Hypothyroidism and Patients with Lupus Agawam MA

Lupus is an "autoimmune" disease also known as systematic lupus erythematosus (SLE). People suffering from autoimmune diseases produce "autoantibodies," abnormal antibodies that attack their own tissue as if it were a foreign invader. The immune system is designed to distinguish "self" from "non-self." When a foreign substance or organism penetrates the body's outer defenses, the immune system recognizes the infiltrator as "non self" and calls up an army of antibodies to destroy it. Scientists are not sure what causes this often-devastating breakdown of normal immune function. A popular theory is that autoimmune diseases such as SLE develop in genetically susceptible individuals after exposure to a "triggering" agent which may be a virus or possibly something in the environment. In the late 19th century, following more detailed descriptions of it clinical manifestations, SLE became recognized as a multi-system disease. SLE is a disease of the connective tissue, the tissue that forms the body's structural framework. Tendons and ligaments are made of connective tissue that attaches muscles to bones and bones to other bones. Cartilage is the connective tissue that cushions bones and functions as the body's shock absorber. Connective tissue binds various tissues and organs together, keeping them in their proper locations, and it forms the network upon which cells cluster together to form organs. All internal organs are held in place with tough sheets of connective tissue called "fascia." Other connective tissues store unused food materials. It is literally the glue that holds us together.

Surrounding the windpipe just beneath the voice box, the thyroid gland is a small organ with a powerful influence on the body. The thyroid secretes hormones that affect virtually every organ. Thyroid hormones are required for growth and development in children. In adults, the thyroid's main assignment is to regulate the production of metabolic energy. The thyroid governs our "basal metabolism," which turns calories into useable heat energy. Hypothyroidism is a complex condition that manifests as a constellation of signs and symptoms caused by low thyroid hormone levels in the body. Hypothyroidism makes one feel like an engine missing a spark plug. The mind and body are sluggish. Digestion is poor, cardiovascular function and mental activity slow down, and muscles weaken. Low basal metabolism causes low body temperature, leaving the hypothyroid individual feeling chilly, with cold hands and feet, most of the time. The old saying, "My get up and go got up and went," aptly describes the person with hypothyroidism.

A study published in the Journal of Clinical Rheumatology sought to determine whether there is a high prevalence of autoimmune thyroid disease in patients with SLE. Researchers reviewed the medical charts of 524 patients with SLE to determine the prevalence and clinical associations of autoimmune thyroid. Those findings were then compared to data collected from 50 women with thyroid problems. It was found that 32 of the 524 patients (6.1%) with SLE had symptomatic autoimmune thyroid disease whereas only 1 of 50 controls were found to have symptomatic autoimmune thyroid disease. It was also determined that subclinical thyroid disease could be identified in 60 (11.5%) and positive thyroid autoantibodies in the absence of thyroid disease in 89 of 524 (17%) of SLE patients. These results suggest that patients with SLE have a high prevalence of symptomatic and significantly more subclinical hypothyroidism and positive thyroid autoantibodies. Since the symptoms of SLE and hypothyroidism can be similar, patients with SLE should be routinely checked for autoimmune thyroid disease.¹

¹ Appenzeller S, Pallone AT, Natalin RA, et al. Prevalence of thyroid dysfunction in systemic lupus erythematosus. J Clin Rheumatol. 2009;15(3):117-9.