Photobiomodulation, Autoimmune Thyroiditis, Infertility, & Menstrual Function.

Vladimir Heiskanen recently sent me some more research into photobiomodulation related to thyroid function. What follows is a translation of the text of one of those studies. It shows improvements in a number of reproductive and hormonal problems in women. The paper does not describe the methods used but refers to a book which does. That book is over 500 pages and the page reference is not given. I wasn’t able to find the book online to look at the methods so there’s a not a lot for me to comment on.
That book is listed here:Gynecological Endocrinology

There are tables and references in the study which I have not translated here.

LASER THERAPY IN THE TREATMENT OF INFERTILITY AND MENSTRUAL FUNCTION AGAINST THE BACKGROUND OF AUTOIMMUNE THYROIDITIS
L.Yu. TITOVA, V.G. ARISTARHOV, R.V. ARISTARKHOV, D.A. PUSIN

Currently, there is no information on the effect of thyroid gland laser therapy in autoimmune thyroiditis on such disorders as ovarian menstrual dysfunction, habitual miscarriage and infertility in women of reproductive age. In order to determine the effect of infrared laser therapy on the course of autoimmune thyroiditis, thyroid function and reproductive activity in women of childbearing age, 180 patients aged 20–35 years were examined, of whom 47 were infertile, 45 had habitual spontaneous miscarriages and 86 were different types of menstrual dysfunction. Depending on the level of functional activity of the thyroid gland, the results were analyzed in three groups of observations: I – euthyroidism, II – subclinical hypothyroidism, III – manifest hypothyroidism. As a result of the treatment, a significant decrease in the level of antibodies to thyroid-peroxidase was found in all groups. It was also stated that the levels of thyroid-stimulating hormone decrease and the increase in thyroxin to normal values in groups I and II and subnormal levels in group III. Normalization of the menstrual cycle in the presence of initial menstrual dysfunction during the 2-month follow-up period was recorded in 75% of patients. Of the women suffering from infertility, within 3 years of observation, pregnant women got pregnant with a healthy delivery to healthy children, 44.2%. Based on the obtained results, we stated the high efficiency of using infrared laser therapy of the thyroid gland in women of reproductive age suffering from autoimmune thyroiditis with impaired thyroid gland function, combined with menstrual dysfunction, habitual miscarriages and infertility.

It is known that a physiologically adequate level of thyroid hormones provides a sufficient concentration of estrogen and progesterone, which, in turn, are necessary for the implementation of the ovulatory cycle, thus creating the necessary prerequisites for fertilization and normal pregnancy with safe delivery [1] .
Disorders of the menstrual cycle and infertility in women of reproductive age are often associated with the pathology of the hypopharyngeal ovarian system and impaired thyroid function (thyroid gland), especially with hypothyroidism [2]. The most common cause of hypothyroidism in women of reproductive age is autoimmune thyroiditis (AIT), which is characterized by increasing lymphoplasma infiltration, destruction and subsequent sclerosis of the thyroid tissue [3-7]. In many women, thyroid dysfunction is often combined with menstrual disorders, infertility and increased morbidity during pregnancy. Isolated AIT also increases the likelihood of miscarriage, especially in the first trimester [8–11]. In recent times, there have been many reports on the use of laser therapy in the treatment of AIT [12-14]. It is assumed that laser therapy can stop the development of AIT or achieve its long-term (up to 1-1.5 years) regress, as well as can prevent the progression of hypothyroidism. However, to date, laser therapy has not been included in the algorithms and industry standards for the treatment of patients with AIT. This is due to the lack of clear criteria for its appointment and insufficient justification of effectiveness. In addition, it seems particularly relevant, there is no information about the effect of laser therapy of ШЖ (pulsed?) during AIT on such disorders as ovarian-menstrual dysfunction, habitual miscarriage and infertility in women of reproductive age.

Purpose of the study
Study of the degree of effectiveness of the effect of infrared laser therapy on the course of AIT, thyroid hormonal background, as well as on ovula second and reproductive activity in women of childbearing age.

Materials and methods

180 women of reproductive age (20-35 years) with AIT in combination with various levels of decreased thyroid function, problems in the reproductive sphere and menstrual dysfunction were examined. Of the total number of patients examined, 47 (26.1%) showed infertility, 45 (25.0%) had habitual miscarriages and 86 (47.8%) had menstrual dysfunction.

The study was conducted in three groups, numbering 60 people each, in which it was stated: I – euthyroidism; II – subclinical hypothyroidism; III – manifest (clinical) hypothyroidism. The average age of patients was 31.0 ± 0.9, 28.7 ± 0.7, and 28.5 ± 0.7 years, respectively. In all 3 groups, an increase in the titer of serum antibodies to TPO was observed. Intergroup differences in the frequency distributions of the above reproductive disorders and menstrual function did not have statistical significance.

Patients of all three groups received thyroid laser therapy according to the method of V.G. Aristarkhov [2], supplemented in group III by hormone replacement therapy with L-thyroxine. In each group, before the start of treatment and at the end of it, the following levels were determined: thyroid-stimulating hormone (TSH), free thyroxine (CT4), and antibodies (AT) to thyroid peroxidase (TPO). At the end of therapy, patients were observed for 3 years. If necessary, in some cases, the treatment was repeated. Data acquisition was analyzed using the Statistica 10.0 computer program.

Results and its discussion

The results obtained are presented in Table 1. As follows from the data prior to treatment, patients of group I were characterized by levels of TSH and CT4 within the physiological norm. In group II, an increased level of TSH was observed at normal values ​​of fT4, and in the third group – an increased level of TSH in combination with a decrease in the concentration of fT4 below the physiological norm. The level of AT to TPO in all 3 observation groups was sharply increased – within 640.5-690.2 IU / l.

At the end of the course of treatment, all groups showed a significant decrease in the level of TSH: in the group –1.5, inII–2.4, and avIII –1.8 times. At this, the end values ​​of the titer of TSH, not going beyond the physiological limits of the I group, reaching them in II and somewhat exceeded the upper threshold of the norm in group III.

At the same time, there was an increase in the level of pT4: in the group –1.2, in II and III – 1.4 times The level of сТ4 in group III (7.9 pM / l) did not reach the lower limit of the physiological norm (9.0 pM / l).
Against the background of the marked changes in the hormonal background, the values ​​of the AT titer to TPO in all 3 groups underwent more significant changes. Thus, in group I, a decrease of this indicator by 2.7 times was stated, in the second group – by 2.0, and in the viIII –v1.9.

Noteworthy is the marked change in the intergroup ratios of the coefficients of variation coefficient (CV%) of the corresponding average parameters. Thus, for average values ​​of the titer of TSH, before the treatment, the indicators of CV were found: 62.0% in the group, 31.3% in IIII and 33.7% in III. A similar tendency of CV decrease at its large values ​​was fixed at the end of treatment: Group I – 80.8%, II – 67.8% and III – 59.8%.
Similar trends in changes in CV indices were also found when determining the AT titer to TOP. So, if prior to treatment, the corresponding values ​​were: 100.0% in Group I, 47.2% in II, and 10.2% in III, then at the end of the course of treatment they are fixed at: 100.0 % in the group, 66.8% –BIIi and 13.1% –bIII.

TABLE

Opposite intergroup (but not temporary) tendencies of CV changes in averages are stated relative to the values ​​of titer fT4. So, if prior to treatment, CV for middle parameters of сТ4 was: 9.5% for group I, 15.5% for II and 78.9% for III, then at the end of the course of treatment, the corresponding indicators were recorded at the levels: 12.8% for group I, 17.3% for II and 39.2% for III.
The CV indicators, characterizing the variability of average values, on the other hand, reflect the degree of their stability, i.e. the possible range of intensity of functioning of those structures (systems) whose activity is studied. Based on the above data, it can be assumed that the use of laser therapy in cases of AIT, in the first place, inhibits the course of autoimmune reactions in the thyroid gland. The greatest therapeutic effect is observed with AIT in combination with euthyroidism, the smallest, but rather significant, with the simultaneous presence of manifest hypothyroidism [15]. It is also significant that after a course of laser therapy, a sharp decrease in AT titer to TPO is accompanied by a definite tendency to decrease the stability of the corresponding indices, especially pronounced in cases of subclinical hypothyroidism. The absence of corresponding changes in CV after treatment in the group with euthyroid.

In our opinion, rheosum indirectly indicates the relative insignificance of structural and functional changes in the thyroid gland caused by AIT in this group [16].
The undoubted direct and positive effect of the course of laser therapy on the function of the thyroid gland is evidenced by the results obtained in groups I and II of observation, where L-thyroxine replacement hormone therapy was not used. Here, a significant decrease in the average level of TSH and an increase in titer of CT4 was accompanied by a significant increase in the CV values ​​of these indicators, which indicates a decrease in their stability and, therefore, an increase in the possible range of individual physiological thyroid reactions [17 ]. A similar therapeutic effect was also observed with respect to the average titer of TSH in group III, although the increase in the average level of fT4 with a parallel increase in the degree of its stability seems to be largely due to substitution hormone therapy, although, taking into account in other groups of observation, it seems undoubtedly that laser therapy had no less effect here.
After a course of laser therapy (in combination with hormone replacement therapy in group III), all patients showed a significant improvement in leu thyroid hormonal background and a decrease in AT titer to TPO [18]. At the same time, on the 2nd month after treatment, an improvement in the general condition was noted in all patients, and signs of normalization of the menstrual cycle – in 75%. Among the women who have suffered from infertility and planned to give birth to a child (86), within 3 years of observation, they became pregnant with a healthy birth permit healthy children 38 (44.2%).