Prunella vulgaris: Efficacy in Treating Thyroiditis and Nodular Goiter – Meta-Analysis and Clinical Results
Traditional Chinese medicine typically plays a significant role in treating various diseases, including thyroid-related conditions, particularly thyroiditis.
Thyroiditis is a term that encompasses all types of conditions causing inflammation of the thyroid gland. Hashimoto’s thyroiditis, painless postpartum thyroiditis, and painless sporadic thyroiditis are the most common types. It can also develop as a result of drug treatments such as amiodarone, lithium, alpha-interferon, and interleukin-2 (Pearce et al., 2003, Slatosky et al., 2000).
Nodular goiter is a type of thyroid enlargement that can be related to endemic iodine deficiency. It may originate from the natural heterogeneity of thyroid follicular cells. If sporadic nodular goiter is amplified by trophic stimuli, it will give rise to micronodules through multiple episodes of proliferative processes and rapid division (Freitas, 2000, Hegedus et al., 2003, Yildirim Simsir et al., 2020). Thyroiditis and nodular goiter are the most common thyroid diseases.
The herb Prunella vulgaris (also known as prunella) has shown effectiveness in treating thyroid diseases in cellular models.
The pentacyclic triterpenoids of prunella can inhibit thyroid cancer cell line activity according to network pharmacology and molecular docking models (Zheng et al., 2022).
The antitumor effects could result from inhibiting the proliferation and migration of thyroid cancer cell lines (Fu et al., 2021, Yu et al., 2021), which are regulated by autophagy-inducing kinase and autophagy-related proteins (Song et al., 2021). Additionally, prunella may decrease pro-inflammatory cytokines to attenuate autoimmune responses in autoimmune thyroiditis (Guo et al., 2021, Qiu et al., 2020).
Hashimoto’s thyroiditis could also be treated with prunella due to its compounds’ high affinity. It may regulate multiple signaling pathways of adaptive immune responses and cell death to protect thyroid cells (Chen et al., 2020, Gan et al., 2021).
Subacute thyroiditis can also be treated with prunella, as it regulates inflammation and apoptosis signaling pathways (Shen et al., 2020).
In human studies, prunella has shown potential enhancing effects against thyroid diseases such as thyroiditis and nodular goiter (Ma and Ma, 2022, Shan et al., 2019).
In a recent meta-analysis, randomized clinical trials of combined therapy with prunella and levothyroxine demonstrated superior clinical efficacy compared to levothyroxine monotherapy for thyroiditis and thyroid nodules (Han et al., 2021). This study aims to explore the clinical effectiveness of prunella-enhancing treatment for thyroiditis and thyroid nodules.
A systematic search and meta-analysis of randomized clinical trials on prunella-enhancing treatment in thyroiditis or nodular goiter were conducted. The clinical efficacy of prunella-enhancing treatment was evaluated by comparing it with typical treatment.
After a rigorous selection process, nine studies and a total of 499 patients with thyroiditis or nodular goiter receiving prunella-enhancing treatment and typical treatment were enrolled, using various formulations and doses of prunella. The meta-analysis was performed using Review Manager 5.4.
Among the enrolled studies, the meta-analysis favored prunella-enhancing treatment over typical treatment.
The results of the meta-analysis showed that prunella-enhancing treatment had significantly superior clinical efficacy and low heterogeneity in fixed-effects and random-effects models.
The significant therapeutic effects remained even after analyzing relative risk and random-effects models.
Despite the relatively low quality of evidence, prunella-enhancing treatment shows promise in helping patients with thyroiditis or nodular goiter achieve remission.
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Source: Xitao Gao, Fan Li. The effects of prunella augmentation therapy for the treatment of thyroiditis or nodular goiter: A systematic review and meta-analysis. Journal of Herbal Medicine.
