| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 29
| Issue : 2 | Page : 64-70 |
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Effect of vitamin D3 in treating hyperthyroidism in patients with graves’ disease
Nermin A Sheriba1, Abeer A.A. Elewa PhD 1, Maram M Mahdy1, Ahmed M Bahaa El Din1, Nesma A Ibrahim1, Dina A Marawan1, Tahany M Abd El Moneim2
1 Department of Internal Medicine, Ain Shams University, Cairo, Egypt
2 Department of Biochemistry, Ain Shams University, Cairo, Egypt
Correspondence Address:
Abeer A.A. Elewa
31 Police Building, Kornish El-Nile, Al Maadi, Cairo
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ejim.ejim_10_17
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Background
Graves’ disease (GD) is an autoimmune disease characterized by hyperthyroidism secondary to circulating autoantibodies. Multiple factors contributed to its etiology, including genetic and environmental factors. The role of vitamin D is well-known in calcium metabolism and skeletal homeostasis. Vitamin D was shown to be a modulator in both innate and adaptive immunity. There is a link between vitamin D deficiency and various autoimmune diseases. The prevalence of vitamin D deficiency was reported to be common in patients with GD. Interestingly, vitamin D deficiency is found to be associated with higher thyroid volume in patients with newly-onset GD. However, vitamin D deficiency relationship with GD remains a controversial issue.
Objective
The objective of this study was to evaluate the effect of vitamin D supplementation in GD with and without ophthalmopathy.
Patients and methods
A randomized prospective study was conducted on 60 adult patients with GD aged 20–40 years. Group 1 comprised 20 patients with GD receiving a daily dose of 30 mg of methimazole alone. Group 2 comprised 40 patients with GD receiving the same dose of methimazole, supplemented with intramuscular injection of vitamin D3 200 000 IU/month for 3 months. Patients were followed up over a 3-month duration.
Results
There was hypovitaminosis D in all participants with a percentage of vitamin D deficiency (vitamin D level: <20 ng/ml) of 73.9% in male and 54.1% in female and a vitamin D insufficiency (vitamin D level: 20–29 ng/ml) of 26.1% in male and 45.9% in female. Vitamin D was significantly correlated with thyroid volume and degree of exophthalmos. On vitamin D supplementation, group 2 had significantly lower thyroid volume and better effect on the degree of exophthalmos.
Conclusion
Vitamin D supplementation for GD has a favorable effect on thyroid volume and on the degree of exophthalmos.
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