Mild thyroid diseases can lead to severe heart problems

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A recent study from Ruhr University Bochum and elsewhere found that even mild thyroid diseases can cause severe heart problems.

Thyroid disease is common, especially among older people and women. The thyroid hormone affects a person’s physical energy, temperature, weight, and mood.

Functional disorders are usually related to the gland producing too little thyroid hormone (hypothyroidism) or too much thyroid hormone (hyperthyroidism).

It has been known for more than 200 years that severe thyrotoxicosis may lead to cardiac arrhythmia (irregular heartbeat), one of the major reasons for sudden cardiac death.

However, the risk linked to mild hyperthyroidism or hypothyroidism hasn’t been understood so far.

In the study, the team examined 32 studies with 1.3 million participants and found that even slight deviations in thyroid function can increase the risk of serious heart diseases.

In particular, serum concentrations of the free thyroid hormone T4 (FT4) correlated directly with the probability of cardiac death and other heart problems.

The results suggest that cardiovascular risk increases continuously with the FT4 concentration, whereas a complex U-shaped risk relationship exists with the concentration of the controlling hormone thyrotropin, i.e. TSH,

This dualism may be explained by two different patterns of thyroid-mediated arrhythmia.

In one form (“dyshomeostatic type”), primary thyroid disease directly elevates the concentration of thyroid hormones and thereby increases cardiovascular risk.

In the other form (“allostatic type”), genetic factors, chronic stress and psychological strain increase the set point of the regulatory circuit between the pituitary gland and the thyroid gland, so the indirectly increased FT4 concentration also promotes arrhythmia.

This puts the understanding of the interaction between the thyroid gland and the heart on a new footing and might pave the way to personalized preventive care.

The team says the results of this study might pave the way to a personalized preventive strategy for heart outcomes.

Moreover, thyroid function might serve as a biomarker for the respective mechanism of origin in patients harboring cardiac arrhythmia, helping to tailor the best medication regimen for each patient.

The study was conducted by Dr. Johannes Dietrich et al and published in Frontiers in Cardiovascular Medicine.

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