The disease known as idiopathic pulmonary fibrosis (IPF) is a hot topic on the pulmonary speaker’s circuit.  I have been asked to give several more regional talks on this subject in recent weeks. One of the newest diseases to be associated with IPF is hypothyroidism.  In a recent report in CHEST magazine it was reported that 17% of patients with IPF had hypothyroidism.  Even more importantly, both men and women with IPF who also had hypothyroidism had significantly shorter survival than did patients who had IPF alone. Having said all this, we really do not know what this correlation means. 

It does not appear that treating the hypothyroidism improves survival.  Therefore, the significance of this information is that it may help predict survival in patients with IPF.  It may mean that patients with IPF should be screened for thyroid disease, if only to advise them of the severity of their illness.  The other side of the coin must be considered as well, that is, should we follow patients with hypothyroidism over long periods of time to see if they develop IPF and have their treatment started sooner.

This is an example of a situation I have come across many times, namely, an answer to one question often leads to many more questions that have no current answers. As it stands right now, early recognition and the use of newer drug therapies may offer some hope to patients with IPF.  I am planning to check thyroid levels on newly diagnosed cases.