Thyroid autoimmunity is the leading cause of hypothyroidism in most westernized countries, but does having thyroid autoimmunity increase your risk of thyroid cancer? Dr. Ruscio reviews a recent study which answers this question.
Dr. Michael Ruscio: Hey, everyone. This is Michael Ruscio.
What is the relationship between thyroid autoimmunity and thyroid cancer?
Well, your fast facts on this issue are: if one has thyroid autoimmunity, the more severe the autoimmunity may indicated a higher chance of thyroid cancer. Potentially, managing the autoimmunity, or trying to get the antibodies as low as possible, may have a favorable outcome.
So, what are some of the details behind this?
Two studies were recently published examining this issue. I will link to those studies (Study 1) (Study 2)
Essentially, both of these studies found a relationship between thyroid autoimmunity and thyroid cancer – those who have or had thyroid autoimmunity had a higher incidence of thyroid cancer. In fact, one study showed that if the thyroid autoimmunity was very severe, meaning the TPO antibodies were over 1,300 – it shouldn’t be above 30 or 35 – there is a greatly increased chance of thyroid cancer risk.
Now, not all of the studies agree on this. There is one review paper (Study 3) that showed that some of this relationship may be overstated because of biases – meaning the researchers were expecting to find thyroid cancer, and that produced a higher amount of thyroid cancer findings. Nonetheless, irrespective of the academic debate or controversy, which there is controversy in many things scientifically, because it is very hard to prove one definitively. Forgetting about all of that for a minute, what does this mean in terms of practical, actionable items?
It means that if your have thyroid autoimmunity, the approach of trying to manage or dampen or lower the amount of thyroid autoimmunity may yield dividends. Now, to my knowledge there have not been any studies published showing that by trying to lower autoimmunity, one would decrease their risk of thyroid cancer. But, we do observe that people with none or lower thyroid autoimmunity seem to have a lower cancer risk.
So, certainly it would make sense to go through some of the strategies we use to try to dampen or lower thyroid autoimmunity. That would involve diet – for example, the autoimmune paleo diet works very well. Second to that, some dietary supplements can be helpful. Potentially fish oils and antioxidants like selenium. Third to that would be the treatment of any kind of infections. For example, there was one published study in Italy that showed when patients with Hashimoto’s are treated for an H. Pylori infection, the severity of thyroid autoimmunity dropped quite dramatically.
So, I don’t think we need to have a really extensive rational to say that if you have thyroid autoimmunity, it wouldn’t be a bad idea to try to manage that as best you can.
Now, I should also tell you that is controversial. Your endocrinologist probably won’t agree with the need to treat thyroid autoimmunity, which is fine; people are going to have different views on this. If you look in the Functional Medicine community, I think you’ll see a number of clinicians who have a clinical experience similar to what I have – when someone has thyroid autoimmunity, which is non-managed, we will see thyroid antibodies usually between 700-1,300. And then, when we manage this, the antibodies usually drop and hover around 100-300. That’s important for me to mention because sometimes people come in not satisfied unless their antibodies are at zero or below 30. It happens in some cases but not in all cases.
So, I define successful thyroid autoimmunity management as having antibodies that hover around 100 or 200, maybe 300, as oppose to between 700-1,400.
So, if you have thyroid autoimmunity, it may be important to address the autoimmunity in conjunction with taking medication, if you need one, so that you are making sure to have adequate thyroid hormone levels, and also making sure that the underlying autoimmunity is addressed, because it may affect more than just the autoimmune component of your thyroid. It may increase the risk for thyroid cancer.
Well, this is Dr. Ruscio. Hope this helps. Thanks.
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