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Hashimoto's Disease and Coronavirus (COVID-19)

This is a regularly updated coronavirus (COVID-19) guide for thyroid patients.
Hashimoto's Disease and Coronavirus (COVID-19)
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The COVID-19 crisis is a worldwide emergency, and you may understandably feel worried about the impact of coronavirus on you and your loved ones—especially if you have a chronic condition like hypothyroidism or Hashimoto's thyroiditis. 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

Coronaviruses are a family of viruses which may cause illness in animals or humans.  In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

On April 11, 2020 WHO updated its Q&A page on COVID-19 to provide information of how the virus spreads and how it is affecting people worldwide.

Symptoms of coronavirus

Confirmed coronavirus illnesses range from mild symptoms to severe illness or death. Symptoms appear on average 5-6 days after exposure, however can be up to 14 days, and include:

Most common symptoms
  • Fever
  • Tiredness
  • Dry cough

Occasional symptoms
  • Aches and pains
  • Nasal congestion
  • Runny nose
  • Sore throat
  • Diarrhea

Some people can be infected without any symptoms and or feelings of unwell, and most people recover from the disease without needing special treatment. Around one out of every six people who contracts COVID-19 becomes seriously ill and develops difficulty breathing.

People with fever, cough, and difficulty breathing should seek medical attention.

Spread of coronavirus

The disease spreads from person-to-person through small droplets from the nose or mouth. These droplets may land on objects or surfaces from an infected person and someone else may introduce the virus to their system when they touch these objects or surfaces then touch their eyes, nose, or mouth. Physical distancing is important because you can also breathe in droplets directly from a person who is sick with COVID-19, and many people with COVID-19 only have mild symptoms so they may not be aware of their infection.

Studies to date suggest that COVID-19 is primarily spread through contact with respiratory droplets rather than through the air. The droplets from coughing or sneezing are too heavy to hang in the air and they quickly fall on floors or surfaces.

Treatment of coronavirus

As of April 15, 2020, there is no vaccine and no specific antiviral medicine to prevent or treat COVID-2019. Possible vaccines and some specific drug treatments are being tested through clinical trials. Until then, the most effective ways to protect yourself and others are to frequently clean your hands, wear a mask, and maintain physical distance from people who are coughing or sneezing. Those affected should receive care to relieve severe symptoms.

If you have a fever, cough, and difficulty breathing, you should seek medical attention. Call in advance so that your healthcare provider can direct you to the right health facility, and you'll help prevent the spread.

Some countries are now testing for antibodies to SARS-CoV-2, the virus that causes COVID-19, which may help experts understand the extent of – and risk factors associated with – infection. However, at this point in the pandemic, there is not enough evidence that the detection of antibodies to SARS-CoV-2 should warrant an “immunity passport” or “risk-free certificate," as there is no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.

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. While experts are still learning about how COVID-19 affects people, older people and people with pre-existing medical conditions (like high blood pressure, heart disease, lung disease, cancer or diabetes) appear to develop serious illness more often than others.

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.

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.

Maintain at least a three-foot distance

  • Maintaining a three-foot distance between yourself and others helps to reduce your—and their—risk of infection when they cough, sneeze, or speak.
  • Keep an even greater distance between yourself and others when indoors. 

Hang out outside

  • Avoid crowded or indoor settings. If you cannot, take precautions.
  • Outdoor gatherings are safer than indoor ones, especially if indoor spaces are small or without outdoor air coming in.
  • If indoors, open a window to increase natural ventilation.

Wear a mask

  • Masks help to limit transmission of COVID-19 and save lives. They reduce potential exposure from an infected person, and they prevent onward transmission when worn by an infected person.
  • Wear a fabric mask, making sure it covers both your nose, mouth, and chin.
  • Wear a medical/surgical mask if you are over 60, have underlying medical conditions, feel unwell, and/or look after an ill family member.
  • Clean your hands before putting your mask on and before you take it off.

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Maintain good hygiene

  • Regularly clean your hands with an alcohol-based sanitizer or wash them with soap and water to eliminate germs, including viruses.
  • Don't overwash the point of exacerbating your skin symptoms like cracked, dry skin where infection can enter. Remember to moisturize between washes.
  • Avoid touching your eyes, nose, and mouth as hands can transfer the virus to your eyes, nose, or mouth. 
  • Cover your mouth and nose with your bent elbow when you cough or sneeze to protect the people around you from viruses.
  • Frequently clean and disinfect surfaces that are regularly touched, like door handles, faucets, and phone screens.
  • Sleep seven to nine hours per night to give your immune system time to repair itself.
  • 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. These micronutrients may not protect you from the virus, but they 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 medications (or other) in case you become limited by travel restrictions or product shortages.

The Federal Drug Administration (FDA) is taking steps to monitor the supply chain.  The Drug Shortage Staff within the FDA’s Center for Drug Evaluation and Research (CDER) has asked manufacturers to evaluate their entire supply chain, including active pharmaceutical ingredients, finished dose forms, and any components that may be impacted in any area of the supply chain due to the COVID-19 outbreak.  For the latest information from the FDA on COVID-19, visit their website.

While there is no need 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 use free services like SingleCare or GoodRx to find the best self-pay price for your medication in your area, or by mail order.

Schedule a live video visit with a Paloma Health thyroid doctor to get necessary refill prescriptions.

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.

What to do if you feel unwell

The most common symptoms of COVID-19 are fever, dry cough, and extreme tiredness. Some patients report experiencing loss of taste or smell, aches and pains, headache, sore throat, nasal congestion, red eyes, diarrhea, or a skin rash.

Take the following measures if you experience these symptoms:

  • Stay home even if you have minor symptoms such as cough, headache, or mild fever until you recover. 
  • If you need to leave your home, or live with/near another person, wear a medical mask to avoid infecting others.
  • If you have a fever, cough, or difficulty breathing, get medical attention immediately. If you can, call by telephone first, and follow the directions of your local health provider.
  • Stay informed of the latest information from trusted sources, like the World Health Organization or your local and national health authorities. 

A note from Paloma Health

Your safety and well-being are of utmost importance to us. All of our services operational, and 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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Join us in the Thyroid Care Club Facebook Group for more on this topic and many others regarding thyroid health and well-being.


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Katie Wilkinson

Katie Wilkinson, previously serving as the Head of Content and Community at Paloma Health, fervently explores the nexus between healthcare and technology. Living with an autoimmune condition, she's experienced firsthand the limitations of conventional healthcare. This fuels both her personal and professional commitment to enhancing patient accessibility to superior care.

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