CIGARETTE-SMOKING AND THE THYROID

Relevant English language articles published from 1970 through 1993 regarding the possible influence of cigarette smoking on the thyroid were identified through a MEDLINE search and manual searches of identified articles. Thiocyanate in tobacco smoke influences the thyroid by a competitive inhibition of iodine uptake and organification in the gland. Also the stimulation of the sympathetic nervous system by cigarette smoke and benzpyrene, another constituent of tobacco, is thought to influence thyroid gland function. The thyroid hormones and TSH receptor autoantibodies are not affected by smoking, but serum TSH levels have been found to be slightly reduced. Smokers have a higher frequency of goiter and increased serum thyroglobulin levels, especially in iodine-deficient areas. Graves' ophthalmopathy is strongly associated with cigarette smoking; the more severe the eye disease the stronger the association. Graves' disease without ophthalmopathy is also associated with smoking, though this association is weaker. Thiocyanate level in cord blood equilibrates completely with the level in the mother, and a reverse correlation has been demonstrated between birth weight and thiocyanate level in cord blood. Cigarette smoking induces similar changes in thyroid function in the adult and the fetus. No separate study has elucidated the effects of cessation of smoking, but there seems to be longstanding effects induced by smoking, some probably irreversible.