Effects of Low-Level Laser Therapy on Oxidative Stress Levels...
Effects of Low-Level Laser Therapy on Oxidative Stress Levels...
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-dose laser therapy
 (DDLT) 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 DDLT 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 DDLT 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 DDLT on thyroid
 autoimmunity, oxidative stress, fatigue and quality of life in patients with Hashimoto's
 diagnosis.
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-dose laser therapy (DDLT) can improve thyroid function
 and reduce levels of thyroid peroxidase antibodies (TPOAb) in patients with hypothyroidism
 caused by chronic autoimmune thyroiditis. DDLT 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 DDLT 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 DDLT 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 DDLT 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 DDLT on thyroid autoimmunity, oxidative stress, fatigue and quality
 of life in patients with Hashimoto's diagnosis.
Inclusion Criteria:

 Cases between the ages of 18-65 who applied to the Kosuyolu Istanbul Medipol Hospital
 Endocrinology and Metabolic Diseases Clinic between 2020-2021 and diagnosed as "Hashimoto
 Thyroiditis" by a specialist physician will be included in the study.

 Exclusion Criteria:

 -  Acute infection

 -  Use of immunosuppressants, immunostimulants and drugs that interfere with the
 production, transport, and metabolism of thyroid hormones

 -  Thyroid nodules

 -  Tracheal stenosis

 -  Serious illness

 -  History of exposure to ionizing radiation and/or neoplasia in the cervical region

 -  Malignancy and a history of thyroid surgery

 -  Hypothyrodism caused by postpartum thyroiditis

 -  Pregnancy and breastfeeding period

 -  Identification and diagnosis of the cases with neurological and psychiatric disorders.