Concerned about coronavirus? We've put together what you need to know about COVID-19 and hypothyroidism, including suggestions on how to protect your health.

Coronavirus and Hashimoto’s Disease

Comprehensive primer about what thyroid patients need to know about novel coronavirus, COVID-19.
Coronavirus and Hashimoto’s Disease
Medically reviewed by Dr. Andrew Cunningham, MD

The COVID-19 crisis has grown into a worldwide emergency in the past few months. Given the widespread media attention, you may understandably feel worried about the spread of this coronavirus. We think it's important for our community to be armed with the most up-to-date information.

In this article: 

  • What we know about COVID-19
  • Am I at risk because of my Hashimoto's diagnosis?
  • How viral infection affects autoimmune thyroid disease
  • What you can do to protect yourself

What we know about the recent coronavirus

The potential global health threat posed by the current coronavirus (COVID-19) is extremely high. On March 11, the World Health Organization declared the coronavirus outbreak to be a pandemic. The coronavirus outbreak has now spread to 49 states. As of March 15th 2020, the virus has been reported in more than 2,700 people, and at least 58 patients have died. The only state not reporting cases is West Virginia. Here’s a full map of U.S. cases.

You can check the risk assessment update on the CDC website.

There are many coronaviruses; it’s the virus that causes a common cold and upper respiratory infections. COVID-19 (like MERS and SARS), however, is a coronavirus that can infiltrate the lower respiratory system (the lungs). Therefore, those who are infected can develop pneumonia. Viral pneumonia is harder to treat because it doesn’t respond to antibiotics, which only fights against bacteria.

Globally, we are still learning about the cause, spread, and treatment of COVID-19. This virus originated in Wuhan City, Hubei Province, China, linked originally to a live animal market. However, now the virus is spreading person-to-person.

The CDC believes that the virus spreads between people who are in close contact with one another (within about six feet). This spread happens via respiratory droplets produced when an infected person coughs or sneezes.

Confirmed coronavirus illnesses range from mild symptoms to severe illness or death. Symptoms may appear 2-14 days after exposure, and include:

  • Fever
  • Cough
  • Shortness of breath

If you develop symptoms, have close contact with a person known to have COVID-19, or recently traveled from an area with ongoing transmission of COVID-19, contact your doctor immediately.

Am I at higher risk because of my Hashimoto's diagnosis?

It doesn't appear that anyone is naturally immune to COVID-19. Some otherwise healthy people seem to get more sick from this infection than expected. Current information indicates that older adults and people who are immunocompromised or who have serious chronic medical conditions, like heart disease, diabetes, and lung disease, are at higher risk of getting very sick from this illness.

If you have Hashimoto's thyroiditis, your are not necessarily immunocompromised, and there is currently no reason to believe that people with thyroid conditions are at heightened risk of contracting this novel coronavirus. Nevertheless, anyone with a chronic illness or autoimmune disease should take every precaution to protect themselves against COVID-19.

Coronavirus risk assessment

Take this quiz to check your level of risk:

How viral infection affects autoimmune thyroid disease

Research believes that both genetic and environmental factors are responsible for the development of autoimmune conditions, like Hashimoto's thyroiditis. Viral infections (like rubella, mumps, or Epstein Barr virus) are one such environmental factor that may induce an autoimmune response. 

There are a few explanations for what causes virus-induced autoimmunity:

Molecular mimicry

Every cell in your body has markers (called antigens) that specifically identify you as being you. Traditional research suggests that viruses carry antigens that are structurally similar to those that are already part of your cells. These antigens activate lymphatic cells and lead to a cross-reactive response against both self- and non-self antigens. 

Bystander activation

Sometimes an overactive immune response releases self-antigens and causes inflammation. Immune cells take up these self-antigens, which activate extra lymphocytes, leading to tissue destruction.

Epitope spreading

When there is a persistent viral infection, tissue damage continues, and new self-antigens continue to release. Immune cells take these self-antigens and activate lymphocytes. This lymphocyte response then spreads to other auto-reactive cells. 

On the other hand, while infections may cause an autoimmune response, some research suggests that multiple viral exposures actually protect the immune system to different infections. These numerous exposures allow the immune system to grow smarter to control autoimmune responses better.

Host, viral, or environmental factors likely direct the two opposing reactions to viral infections. More research is needed to understand the specific mechanism that connects viral infections to autoimmune responses.

What you can do to protect yourself

While this outbreak is undoubtedly a cause for awareness and concern, there are steps you can take to protect and prepare yourself with the information currently available.

Stay home in the case of an outbreak in your community

During an outbreak in your community, protect yourself and others by:

  • Staying home from work, school, and all activities
  • Distancing yourself from others who are sick
  • Limiting close contact with others as much as possible (about 6 feet)
  • Keeping enough household items and groceries on hand to prepare to stay at home for an extended period of time

Take standard flu precautions

Take the same steps you take to protect yourself from getting or spreading influenza, to prevent catching or spreading coronavirus:

  • Cover your mouth
  • Wash your hands as much as you can

Strengthen your immune system

  • Sleep seven to nine hours per night to give your immune system time to repair itself
  • Practice balanced hand hygiene - often wash with soap and water, but don't overdo to the point of exacerbating your skin symptoms like dry, cracked skin where infection can enter; remember to moisturize between washes
  • Avoid sugar because it suppresses immune system function
  • Move your body to boost the immune system function
  • Eat nutrient-rich whole foods to protect against disease and maintain a healthy gut microbiome
  • Talk to your doctor about adding immune-boosting supplements like vitamins A, D, or C, magnesium, or zinc, which may not protect you from the virus, but will help keep your immune response strong
  • Drink a lot of water to stay well hydrated

Stock up on critical prescription refills

It may be advisable to stock up on your thyroid (or other) medications in case you become limited by travel restrictions or product shortages.

The U.S. Department of Health and Human Services (HSS) warns of potential shortages for products that come from China - particularly finished pharmaceutical products or active pharmaceutical ingredients. As of March 2, 2020, no drug manufacturers have reported anticipating shortages of particular drugs due to the coronavirus, but the FDA and HSS are paying close attention to the potential challenges.

So, while there is no reason to panic, now is a good time to prepare in case you are advised to shelter-in-place. We recommend 2-3 extra months of prescriptions. You may need to pay out-of-pocket before you are due with your insurance.  You can go to free services like SingleCare or GoodRx to find the best self-pay price for your medication in your area, or by mail order.

You can schedule a live video visit with a Paloma Health thyroid doctor to get necessary refill prescriptions.

Control the spread

  • Wash your hands and practice good cough etiquette
  • Diligently clean shared exercise equipment and workspaces
  • Bring bleach wipes and Emergen-C or Airborne on an airplane
  • Avoid big crowds if there’s an outbreak in your area
  • Check the CDC and local health department websites for spread updates

Stay informed

We recommend that you continue to monitor the Centers for Disease Control and World Health Organization websites for reliable COVID-19 updates.

To increase access to reliable information, the World Health Organization has partnered with WhatsApp and Facebook to launch a Health Alert messaging service. This service provides the latest news and information on COVID-19, including details on symptoms and how people can protect themselves. To access the service, send the word "hi" to the number +41 798 931 892 on WhatsApp.

A note from Paloma Health

Your safety and well-being are of utmost importance to us. We are working hard to keep all of our services operational. Extra steps are being taken to make sure our offices, labs, and warehouse are diligently and frequently disinfected and sanitized. If you need hypothyroid care while you stay home to protect yourself and others, all of our services are built to be used from the comfort of your home.

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