Lifestyle and socioeconomic determinants of autoimmune activity in newly diagnosed Hashimoto’s thyroiditis
- 1Medical University of Plovdiv, Vassil Aprilov, 15A, Plovdiv, 4002
Abstract
Hashimoto’s thyroiditis (HT) is a prevalent autoimmune disorder in which clinical expression is defined not only by immunological mechanisms but also by lifestyle and socioeconomic determinants. These factors may be particularly influential in newly diagnosed, untreated patients, where autoimmune activity reflects the natural course of the disease. Understanding how behavioral and social variables relate to subjective health and autoantibody levels may support early, non-pharmacological interventions.Aim: to assess the relationship between health behaviors, socioeconomic indicators, subjective health, and autoantibody levels in newly diagnosed, untreated HT patients.A case-control study was conducted among 105 newly diagnosed HT patients and 25 healthy controls. Sociodemographic characteristics, lifestyle behaviors, and dietary patterns were assessed using the validated KomPAN questionnaire. Thyroid function (thyroid-stimulating hormone,free thyroxine (TSH, fT4)) and serum anti-TPO(thyroid peroxidase) and anti-TG (thyroglobulin) concentrations were measured. Correlation analyses were performed to assess relationships between questionnaire-derived numerical scores of lifestyle and socioeconomic variables and autoimmune markers.HT patients exhibited significantly higher TSH and autoantibody levels and lower fT4 compared with controls. Diet quality, physical activity, and financial status showed significant correlations with anti-TPO antibody concentrations. Socioeconomic indicators demonstrated significant inverse associations with anti-TG antibody levels: financial status (r= -0.232), education (r= -0.182), and employment (r= -0.260) were inversely correlated with anti-TG levels (all p<0.01). Patients more frequently rated their health as “worse than peers,” reflecting the psychosocial burden of early disease stages.Lifestyle behaviors were closely linked to subjective health, while socioeconomic vulnerability was associated with higher anti-TG antibody levels in untreated HT patients. These findings suggest that financial insecurity, lower level of education, and unstable employment may be related to increased autoimmune reactivity, potentially through mechanisms involving chronic stress and limited access to healthcare. Early lifestyle optimization and multidisciplinary support may improve well-being even before hormone therapy is initiated. Larger prospective studies are needed to confirm these associations and clarify the pathways through which behavioral and social determinants influence autoimmune activity.
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BibTeX
@article{levterova2026lifestyle,
title = {{Lifestyle and socioeconomic determinants of autoimmune activity in newly diagnosed Hashimoto’s thyroiditis}},
author = {B.A. Levterova and D.G. Tomov},
journal = {Medičnì Perspektivi},
year = {2026},
month = sep,
doi = {10.26641/2307-0404.2026.3.376673},
url = {https://doi.org/10.26641/2307-0404.2026.3.376673},
note = {CC BY},
}
RIS
TY - JOUR
TI - Lifestyle and socioeconomic determinants of autoimmune activity in newly diagnosed Hashimoto’s thyroiditis
AU - B.A. Levterova
AU - D.G. Tomov
PY - 2026
DA - 2026/09/01
JO - Medičnì Perspektivi
DO - 10.26641/2307-0404.2026.3.376673
UR - https://doi.org/10.26641/2307-0404.2026.3.376673
AB - Hashimoto’s thyroiditis (HT) is a prevalent autoimmune disorder in which clinical expression is defined not only by immunological mechanisms but also by lifestyle and socioeconomic determinants. These factors may be particularly influential in newly diagnosed, untreated patients, where autoimmune activity reflects the natural course of the disease. Understanding how behavioral and social variables relate to subjective health and autoantibody levels may support early, non-pharmacological interventions.Aim: to assess the relationship between health behaviors, socioeconomic indicators, subjective health, and autoantibody levels in newly diagnosed, untreated HT patients.A case-control study was conducted among 105 newly diagnosed HT patients and 25 healthy controls. Sociodemographic characteristics, lifestyle behaviors, and dietary patterns were assessed using the validated KomPAN questionnaire. Thyroid function (thyroid-stimulating hormone,free thyroxine (TSH, fT4)) and serum anti-TPO(thyroid peroxidase) and anti-TG (thyroglobulin) concentrations were measured. Correlation analyses were performed to assess relationships between questionnaire-derived numerical scores of lifestyle and socioeconomic variables and autoimmune markers.HT patients exhibited significantly higher TSH and autoantibody levels and lower fT4 compared with controls. Diet quality, physical activity, and financial status showed significant correlations with anti-TPO antibody concentrations. Socioeconomic indicators demonstrated significant inverse associations with anti-TG antibody levels: financial status (r= -0.232), education (r= -0.182), and employment (r= -0.260) were inversely correlated with anti-TG levels (all p<0.01). Patients more frequently rated their health as “worse than peers,” reflecting the psychosocial burden of early disease stages.Lifestyle behaviors were closely linked to subjective health, while socioeconomic vulnerability was associated with higher anti-TG antibody levels in untreated HT patients. These findings suggest that financial insecurity, lower level of education, and unstable employment may be related to increased autoimmune reactivity, potentially through mechanisms involving chronic stress and limited access to healthcare. Early lifestyle optimization and multidisciplinary support may improve well-being even before hormone therapy is initiated. Larger prospective studies are needed to confirm these associations and clarify the pathways through which behavioral and social determinants influence autoimmune activity.
SN - 2307-0404
SN - 2786-4804
ER -