Acupuncture and moxibustion cake may reduce thyroid antibodies in Hashimoto thyroiditis
Photo by Karthik M / Unsplash
Key Takeaway
Acupuncture and moxibustion cake may lower thyroid antibodies in Hashimoto thyroiditis, but evidence is limited and unreliable for clinical use.
A systematic review and meta-analysis of 15 articles evaluated acupuncture and moxibustion cake for Hashimoto thyroiditis. The primary outcomes were thyroid function markers, including thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid-stimulating hormone (TSH), free triiodothyronine, and free thyroxine.
Results showed that acupuncture significantly reduced TPOAb (pooled MD -61.97, P<.00001), TGAb (MD -44.78, P=.001), and TSH (MD -2.64, P<.00001), while increasing free triiodothyronine (MD 0.47, P=.09) and free thyroxine (MD 1.46, P=.02). Moxibustion cake also reduced TPOAb (MD -11.44, P=.0002) and TGAb (MD -8.63, P=.004), with non-significant changes in other markers.
The analysis included 306 records but faced methodological weaknesses, heterogeneity, and publication bias. No adverse events were reported, and safety data were lacking. The certainty of evidence is highly limited, precluding reliable clinical recommendations.
Practice relevance is constrained by these limitations, and causality cannot be inferred. Future high-quality trials are needed to confirm these findings and assess long-term safety and efficacy.
View Original Abstract ↓
BACKGROUND: Hashimoto thyroiditis (HT) is a prevalent autoimmune thyroid disorder that currently lacks a specific treatment. While oral levothyroxine sodium tablets have been found to significantly enhance thyroid function, they do not contribute to a decrease in concentrations of thyroid-related antibodies. We aimed to design a systematic review, meta-analysis, and trial sequential analysis of the effect of acupuncture and moxibustion cake on thyroid function in patients with HT.
METHODS: We conducted an unrestricted search up until March 29, 2024, across 7 databases. These included 4 international databases, namely, PubMed, Web of Science, Scopus, and Cochrane Library, as well as 3 Chinese databases such as CNKI, VIP, and Wanfang. We used Review Manager, version 5.3, for meta-analysis and presented the data as mean difference (MD) and 95% confidence interval to evaluate the role of acupuncture or moxibustion on biomarker levels in HT.
RESULTS: A total of 306 records were identified through databases, and 15 articles were included in the meta-analysis. In the acupuncture group: thyroid peroxidase antibody (TPOAb): the pooled MD is -61.97 (P < .00001), thyroglobulin antibody (TGAb): the pooled MD is -44.78 (P = .001), thyroid-stimulating hormone (TSH): the pooled MD is -2.64 (P < .00001), free triiodothyronine: the pooled MD is 0.47 (P = .09), and free thyroxine: the pooled MD is 1.46 (P = .02). In the moxibustion group: TPOAb: the pooled MD is -11.44 (P = .0002), TGAb: the pooled MD is -8.63 (P = .004), TSH: the pooled MD is -1.00 (P = .27), free triiodothyronine: the pooled MD is 1.12 (P = .14), and free thyroxine: the pooled MD is 1.04 (P = .07).
CONCLUSION: The meta-analysis indicates that acupuncture and moxibustion may influence thyroid-related biomarkers (TPOAb, TGAb, and TSH) in patients with HT; however, the evidence is highly limited by methodological weaknesses, heterogeneity, and publication bias. These factors preclude reliable clinical recommendations at this stage. Further well-designed, large-scale randomized controlled trials are essential to determine whether these interventions have true clinical efficacy.
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