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Flagler Beach, FL, United States

Schmeltz L.R.,P.C. | Blevins T.C.,Texas Diabetes and Endocrinology | Aronoff S.L.,Endocrine Assocs. of Dallas | Ozer K.,Texas Diabetes and Endocrinology | And 8 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014

Context: Hashimoto's thyroiditis is less prevalent in tobacco smokers. Anatabine, an alkaloid found in Solanaceae plants including tobacco, has been reported to ameliorate a mouse model of Hashimoto's thyroiditis. Objective: The effects of anatabine in patients with Hashimoto's thyroiditis were studied. Design, Setting, Patients, and Intervention: This was a double-blind, randomized, placebo-controlled multisite study. A total of 146 patients (70 treated with anatabine and 76 with placebo) completed the study. Approximately 50% of patients in each group were taking levothyroxine. Anatabine lozenges (9-24 mg/d) or placebo, each containing vitaminsAandD3, were administered orally 3 times a day for 3 months. Main Outcome Measures: Serum thyroperoxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) levels were assessed. Safety was assessed through adverse events, clinical laboratory evaluations, and vital sign measurements. Results: Anatabine-treated patients had a significant reduction in absolute serum TgAb levels from baseline by study end relative to those receiving placebo (P = .027); however, there were no significant changes or differences in treatment group means for TPOAb or TgAb levels. Mean ± SD TgAb values decreased by 46.2 ± 101.1 and 3.9 ± 83.9 World Health Organization units for the anatabine and placebo groups, respectively. Significantly more patients had a>20% drop in TgAb levels in the anatabine than placebo group (P = .023). Overall, the anatabine supplement was safe and well tolerated, although significantly (P < .05) more patients in the anatabine group reported adverse events. Conclusions: These results demonstrate an immunological effect of anatabine on TgAb levels. Further studies are warranted to determine the longer-term effects and possible actions of anatabine on the course of Hashimoto's thyroiditis. (J Clin Endocrinol Metab 99: E137-E142, 2014). © Copyright 2014 by The Endocrine Society. Source

Horowitz B.S.,Metabolic Research Institute Inc. | Horowitz M.E.,Metabolic Research Institute Inc. | Fonseca S.,Metabolic Research Institute Inc. | Ruiz M.,Metabolic Research Institute Inc. | Kaye W.A.,Metabolic Research Institute Inc.
Endocrine Practice | Year: 2011

Objective: To determine whether teriparatide increases lumbar spine bone mineral density (BMD) in patients who have undergone parathyroidectomy for primary hyperparathyroidism (PHPT) and are at continued risk for fracture. Methods: This open-label, nonrandomized, uncontrolled exploratory design study included patients who had undergone parathyroidectomy for PHPT and were judged to be at continued risk for fracture according to National Osteoporosis Foundation criteria. Patients were administered teriparatide subcutaneously, 20 mcg daily, for 18 months after they satisfactorily completed the screening period to ensure their eligibility for study participation. BMD was assessed by dual-energy x-ray absorptiometry at baseline, 6 months, 12 months, and 18 months. Secondary objectives included efficacy of teriparatide on increasing hip BMD, incidence of fractures, and safety measurements. Results: Seven women and 3 men were included. Change in mean lumbar spine BMD was 0.059 gm/cm 2, which is a 7.1% increase (P = .005). Change in mean femoral neck BMD was 0.019 gm/cm2, which is a nonsignificant increase of 3.3% (P = .49). There was no incidence of fractures. There were no significant changes in the safety measurements. Conclusions: The use of teriparatide in patients with PHPT who have undergone parathyroidectomy and are still at risk for fracture is effective in improving lumbar spine BMD without deleterious effects on safety. Teriparatide should therefore be considered as a viable alternative for the treatment of these patients, as it may help in the prevention of fractures and their complications. © 2011 AACE. Source

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