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Smoking and autoimmune thyroid disease: the plot thickens

Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Tsimiski 92, Thessaloniki 54622, Greece and ¹ Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands

(Correspondence should be addressed to G E Krassas; Email: krassas{at}the.forthnet.gr)

Abstract

New studies have shown that smoking may protect against the development of thyroid peroxidase antibodies, which may result in a decreased risk of Hashimoto’s hypothyroidism (HH), whereas it stimulates the development of Graves’ hyperthyroidism (GH). According to the above-mentioned hypothesis, to stop smoking would decrease the risk of GH but increase the risk of HH. Also, smoking has been identified as one of the risk factors for the development or worsening of eye changes after ¹³¹I treatment of GH. Additionally, the outcome of medical treatment of Graves’ ophthalmopathy (GO) is less favourable in smokers as compared to non-smokers. There is concern also about the effect of passive smoking on autoimmune thyroid disease. In a recent study it has been shown that the latter may have a deleterious effect on childhood GO.

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