Does Hashimoto’s increase your risk of heart disease?

Hashimoto’s thyroiditis is an autoimmune condition where your own bodies immune system cells attacks your thyroid gland1. Over time, the thyroid becomes damaged and its ability to release hormones decreases, giving you symptoms of underactive thyroid (hypothyroid). Symptoms of hypothyroid include1:

  • Fatigue and sluggishness
  • Increased sensitivity to cold
  • Constipation
  • Pale, dry skin
  • A puffy face
  • Hoarse voice
  • Unexplained weight gain — occurring infrequently and rarely exceeding 10 to 20 pounds, most of which is fluid
  • Muscle aches, tenderness and stiffness, especially in your shoulders and hips
  • Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet
  • Muscle weakness, especially in your lower extremities
  • Excessive or prolonged menstrual bleeding (menorrhagia)
  • Depression

The way for you to know if these symptoms are caused by Hashimotos’s is for your doctor to measure your thyroid antibodies (thyroid peroxidase antibody and thyroglobulin antibody), along with other tests to determine whether you fit the diagnosis of Hashimoto’s thyroiditis3.

Research has shown that hypothyroidism leads to an increase in risk of cardiovascular disease6,7, but its now being researched how autoimmune thyroid conditions may also be a risk factor for atherosclerosis (build up of plaque on artery walls) and ischemic heart disease (heart not getting enough oxygen).

A clinical finding of Hashimoto’s thyroiditis that is not always talked about is the chronic low-grade inflammation that it causes2. The persistent antibodies that are being produced by your immune system orchestrate the recruitment of leukocytes (white blood cell) to deal with the antibodies. These leukocytes release cytokines (chemical messengers) that trigger this chronic inflammation4,5. The activation of these inflammatory cytokines causes an increase in the amount of oxidative stress that is put on your body4. Researchers have found that the mix of increased oxidative damage and the decrease of our own bodies antioxidant storage, is leading to damage of the blood vessel endothelium (lining)5. The damage to the lining allows plaques to be formed in your blood vessels, increasing your risk of atherosclerosis4.

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Figure 1.0 Schematic of endothelial dysfunction as presented.

You can assess your levels of inflammation and risk of cardiovascular disease by having your doctor run a high-sensitivity CRP (hs-CRP), or serum homocysteine8. A carotid intima media thickness test could be helpful in determining your cardiovascular disease risk in subclinical hypothyroid or Hashimoto’s by seeing how much plaque is built up in the arteries8,9.

 

 

 

 

 

This article should not be used to diagnose or treat any medical condition. The purpose is for informational use only. Consult your physician pertaining to medical decisions.

 

References:

  1. http://www.mayoclinic.org/diseases-conditions/hashimotos-disease/basics/definition/con-20030293
  2. Coppola AR, Ladenson PW. Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 2003; 88:2438-2444
  3. https://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test/
  4. Taddei S, et al. Low-Grade Systemic Inflammation Causes Endothelial Dysfunction in Patients with Hashimoto’s Thyroiditis. J of Clin Endocrinology & Metabolism. 2006; 91(12):5076-5082.
  5. Libby, Peter. Inflammatory Mechanisms: The Molecular Basis of Inflammation and Disease. Nutrition Reviews. 2007; 65(12):S140-146.
  6. Nanda N, Bobby Z, Hamide A. Inflammation and oxidative stress in hypothyroids: additive effects on cardiovascular risk. Indian Journal Of Physiology And Pharmacology [serial online]. October 2011;55(4):351-356.
  7. http://www.ncbi.nlm.nih.gov/pubmed/15249698
  8. Isgüven P, et al. Effects of Thyroid autoimmunity on Early Atherosclerosis in Euthyroid girls with Hashimoto’s Thryroiditis. J Clin Res Pediatr Endocrinol 2016;8(2):150-156.
  9. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta- analysis. Circulation 2007;115:459-467.

 

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