Медицина/7.Клиническая медицина

Olenovych O.A.

Higher State Educational Establishment of Ukraine

«Bukovinian State Medical University», Chernivtsi

CLINICAL EFFICACY OF ANTIOXIDANT AND SELENIUM-CONTAINING MEDICATION OXYLYC IN COMPLEX TREATMENT OF PATIENTS WITH DIFFUSE NON-TOXIC GOITER

Introduction. Selenium has been proved to play an important role in prevention and treatment of numerous diseases, including thyropathies. It is one of the most important micronutrients for thyroid function [1]. It can reduce thyroid antibodies, and plays a crucial role in thyroid hormone synthesis. It also shields the thyroid against damage as it’s a key component of glutathione peroxidase – our thyroid’s antioxidant protector. In fact, the thyroid has the highest concentration in the entire body of selenium [1, 3, 4].

The principal questions, discussed by scientists from different countries lately, concern the influence of selenium deficiency on the pathogenesis of endemic goiter [3, 4], and the application of selenium-containing medications to treatment and prophylaxis of diffuse non-toxic goiter (DNG).

Considering that, the objective of this research was to study the efficacy of antioxidant and selenium-containing medication Oxylyc in complex treatment of patients with DNG.

Materials and methodology. To accomplish this, 21 patients with DNG (10 men and 11 women – 47,6 and 52,4% respectively, mean age – 32,9±0,93 years) participated in the study.

The verification of the diagnosis was based on a thorough clinical-anamnestic and laboratory-instrumental investigations according to the criteria, proposed by the WHO experts committee: thyroid gland enlargement was assessed by palpation (goiter of IA – 12 patients (57,1%) and IB degrees – 9 patients (42,9%)) and according to ultrasound imaging data, euthyroid condition was confirmed by measurement of blood concentration of pituitary-thyroid hormones: the level of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were determined. To study the functional status of the pituitary-thyroid axis, we calculated fT3/fT4 ratio, peripheral activity of thyroid hormones was estimated by fT4/fT3 ratio [2].

Examined patients were divided in two groups: group 1 (control) – patients with DNG under standard treatment program by potassium iodide-containing medications (10 individuals); group 2 (basic) – patients with DNG under a complex treatment with additional administration of Oxylyc (Woerwag Pharma, Germany), 1 capsule a day during meal for 1 month (11 individuals).

Results and discussion. The analysis of obtained findings revealed a tendency for the decrease of fT3 level and elevation of fT4 level in the patients before treatment, but those changes weren’t statistically significant and mentioned parameters remained within referent ranges, common for euthyroid condition. These findings, probably, are the consequence of lowered deiodinases activity and inhibition of peripheral conversion of fT4 to fT3.

As a proof of that, reliable reduction of fT3/fT4 ratio and elevation of fT4/fT3 ratio was noted, that is indicative of the «euthyroid sick syndrome» in the examined patients.

After the administration of selenium-containing medication Oxylic fT4 level bacame 21,4% lower, while in the control group of patients it was reduced only by 6% lower than before treatment. FT3 level became 22,7 % higher in basic group after treatment, at the same time in control group it's changes weren't statistically significant.

Reliable increase of fT3/fT4 ratio in both groups after treatment has been obtained (by 29,2% in basic group and by 8,4% in control group), followed by the decrease of fT4/fT3 ratio (by 29,9% in basic group and by 7,2% in control group). The results indicate the improvement of peripheral conversion of thyroid hormones activity after sodium intake in the examined patients with by deiodinases activity balancing.

Conclusion. The results of conducted research are indicative of high efficacy of antioxidant and selenium-containing medication Oxylyc in a complex treatment of diffuse non-toxic goiter and the possibility of its application to complex treatment of this disease.

REFERENCES:

1. Пашковская Н.В. Селен и заболевания щитовидной железы / Н.В.Пашковская // Международный эндокринологический журнал. – 2015. – № 7(71). – C. 89-93.

2. Abramova N.O. Peculiarities of indices of thyroid homeostasis in patients with metabolic syndrome depending on body mass index / N.O.Abramova, N.V.Pashkovska // Международный эндокринологический журнал. – 2015. – № 8(72). – C.27-30.

3. Dentice M. Deiodinases: the balance of thyroid hormone: local impact of thyroid hormone inactivation / M.Dentice, D.Salvatore // J. Endocrinol. – 2011. – Vol. 209, №3. – P.273-282.

4. Kelly G. Peripheral metabolism of thyroid hormones: A review / G.Kelly // Alternative medicine review. – 2000. – Vol.5, №4. – P.306-333.