Best known for their pain relieving and euphoric effects, opioids are powerful drugs with a wide range of side effects.
In the short term these side effects can include nausea, vomiting, constipation, lethargy and severe itching amongst others.
Though unpleasant, these are not anything to be particularly concerned about. However, it will come as no surprise to learn that excessive opioid use is not good for your health, and can cause several much more serious health complications in the long term.
Addiction and overdose are very real risks, whilst other damaging health effects can include depression, chronic digestive issues, and heart problems, particularly increased risk of heart attacks.
One lesser-known side effect of opioid use is how it can cause hormonal problems, and specifically how it can affect the thyroid gland.
In this article, we’ll take a look at how opioids can affect the thyroid, how serious the problems are, and what to do if you’re concerned your opioid use may be affecting your thyroid.
First, however, we’ll tackle the basics. What is the thyroid gland, and what does it do?
What Is The Thyroid Gland?
The thyroid gland can be found at the front of the neck, just below the Adam’s apple. It is made up of two lobes, one either side of the windpipe, each about the size of half a plum and connected by a piece of tissue known as the thyroid isthmus.
It is an endocrine gland, and its primary purpose is to produce two hormones that are secreted into the blood- thyroxine (T4) and triiodothyronine (T3).
These hormones are vital in ensuring the normal functioning of all the cells in the body.
Both T3 and T4 contain iodine, which is made in the thyroid. It is the T3 that is the biologically active substance, and this substance controls the metabolism of all the body’s cells.
In other words, it controls the speed at which the body’s cell’s function. As you can imagine, this is pretty important, as the cells are one of the ‘building blocks’ of the human body.
Too much of these hormones in your blood and your cells start working too quickly, and too little and your cells will start working too slowly.
By extension, this affects your organs and can cause all sorts of issues with your bodily functions.
For example, hyperthyroidism, or an overactive thyroid, could cause an increased heart rate, whilst the opposite, hypothyroidism, would cause a heart rate slower than usual.
How Do Opioids Affect The Thyroid?
Opioid use can affect the thyroid in a number of ways, but these issues can be tricky to diagnose, as the symptoms can often be similar to those of other illnesses or disorders.
One of the biggest concerns however is a condition known as ‘Opioid Induced Endocrinopathy’. So, what is endocrinopathy?
The endocrine system is the umbrella term for all the hormone secreting glands in the body, which includes the thyroid as well as others such as the pituitary gland and the adrenal glands.
To put it simply, endocrinopathy is any disease of an endocrine gland, including the thyroid gland. Therefore, both hyperthyroidism and hypothyroidism can be described as endocrinopathy.
Studies have shown that sustained, long term opioid use can cause hormonal deficiencies, affecting the production and secretion of vitally important hormones not just from the thyroid gland but also from other glands in the endocrine system.
For example, the levels of the steroidal hormones adrenal androgen and cortisol have been shown to be below normal in approximately two-thirds of people who have been taking opioids for over a month.
One way in which the thyroid gland specifically is affected by opioid abuse is seen in increased levels of the active hormone T3, which can cause hyperthyroidism.
The symptoms of hyperthyroidism are varied, but include heart palpitations, weight loss, anxiety, persistent fatigue, and sensitivity to heat, amongst others.
Combining this with, for example, low cortisol levels, which can cause many of the same symptoms, it’s easy to see how long-term opioid use can cause hormonal imbalances and by extension persistent health problems.
Not only can it affect your physical health, but your mental health and quality of life can be seriously impacted, too. However, it should be noted these problems are not life-threatening.
Should I Be Worried?
Obviously, this all sounds very concerning. But it’s important to stress that not everyone taking opioids will suffer any negative implications for either the health of their thyroid or to their hormonal balance in general.
Crucially, whilst patients who have been taking opioids for a sustained length of time are likely to suffer from some form of hormone imbalance, anyone using opioids over a short time frame will almost certainly be fine.
Even if your opioid use is long term, the good news is that any damage is highly likely to be reversible, and you should be able to regain a normal hormonal balance when you stop using opioids.
Reassuringly, if you are receiving treatment with opioids equivalent to 100 mg of morphine daily, your doctor should be monitoring the hormone levels in your blood in order to spot any issues with thyroid function or the function of other endocrine glands before any issues develop.
Another important factor to bear in mind when considering your thyroid health is that hypothyroidism is relatively common, especially in older women.
It affects one in ten women over 40, compared with one in a hundred men. Hyperthyroidism is less common, but women are more at risk of developing that too.
The point is that if managed correctly, thyroid issues need not be any hindrance to enjoying a happy, fulfilling life.
What To Do If You Suspect Your Opioid Use Is Causing Thyroid Problems
The first thing you should do is arrange a blood test with your doctor to check your hormone levels.
If your opioid use is part of a course of treatment, you will likely be screened anyway, but if you are concerned do get yourself tested. Your doctor will treat you if necessary.
If your opioid use is non-regulated, you will need medical help to draw up a treatment plan that involves not just medication and hormone therapy, but also help to end your addiction to opioids and thereby remove the cause of the problem.
Once the chemical dependency has been removed, the body’s normal functions will begin to return with the help of treatment provided the patient can remain free of opioids.
Thyroid problems and other hormonal problems can be treated, but it needs co-operation between the patient and health professionals, which in cases of individuals with opioid abuse issues can be difficult to achieve.
So, now it’s time to recap.
The thyroid gland is one of several hormone secreting glands in the body, part of the endocrine system.
The thyroid produces T3 and T4, hormones that directly affect the speed at which the body’s cell’s function.
Therefore, any problems with the thyroid can disrupt bodily functions and cause a range of unpleasant symptoms that can negatively impact quality of life and mental well-being.
Though these symptoms are unpleasant and need medical attention, they are not life-threatening. Many people, with older women particularly susceptible, live with thyroid issues and live happy, healthy lives.
Long-term opioid use has been shown to be a risk factor for thyroid health and the endocrine system in general, usually resulting in hormonal imbalance and associated health issues.
However, these symptoms can usually be alleviated by the correct treatment. In cases of opioid abuse, a large part of this treatment will be ending the patient’s reliance on opioids in the first place.
So, yes, long term opioid use can cause thyroid problems, but don’t panic! It can be treated.