A study conducted by researchers at the Chung-Ang University College of Medicine in Seoul, Korea have investigated the correlation between TSI antibodies, 25 OH vitamin D levels and remission/relapse in 143 Graves' disease patients treated with anti-thyroid drugs (ATDs).

In this study, 95 patients (66.4 percent) experienced a recurrence of Graves' disease with a median latency period of 182 days (ranging 28-1219) days. The 25 OH level of the these patients was not correlated with thyroid stimulating immunoglobulins (TSI) or total TSH receptor antibodies. In the Cox proportional hazard regression analysis, higher FT4 levels and low 25 OH vitamin D levels were associated with a higher probability of Graves' disease recurrence.

Levels of 25 OH vitamin D were studied because of the high incidence of vitamin D deficiency in individuals with autoimmune diseases, particularly autoimmune thyroid diseases. The low levels of vitamin D in thyroid patients negatively correlated with thyroid volume. Vitamin D levels did not correlate with levels of TSI or total TSH receptor antibodies.

Previous studies have shown that Graves' patients on anti-thyroid drugs who also used vitamin D3 supplements achieved a return to normal FT4 and FT3 levels than patients using ATDs alone. Additional studies have also shown that relapse is more likely in patients who smoked, had higher levels of TSH receptor antibodies, or large goiters.

 Resource:

Ahn H, Chung YJ, and BY Cho. 2017. "Serum 25-hydroxyvitamin D might be an independent prognostic factor for Graves disease recurrence." Medicine Aug; 96(31).

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