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Hashimoto's and Injury Recovery

Learn why Hashimoto's thyroiditis may prolong injury recovery.
Hashimoto's and Injury Recovery

In this article:

  • What is Hashimoto’s thyroiditis?
  • Overview of how tissues heal
  • The relationship between thyroid hormone and tissue repair
  • How to increase healing time from injury and surgery 


What Is Hashimoto’s?


Hashimoto’s thyroiditis is an autoimmune condition that causes chronic inflammation of the thyroid gland. This condition can eventually lead to hypothyroidism. Also known as chronic lymphocytic thyroiditis, Hashimoto’s is the leading cause of hypothyroidism in the United States. It most commonly affects middle-aged women, but men, children, and older adults can also have Hashimoto’s. 


There are still many questions as to why people develop Hashimoto’s. What we know is that this autoimmune condition tends to run in families and often accompanies other autoimmune conditions such as Sjogren’s syndrome and rheumatoid arthritis. Polyautoimmunity is the term for people who have more than one autoimmune disease. 


People with Hashimoto’s have symptoms similar to hypothyroidism, including:


  • Fatigue and sluggishness
  • Weight gain
  • Cold intolerance
  • Goiter (an enlarged thyroid gland)
  • Hair loss and dry skin
  • Joint pain and muscle weakness
  • Constipation
  • Irregular menstrual periods


Aside from assessing your symptoms and performing a physical exam, a diagnosis of Hashimoto’s is made based on lab tests that assess your thyroid function, including thyroid-stimulating hormone (TSH), free thyroxine (T4), and thyroperoxidase antibodies (TPO antibodies). 


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Overview of how tissues heal


Multiple systems in your body help heal injuries from trauma and surgery. However, our immune and vascular systems are the key players in tissue repair. 


There are four general overlapping phases of tissue repair, whether you have surgery or an unintentional injury like a scraped knee.


Homeostasis

The first phase of tissue repair begins the moment injury occurs and focuses on coagulation. Platelets and collagen in your blood congregate at the wound site to stop the bleeding.  


Inflammatory

In this phase, the body focuses on removing bacteria and debris by sending white blood cells to prevent infection. The inflammatory period lasts about four to six days and is usually accompanies by pain, heat, inflammation, and redness. 


Proliferative

Tissue is repaired and rebuilt in this phase. The tissue below the skin’s surface fills in with connective tissue, and blood vessels are formed and fixed. The edges of the wound pull together, and epithelial tissue (which is the top layer of your skin) covers the injury site.  


Maturation

The final phase is where new tissues gain strength and flexibility as collagen fibers reorganize for greater strength. Maturation is the most prolonged phase that lasts anywhere between 3 weeks to 2 years. 


Tissue repair can be affected by local, systemic, and environmental factors, including skin moisture, the severity of the injury, infection, age, nutritional status, and chronic health conditions.  


The relationship between thyroid hormone and tissue repair


The thyroid gland produces hormones that help regulate every cell in your body. Among its many roles are metabolism, growth and development, body temperature, heart rate, and reproduction. The effects of thyroid hormones even extend into your blood composition and the way your body repairs itself.


Low platelet counts


Hashimoto’s is linked to low platelet counts. Platelets make up a portion of our blood and are responsible for forming clots to stop injuries from bleeding. When platelets are low, people can lose more blood because it takes longer for these critical cells to form a barrier at an injury site. Some studies find that patients with subclinical hypothyroidism and Hashimoto’s see an improvement in their platelet count when they take levothyroxine. 


Inflammation and oxidative stress


Autoimmune conditions are characterized by chronic inflammation because of the tissue destruction that occurs when your immune system goes rogue. People with Hashimoto’s may experience a longer duration of inflammation following injury or surgery because their immune system is hyperactive. 


Thyroid hormones often have a protective role by regulating antioxidants in your system. Antioxidants prevent cellular damage caused by free radicals. When you do not have enough antioxidants in your system, it is hard to detoxify your body. This condition is called oxidative stress. Thus, low thyroid hormones can increase oxidative stress, which consequently worsens inflammation.  


How to increase healing time from injury and surgery 


Whether you have undergone surgery or are recovering from an injury, Hashimoto’s may slow your healing time. Try these steps to give yourself the best chance at a timely recovery.


Take your thyroid medication

Make sure you are on the right dose of thyroid hormone medication. Hashimoto’s can slow your vascular and immune responses to injury. Symptoms of low thyroid hormone can also make you feel worse during recovery, including fatigue and sluggishness.


Prevent infection

Follow wound care instructions from your doctor if you are recovering from surgery or have a deep wound. Make sure to avoid soaking in water as that increases healing time and your risk for infection.


Eat well to heal      

Healthy, wholesome foods provide essential vitamins, minerals, antioxidants, and proteins for repairing damaged tissues. Some foods have anti-inflammatory properties as well, including berries, broccoli, fatty fish, and avocados. 


Reduce stress

Try to limit physical, mental, and emotional stress in general, but especially when you are recovering from an injury or surgery. Stress increases cortisol in your body, which takes your body’s attention away from healing. 


Follow your provider’s instructions

Every injury and surgical incision requires a unique plan of care. Your doctor will talk to you about how to care for your injury or surgical site and let you know what medications are safe to take to control pain and inflammation. They should also tell you how much activity is safe. Make sure your doctor is aware that you have Hashimoto’s when creating your plan of care.

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