Can hypothyroidism increase the chance of sepsis?

I’ll come back to this question later.

Sepsis affects millions of people. The number of patients who present this condition are increasing each and every year. The blame for this rise has been put down to antibiotic resistance and a shortage of nursing staff.

According to the official medical doctrine “Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection”.[R]

Sepsis is a response to infection. It tends to take hold primarily in patients who have weakened immune systems. Usually, the patient will have an existing autoimmune condition.

When the immune system is at full strength, an infection will cause an increase in white blood cells that attack and disable the unwanted bacteria. With a compromised system, bacteria will establish itself and multiply.

If an infection takes hold, total organ wide inflammation (multiorgan distress syndrome (MODS)) occurs followed by an anti-inflammatory response. At the mitochondrial level, oxygen would normally help to generate energy for the cell. Under sepsis conditions, the mitochondria stop utilising oxygen and resort to a kind of hibernation. This is thought to be for protective reasons. [R]

A situation of gradual reduction in normal cellular activity. Normal immunoregulatory activity fails resulting in an inappropriate response.

Essentially, you do not have the right tools for the job. You are trying to repair a burst pipe with a sledge hammer. 

This leads to low blood pressure, resulting in the possible failure of critical organs; sceptic shock. It is the bodies last resort in it’s defence arsenal, it’s either make or break by the time this happens.

It may be no coincidence that mitochondrial activity is suppressed during hypothyroidism.

Causes

A major cause of sepsis is a candida overgrowth [R]. Candida overgrowth is a consequence of hypothyroidism [R].

However, any type of bacterial overgrowth, virus or even parasitic infection can perpetrate sepsis.

According to sepsis.org

People with impaired immune systems are more likely to develop sepsis with fungal infections than people with normal immune systems.

Auto immune diseases are on the rise. Having an auto immune related condition means that your immune system is dysfunctional. Also known as immunocompromised, the causes are varied. See ‘Sepsis risk factors’ below

Vitamin C

There is discussion of vitamin C (acorbic acid) being utilised to mitigate the onset of sepsis symptoms [R]. The studies of ascorbic acid treatment have led to a discovery that 40% (in this study) were deficient in the vitamin, so much so they were clinically diagnosed with scurvy.

Critically ill patients have low vitamin C concentrations despite receiving standard ICU nutrition. Septic shock patients have significantly depleted vitamin C levels compared with non-septic patients, likely resulting from increased metabolism due to the enhanced inflammatory response observed in septic shock. [R]

Ascorbic acid is well known as an immune system protagonist.

Thyroid Connection

A comprehensive study of 66 patients with sepsis was conducted in 2004. The authors point to an unmistakable link between the condition and either dysfunctional cortisol levels or hypothyroidism. [R]

A total of 66 consecutive patients were studied…. Of the 58 patients with severe sepsis and septic shock, 10 (17.3%) were trauma patients. All 10 patients sustained blunt trauma with multiple injuries. Of the 66 patients, 5 patients (7.6%) had only hypothyroidism and 35 patients (53.0%) had only adrenal insufficiency. Eight patients (12.1%) had hypothyroidism and adrenal insufficiency and 18 patients (27.3%) had neither.

Looking at the results of this study it is noteworthy that out of 66 patients just five were diagnosed with hypothyroidism. The issue I find with this study is their testing parameters, which they admit was a limitation. Whilst 35 patients had only adrenal insufficiency. I would hazard a guess that the 35 adrenal fatigued people were also hypothyroid to some degree. A clinical diagnosis of hypothyroidism requires a TSH to be above 5, when in reality if the level is above 1.18 [R], symptoms can be less obvious.

One limitation of our study is that the levels of T3 and T4 were not tested in patients with elevated TSH concentrations….Although we measured TSH levels during the acute phase of the critical illness, when TSH elevation most likely reflects true hypothyroidism, T3 and Tlevels would have allowed us to differentiate between patients with clinical and subclinical hypothyroidism….There seems to be a close association between adrenal and thyroid dysfunction. Treatment of hypothyroidism may unmask adrenal insufficiency….

They often have mental, pulmonary, cardiovascular, renal, and hepatic dysfunction that can easily mask the presence of hypothyroidism as well as adrenal insufficiency….

The current evidence suggests that treatment of hypothyroidism and adrenal insufficiency may improve the outcome of these critically ill patients.

It is quite alarming how patients are now presenting sepsis and sceptic shock at a younger age.

Children with septic shock who died…. had higher TSH levels compared to those who survived. [R]

Sepsis risk factors

Your immune system is below par. There are a multitude of factors that can lead into this situation.

Primary causes;

Organ Replacement. You have a replacement organ and take immuno supressors.

Cancer Treatment. Your infection fighting cells can be limited due to chemotherapy.

Low white blood count. Essentially, immunocompromised due to you having an infection or are taking certain drugs which result in this as a side effect.

Other causes;

Stress. The way in which stress causes a decrease in white blood cells, is primarily by readjusting your hormone levels from normal to emergency (fight or flight). The body is taking resources from your immune system to strengthen your defence system.

Bad diet. PUFAs (polyunsaturated fatty acids) have the most effect on your immune system health. You may be suppressing your immune system believing you have a healthy diet.

Lifestyle. Drinking too much, smoking, over eating, not enough exercise, toxic relationships, lack of exercise, over exercising, over working. The list is endless.

Conclusion

Back to the question of whether hypothyroidism affect sepsis. It all comes down to the immune/metabolic systems balance. If your thyroid is not working efficiently, it cannot provide enough resources to power both systems effectively.

Resources are taken away from your immune system, as your body will consider this system secondary to your prime metabolic energy system.

What can you do to protect yourself?

As long as you havn’t had an organ transplant and your spleen is in good condition then you should be able to strengthen your metabolic status by diet and lifestyle adjustments.

References

Thyroid function in children with sepsis and septic shock. https://www.ncbi.nlm.nih.gov/pubmed/17407466

The evidence for a narrower thyrotropin reference range is compelling. https://www.ncbi.nlm.nih.gov/pubmed/16148345/

Patients with sepsis have SCURVY  https://emcrit.org/isepsis/isepsis-patients-sepsis-scurvy/

Primary Adrenal Insufficiency Misdiagnosed as Hypothyroidism in a Patient with Polyglandular Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899963/

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