).

2. Cerebellar ataxia
Both hypothyroidism and Hashimoto’s thyroiditis (HT) can rarely be associated with cerebellar ataxia.
but patients with hypothyroidism with history of severe essential tremor may develop Hashimoto’s thyroiditis(4).

C. Risk factors
1. Childhood weight gain and childhood overweight
Childhood weight gain and childhood overweight conferred an increased risk to later hypothyroidism and thyroid autoimmunity, particularly in women, according to the study by the Medical Research Council Unit for Lifelong Health and Ageing(5).

2. Genetic factors
CTLA-4 gene located in chromosome 2q33 region has a strong association with several autoimmune diseases, including Hashimoto’s thyroiditis(6).

3. Female
If you are female with type I diabetes, you are at increased risk for the development of HT,
according to the study of thyroid autoimmunity in a very large nationwide cohort of children and adolescents with type 1 diabetes, 63% of type I diabetes patients with positive antibodies were girls, compared with 45% of patients without antibodies(7).

4. Other risk factors
According to the study by the Kaunas University of Medicine, pregnancy, drugs, age, sex, infection, and irradiation may also be associated to the risk factors of Hashimoto's thyroiditis (HT)(8).

D. Diseases associated to Hashimoto’s thyroiditis
1. Hashimoto’s encephalopathy (HE)
Hashimoto’s encephalopathy (HE) is a rarely recognized neurocognitive syndrome associated with thyroid autoimmunity and occurred more common in women(14).

2. Neurofibromatosis Type 1
Hashimoto’s thyroiditis is a common form of chronic autoimmune thyroid disease (AITD) and often coexists with other autoimmune diseases, including Hashimoto’s thyroiditis(15).

3. Chronic hepatitis C(CHC)
The prevalence of of thyroid dysfunction is significantly higher among Chronic hepatitis C patients with Hashimoto’s thyroiditis(HT) than CHC patients without HT(16).

4. Reactive thrombocytosis
Reactive thrombocytosis, an elevated platelet count (> 450,000/μL) developed secondary to another disorder, including Hashimoto’s thyroiditis and/or subclinical hypothyroidism(17).

5. Thyroid papillary carcinoma
Patients with Thyroid papillary carcinoma are associated to 26.8% risk of HT without differences in relation to tumor size(18).

E. Misdiagnosis
Although fine-needle aspiration (FNA)is extremely valuable in the initial evaluation of thyroid lesions, with an accuracy of 98.6% and 80% positive predictive value, and 100% negative predictive value, misdiagnosis can be abserved(19).

1. Overlapping thyroid follicular lesions coexisting with Hashimoto’s thyroiditis
Overlapping cytological features of FN and HT were showed to be the main causes of false-positive results in diagnosis of thyroid follicular lesions coexisting with Hashimoto’s thyroiditis' dominant in some patients, if not taken account of presented forms of follicular-cell and/or moderate to excessive numbers of lymphoid cells(20).

2. Papillary thyroid carcinoma (PTC)
An association between papillary thyroid carcinoma (PTC) and Hashimoto’s thyroiditis (HT) is well recognized, but papillary thyroid carcinoma (PTC) is most often misdiagnosed as either follicular neoplasm or colloid nodule with or without HT(21).

3. Follicular adenoma, nodular goiter, macrofollicular adenoma and malignant lymphoma
Hashimoto’s thyroiditis (HT) can be misdiagnosed as follicular adenoma, nodular goiter, macrofollicular adenoma and malignant lymphoma, if FNABs an associated lesion was not sampled or some of the cellular features of HT were misinterpreted(22).

4. Solitary thyroid nodule
Solitary thyroid nodule also can be misdiagnosed as Hurthle cell neoplasm on FNAC in patients of Hashimoto’s thyroiditis with marked Hurthle cell change(22a).

F. Diagnosis
After recording the past and present history and completing a physical exam, including assessing symptoms and complaints commonly seen in hypothyroidism and neck examination. The tests which your doctor orders may include
1. Blood test
The aim of the test is to determine the level of thyroid function. Underactive thyroid gland is presented with the low level of thyroid hormone with elevated TSH as your pituitary gland tries to stimulate your thyroid gland to produce more thyroid hormone.

2. An antibody test
The aim of the test is to check for the presence of antibodies against thyroid peroxidase, the an enzyme which plays an important role in the production of thyroid hormones.

3. Thyroid scan
Thyroid scan in Hashimoto’s thyroiditis can mimic a wide range of thyroid disorders, due to overlapping (23).

4. Fine needle aspiration cytology
FNAC can accurately diagnose Hashimoto’s thyroidits in most patients. However, a small percentage of cases may be missed due to the limitations of this procedure and the varied sell structures of the disease (24).

G. Prevention
G.1. Diet to prevent Hashimoto’s thyroiditis
1. Brazil Nuts and Sunflower Seeds
Selenium found abundantly in Brazil Nuts and sunflower seeds was significantly related to the production of thyroid gland. A low selenium status significantly increased the risk for thyroid enlargementand and development of multiple nodules(25a). Overdose may have a toxic effect on growth hormone, causing adverse effects of anorexia, diarrhea, depression, hemorrhage, liver and kidney necrosis, blindness, ataxia and respiratory disturbances(25).

2. Sea buckthorn
Sea buckthorn (Hippophae rhamnoides L.) constitutes thorny nitrogen fixing deciduous shrub. Sea buckthorn(SBT) is primarily valued for its very rich vitamins A, B(1), B(12), C, E, K, and P; flavonoids, lycopene, carotenoids, and phytosterols. and therapeutically important since it is rich with potent antioxidants. Scientifically evaluated pharmacological actions of SBT are like inflammation inhibited by reduced permeability, loss of follicular aggregation of lymphocytes from the inflamed synovium and suppress lymphocyte proliferation(26).

3. Balanced diet
Several trace minerals, including iodine, iron, selenium, and zinc. and trace elements are essential for normal thyroid hormone metabolism, Coexisting deficiencies of these elements can impair thyroid function. Iron deficiency impairs thyroid hormone synthesis and reduces the efficacy of iodine. Combined selenium and iodine deficiency leads to severely stunted physical and mental growths(27).

G.2. Phytochemicals and Antioxidants to prevent and treat Hashimoto’s thyroiditis
Patients with in Hashimoto’s thyroiditis (HT) were found to significant increase in oxidative stress parameters in serum and LDL-fraction(28).
1. Resveratrol
Resveratrol, found in skin and seed of grape regulates several biological processes, including sell cycle arrest, in both papillary and follicular thyroid cancer. resveratrol also influences thyroid function by enhancing iodide trapping and increasing TSH secretion(29).

2. Polyphenolic flavonoids
Polyphenolic flavonoids found in black and green tea extracts showed to alter the thyroid gland physiology and architecture, including inhibited enlargement of thyroid gland, decreased serum T3 and T4, and a parallel increase in serum thyroid stimulating hormone (TSH) at green tea extract at 2.5 g% and 5.0 g% doses and black tea extract at 5.0 g% dose(30).

3. Selenium
According to the study by the Hôpital du Cluzeau, selenium supplementation decreases anti-thyroid antibody levels and improves the ultrasound structure of the thyroid gland(31).

2. Vitamin D
Vitamin D deficiency may have a role in the autoimmune process in Hashimoto thyroiditis in children.
Children with Hashimoto thyroiditis showed to associate with higher vitamin D deficiency rates in comparison to vitamin D levels in the Hashimoto group(32).

H. Treatments
A. In conventional Medicine
1. Levothyroxine therapy
Beside monitoring thyroid functions of the patients with HT periodically for hypothyroidism, treatment of Levothyroxine therapy is necessary to improve positively affect the clinical course of the disease and the antibody titers(33).

2. Combination of liothyronine (T3) and levothyroxine
Although ombinations of levothyroxine plus liothyronine appear to have beneficial effects on the mood, quality of life, and psychometric performance of the patients over levothyroxine alone with the possibility of adverse effects, large sample size is necessary for further study(34).

H.2.In Herbal Medicine
1. Alkaloid tetrandrine
According to the study by the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, TTetrandrine (Tet), purified from a creeper Stephania tetrandra S Moore, used to treat patients with silicosis, autoimmune disorders, and hypertension in Mainland China for decades. exhibited a wide variety of immunosuppressive effects both in vitro and in vivo(38).

2. Salvia miltiorrhiza, Tripterygium wilfordi, Tanacetum parthenium and Curcuma longa
A number of herbal products used for their immunosuppressive effects, may be useful in immune-mediated disorders including autoimmune diseases and organ transplant rejection, including Salvia miltiorrhiza and Tripterygium wilfordii functions in reduced inflammatory cytokines and mediators, Tanacetum parthenium function in inhibited the release of pro-inflammatory mediators and Curcuma longa function in down regulates the expression of inflammation(39).

3. Radix Bupleuri
Radix Bupleuri, used most frequently prescribed crude herbs in the prescriptions of traditional Chinese medicine for the treatment of inflammatory diseases and auto-immune diseases showed to inhibit production of serum autoantibodies and total immunoglobulin G (IgG) with doses depended for 35 days
(40).

4. Polygonum multiflorum and Artemisia scoparia
According to the study by the National Taiwan University, emodin and scoparone, the active principles isolated from Polygonum multiflorum and Artemisia scoparia, respectively, both exhibit vasorelaxant and immunosuppressive effects. In dose depended the phytochemicals also suppressed the responses of white blood cells with a one-lobed nucleus, and cell proliferation(41).

H.3. In traditional Chinese Medicine
1. Aconite cake-separated moxibustion and option the better therapeutic program
Application of aconite cake-separated moxibustion therapy with acupoints of [(1) Danzhong (CV 17), Zhongwan (CV 12), Guanyuan (CV 4); (2) Dazhui (GV 14), Shenshu (BL 23), Mingmen (GV 4)] alternatively with oral administration of 25 microg Euthyrox everyday, showed to improve clinical symptoms and thyroid function in patients of Hashimoto’s thyroiditis, in comparison of simple oral administration of Euthyrox (levothyroxine)(35).

2. Brown seaweed Sargassum
Sargassum spp., a brown seaweed, used in Traditional Chinese Medicine (TCM) to treat a variety of diseases over 2000 years including thyroid disease, exhibited its immunomodulator effects and could be useful in the treatment of thyroid related diseases such as Hashimoto’s thyroiditis(36).

Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight

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References
(1) http://www.ncbi.nlm.nih.gov/pubmed/22191404
(2) http://www.ncbi.nlm.nih.gov/pubmed/23744563
(2a) http://www.ncbi.nlm.nih.gov/pubmed/21112862
(2b) http://www.ncbi.nlm.nih.gov/pubmed/21381622
(3a) http://www.ncbi.nlm.nih.gov/pubmed/19667753
(3) http://www.ncbi.nlm.nih.gov/pubmed/23865082
(4) http://www.ncbi.nlm.nih.gov/pubmed/23439792
(5) http://www.ncbi.nlm.nih.gov/pubmed/23436917
(6) http://www.ncbi.nlm.nih.gov/pubmed/22851994
(7) http://www.ncbi.nlm.nih.gov/pubmed/12145233
(8) http://www.ncbi.nlm.nih.gov/pubmed/19667753
(14) http://www.ncbi.nlm.nih.gov/pubmed/23767389
(15) http://www.ncbi.nlm.nih.gov/pubmed/23691379
(16) http://www.ncbi.nlm.nih.gov/pubmed/23663880
(17) http://www.ncbi.nlm.nih.gov/pubmed/23518829
(18) http://www.ncbi.nlm.nih.gov/pubmed/23306572
(19) http://www.ncbi.nlm.nih.gov/pubmed/22619157
(20) http://www.ncbi.nlm.nih.gov/pubmed/12508180
(21) http://www.ncbi.nlm.nih.gov/pubmed/11403259
(22) http://www.ncbi.nlm.nih.gov/pubmed/10349369
(22a) http://www.ncbi.nlm.nih.gov/pubmed/22090699
(23) http://www.ncbi.nlm.nih.gov/pubmed/2847097
(24) http://www.ncbi.nlm.nih.gov/pubmed/22090699
(25) http://www.ncbi.nlm.nih.gov/pubmed/20883174
(25a) http://www.ncbi.nlm.nih.gov/pubmed/21242171
(26) http://www.ncbi.nlm.nih.gov/pubmed/22530142
(27) http://www.ncbi.nlm.nih.gov/pubmed/12487769
(28) http://www.ncbi.nlm.nih.gov/pubmed/22951187
(29) http://www.ncbi.nlm.nih.gov/pubmed/21946130
(30) http://www.ncbi.nlm.nih.gov/pubmed/20801949
(31) http://www.ncbi.nlm.nih.gov/pubmed/23046013
(32) http://www.ncbi.nlm.nih.gov/pubmed/22876540
(33) http://www.ncbi.nlm.nih.gov/pubmed/22155461
(34) http://jcem.endojournals.org/content/90/8/4946.full
(35) http://www.ncbi.nlm.nih.gov/pubmed/?term=Hashimoto+thyroiditis+in+TCM
(37) http://www.ncbi.nlm.nih.gov/pubmed/2268942
(38) http://www.ncbi.nlm.nih.gov/pubmed/12466046
(39) http://www.ncbi.nlm.nih.gov/pubmed/22761185
(40) http://www.ncbi.nlm.nih.gov/pubmed/19467314
(41) http://www.ncbi.nlm.nih.gov/pubmed/1830846

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