More susceptible to infections? And other questions.

[borninquisitive]

Hello Dr. Lupo,

I have a few questions for you:

1)Are those with thyroid disorders more susceptible to infections? Be they hyper/hypo/graves/hashi?

2)Are those with thyroid disorders more prone to respiratory "issues"?

I have heard many with respiratory issues, found a reduction (if not resolve)after treatment. As well, experiences less infections after treatment.

3)Have your patients found a benefit in taking Selenium?

I did read that Selenium reduces TPO antibodies. Interestingly, I have somewhat elevated TgAb but in range TPO. My MV contains 250 mcg of Selenium. One that I have been taking for years.

Just for clarification,

4) I read that you suggested an U.S. for those with elevated antibodies and that in your findings, found a large percentage of those with elevated TgAb (only,I think)as having nodules. Correct?

5) I have read that a small percentage of Hashimotos may have TRab, causing suppression of TSH. Is this correct?

6)There seems to be 2 schools of thought in regards to Hashimotos, those with in range TSH. a) treat b) do not treat.
What is your possition on this?

7) What criteria must be met, to appropriately diagnose Hashimotos?

8) Do you find many patients with thyroid disorders as also having issues with the adrenals?

I hope I haven't asked too many questions, requiring too much of your time.

Thank you for your time.

[Mark Lupo, M.D.]

usually no increase in infections, resp disease.  Selenium may help and 250mcg is not known to be harmful.  TgAb only (ie negative TPO) may be associated with nodules -- not predictive of nodules being cancer though.  TRab can cause hyperthyroidism.  Treating hashi (ie, high TSH and positive antibodies without a history of recent other thyroiditis) based on TSH varies from patient to patient, a TSH >3 merits consideration for treatment.  Very few have adrenal comorbidities.

[borninquisitive]

First of all, thank you Dr. Lupo.

If I do recall, you said that you had seen a higher incidence of nodules with those having TGab alone, with your patients.

I found this a few days ago:

Takamatsu et al., Osaka, Kobe and Mibucho, Japan, studied characteristics of three groups of patients with Hashimoto's disease, i.e. having both TGAb and TPOAb, TGAb alone, or TPOAb alone.
Of 401 patients with Hashimoto's thyroiditis:
79% had both antibodies,
19% TGAb alone,
and 2% TPOAb alone.
Age, gender-ratio, and incidence of familiar predisposition were similar in the three groups.
The main findings were that patients with TGAb alone have frequently nodular lesions i.e. 53%
versus 20% TPOAb alone,
and 9% both antibodies.
In this group hypothyroidism was relatively rare i.e. 23% versus 50% and 58% respectively.
The frequences of low echo-amplitude of the thyroid were 26%, 0%, and 69% respectively.
http://www.merck.de/servlet/PB/menu/1266180/1266180.html

And regarding immunity (thank you Helen):

http://www.ebmonline.org/cgi/content/full/231/3/229
http://edrv.endojournals.org/cgi/content/full/21/3/292

For those who may be interested.