Thyroid Malignancy Associated with ME/CFS

It has recently been discovered that the prevalence of thyroid malignancy in patients with ME/CFS is a lot greater than any other subgroup that was studied.

In the subgroup that had ME/CFS, the incidence of thyroid malignancy was as much as 6,000 cases out of 100,000 and may even exceed that amount. The researchers from this study are suggesting that people with ME/CFS be tested by thyroid ultrasound for evidence of thyroid pathology and malignancy. Thyroid pathology may be missed in this group of patients if investigation relies only upon serum testing for TSH, FT3, FT4, microsomal and thyroglobulin antibodies, which are usually normal. Thyroid uptake scans can often miss malignant lesions as well and the scan often tends to come out normal.

It is being suggested that a newly recognized syndrome may exist in ME/CFS patients that consists of:

• thyroid malignancy
• Persistent abnormal cortical and subcortical SPECT brain scans
• Failure of thyroid surgery and hormone replacement to heal the fatigue syndrome
• an unusual high incidence of cervical vertebrae osteoarthritic changes

Even ME/CFS patients who are receiving treatment for thyroid disease that is non-malignant along with abnormal SPECT scans might also not improve despite hormone replacement therapy. How many of us with ME/CFS reading this are on thyroid medicine (I’m raising my hand!).

In thegeneral population, thyroid malignancy is only found in approximately 0.5 – 3 patients in 100,000. As a comparision, when a subgroup of patients havning a mammography were tested for thyroid malignancy, the incidence rate was as high as 3 in 100,000. Another study revealed it was 15 per 100,000.

For ME/CFS 6,000 cases per 100,000 is a lot – especially when you compare it to the general population statistics of less than one to 3 cases per 100,000. That’s kind of scary.

For this study, there were 100 ME/CFS patients tested for thyroid malignancy. In each of these patients the diagnosis was made by ultrasonography and needle biopsy under ultrasonography. This was followed by surgical removal of the thyroid, and each case the malignancy was confirmed.

These findings would suggest that 6% of the ME/CFS patients seen, or 6,000 cases per 100,000, had a confirmed thyroid malignancy. Unfortunately, these figures may be conservative since we are in the process of obtaining needle biopsies on six further cases of these first 100 patients. In addition, we have not yet performed thyroid ultrasound on all 100 cases. We are in the process of further investigation of those patients who had not yet been investigated by thyroid ultrasound.

Previously, it has been noted that the increased incidence of thyroid malignancy in the general population is only associated with increased radiation exposure. Patients presenting with symptoms of ME/CFS or Fibromyalgia may have significant higher thyroid malignancy incidence.

Source: Alasbimn Journal