here's something to start
I'll have to look into seeing about that, he lives out of state, I speak with him on the phone periodically.
Here's something he recently emailed me on thyroid and Asacol links as far as goiters, in case it's of any use to anyone else. I was on Asacol for 16 months before being taken off of it due to the new GI dr. thinking it was one of the causes of the worsening of my symptoms (since it actually can make diarrhea worse by causing the small bowel to secret more fluid and there isn't a healthy colon to absorb it).
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Here are several links and clips regarding colloid goiter/Asacol or mesalamine/Hashimoto's Thyroiditis. They are in no particular order.
In summary, there is not a lot of data to directly link Asacol as a cause of thyroid problems, but there is enough roundabout references to make me wonder anyway. It may be unlikely, it may even be highly unlikely, but I firmly believe that there are very few absolute impossibilities in medicine. There is a stronger correlation to the autoimmune component of Crohn's and Hashimoto's, however. Your diet and diarrhea may also have affected your iodine intake, absorption or retension, too.
"The sulfonamides bear certain chemical similarities to some goitrogens, diuretics (acetazolamide and the thiazides), and oral hypoglycemic agents. Goiter production, diuresis and hypoglycemia have occurred rarely in patients receiving sulfonamides. Cross-sensitivity may exist with these agents. Rats appear to be especially susceptible to the goitrogenic effects of sulfonamides and long-term administration has produced thyroid malignancies in this species."
http://en.wikipedia.org/wiki/Goitrogens
http://www.jcge.com/pt/re/jclngastro/abstract.00004836-199803000-00006.htm;jsessionid=HkGPYj75FnjQn1f1h0tyYLhxwvpl9dTQndpybBLk1SFx34ck4TdM!238297732!181195628!8091!-1
from
http://www.microscopiccolitis.org/sallyread/id21.html :
"5-Aminosalicylates or 5-ASA
5-ASA is one-half of the drug Salazopyrin® (sulfasalazine.) It is the 5-ASA portion (the "active" part), without the sulfa portion (the "carrier" part). Research carried out in the past 15 years has shown that many of the adverse reactions to Salazopyrin® were, in fact, reactions to the inactive sulfa carrier portion and not to the active 5-ASA part. This led pharmaceutical companies to split the drug and manufacture just the 5-ASA part. In general, the 5-ASA group of drugs has the effect of Salazopyrin® without the same degree of side effects.
As with sulfasalazine, 5-ASA is used to treat mild-to-moderate flare-ups of IBD. It decreases inflammation and reduces diarrhea and may also prevent flare-ups of IBD in some people. Those with proctitis (colitis limited to the rectum) or colitis involving the last meter of the colon may find that 5-ASA is more effective taken rectally, rather than orally. It may also delay the return of Crohn's disease after surgery.
5-ASA is generally used now instead of sulfasalazine, if neither one has been given before. It is the alternative treatment for people who can't take sulfasalazine because they can't tolerate its sulfa component. Like sulfasalazine, 5-ASA reduces the production of diarrhea-causing chemicals in the intestine. Also like sulfasalazine, it inactivates oxygen radicals that can destroy tissue.
Side effects are essentially the same as for sulfasalazine, but they occur far less often. When the drug is first taken, patients may experience nausea, headaches, and diarrhea. Less common side effects include allergic reactions and abdominal pain."
This one seems to say that thyroid is NOT directly affected by the 5ASA-Asacol/mesalamine, but does refer to Hashimoto's.
http://www.medhelp.org/posts/show/415728
http://en.wikipedia.org/wiki/Hashimoto's_thyroiditis :
"Hashimoto's thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease where the body's own antibodies attack the cells of the thyroid.
This disorder is believed to be the most common cause of primary hypothyroidism in North America. It occurs far more often in women than in men (10:1 to 20:1), and is most prevalent between 45 and 65 years of age."
(Note that since you are a young male, you would be in the minority of those affected).
This is on 4-ASA which is para amino salicylic acid and NOT the 5-ASA, Asacol.
http://en.wikipedia.org/wiki/Aminosalicylic_acid :
"Gastrointestinal side-effects (nausea, vomiting, diarrhoea) are common; the delayed-release formulation is meant to help overcome this problem. It is also a cause of drug-induced hepatitis. Patients with glucose-6-phosphate dehydrogenase deficiency should avoid taking aminosalicylic acid as it causes haemolysis. Thyroid goitre is also a side-effect because aminosalicylic acid inhibits the synthesis of thyroid hormones."
This also seems to indicate that your Asacol does not directly affect the thyroid:
http://en.wikipedia.org/wiki/Mesalazine
