The annual appointment with the ‘World Thyroid Week’ is back from 22 to 28 May. In Italy there are 6 million people with thyroid problems, even if they are mainly non-serious and treatable pathologies. The considerable diffusion of these diseases in the population, especially women, and the ever-increasing interest of people, makes the theme of correct information central. For this reason, World Thyroid Week, on the recommendation of the European thyroid association and the Committee of Endocrine Patient Associations (Cape), will deal with information on the theme “Thyroid: genetics, family history and chronicity”. In Italy, the World Week is sponsored by the Higher Institute of Health and promoted by the main endocrinological, medical and surgical scientific societies together with the Cape, with the unconditional contribution of Ibsa Farmaceutici Italia, Merck and Merck Serono.
“Faced with a new diagnosis for a possibly familiar disease, the first thought, after concern for one’s health, is the possible relapse on the children – explains Anna Maria Biancifiori, president of Cape -. This is why we felt the urgency to ask the experts to shed light on these aspects. Knowing your family’s medical history can be helpful in allowing you to identify any predispositions or risks early and therefore implement the necessary measures to at least reduce the modifiable risk factors for that disease or undergo active prevention procedures “. The scientific societies have drawn up a clarifying document, shared with the ISS, aimed at dispelling doubts and answering the most frequently asked questions entitled “Thyroid: genetics, familiarity and chronicity”.
“Often the conviction is rooted that these pathologies, especially if present within the same family nucleus, are caused by a genetic predisposition or a familiarity with the disease – says Marcello Bagnasco, scientific coordinator of the Smt and president of the Italian thyroid association ( Ait) – and that, therefore, there is some degree of risk of contracting the disease for family members. Through this document, the result of the collaboration of the main scientific societies and the Cape, we want to clarify the doubts that revolve around genetic predisposition and familiarity, first among all the preconception that they are interchangeable terms: familiarity with any pathology, including thyroid disease, takes into consideration genetic factors, but also environmental ones, some of which are well known and can be successfully modified. we distinguish those that are the cause of hereditary diseases from non-communicable ones”.
In particular – reads a note – there are congenital diseases caused by alterations in the functioning or development of the thyroid gland which manifest themselves from birth and whose clinical manifestation is congenital hypothyroidism. These conditions in most cases are not familiar. It is essential, however, to recognize the disease early, from birth, to prevent severe developmental and neurocognitive deficits. “In Italy, thanks to law 104/1992, a national neonatal screening program for congenital hypothyroidism is active – specifies Antonella Olivieri, scientific director of the national register of congenital hypothyroidism and of the national observatory for the monitoring of iodine prophylaxis of the ISS – The presence of a neonatal screening aimed at all newborns and the availability of an active disease surveillance system guarantee the maximum efficiency of a prevention system which allows these children an excellent quality of life”.
The document also shows that for autoimmune thyroid diseases, which are the main causes of hypothyroidism and hyperthyroidism in our country, there is a predisposition on a multigenic basis (i.e. given by the combination of many different genetic factors), together with the additional intervention of multiple environmental factors, including cigarette smoke, major stressful events and exposure to pollutants (called endocrine disruptors). Even in these cases, healthy children of people with autoimmune thyroid disease need not be screened for thyroid function unless symptoms such as fatigue, anxiety, restlessness, and palpitations appear. Instead, even in the absence of symptoms, thyroid function must be monitored in the event of pregnancy planning, given the importance of early diagnosis for the health of the fetus.
“Most thyroid diseases – underlines Bagnasco – have the character of chronicity, that is, even if in most cases they allow a life in full well-being if treated, they need lifelong care and control, and, in particularly with advancing age, the problems they involve add up to those of other chronic diseases (for example metabolic and cardiovascular) widespread in the general population”.