One of the most common questions I have received in 2020 is whether or not those with autoimmune thyroid conditions are more susceptible to getting Covid-19. It’s a good question, as both Graves’ disease and Hashimoto’s are immune system conditions, and viruses are more likely to impact those people with a compromised immune system. Up until this point my response to this question has been that I don’t think having an autoimmune condition itself is the biggest factor, but of greater concern is that many people with thyroid autoimmunity have other things “dragging down” their immune system, which might make them more susceptible to getting Covid-19 (as well as other viruses).
But now that Covid-19 has been around for awhile there have been a few studies evaluating its effects on thyroid health, and whether people with thyroid autoimmunity are more susceptible to contract this virus. In June of this year a study came out in the United Kingdom showing that there was no data available at that time suggesting that patients with an autoimmune thyroid condition remain at higher risk of getting Covid-19 (1) [1]. The study also mentioned that in patients severely affected by Covid-19, changes in thyroid function might be a result of a “sick euthyroid” syndrome, although the authors did mention that there might be specific thyroid-related damage which requires further investigation.
However, in July a journal article was released entitled “Thyroid disease is associated with severe coronavirus disease 2019 (COVID-19) infection” (2) [1]. The article looked to explore the relationship between thyroid conditions and severe cases of Covid-19. Based on the data the authors concluded that thyroid disease seems to be associated with an increased risk of severe Covid-19 infection, and they gave the following three reasons why this may be the case:
1. Thyroid hormones are important in the regulation of the innate immune response. Therefore, an excess or deficiency of thyroid hormones levels observed in thyroid disease will lead to dysregulation of the innate immune response.
2. Increased levels of proinflammatory cytokines such as TNF-α and IL-6 was observed in patients with thyroid disease. Increased levels of these cytokines were also observed in patients with severe Covid-19 and correlates to the development of severe outcomes.
3. Some thyroid patients, especially those with subacute thyroiditis, were taking corticosteroids. Meta-analysis showed that corticosteroid treatment in Covid-19 patients was associated with higher mortality, longer length of hospital stay, and higher rate of bacterial infections. This isn’t surprising since corticosteroids suppress the immune system.
Most of the people I work with aren’t taking corticosteroids, and I think it’s safe to say that “point #3” doesn’t apply to most people with Graves’ disease or Hashimoto’s, although I should mention that some people with moderate to severe thyroid eye disease will take corticosteroids such as Prednisone, thus making them more susceptible to getting Covid-19 (or another viral infection). The first and second points mentioned above do apply to most of the people I work with. But as I mentioned earlier, there are other factors that can be having a negative effect on one’s immune system that can make them more susceptible to viruses such as Covid-19, including having weak adrenals, an unhealthy gut (most of the immune cells are located in the gut), an increased toxic load, certain nutrient deficiencies, exposure to toxic mold, etc.
Can Covid-19 Cause Subacute Thyroiditis?
Subacute thyroiditis is an inflammatory condition of the thyroid gland which causes damage to the thyroid follicles, and as a result, large amounts of thyroid hormones are released into the circulation, resulting in overt hyperthyroidism. However, unlike Graves’ disease, this state usually self resolves after a few months, although many will first experience a transient period of hypothyroidism. To learn more about this condition you might want to check out my blog post entitled “Graves’ Disease vs. Subacute Thyroiditis: What’s The Difference? [2]“.
A case study in July showed that an 18-year-old woman developed subacute thyroiditis after getting infected with Covid-19 (3) [3]. Another study revealed that a substantial proportion of patients with Covid-19, requiring high intensity of care, present with thyrotoxicosis and low serum thyroid stimulating hormone (TSH) concentrations, possibly as a consequence of subacute thyroiditis induced by SARS-CoV-2 (4) [4]. In other words, SARS-Cov-2 can directly infect the thyroid gland, leading to subacute thyroiditis.
Black Cumin and Covid-19
While on the subject of Covid-19, I would like to mention that there are a few studies which show that Nigella Sativa (black cumin) might benefit those with Covid-19. Black cumin has numerous health benefits, as it has demonstrated antiviral, antioxidant, anti-inflammatory, immunomodulatory, bronchodilatory, and antihistaminic properties (5) [5]. It also shows anti-hypertensive, anti-obesity, anti-diabetic, anti-hyperlipidemic, anti-ulcer, and antineoplastic activities, which can help with comorbidities commonly found in Covid-19 patients (5) [5]. In addition, the active constituents of N. sativa such as nigellidine and α-hederin have been identified as potential inhibitors of SARS CoV-2, and thymoquinone (the chief bioactive constituent of black cumin) suppresses mRNA expression which downregulate interferon genes and other inflammatory responses (5) [5] (6) [6].
Even though I have written a blog post on black cumin [7], in the past this is something I’ve mainly given as part of a protocol to those with H. pylori. And while I’m not suggesting for everyone to take black cumin specifically to reduce their chances of getting Covid-19, keep in mind that it can potentially help to minimize the impact other viruses have on your health as well, and as I listed above, it has numerous other health benefits. So at the very least it might be something to have on hand. There is one more thing I would like to mention, as the blog post I wrote related to black cumin focused on hypothyroidism and Hashimoto’s, but it’s also fine for most people with hyperthyroidism and Graves’ disease to take black cumin.
In summary, according to the research people with Graves’ disease and Hashimoto’s thyroiditis seem to be more susceptible to getting Covid-19. However, as I mentioned earlier, the reason for this might be related to other imbalances commonly found in people with these conditions that can further compromise the immune system. Either way the goal should be to do everything you can to improve the health of your immune system, and black cumin might also be something to consider adding to your supplement arsenal when combating viruses. You also might want to check a blog post I released earlier this year entitled “5 Ways To Improve Your Immune Health Without Taking Supplements [8]”.