Abstract

Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene–environment interactions underlying the pathology of thyroid diseases.

Highlights

  • Thyroid hormones are crucial for normal development and necessary for the proper functioning of physiological systems

  • Lifestyle factors that showed the clearest association with thyroid-stimulating hormone (TSH) and thyroid hormones were smoking, body mass index (BMI) and iodine

  • The scope of this review was to provide a comprehensive insight into the literature discussing the influence of environmental factors on TSH and thyroid hormone levels in healthy adults

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Summary

Introduction

Thyroid hormones are crucial for normal development and necessary for the proper functioning of physiological systems. Genetic factors account for up to 65% of interindividual variations in TSH and thyroid hormone levels [6,7], but many other factors can influence thyroid function. Twin studies have shown that genetic factors underlie 45–65% of interindividual variations in TSH and thyroid hormone levels [6,7]. Most studies investigating the influence of smoking on TSH and thyroid hormone levels have observed a decrease in TSH levels and an increase in T3 and T4 levels in smokers [16,21,22,23]. Several studies have suggested that smoking reduces autoimmune processes in the thyroid gland [24,31], resulting in alterations in TSH and thyroid hormone levels. Alarming results were obtained in the study of Filis et al, showing that maternal smoking disrupts fetal thyroid development [34]

Alcohol Consumption
Body Mass Index
Exercise
Heavy Metals
Findings
Conclusions
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