The Link between Thyroid Dysfunction and Mental Health Disorders

Aifer Elisabeta^*
*Correspondence: Aifer Elisabeta, Department of Dermatology, Carol Davila’ University of Medicine and Pharmacy, Romania, Email:

Introduction

Systemic sclerosis, also known as scleroderma, is a chronic autoimmune disease characterized by fibrosis of the skin and internal organs. Thyroid dysfunction is a common complication of SSc, affecting both the thyroid gland and the hypothalamic-pituitary-thyroid axis. In this article, we provide an extensive analysis of thyroid conditions in SSc, including the prevalence, pathogenesis, clinical manifestations, diagnosis, and management of thyroid dysfunction in SSc patients. Thyroid dysfunction is a common comorbidity in patients with SSc, with reported prevalence rates ranging from 10% to 40%. Both hypothyroidism and hyperthyroidism can occur in SSc, although hypothyroidism is more common. Thyroid autoimmunity, characterized by the presence of thyroid antibodies such as antithyroid peroxidase and antithyroglobulin antibodies, is also frequently observed in SSc patients. The exact pathogenesis of thyroid dysfunction in SSc is not fully understood but is believed to involve a complex interplay between genetic, immunological, and environmental factors. Autoimmune mechanisms, similar to those involved in SSc, may contribute to the development of thyroid autoimmunity. Additionally, fibrotic processes seen in SSc may affect the thyroid gland's structure and function. Thyroid dysfunction in SSc can manifest with a wide range of symptoms, depending on whether the patient has hypothyroidism or hyperthyroidism. Symptoms of hypothyroidism may include fatigue, weight gain, cold intolerance, constipation, and dry skin, while symptoms of hyperthyroidism may include weight loss, increased appetite, heat intolerance, palpitations, and tremors. However, some patients with SSc-related thyroid dysfunction may be asymptomatic, highlighting the importance of routine thyroid screening in this population [1].

Description

Diagnosing thyroid dysfunction in SSc involves a combination of clinical evaluation, thyroid function tests, and imaging studies. Thyroid function tests, including measurement of serum levels of thyroid-stimulating hormone , free thyroxine, and free triiodothyronine, are essential for assessing thyroid function. Imaging studies, such as thyroid ultrasound, may be used to evaluate the thyroid gland's structure and detect nodules or other abnormalities. The management of thyroid dysfunction in SSc depends on the specific thyroid condition present. In cases of hypothyroidism, thyroid hormone replacement therapy with levothyroxine is the mainstay of treatment. For hyperthyroidism, treatment options include antithyroid medications, radioactive iodine therapy, or surgery, depending on the underlying cause and severity of the condition. Close monitoring of thyroid function is essential to ensure optimal treatment outcomes in SSc patients with thyroid dysfunction [2].

Conclusion

Thyroid dysfunction is a common complication of systemic sclerosis, affecting a significant proportion of patients. Understanding the prevalence, pathogenesis, clinical manifestations, diagnosis, and management of thyroid conditions in SSc is crucial for providing comprehensive care to affected individuals. Routine screening for thyroid dysfunction and prompt initiation of treatment can help improve outcomes and quality of life for SSc patients with thyroid involvement. Collaborative efforts between rheumatologists, endocrinologists, and other healthcare providers are essential for managing thyroid conditions in SSc effectively.

References

1. Van Den Hoogen, Frank, Dinesh Khanna, Jaap Fransen and Sindhu R. Johnson, et al. "2013 classification criteria for systemic sclerosis: An American College of Rheumatology/European League against Rheumatism collaborative initiative." Arthritis Rheumatol 65 (2013): 2737-2747.

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2. Elhai, Muriel, Christophe Meune, Jerome Avouac and André Kahan, et al. "Trends in mortality in patients with systemic sclerosis over 40 years: A systematic review and meta-analysis of cohort studies." Rheumatology 51 (2012): 1017-1026.

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