Hypothyroidism affects 4–7% of the population, but most goes undiagnosed.

If you’re a woman, you’re 11–15% more likely to have it than if you’re a man.

The epidemiology of this is interesting, but not our main topic today, so if you’d like to read more about that, then you might want to bookmark this paper to read later: Low awareness and under-diagnosis of hypothyroidism

If you’re wondering if this might be you, then check out: Doctor Explains: 15 Signs Of Hypothyroidism

And perhaps, while you’re at it, A Fresh Take On Hypothyroidism

Meanwhile, what’s this about hypothyroidism and your heart?

Let’s get to the heart of things

Researchers (Dr. Irsa Munir et al.) analyzed 112 ICU patients with hypothyroidism using transthoracic echocardiography and speckle-tracking echocardiography, including patients with myxedema coma.

That’s a lot of big words, but a fair oversimplification would be: they used low- and high-tech means to monitor cardiac function in various ways.

What they found is that hypothyroidism was strongly associated with measurable heart dysfunction, which makes it look a lot like low thyroid hormone levels can directly impair how well the heart contracts and relaxes.

In numbers:

• 66.7% had abnormal diastolic function
• 68.2% had impaired left ventricular global longitudinal strain
• 37.5% had reduced left ventricular ejection fraction
• 34.0% had impaired right ventricular strain

You might be wondering: why are we assuming causality?

And the answer is: thyroid hormones help regulate your heart’s response to adrenaline, energy use, blood vessel tone, and the timing and force of contraction, so deficiency can weaken cardiac performance.

Notably, cardiac abnormalities occurred at similar rates in patients with and without overt myxedema coma, indicating that hypothyroidism itself (not only the coma state) was linked to dysfunction.

Another factor that Dr. Munir and her team highlighted is that of the various thyroid hormones, low T3 levels are common in septic shock and raised the possibility that prolonged thyroid hormone deficiency can contribute to septic cardiomyopathy.

You can read the paper in full, here: Heart ventricular function in hospitalized patients with severe hypothyroidism and myxedema coma

As for what to do about it? Their preliminary lab work strongly suggested thyroid hormones can improve cardiac muscle contractility within minutes, and a clinical trial protocol has been approved to test hormone replacement in septic shock patients, so we’ll look forward to seeing that when it comes out.

Aside from treating it with thyroid hormones directly, this problem is often approached from the perspective of “can we fix it with diet?”, and indeed, there are prevailing methods for at least managing the condition, for example: Foods For Managing Hypothyroidism (incl. Hashimoto’s)

However, we recently wrote about an approach that evidence suggests is not only stronger, but also much easier to adhere to in real life with real life’s practicalities: No More Restrictions In This Diet Against Thyroid Disease?

Want to learn more?

If you’d like to read more about a common form of hypothyroidism, then check out:

Hashimoto’s Food Pharmacology – by Dr. Izabella Wentz

Take care!

Some people have never yet had COVID (so far so good, this writer included); others are on their third bout already; others have not been so lucky and are no longer with us to share their stories.

Obviously, even the healthiest and/or most careful person can get sick, and it would be folly to be complacent and think “I’m not a person who gets sick; that happens to other people”.

Nor is COVID the only thing out there to worry about; there’s always the latest outbreak-du-jour of something, and there are always the perennials such as cold and flu—which are also not to be underestimated, because both weaken us to other things, and flu has killed very many, from the 50,000,000+ in the 1918 pandemic, to the 700,000ish that it kills each year nowadays.

And then there are the combination viruses:

Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now

So, why are some people more susceptible?

Firstly, some people are simply immunocompromised. This means for example that:

• perhaps they have an inflammatory/autoimmune disease of some kind (e.g. lupus, rheumatoid arthritis, type 1 diabetes), or…
• perhaps they are taking immunosuppressants for some reason (e.g. because they had an organ transplant), or…
• perhaps they have a primary infection that leaves them vulnerable to secondary infections. Most infections will do this to some degree or another, but some are worse for it than others; untreated HIV is a clear example. The HIV itself may not kill people, but (if untreated) the resultant AIDS will leave a person open to being killed by almost any passing opportunistic pathogen. Pneumonia of various kinds being high on the list, but it could even be something as simple as the common cold, without a working immune system to fight it.

See also: How To Prevent (Or Reduce) Inflammation

And for that matter, since pneumonia is a very common last-nail-in-the-coffin secondary infection (especially: older people going into hospital with one thing, getting a secondary infection and ultimately dying as a result), it’s particularly important to avoid that, so…

See also: Pneumonia: What We Can & Can’t Do About It

Secondly, some people are not immunocompromised per the usual definition of the word, but their immune system is, arguably, compromised.

Cortisol, the stress hormone, is an immunosuppressant. We need cortisol to live, but we only need it in small bursts here and there (such as when we are waking up the morning). When high cortisol levels become chronic, so too does cortisol’s immunosuppressant effect.

Top things that cause elevated cortisol levels include:

• Stress
• Alcohol
• Smoking

Thus, the keys here are to 1) not smoke 2) not drink, ideally, or at least keep consumption low, but honestly even one drink will elevate cortisol levels, so it’s better not to, and 3) manage stress.

See also: Lower Your Cortisol! (Here’s Why & How)

Other modifiable factors

Being aware of infection risk and taking steps to reduce it (e.g. avoiding being with many people in confined indoor places, masking as appropriate, handwashing frequently) is a good preventative strategy, along with of course getting any recommended vaccines as they come available.

What if they fail? How can we boost the immune system?

We talked about not sabotaging the immune system, but what about actively boosting it? The answer is yes, we certainly can (barring serious medical reasons why not), as there are some very important lifestyle factors too:

Beyond Supplements: The Real Immune-Boosters!

One final last-line thing…

Since if we do get an infection, it’s better to know sooner rather than later… A recent study shows that wearable activity trackers can (if we pay attention to the right things) help predict disease, including highlighting COVID status (positive or negative) about as accurately (88% accuracy) as rapid screening tests. Here’s a pop-science article about it:

Wearable activity trackers show promise in detecting early signals of disease

Take care!