Over many years, the links between smoking and thyroid have proved to be extraordinarily unclear. With the exception of Graves and TED, we have seen all sorts of ideas and supposition but little evidence. One particularly interesting possibility is that smoking is far more intimately linked - and might help to stave off thyroid disorders, or at least somehow mask them, which is why so many people seem to report "giving up" as a the time that they started to suffer.
Endokrynol Pol. 2014;65(1):54-62. doi: 10.5603/EP.2014.0008.
Influence of cigarette smoking on thyroid gland - an update.
Sawicka-Gutaj N1, Gutaj P, Sowiński J, Wender-Ożegowska E, Czarnywojtek A, Brązert J, Ruchała M.
Many studies have shown that cigarette smoking exerts multiple effects on the thyroid gland. Smoking seems to induce changes in thyroid function tests, like decrease in TSH and increase in thyroid hormones. However, these alterations are usually mild. In addition, tobacco smoking may also play a role in thyroid autoimmunity. Many studies have confirmed a significant influence of smoking on Graves' hyperthyroidism and particularly on Graves' orbitopathy. Here, smoking may increase the risk of disease development, may reduce the effectiveness of treatment, and eventually induce relapse. The role of smoking in Hashimoto's thyroiditis is not as well established as in Graves' disease. Nonetheless, lower prevalence of thyroglobulin antibodies, thyroperoxidase antibiodies and hypothyroidism were found in smokers. These findings contrast with a study that reported increased risk of hypothyroidism in smokers with Hashimoto's thyroiditis. Moreover, cigarette smoking increases the incidence of multinodular goitre, especially in iodine-deficient areas. Some studies have examined cigarette smoking in relation to the risk of thyroid cancer. Interestingly, many of them have shown that smoking may reduce the risk of differentiated thyroid cancer. Furthermore, both active and passive smoking during pregnancy might modify maternal and foetal thyroid function. This review evaluates the current data concerning the influence of cigarette smoking on thyroid gland, including hormonal changes, autoimmunity and selected diseases. These findings, however, in our opinion, should be carefully evaluated and some of them are not totally evidence-based. Further studies are required to explain the effects of smoking upon thyroid pathophysiology. (Endokrynol Pol 2014; 65 (1): 54-62).
PMID: 24549603 [PubMed - in process]
Image: Thomas Rowlandson - Taunting with Smoke from a Pipe