Silent thyroiditis

Before It's News | Popular Health

Silent thyroiditis

Home of Kyle J. Norton for The Better of Living & Living Health
Silent thyroiditis is the inflammation of the thyroid gland. Patients with silent thyroiditis are experience  back and forth between hypothyroidism and hyperthyroidism. The disease classically present with a triphasic course: a brief period of thyrotoxicosis due to release of preformed thyroid hormone that lasts for 1 to 3 months, followed by a more prolonged hypothyroid phase lasting up to 6 months, and eventual return to a euthyroid state. However, the types and degree of thyroid dysfunction are variable in these disorders, and individual patients may present with mild or more severe cases of thyrotoxicosis alone, hypothyroidism alone, or both types of thyroid dysfunction(a).

A. Symptoms  
Symptoms  are associated to the stage of the diseases and may include
1. Chronic fatigue
chronic fatigue are assciated to the presence of  chronic lymphocytic thyroiditis. Bo Wikland and colleagues (March 24, p 956)1 report relief of symptoms when patients with chronic fatigue and chronic lymphocytic thyroiditis (on fine-needle biopsy) were treated with thyroxine(1).

2. Heat intolerance
Patient with silent thyroiditis may be experience the symptoms of heat intolerance, according to the Gifu Red Cross Hospital, Japan(2).

3. Hypertension
Hyperthyroidism is associated with unpleasant symptoms and hypertension due to increased adrenergic tone, according to the study by the Harran University Faculty of Medicine(3).

4. Tachycardia, fatigue, and weight loss, hyperactive reflexes, increased sweating, heat intolerance, tremor, nervousness, polydipsia, and increased appetite, anorexia,  atrial fibrillation and goiter
Depending to the age of the patients with Thyroid adenoma with the presence of hyperthyroidism may be experience certain above symptoms, according to the study by the Centre Hospitalier et Universitaire de Rouen, in the study to determine if aging modifies the clinical presentation of hyperthyroidism and the signs of thyrotoxicosis in older people(4).
 
5. Weight gain and fatigue
In a prospective observational research design where 198 consecutive breast cancer patients receiving adjuvant chemotherapy were monitored from start to end and 6 months post-therapy on changes in anthropometics, fatigue, nutritional intake, physical activity, thyroid and steroid hormones, found that a weight gain over >5 lb in 22.2% of this patient population with a significant and progressive gain of 6.7 lb (P < 0.0001) at 6 months. Ninety four percent of all patients reported fatigue and 56% of patients reported lowered physical activity. A significant reduction in serum free and total estradiol (P < 0.0001) was observed indicative of reduction in ovarian function with 86% amenorrehic at the end of treatment. A significant reduction in mean serum triiodothyronine uptake levels (P < 0.05), in addition to a significant increase in TBG (P < 0.0001) from baseline to end of chemotherapy, was observed. In addition 20-25% of this patient group was already diagnosed with clinical hypothyroidism at diagnosis and treated. Changes in fatigue frequency and serum sex-hormone-binding globulin (SHBG) were variables significantly predictive of weight gain (P < 0.0001)(5).

6. Vitiligo and alopecia areata
There is a report of the parents of an 18-year-old woman had noticed white hair while combing their daughter's hair 12 years ago. They found tiny white spots on her scalp, but she was asymptomatic. The spots have since progressed. Examination of the affected skin on the scalp was marked by the presence of a chalky/ivory white macule, 8 to 10 cm in diameter, conforming to that of segmental (zosteriformis) vitiligo (Figure 1). The lesions were located on the temporoparietal region of the scalp. The hair over the macules was white (leukotrichia) and dry, coarse, and brittle. The patient's nails were thin and dull. Her thyroid profile revealed the following: triiodothyronine, 1.12 nmol/L (0.95-2.5 nmol/L); thyroxine, 69.21 nmol/L (60.0-120.0 nmol/L); and thyroid-stimulating hormone, 6.26 microIU/mL (0.25-5.00 microIU/mL), indicative of primary hypothyroidism(6).

7. Chronic constipation
Geriatric patient educational material and a general practice review suggest insufficient dietary fiber intake, inadequate fluid intake, decrease physical activity, side effects of drugs, hypothyroidism, sex hormones and colorectal cancer obstruction may play a role in the pathogenesis of constipation, according to the study by the University of California at Los Angele(7).

8. Urticaria and puffiness of hands and feet, yellow ivory skin, coarse rough dry skin, alopecia periorbital edema, amenorrhe, dysparunia, PCO, PMS and Breast tenderness, menstrual irregularities and infertility
In the study to  study is to highlight the presenting dermatologic and gynecologic manifestations of firstly-diagnosed hypothyroid females, showed that Compared to euthyroid cases, hypothyroid ones were presenting mostly with amenorrhea (OR=7.76). Other gynecologic manifestations that were prominent in hypothyroid cases were dysparunia, PCO, PMS and Breast tenderness. On the other hand, rate of menstrual irregularities and infertility were non-significantly different in both groups.hypothyroid women showed also significantly higher frequency of urticaria and puffiness of hands and feet (both were present in 16.7% in hypothyroid vs. 3.3% of euthyroid cases, p =0.007, OR=5.8). Hypothyroid cases showed also significantly higher frequency of yellow ivory skin (OR=5.4) and coarse rough dry skin (OR=3.8). On the other hand, alopecia and periorbital edema were observed only among cases of hypothyroidsm and none of euthyroid cases(8).

9. Depression
In the study to investigate the depression-like behavior performances of subclinical hypothyroidism (SCH) rat. SCH rat model induced by hemi-thyroid electrocauterization, and the behavior performances were measured by sucrose preference test, force swimming test (FST), and tail suspension test (TST). SCH rat model was established successfully by hemi-thyroid electrocauterization, found that SCH could result in depression-like behavior, accompanied with subtle hyperactivity of HPA axis. The reduced hippocampal T3 prior to the reduction of thyroid hormone in serum might be taken as an early sign of hippocampus impairment in the progression from SCH to CH(9).

10. Mood, declarative memory, motor learning and working memory
In a double-blinded, randomized, cross-over study of usual dose l-T(4) (euthyroid arm) vs. higher dose l-T(4) (subclinical thyrotoxicosis arm) in hypothyroid subjects, showed that The Profile of Mood States (POMS) confusion, depression, and tension subscales were improved during the subclinical thyrotoxicosis arm. Motor learning was better during the subclinical thyrotoxicosis arm, whereas declarative and working memory measures did not change. This improvement was related to changes in the SF-36 physical component summary and POMS tension subscales and free T(3) levels(10).

B. Causes and Risk factors
 Although the cause of silent thyroiditis is known. The autoimmune thyroiditis processus progressively and slowly tends to the necrosis/apoptosis of thyroid cells and their functional impairment. Other forms of autoimmune thyroiditis, postpartum thyroiditis and silent thyroiditis(11).  There is a suggestion that silent thyroiditis is an autoimmune disease characterized by lymphocytic infiltration of the thyroid and by transient hyperthyroidism, followed occasionally by transient hypothyroidism and eventual recovery(12).
Other indicated that clinically important autoimmune thyroid disease might thus be present both in individuals with normal and with raised thyrotropin concentrations. Rises in thyrotropin concentration might also occur for several reasons other than autoimmune thyroiditis(13).

 B.2. Risk factors
1. Gentic and environment factors
Genetic and/or environmental factors are important in the development of this familial type of silent thyroiditis, according to the study by the Gifu Red Cross Hospital(14). Other study indicated that antecedent infection or exposure to antigen may cause the development of silent thyroiditis(15). 

2. Adrenalectomy 
There is a report of a case of silent thyroiditis after unilateral adrenalectomy for treatment of Cushing's syndrome as the left adrenocortical adenoma was resected, according to the Gifu University School of Medicine(16).

3. Lithium therapy
While hypothyroidism secondary to treatments by lithium are well known, cases of hyperthyroidism are less common. A 48 years old patient under lithium carbonate from about 10 years ago presents hyperthyroidism without any auto-immunity biological markers, associated with a very low thyroid tracer uptake on scintigraphy(17).

 4. Alpha-interferon therapy
There is a report of a a 30-year-old woman with chronic active hepatitis C develops silent thyroiditis developed during alpha-interferon therapy(18). Other study report the development of a episode of silent thyroiditis in a patient with chronic thyroiditis and papillary adenocarcinoma following alpha interferon treatment for hepatitis C(19).

5. Thyroid-stimulation-blocking antibodies (TSBAb)
There is a report of a 24-year-old man showed thyrotoxic symptoms with hypokalemic periodic paralysis. Serum thyroid hormone levels were high and thyrotropin (TSH) was undetectable. 123I-thyroidal uptake was suppressed. TSH-binding inhibitor immunoglobulin (TBII) was positive(20).


6. Infections
Viral infection such as rubella could cause the development of silent thyroiditis. There is a report of A 40-year-old housewife was referred to our hospital for evaluation of a thyrotoxic state. A month after rubella infection, she developed heat intolerance(21).

 7. Gender
If you are women, you are associated to increased risk of silent thyroiditis

8. Low level of selenium
Se levels were significantly decreased in cases of sub-acute and silent thyroiditis. according to WOMED(22).

9. Postpartum period
Silent or painless thyroiditis is a frequent cause of transient hyperthyroidism, which is characterized by recent onset of symptoms in a patient with a normal to modestly enlarged and firm thyroid gland. No pathogenetic factors are known, but the disease may conceivably have an autoimmune basis, particularly in the postpartum patient(22a).

10. Autoimmune type 1 diabetes mellitus
Patients with autoimmune type 1 diabetes mellitus have often, besides immune diabetes markers, also other organ-specific antibodies, particularly thyroid autoantibodies (antithyreoglobulin antibodies - ATG and/or thyroid peroxidase antibodies - TPO)(22b).

11. Thyroid peroxidase autoantibodies 
Thyroid peroxidase (TPO) is a key enzyme in the formation of thyroid hormones and a major autoantigen in autoimmune thyroid diseases. Titers of TPO antibodies also correlate with the degree of lymphocytic infiltration in euthyroid subjects, and they are frequently present in euthyroid subjects (prevalence 12-26%)(22c).

C. Complications and Diseases associated to Silent thyroiditis
C.1. Complications
1. Sudden unexpected death
In a forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death, showed that the most striking result was the finding of extensive lymphocytic infiltration of the thyroid parenchyma in five of the 124 cases, of which four belonged in the group of 'unknown cause of death'. This discovery leads to reflections regarding lymphocytic thyroiditis as a cause of death, either by itself or in combination with other disorders. Silent (painless) thyroiditis, especially, is easily overlooked at autopsy as there are no macroscopic changes and often no prior symptoms or history of thyroid disease pointing towards this condition(23).

2. Oncocytic follicular nodules
Oncocytic follicular (OF) cells can be a prominent component of fine needle aspiration (FNA) specimens from neoplasms (adenomas and carcinomas) and nodules arising in multinodular goiter and chronic lymphocytic thyroiditis (CLT)(24).

3. Recurrent Silent thyroiditis (ST)
Silent thyroiditis (ST) recurred with a high incidence (65%, 35/54), according to the study by the Department of Endocrinology and Metabolism, Toranomon Hospital(25).

4. Hashimoto's thyroiditis
In the study of twenty-six specimens obtained from 23 patients with clinically and laboratory-proven silent thyroiditis were examined histologically; 11 specimens were obtained during the thyrotoxic phase, and 15 specimens during the early or late recovery phase. All specimens showed chronic thyroiditis, focal or diffuse type; and lymphoid follicles were present in about half of the specimens(26).

5. Thyrotoxicosis
There is a report of a 3 patients (2 male, 1 female) presented with symptoms of thyrotoxicosis associated with elevated blood-levels of thyroid hormone and a markedly depressed thyroidal uptake of 131-I. The male patients (aged 59 and 47) each had a cardiac arrhythmia, but did not have any thyroid pain or swelling. The female with a goitre had no discomfort in the neck. Thyrotoxicosis factitia was excluded by history. The subsequent course of their disease was typical of subacute thyroiditis(27).

6. Left ventricular rupture
There is a report of a case of left ventricular rupture and formation of a pseudoaneurysm after silent myocardial infarction in a patient with Schmidt syndrome (polyglandular deficiency syndrome including Addison's disease, lymphocytic thyroiditis and diabetes mellitus)(28).  

C.2. Diseases associated to Silent thyroiditis
1. Rheumatoid arthritis
There is a report of a 41-year-old female with rheumatoid arthritis had nontender enlarged thyroid gland. Thyroid function tests revealed increased concentrations of serum free T3 (FT3, 10.8 pmol/L) and free T4 (FT4, 31.1 pmol/L) with suppressed concentration of thyrotropin (TSH, lower than 0.1 mU/L) and low 24-hour thyroidal radioactive iodine uptake (1.6%). Serum thyrotropin receptor antibody (TRAb) was negative (0%) and she had positive anti-thyroglobulin and anti-microsomal antibodies(29).

2. Graves' disease
There is a report of a patient who developed silent thyroiditis during the course of Graves' disease, according to the study by the Fourth Department of Internal Medicine, Saitama Medical School(30).
Other study indicated that Silent thyroiditis (ST) and Graves' disease (GD) are two clinical entities belonging to the wide spectrum of autoimmune thyroid diseases (AITD). The two diseases are closely linked because sequential development of GD followed by ST, or the reverse course of events(31).

3. Progressive systemic sclerosis (PSS)
There is a report of a patient with progressive systemic sclerosis (PSS) who had increased serum T3 (235 ng/dl) and T4 (13.2 micrograms/dl) and low 24-h thyroidal 123I-uptake (1.2%). A diagnosis of silent thyroiditis was made on the basis of the clinical course and laboratory and histopathologic findings(32).

4. Idiopathic thrombocytopenic purpura (I.T.P.)
There is a report of a 51-year-old woman had symptoms of thyrotoxicosis which disappeared spontaneously within two months. She was diagnosed as a case of silent thyroiditis on the basis of both the clinical course and the laboratory data such as low uptake of radioactive iodine and technesium. She also had petechiae in her arms which were diagnosed as an idiopathic thrombocytopenic purpura (I.T.P.)(33).

5. Thymoma
Thymoma often accompanies an autoimmune disease as a paraneoplastic syndrome, and an immunological mechanism is thought to be involved in the onset of silent thyroiditis(34).

6. Chronic adrenocortical insufficiency
There is report of a case of a 23-year-old woman had silent thyrotoxic thyroiditis and chronic adrenocortical insufficiency (Addison's disease)(35).

D. Misdiagnosis and diagnosis
D.1. Misdiagnosis
There is a report of silent thyroiditis misdiagoesd as Malignant lymphoma of the thyroid.
It was difficult to make differential diagnosis of this case from malignant lymphoma of the thyroid clinically and cytologically when immune rebound phenomena with invasion of lymphocyte and appearance of lymph follicle were the strongest.  There is a report of a case of a 30-year-old female with postpartum silent thyroiditis misapprehended as malignant lymphoma of the thyroid(36).

D.2. Diagnosis
After recording the past and present history and completing a physical exam, including assessing symptoms and complaints commonly seen including enlarged thyroid gland, heart rate, shaking hand etc. The tests which your doctor orders may include
1.  Radioactive iodine uptake test, or RAIU test
In the study to investigate the effects of iodine restriction on the RAIU value, and the necessity of iodine restriction in differentiating between Graves' disease (GD) and silent thyroiditis (ST) of 415 patients, 277 of whom were patients with GD who had undergone iodine restriction before RAIU [GD(+)], 66 were patients with GD who did not undergo iodine restriction [GD(-)], 61 were patients with ST who had undergone iodine restriction [ST(+)], and the remaining 11 were patients with ST who did not undergo iodine restriction [ST(-)], indicated that high diagnostic value of the RAIU test was confirmed, but not affected by the presence of iodine restriction in the differentiation between GD and ST, therefore, iodine restriction before the RAIU test was unnecessary(37).

2. Blood test for blood levels of the thyroid hormones T3 and T4
The aim of the test is to the level of free T4 and thyroid stimulating hormone (TSH) levels. Circulating analytes used in the exploration of thyroid function are TSH and free thyroid hormones (FT4 and FT3). TSH is used as first line analysis in diagnosis because a normal value excludes almost always a thyroid dysfunction(38).

3. Thyroid scintigraphy
Thyroid scintigraphy with 99mTc allows establishing the functional characteristics of thyroid nodules (warm or cold) and to precise the origin of a thyrotoxicosis (autonomous toxic nodule vs Graves-Basedow, sub acute or silent thyroiditis(39).

4. Thyroid biopsy
In the study of usefulness of thyroid needle biopsy in the differential diagnosis of thyroid disorders revealing unusual thyroid function, in 601 cases of chronic thyroiditis. indicated that group A, the majority of the cases showed a latent or overt hypothyroidism and in histologic group B, hyperthyroid, euthyroid and latent hypothyroid cases were found in nearly equal frequency, respectively. In histologic group C, most cases were in euthyroid and in histologic group D, most cases showed a hyperthyroidism. In the silent thyroiditis and postpartum thyroiditis, known to show a characteristic clinical and laboratory finding, the histologic features of thyroid gland were as follows: the observed characteristic histologic changes in both diseases were an extensive follicular destruction associated with chronic diffuse thyroiditis(40).

E. Prevention
E.1. Diet to prevent silent thyroiditis
1. Broccoli
Sulforaphane (SFN), a natural constituent of cruciferous vegetables such as broccoli, Brussels sprouts, etc.. In the study to investigate the role of prosurvival, cell death and inflammatory signaling pathways using a rodent model of CIS-induced nephropathy, and explored the effects of SFN on these processes, found that Cisplatin triggered marked activation of stress signaling pathways [p53, Jun N-terminal kinase (JNK), and p38-α mitogen-activated protein kinase (MAPK)] and promoted cell death in the kidneys (increased DNA fragmentation, caspases-3/7 activity, terminal deoxynucleotidyl transferase-mediated uridine triphosphate nick-end labeling), associated with attenuation of various prosurvival signaling pathways [e.g., extracellular signal-regulated kinase (ERK) and p38-β MAPK]. Cisplatin also markedly enhanced inflammation in the kidneys [promoted NF-κB activation, increased expression of adhesion molecules ICAM and VCAM, enhanced tumor necrosis factor-α (TNF-α) levels and inflammatory cell infiltration]. These effects were significantly attenuated by pretreatment of rodents with SFN. Thus, the cisplatin-induced nephropathy is associated with activation of various cell death and proinflammatory pathways (p53, JNK, p38-α, TNF-α and NF-κB) and impairments of key prosurvival signaling mechanisms (ERK and p38-β)(41).

2. Tart cherry 
In the study of the effect of anthocyanin-rich tart cherries was tested in the Zucker fatty rat model of obesity and metabolic syndrome, found that tart cherry intake was associated with reduced hyperlipidemia, percentage fat mass, abdominal fat (retroperitoneal) weight, retroperitoneal interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) expression, and plasma IL-6 and TNF-alpha. Tart cherry diet also increased retroperitoneal fat PPAR-alpha and PPAR-gamma mRNA (P = .12), decreased IL-6 and TNF-alpha mRNA, and decreased nuclear factor kappaB activity(42).

3. Walnut 
Consumption of walnuts was associated with a statistically significant increase in serum apolipoprotein A concentrations (P = .03), but did not affect circulating levels of fetuin A, resistin, C-reactive protein, serum amyloid A, soluble intercellular adhesion molecules 1 and 3, soluble vascular cell adhesion protein 1, interleukins 6 and 8, tumor necrosis factor α, E-selectin, P-selectin, and thrombomodulin. Four days of walnut consumption (48 g/d) leads to mild increases in apolipoprotein A concentrations, changes that may precede and lead to the beneficial effects of walnuts on lipid profile in obese subjects with the metabolic syndrome(43).

4. Garlic
1,2-vinyldithiin from garlic inhibits differentiation and inflammation of human preadipocytes(44).


E.2. Phytochemicals and antioxidants to prevent silent thyroiditis
1. Resveratrol
  In a study of "Resveratrol, MicroRNAs, Inflammation, and Cancer." by Tili E, Michaille JJ. (Source from Department of Molecular Virology, Immunology, and Medical Genetics, Ohio State University, Biomedical Research Tower, 460 W 12th Avenue, Columbus, OH 43210, USA.), posted in PubMed, researchers mentioned in abstract that the above microRNAs are thought to link inflammation and cancer. Recently, resveratrol (trans-3,4',5-trihydroxystilbene), a natural polyphenol with antioxidant, anti-inflammatory, and anticancer properties, currently at the stage of preclinical studies for human cancer prevention, has been shown to induce the expression of miR-663, a tumor-suppressor and anti-inflammatory microRNA, while downregulating miR-155 and miR-21.

2. Pterostilbene
In the examination of the molecular mechanisms of the action of pterostilbene in colon cancer,
indicated that A combination of cytokines (tumor necrosis factor-alpha, IFN-gamma, and bacterial endotoxin lipopolysaccharide) induced inflammation-related genes such as inducible nitric oxide synthase and cyclooxygenase-2, which was significantly suppressed by treatment with pterostilbene. We further identified upstream signaling pathways contributing to the anti-inflammatory activity of pterostilbene by investigating multiple signaling pathways, including nuclear factor-kappaB, Janus-activated kinase-signal transducer and activator of transcription, extracellular signal-regulated kinase, p38, c-Jun NH(2)-terminal kinase, and phosphatidylinositol 3-kinase, according to "Anti-inflammatory action of pterostilbene is mediated through the p38 mitogen-activated protein kinase pathway in colon cancer cells" by Paul S, Rimando AM, Lee HJ, Ji Y, Reddy BS, Suh N.(45).

3. Phytofluene
In the investigation of the effects of CoQ10 and colorless carotenoids (phytoene and phytofluene, or to combinations of these antioxidants) on the production of inflammatory mediators in human dermal fibroblasts treated with UV radiation (UVR) and the possible synergistic effects of these two antioxidants, found that CoQ10 is able to suppress the UVR- or IL-1-induced inflammatory response in dermal fibroblasts. Furthermore, this compound can block the UVR induction of the matrix-eroding enzyme, MMP-1. Finally, the combination of carotenoids plus CoQ10 results in enhanced suppression of inflammation. The results suggest that the combination of carotenoids and CoQ10 in topical skin care products may provide enhanced protection from inflammation and premature aging caused by sun exposure, according to "Anti-inflammatory effects of CoQ10 and colorless carotenoids" by Fuller B, Smith D, Howerton A, Kern D.(46).

4. Piceatannol
In the investigation of the modulation of inflammation by resveratrol and its metabolites by determining the expression and release of chemokine, eotaxin-1, in cultured human pulmonary artery endothelial cells, found that piceatannol showed potency similar to resveratrol. We propose that control of eotaxin-1 expression and release by proinflammatory cytokines in HPAEC may be considered as an in vitro model for screening and discovering polyphenols with anti-inflammatory activities and cardioprotective potentials, according to "Control of eotaxin-1 expression and release by resveratrol and its metabolites in culture human pulmonary artery endothelial cells" by Yang CJ, Lin CY, Hsieh TC, Olson SC, Wu JM.(47)

5.  Selenium 
Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 +/- 23.1 microg/l and 59.3 +/- 20.1 microg/l, respectively) as well as in follicular and papillary thyroid carcinoma(48). 

F. Treatments
F.1. In conventional medicine perspective
Treatment of the disease is to relive the symptoms, as it usually needs no treatment, and most of the patients show complete recovery and return of the thyroid gland to normal after 3 months. Study indicated that SAT and SAT-SRH are transient thyroid disease rarely leading to permanent thyroid disease, although some loss of thyroid reserve may occur. However, LT-SRH is a persistent progressive disease similar to or the same as chronic LT, in which goiter formation and thyroid failure are a natural course(49). Also, in some study showed that thyroid suppression with thyroid hormone may be ineffective in preventing this disease(50).

F.2. In traditional Chinese medicine perspective
The below TCM herbal medicine has been proven to be effective in treating inflammatory diseases
1. Deer antler 
Deer antler base (Cervus, Lu Jiao Pan) has been recorded in the Chinese medical classics Shen Nong Ben Cao Jing 2000 years ago and is believed to nourish the Yin, tonify the kidney, invigorate the spleen, strengthen bones and muscles, and promote blood flow. In China, deer antler base has been extensively used in traditional Chinese medicine (TCM) to treat a variety of diseases including mammary hyperplasia, mastitis, uterine fibroids, malignant sores and children's mumps. According to the study by the Dalian University of Technology, both in vitro and in vivo pharmacological studies have demonstrated that deer antler base possess immunomodulatory, anti-cancer, anti-fatigue, anti-osteoporosis, anti-inflammatory, analgesic, anti-bacterial, anti-viral, anti-stress, anti-oxidant, hypoglycemic, hematopoietic modulatory activities and the therapeutic effect on mammary hyperplasia(51).

2. Brown seaweed Sargassum
According to the study by the Southern Cross University, the therapeutic effects of Sargassum spp. are scientifically plausible and may be explained partially by key in vivo and in vitro pharmacological activities of Sargassum, such as anticancer, anti-inflammatory, antibacterial and antiviral activities(52).

3. Callicarpa L. (Verbenaceae)
According to the study by the Second Military Medical University, a variety of ethnomedical use of Callicarpa has been recorded in many ancient Chinese books. Phytochemical investigation of this genus has resulted in identification of more than 200 chemical constituents, among which diterpenes, triterpenoids and flavonoids are the predominant groups. The isolates and crude extract have exhibited a wide spectrum of in vitro and in vivo pharmacological effects involving anti-inflammatory, hemostatic, neuroprotective, anti-amnesic, antitubercular, antioxidant, antimicrobial and analgesic activities. Preparations containing Callicarpa species exerted good efficacy on clinical applications of gynecological inflammation, internal and external hemorrhage as well as acne vulgaris and chronic pharyngitis, etc(53).

F.3. In herbal medicine perspective
The below herbal medicine has been proven to be effective in treating inflammatory diseases
1. Myrrh
According to the study by the Shandong University, the resins of Commiphora species have emerged as a good source of the traditional medicines for the treatment of inflammation, arthritis, obesity, microbial infection, wound, pain, fractures, tumor and gastrointestinal diseases(54).

2. Desmodium gangeticum (L.) DC. and Desmodium adscendens (Sw.) DC.
According to the study by the, Desmodium gangeticum (L.) DC. and Desmodium adscendens (Sw.) DC. are two important and well explored species of genus Desmodium (Fabaceae (alt. Leguminosae) subfamily: Faboideae). Desmodium gangeticum is used as a tonic, febrifuge, digestive, anticatarrhal, antiemitic, in inflammatory conditions of chest and in various other inflammatory conditions in the Ayurvedic System of Medicine while Desmodium adscendens is widely used for the treatment of asthma in Ghana, Africa(55).

3. Senecio scandens
Senecio scandens is a medicinal plant with a climbing woody stem. Phytochemical studies have shown the presence of numerous valuable compounds, such as flavonoids, alkaloids, phenolic acids, terpenes, volatile oils, carotenoids, and trace elements. Among them, PAs are the characteristic constituents, adonifoline is one of the index ingredients of Senecio scandens. Studies in modern pharmacology have demonstrated that extracts and compounds isolated from Senecio scandens show a wide spectrum of pharmacological activities, including anti-inflammatory, antimicrobial, anti-leptospirosis, hepatoprotective, anti-infusorial, antioxidant, antiviral, antitumoral, analgesic, mutagenic, and toxicological activities(56).

Chinese Secrets to Fatty Liver and Obesity Reversal
Research based & Scientifically proven Efficacy To Treat Fatty Liver Diseases & Achieve Optimal Health & Loose Weight Recommended by Kyle J. Norton

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

For the world most healthy foods lists, visit http://healthy-foods-index.blogspot.com/2011/03/healthy-foods-list.html
For other health articles, please visit http://medicaladvisorjournals.blogspot.ca  
Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/22443972
(1) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2905358-2/fulltext
(2) http://www.ncbi.nlm.nih.gov/pubmed/2384053
(3) http://www.ncbi.nlm.nih.gov/pubmed/22571552
(4) http://www.ncbi.nlm.nih.gov/pubmed/8537590
(5) http://www.ncbi.nlm.nih.gov/pubmed/14997046
(6) http://www.ncbi.nlm.nih.gov/pubmed/21675503
(7) http://www.ncbi.nlm.nih.gov/pubmed/17219073
(8) http://www.ncbi.nlm.nih.gov/pubmed/21475555
(9) http://www.ncbi.nlm.nih.gov/pubmed/23794115
(10) http://www.ncbi.nlm.nih.gov/pubmed/18285414
(11) http://www.ncbi.nlm.nih.gov/pubmed/23164679.
(12)  http://www.ncbi.nlm.nih.gov/pubmed/7396620
(13) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2905358-2/fulltext#bib5 
(14) http://www.ncbi.nlm.nih.gov/pubmed/16284442.
(15) http://www.ncbi.nlm.nih.gov/pubmed/1752238
(16) http://www.ncbi.nlm.nih.gov/pubmed/8484389
(17) http://www.ncbi.nlm.nih.gov/pubmed/17166635
(18) http://www.ncbi.nlm.nih.gov/pubmed/8128980
(19) http://www.ncbi.nlm.nih.gov/pubmed/7920883
(20) http://www.ncbi.nlm.nih.gov/pubmed/1983199
(21) http://www.ncbi.nlm.nih.gov/pubmed/2384053
(22) http://www.ncbi.nlm.nih.gov/pubmed/18221503 
(22a) http://www.ncbi.nlm.nih.gov/pubmed/21278944
(22b) http://www.ncbi.nlm.nih.gov/pubmed/23599721
(23c) http://www.ncbi.nlm.nih.gov/pubmed/15826919
(23) http://www.ncbi.nlm.nih.gov/pubmed/17520957
(24) http://www.ncbi.nlm.nih.gov/pubmed/17520957
(25) http://www.ncbi.nlm.nih.gov/pubmed/10483248
(26) http://www.ncbi.nlm.nih.gov/pubmed/3284807
(27) http://www.ncbi.nlm.nih.gov/pubmed/46512
(28) http://www.ncbi.nlm.nih.gov/pubmed/7558468
(29) http://www.ncbi.nlm.nih.gov/pubmed/1506621
(30) http://www.ncbi.nlm.nih.gov/pubmed/1688049
(31) http://www.ncbi.nlm.nih.gov/pubmed/10595464
(32) http://www.ncbi.nlm.nih.gov/pubmed/1794333
(33) http://www.ncbi.nlm.nih.gov/pubmed/3250857
(34) http://www.ncbi.nlm.nih.gov/pubmed/9711887
(35) http://www.ncbi.nlm.nih.gov/pubmed/7396620
(36) http://www.ncbi.nlm.nih.gov/pubmed/8341248 
(37) http://www.ncbi.nlm.nih.gov/pubmed/15307943 
(38) http://www.ncbi.nlm.nih.gov/pubmed/23091928
(39) http://www.ncbi.nlm.nih.gov/pubmed/23091928
(40) http://www.ncbi.nlm.nih.gov/pubmed/1942566
(41) http://www.ncbi.nlm.nih.gov/pubmed/21684138
(42) http://www.ncbi.nlm.nih.gov/pubmed/19857054
(43) http://www.ncbi.nlm.nih.gov/pubmed/22075273
(44) http://www.ncbi.nlm.nih.gov/pubmed/19759245
(45) http://www.ncbi.nlm.nih.gov/pubmed/19549798
(46) http://www.ncbi.nlm.nih.gov/pubmed/17173569
(47) http://www.ncbi.nlm.nih.gov/pubmed/22254182
(48) http://www.ncbi.nlm.nih.gov/pubmed/?term=Selenium+and+silent+thyroiditis
(49) http://www.ncbi.nlm.nih.gov/pubmed/7283556
(50) http://www.ncbi.nlm.nih.gov/pubmed/6897348
(51) http://www.ncbi.nlm.nih.gov/pubmed/23246455
(52) http://www.ncbi.nlm.nih.gov/pubmed?term=inflammatory+thyroiditis+treatment+in+TCM&cmd=DetailsSearch
(53) http://www.ncbi.nlm.nih.gov/pubmed/23313870
(54) http://www.ncbi.nlm.nih.gov/pubmed/22626923
(55) http://www.ncbi.nlm.nih.gov/pubmed/21530632
(56) http://www.ncbi.nlm.nih.gov/pubmed/23747644
http://medicaladvisorjournals.blogspot.com

more info...