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Smoking has a complex relationship with thyroid autoimmunity it appears to mildly protect against Hashimotos while increasing risk of Graves disease

doi: 10.1186/s12974-020-02064-0, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar] Nishi D., Hashimoto K., Noguchi H., Hamazaki K., Hamazaki T., Matsuoka Y

This is due to the fact that M1 macrophages, which are pro-inflammatory, possess higher concentrations of inducer nitric oxide synthase (iNOS), leading to a greater production of nitric oxide free radicals and stronger protection against lipid peroxidation, when compared to M2 macrophages, which are anti-inflammatory and have lower iNOS concentrations (83)

What to watch for: GI side effects often increase with this first dose bump

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