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GRAVES’ DISEASE
Asthmatic patients have increased risk of hyperthyroidism
BACKGROUND
Asthma is a condition that is estimated to have affected approximately 262 million people in 2019 worldwide. Graves’ disease is the most common cause of hyperthyroidism. Both asthma and Graves’ disease are considered to be autoimmune disorders, where the body makes antibodies that cause the disease. These antibodies are produces by blood cells known as T-lymphocytes. Asthma is believed to be cause by the subtype T cell called T helper 2, and Graves’ disease is believed to be caused by the subtype T cell called T helper 1. There have been reports of flares of asthma caused by hyperthyroidism as early as 1944. However, whether asthma would be associated with an increased risk for developing hyperthyroidism has not been adequately studied. In this study, the authors aimed at describing a relationship between asthma and potential risk for developing hyperthyroidism.
THE FULL ARTICLE TITLE
Gau SY et al. 2021 Higher risk of hyperthyroidism in people with asthma: Evidence from a nationwide, population- based cohort study. J Allergy Clin Immunol Pract. 2021 Sep 23: S2213–2198(21)01013–8.
SUMMARY OF THE STUDY
This was a study done in Taiwan, using data from a health insurance database. Patients who were given a new diagnosis of asthma from 2000-2013, who were prescribed inhaled steroids from more than 28 days within 3 months after diagnosis, was the group that was studied. Patients matched by age and sex without the diagnosis of hyperthyroidism or asthma were used as controls.
A total number of 45,182 individuals were included in the final analyses, consisting of 22,591 individuals with asthma and an equal number of matched controls. The overall incidence of hyperthyroidism (per 100,000 personmonths) in the asthma and control groups were 16.95 and 12.88 respectively. The asthma group showed a significantly higher cumulative probability of hyperthyroidism than the controls. Further analysis showed that patients with a more recent asthma diagnosis ( <3 years) and older age at asthma diagnosis ( >30 years of age) had a higher probability of developing hyperthyroidism.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study showed that patients with asthma were at higher risk of developing hyperthyroidism, especially those older than 30 years old. This study is important for patients and for doctors taking care of patients with asthma. Some of the side effects of the medications used to treat asthma such as palpitations, rapid heart rate, emotional lability, are also symptoms of hyperthyroidism. Being aware of the higher risk of developing hyperthyroidism in these patients will help lead to early diagnosis and appropriate management of hyperthyroidism.
— Jessie Block-Galarza, MD
ATA THYROID BROCHURE LINKS
Graves’ Disease: https://www.thyroid.org/graves-disease/
ABBREVIATIONS & DEFINITIONS
Graves’ Disease: the most common cause of hyperthyroidism in the United States. It is caused by antibodies that attack the thyroid and turn it on.
Hyperthyroidism: a condition where the thyroid gland is overactive and produces too much thyroid hormone. Hyperthyroidism may be treated with antithyroid meds(Methimazole, Propylthiouracil), radioactive iodine or surgery.
Lymphocytes: blood cells involved in the immune response that produce antibodies that fight off infection
Asthma: a condition in which airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.
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