Effect of calorie restriction on thyroid antibodies and symptoms in Hashimoto’s thyroiditis patients: a randomized controlled trial

Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody (TPO-Ab) and/or thyroglobulin antibody (TG-Ab). The antibody titers are positively correlated with multiple symptoms despite adequate hormone substitution. However, no specific treatment exists to reduce the levels of antibodies. We carried out a randomized controlled trial to determine the effect of calorie-restricted (CR) diet on Hashimoto disease. Results showed that serum TPO-Ab (-191.46 KU/L, 95% CI: -278.35 to -104.58) and TG-Ab (-49.30 KU/L, 95% CI: -99.12 to 0.53) in the CR group were sharply reduced, accompanied by an improvement in thyroid gland shown by magnetic resonance imaging. The CR group exhibited significant alleviation of non-hypothyroid symptoms, with this improvement positively correlating with the reduction of thyroid antibodies. Moreover, CR also improved immune dysfunction, as well as decreased levels of pro-inflammatory biomarkers and serum lipids. These findings provide evidence that calorie restriction may serve as a potential adjuvant treatment strategy for patients with HT.