Did you know that your thyroid expresses more ACE 2 receptors than your lungs? So while there is nothing new about the potential for a virus (or indeed even a vaccine against a virus) to impact thyroid form and function, the particular predilection this recent virus has demonstrated for this gland, and in turn, the wide spectrum of thyroid dysfunction and disease that has now been documented in response to this, is unparalleled and warrants our attention.
There’s a push to publish right now such that information and knowledge regarding anything and everything to do with the Covid 19 pandemic can be quickly shared.
While we need to balance this with the deeper appreciation that research that reflects the entirety of the story will take a lot longer to come to light – the data already in, speaking to this strong pathophysiological relationship between Covid 19 & thyroid health, is hard to look away from – especially when patients are already presenting with this chapter in their ‘thyroid health biography’.
That might sound like a patient who tells you their ‘thyroid was affected’ by the virus when they were really sick, but apparently is ‘ok’ now (but don’t feel it!), or someone post vaccination who has had some ‘funny results’. Or it might look like reactivation of a previously under control or quiescent Grave’s or Hashimoto’s disease, or, in fact, a new AITD diagnosis all together post 2020. There’s a lot of candidates & contenders for the ‘next NEXT wave’ in this pandemic – but even higher numbers of even more diverse thyroid issues is a strong one.
Once you learn about the about the interplay between thyroid anatomy and physiology, viruses generally (yes viruses are *BIG* news in many patient’s progression to thyroid pathology) and this virus, specifically, it becomes clear that we need to tune-in even more than before, to our patients’ potential for thyroid issues, as a contributor to why they’re seeking help for health concerns.
Thyroid health in a time of Covid
While there’s nothing new about the potential for viral driven thyroid disturbance, both acutely during infection and chronically following ‘recovery’, what is new and making news in the aftermath of the Covid 19 pandemic is the particular predilection this virus has shown for this gland. Thanks to its naturally high expression of ACE2 receptors (far more than seen in the lungs for example) the potential impacts, covering a wide spectrum of thyroid dysfunction & disease, have been observed and documented. This ranges from unprecedented rates of Euthyroid Sick Syndrome & Thyrotoxicosis during the acute phase to either activation (in an individual with a personal hx) or provocation (no previous hx or diagnosis) of autoimmune thyroid conditions as a result of either the infection or vaccination. Although there will be much more research to come that will help us clarify and confirm some of this detail, the data already in existence is undeniable and warrants our attention.
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