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Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto's) thyroiditis: a randomized controlled clinical trial.

Author(s): Schmeltz LR(1), Blevins TC, Aronoff SL, Ozer K, Leffert JD, Goldberg MA, Horowitz BS, Bertenshaw RH, Troya P, Cohen AE, Lanier RK, Wright C 4th.

Affiliation(s): Author information: (1)Associated Endocrinologists, PC (L.R.S.), West Bloomfield, Michigan 48322; Texas Diabetes and Endocrinology (T.C.B.), Austin, Texas 78731; Endocrine Associates of Dallas (S.L.A.), Dallas, Texas 75231; Texas Diabetes and Endocrinology (K.O.), Round Rock, Texas 78681; North Texas Endocrine Center (J.D.L.), Dallas, Texas 75231; New Jersey Physicians, LLC (M.A.G.), Clifton, New Jersey 07012; Metabolic Research Institute, Inc (B.S.H.), West Palm Beach, Florida 33401; Diabetes and Endocrine Associates (R.H.B.), La Grange, Illinois 60525; Bay Area Endocrinology Associates, LLC (P.T.), Tampa, Florida 33614; and Rock Creek Pharmaceuticals, Inc (A.E.C., R.K.L., C.W.), Gloucester, Massachusetts 01930.

Publication date & source: 2014, J Clin Endocrinol Metab. , 99(1):E137-42

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 vitamins A and D3, 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.

Page last updated: 2014-11-30

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