Impact of smoking on thyroid gland functioning: a literature review

Houas Jihene; Heyfa Belhadj-Miled; Monia Ghammam; Omri Malika El; Abir Meherzi; Mouna Bellakhdhar; El Abed Yosra Hasni; Wassim Kermani; Mohamed Abdelkafi

doi:10.1530/endoabs.99.EP272

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Endocrine Abstracts (2024) 99 EP272 | DOI: 10.1530/endoabs.99.EP272

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Impact of smoking on thyroid gland functioning: a literature review

Houas Jihene ¹ , Heyfa Belhadj-Miled ¹ , Monia Ghammam ¹ , Malika El Omri ¹ , 1 , Abir Meherzi ¹ , Mouna Bellakhdhar ¹ , Yosra Hasni El Abed ² , Wassim Kermani ¹ & Mohamed Abdelkafi ¹

Err

Author affiliations

¹Farhat Hached Hospital, ENT department, Sousse, Tunisia; ², Department of endocrinology, Sousse, Tunisia

Introduction: Smoking is a major public health problem with a role as an endocrine disruptor, particularly on the thyroid. The aim of our study is to assess the effects of tobacco on the thyroid.

Methods: We conducted a systematic literature review from 1984 to 2022. The keywords used for the search included "Tobacco, " "Thyroid, " "Goiter, " "Thyroid nodule, " "Hypothyroidism, " "Hyperthyroidism, " "Thyroid cancer, " and "TSH." Evaluation in different studies focused on thyroid function, TSH levels, FT4 levels, thyroglobulins, anti-TPO and anti-TG antibodies, goitrogenic effect, impact on Graves’ disease, Graves’ ophthalmopathy, and the effect on thyroid cancer.

Results: Eleven articles were included in this literature review, involving a total of 19, 621 subjects, including 17, 000 smokers. The average age of the patients was 47 years. 43.66% of the subjects were male, and 56.33% were female, with a sex ratio of 0.77. According to the studies reviewed, smoking leads to a decrease in TSH levels, potentially resulting in hyperthyroidism. It has a goitrogenic effect, which can be explained by elevated plasma concentrations of thiocyanates in smokers, with the implicated mechanism being a decrease in iodide uptake. Smoking may also worsen Graves’ ophthalmopathy and appears to reduce the effectiveness of treatments. Tobacco has not been implicated in the genesis of thyroid cancers.

Conclusion: Tobacco has a direct and often detrimental effect on neuroendocrine and thyroid function. It promotes hyperthyroidism, has a goitrogenic effect, and exacerbates Graves’ ophthalmopathy.