Grave’s Disease after COVID Infection & Vaccination
As we go into another round of COVID-19 infections and surges, and as people are getting second boosters, there are some important symptoms that have been coming up that are worth noting. One of those is the connection between infection and vaccination and Grave’s disease.
Grave’s Disease or Autoimmune Hyperthyroidism is caused by overstimulation of the thyroid gland by the immune system. Antibodies such as Thyroid Stimulating Immunoglobulin (TSI) and Thyroglobulin Receptor Antibodies (TRAb) are commonly produced. TSI binds to receptors on the thyroid gland that increases thyroid hormone. Additionally, the feedback mechanism that normally keeps the thyroid hormone stable cannot function properly. This leads to excessive thyroid hormone in the blood. Grave’s Disease was once thought of a rare disease where 20-50/100,000 people are affected. Rates are often higher in females compared to males (1).
COVID-19 and Grave’s Disease
The number of patients we have seen with Grave’s has increased in the past 1.5 years. What we have been seeing in office is that 1-3 months post-infection or vaccination for COVID-19 can sometimes cause hyperthyroid symptoms or Grave’s in patients without known past autoimmune or thyroid disease. The number of case reports continue to increase with other providers noticing similar increases in the number of Grave’s cases. In an Italian study, which looked at 287 COVID positive patients with no history of hyper- or hypo-thyroidism, the researchers found 20.2% of patients to have thyrotoxicosis (clinically evident excessive excess thyroid hormone) (2). So far only case studies have been reported of those developing Grave’s disease after vaccination – usually within 2-3 weeks post vaccination (3). This has occurred with initial vaccinations as well as with booster shots, and usually occurs in younger populations (under 60 years old).
The proposed mechanism of COVID-19 infection and vaccination effect on the thyroid gland include molecular mimicry and immune system activation. Molecular mimicry is when a piece of virus or vaccine looks similar to cells in our body. This causes an autoimmune reaction against our own cells. This leads to thyroid inflammation resulting in hyperthyroidism.
Symptoms of Grave’s Disease
If you are experiencing any of the symptoms below of Grave’s disease after COVID-19 infection or vaccination, make an appointment with your healthcare provider.
- Anxiety, irritability or nervousness
- Fatigue
- Heart palpitations, increased heart rate, or irregular heart beats
- Feeling hot or heat intolerance
- Weight-loss or weight gain unexpected
- Hand tremor
- Enlarged thyroid gland or goiter
- Difficulty swallowing
- Eye bulging, eye puffiness, eye pain, light sensitivity
- Difficulty sleeping
- Muscle weakness
- Diarrhea or increased bowel movement frequency
- Changes to skin, including skin thickening and reddening
If you or any of your family has lingering symptoms from COVID-19 infection or vaccination, please reach out to your provider for more information. If you are concerned that you may have an autoimmune disease post infection or vaccine, our physicians are here to help! Schedule a free phone consult with us today!
References:
- Pokhrel B, Bhusal K. Graves Disease. [Updated 2021 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan
- Lania A et al on behalf of Humanitas COVID-19 Task Force. Thyrotoxicosis in patients with COIVD-19: the THYRCOV study. Eur J Endocrinol. 2020. doi: 10.1530/ EJE-20-0335.PMID: 32698147
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Singh G, Howland T. Graves’ Disease Following COVID-19 Vaccination. Cureus. 2022 Apr 23;14(4):e24418. doi: 10.7759/cureus.24418. PMID: 35497078; PMCID: PMC9038595.
