Effects of Low-Level Laser Therapy on Oxidative Stress Levels...
Condition: Hashimoto Thyroiditis; Autoimmune Thyroiditis; Thyroiditis; Thyroid Diseases; Autoimmune Diseases
MeSH terms: Thyroid Diseases; Thyroiditis; Hashimoto Disease; Thyroiditis, Autoimmune; Autoimmune Diseases
Study type: Interventional

Summary: 
      Hashimoto's thyroiditis (HT) is the most commonly observed inflammatory and autoimmune
      disease of the thyroid gland. Many genetic and environmental factors play a role in the
      pathogenesis of the disease, including iodine exposure, drugs, chemicals, toxins, infections
      and smoking. In recent years, the relationship between oxidative stress level and thyroid
      autoantibodies in HT has attracted increasing attention of researchers. In the studies, it
      has been reported that oxidative stress levels may increase due to chronic inflammation,
      insufficient thyroid hormone levels, excessive autoimmune response and excessive iodine
      intake. Data from clinical studies clearly show that the balance between oxidants and
      antioxidants shifts towards the oxidative side in patients with autoimmune thyroiditis,
      suggesting that oxidative stress may be a key event in the pathophysiology of the disease,
      independent of thyroid function. Recent evidence has suggested that low-level laser therapy
      (LLLT) can improve thyroid function and reduce levels of thyroid peroxidase antibodies
      (TPOAb) in patients with hypothyroidism caused by chronic autoimmune thyroiditis. In the
      literature, data examining the effects of LLLT on oxidative stress level and quality of life
      in patients with HT is limited. As far as we know, it will be the first study examining the
      effect of LLLT on oxidative stress, fatigue and quality of life in cases diagnosed with HT.
      The aim of the study is to examine the effects of LT4 treatment combined with LLLT on thyroid
      autoimmunity, oxidative stress, fatigue and quality of life in patients with Hashimoto's
      diagnosis.
    

Detailed description: 
      Hashimoto's thyroiditis (HT) is the most commonly observed inflammatory and autoimmune
      disease of the thyroid gland. HT is the main cause of spontaneous hypothyroidism in adults.
      Symptoms of hypothyroidism may develop within a few years in patients with initial
      euthyroidism. Many genetic and environmental factors play a role in the pathogenesis of the
      disease, including iodine exposure, drugs, chemicals, toxins, infections and smoking. In
      recent years, the relationship between oxidative stress level and thyroid autoantibodies in
      HT has attracted increasing attention of researchers. In the studies, it has been reported
      that oxidative stress levels may increase due to chronic inflammation, insufficient thyroid
      hormone levels, excessive autoimmune response and excessive iodine intake. OS occurs as a
      result of an imbalance between free radical production and antioxidant defense mechanisms.
      Data from clinical studies clearly show that the balance between oxidants and antioxidants
      shifts towards the oxidative side in patients with autoimmune thyroiditis, suggesting that
      oxidative stress may be a key event in the pathophysiology of the disease, independent of
      thyroid function. Gerenova et al. divided patients with a diagnosis of HT into three
      subgroups according to thyroid function (group 1-euthyroid, group 2-hypothyroid, and group
      3-Levothyroxin treated patients) and pointed out cellular antioxidative deficiency in all
      stages of the disease. Standard treatment in patients with HT is lifelong levothyroxine (LT4)
      treatment, which adjusts the dose to reach normal circulating thyrotropin (TSH) levels.
      Studies have found persistent fatigue, psychological and general well-being, and impairments
      in cognitive function in patients with HT despite LT4 replacement therapy. Gomez et al.
      compared 152 hypothyroid women treated with levothyroxine and 238 women without
      hypothyroidism disorder. Female patients with hypothyroidism, despite being euthyroid, showed
      worse quality of life than the control group. It was emphasized that the quality of life of
      women with hypothyroidism should be evaluated and further research should be conducted.
      Recent evidence has suggested that low-level laser therapy (LLLT) can improve thyroid
      function and reduce levels of thyroid peroxidase antibodies (TPOAb) in patients with
      hypothyroidism caused by chronic autoimmune thyroiditis. LLLT is a non-invasive, painless,
      low-risk and low-cost method that uses the interaction of light with molecular structures to
      support anti-inflammatory effects and regeneration of biological tissues. In the literature,
      data examining the effects of LLLT on oxidative stress level and quality of life in patients
      with HT is limited. As far as we know, it will be the first study examining the effect of
      LLLT on oxidative stress, fatigue and quality of life in cases diagnosed with HT. The planned
      research is trying to improve and expand the existing literature on LLLT in cases with HT and
      to contribute to the treatment protocol in order to reduce the negative consequences that may
      be experienced in this group of patients now and in the future. These statements show the
      originality of the study. Purpose: The aim of the study is to examine the effects of LT4
      treatment combined with LLLT on thyroid autoimmunity, oxidative stress, fatigue and quality
      of life in patients with Hashimoto's diagnosis.
    

Intervention name(s): Low-Level Laser Therapy
Intervention type(s): Other
Intervention description(s): Eight target points (superior, mediolateral, inferior border of the right and left thyroid lobes, right and left sides of the isthmus) will be marked with a surgical pen by determining the thyroid borders on the skin by thyroid ultrasonography by the specialist physician. Low-level laser (28.57 J / cm2) fixed applications will be made on the thyroid gland, approximately 1 cm from each other. In practice, the patient's neck will be maintained in the extension position. Each application will last 20 seconds and the radiant energy will be 2 J, the tip of the laser will be kept in contact with the skin and upright. Duration of treatment is 6 sessions 2 days a week. The cumulative dose will be 96 J.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Hashimoto Thyroiditis; Oxidative Stress; Low-Level Laser Therapy; Fatigue; Quality of Life; Autoimmune Thyroiditis; Depression; Sleep; Anxiety; Thyroid Hormones; Photobiomodulation Therapy