Histological Study of Commiphora mukul, Withania somnifera and Thyroxine in a Murine Model of Hypothyroidism

Introduction: Hypothyroidism is a common endocrine disorder not only in developing countries like Pakistan but also in the developed countries having a prevalence of about 4-5%. Thyroxine remains the gold standard treatment for hypothyroidism but due to its adverse effects, newer and safer phyto alternatives are the need of hour. Aims & Objectives: Present study was designed to establish effects of Commiphora mukul, and Withania somnifera on thyroid histology in methimazole induced hypothyroidism in order to compare the effects of these plants on thyroid histology with thyroxine. Place and duration of study: This experimental study was carried out in the animal house of PGMI, Lahore. Total duration of study was 38 days. Material & Methods: 60 rats were sorted in 6 groups with 10 animals each. G-1 was the control group. G-2 received methimazole 60mg/kg/day for 21 days to induce hypothyroidism and left untreated for self recovery & G3-6 were induced with methimazole in the same way. After induction G3-6 were treated for 15 days except group 2, G-3: Commiphora mukul Ethanolic Extract (CMEE) 0.2g/kg/day orally, G4: Withania somnifera Ethanolic Extract (WSEE) 1.4g/kg/day orally. G-5: CMEE 0.2g/kg/day + WSEE 1.4g/kg/day orally. G-6 received the gold standard Thyroxin 0.6ug/100gm BW S/C. Thyroid was excised for histology at the end i.e at day 38. Results: Improved thyroid follicular morphology was seen in all treatment groups in their epithelium, colloid content, reversion of chromatin to normal and decreased nuclear pyknosis. However both extract CMEE & WSEE in combination exhibited equi to greater potential than thyroxine 0.6?g/100gm BW alone. Conclusion: So our study shows that treatment with combination of CMEE 0.2g/kg + WSEE 1.4g/kg orally for 15 days improved thyroid histology significantly which is comparable to gold standard thyroxine proving the potential of this combination to substitute thyroxine.

MECHANISTIC ROLE OF VARUNA (CRATAEVA NURVALA) EXTRACT ON THYROID GLAND AND ITS HISTOLOGY THROUGH IODOTHYRONINE DEIODINASES

Objective: Crataeva nurvala (CN) is used for its therapeutic effects, but its effect on the thyroid gland in euthyroid conditions and mechanism behind its thyrotropic activity in hypothyroidism is still not explored. This study screened the pharmacological effect of the ethanolic extract of the bark of CN on thyroid hormones, free and total thyroxine (FT4 and T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH) levels, and thyroid histology in normal Swiss albino female mice.Methods: Eighteen animals of 28–33 g were segregated into three groups: Group I treated with vehicle (NOR+VEH), Group II administered CN 400 mg/kg (NOR+CN 400), and Group III given CN 600 mg/kg (NOR+CN 600), for 15 days, per os (p.o.). The variation in the T4, FT4, T3, and TSH levels was recorded using ELISA, 24 h after the last dose, and T3/T4 ratio thus calculated along with the histopathological studies of the thyroid gland.Results: The findings were presented as mean ± standard error of the mean, using one-way ANOVA, followed by Dunnett’s post-tests to compare all columns with the control. NOR+CN 600 has shown thyroid protective effect through retaining euthyroid profile, normal T3/T4 ratio, and near-normal histology. However, NOR+CN 400 had shown the significant decline in T3/T4 ratio and pathological changes in thyroid histology, in comparison with the control and NOR+VEH group.Conclusion: The higher dose of CN was found to sustain the euthyroid levels through retention of iodothyronine deiodinases activity, facilitating the peripheral conversion of T4 to T3, and in retaining normal histoarchitecture of the thyroid gland in contrary to a lower dose.

Thyroidectomy for Painful Thyroiditis Resistant to Steroid Treatment: Three New Cases with Review of the Literature

Thyroidal pain is usually due to subacute thyroiditis (SAT). In more severe forms prednisone doses up to 40 mg daily for 2-3 weeks are recommended. Recurrences occur rarely and restoration of steroid treatment cures the disease. Rarely, patients with Hashimoto’s thyroiditis (HT) have thyroidal pain (painful HT, PHT). Differently from SAT, occasional PHT patients showed no benefit from medical treatment so that thyroidectomy was necessary. We report three patients who did not show clinical response to prolonged high dose prednisone treatment: a 50-year-old man, a 35-year-old woman, and a 33-year-old woman. Thyroidectomy was necessary, respectively, after nine-month treatment with 50 mg daily, two-month treatment with 75 mg daily, and one-month treatment with 50 mg daily. The two women were typical cases of PHT. Conversely, in the first patient, thyroid histology showed features of granulomatous thyroiditis, typical of SAT, without fibrosis or lymphocytic infiltration, typical of HT/PHT, coupled to undetectable serum anti-thyroid antibodies. Our data (1) suggest that not only PHT but also SAT may show resistance to steroid treatment and (2) confirm a previous observation in a single PHT patient that increasing prednisone doses above conventional maximal dosages may not be useful in these patients.