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Sample Interview

Your Expotype, weighed and cited.

We map your interviews against thousands of peer-reviewed research findings about specific exposures, creating potential "matches." We weight and score each match by the strength of scientific evidence around that exposure and by its relevance to your story, so the matches we report are both precise and practical. The picture grows clearer with every interview you complete.

Sample Expotype Report

Jane

Female · born April 12, 1988 · updated July 31, 2026

What we checked

Published research on exposures and health, weighed finding by finding against what you told us about your life.

published findings: 611
exposures screened: 79
deemed relevant: 12
highly relevant: 1

High relevance

These fit what you told us, and the science behind them is solid.

Phthalates (DEP)

Diethyl phthalate (DEP) is commonly used in cosmetic products to make scents last longer. DEP is easily inhaled, ingested, or absorbed through skin contact. Phthalates have been linked to endocrine disruption and are associated with altered thyroid hormone levels. Given that you wear scented body lotion and perfume daily, these products could be contributors to your disease worth examining. Phthalates are processed and cleared rapidly through urine, so changing your product choices can have an immediate impact.

Urinary monoethyl phthalate (MEP), the metabolite of diethyl phthalate, is associated with higher odds of subclinical hypothyroidism in early pregnancy, alongside metabolites of di(2-ethylhexyl) phthalate, with disruption of the hypothalamus-pituitary-thyroid axis proposed as the mechanism. The design is case-control and cannot establish that exposure preceded the thyroid change.

Study type: observational study
Citation: Yang Z, Shan D, Zhang T, et al. Associations between exposure to phthalates and subclinical hypothyroidism in pregnant women during early pregnancy: A pilot case-control study in China. Environ Pollut. 2023;320:121051. doi:10.1016/j.envpol.2023.121051 (opens in new tab)
Biomarkers: monoethyl phthalate (MEP)urine
mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP)urine
mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP)urine
thyroid peroxidase antibody (TPOAb)serum
thyroid-stimulating hormone (TSH)serum
free thyroxine (FT4)serum
Methods: Pilot case-control study drawn from a cohort of pregnant women in Beijing, China: 42 women with subclinical hypothyroidism and 84 non-case controls matched on age and body mass index. Serum thyroid peroxidase antibody, free thyroxine, and thyroid-stimulating hormone, together with ten urinary phthalate metabolites, were measured during early pregnancy.
Results: Urinary MEP was significantly higher in the 42 subclinical hypothyroidism cases than in the 84 matched controls (p = 0.01). Conditional logistic regression found MECPP, MEP, MEOHP, and the sum of DEHP metabolites each associated with higher odds of subclinical hypothyroidism, with adjusted odds ratios of 1.89, 1.42, 1.81, and 1.92 respectively. Multiple linear regression showed MECPP, MEOHP, and the DEHP sum positively associated with TSH and with FT4 x TSH across the whole study population, and Bayesian kernel machine regression with analysis stratified by body mass index showed upward tendencies in both. The authors conclude that DEHP carried the strongest signal and describe the study as a pilot.

Co-exposure to a mixture of phenols, parabens, and phthalates is associated with altered serum thyroid hormone concentrations and with the likelihood of positive thyroid peroxidase and thyroglobulin antibodies, with the size and direction of the effect varying by sex and by age. The analysis is cross-sectional and the authors state that causality has not been established.

Study type: observational study
Citation: Cheng F, Chen X, Fan J, Qiao J, Jia H. Sex-specific association of exposure to a mixture of phenols, parabens, and phthalates with thyroid hormone and antibody levels in US adolescents and adults. Environ Sci Pollut Res Int. 2023;30(57):121207-121223. doi:10.1007/s11356-023-30739-7 (opens in new tab)
Biomarkers: thyroid peroxidase antibody (TPOAb)serum
thyroglobulin antibody (TgAb)serum
thyroglobulin (Tg)serum
total thyroxine (T4)serum
total triiodothyronine (T3)serum
free thyroxine (FT4)serum
free triiodothyronine (FT3)serum
thyroid-stimulating hormone (TSH)serum
Methods: Cross-sectional analysis of 704 adolescents and 2,911 adults from the 2007-2012 National Health and Nutrition Examination Survey (NHANES). Sixteen endocrine-disrupting compounds were measured in urine and eight thyroid measures in serum. Single-compound associations used generalized linear regression; the mixture effect used Bayesian kernel machine regression and quantile-based g-computation, with results stratified by sex and age.
Results: Sixteen endocrine-disrupting compounds (3 phenols, 2 parabens, 11 phthalates) were measured in urine against eight serum thyroid measures in 704 adolescents and 2,911 adults. In single-compound regressions several compounds were positively associated with T3 and free T3 in boys and negatively associated with T4 and free T4 in girls; among adults, five compounds were negatively associated with T3, T4, or free T4. Bayesian kernel machine regression and quantile-based g-computation confirmed that co-exposure was associated with higher T3 in adolescents and lower T4 in both adolescents and adults. Nonlinear and linear relationships were identified between co-exposure and the risk of positive TPOAb and TgAb in girls and in adult females respectively. The authors call for prospective research into causal effects and mechanisms.

Moderate relevance

Real associations, but part of the picture is less certain: either the science, or how well it fits you.

SARS-CoV-2 and COVID-19

COVID-19 infection has been linked to significantly elevated risk of new thyroid disease, including hypothyroidism, in the years following illness, and SARS-CoV-2 has even been found to directly infect thyroid tissue. Given that you already have Hashimoto's disease and reported losing your appetite for several months after your first COVID infection in early 2020, that illness could be a contributor to ongoing thyroid disruption worth discussing with your doctor.

Nonhospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with moderately elevated risk of new-onset hypothyroidism, hyperthyroidism, and other thyroid disease over 4.5 years. Effects are smaller than in hospitalized patients but persist, suggesting even mild infection elevates long-term thyroid risk.

Study type: observational study
Citation: Mehrotra-Varma S, Hadidchi R, Henry S, et al. Elevated risk of new-onset thyroid disease associated with SARS-CoV-2 infection: a 4.5-year observational study. J Clin Endocrinol Metab. 2025. doi:10.1210/clinem/dgaf688 (opens in new tab)
Biomarkers: thyrotropin (TSH)
free thyroxine (FT4)
free 3,5,3ffde-triiodothyronine (FT3)
Methods: Retrospective cohort study using electronic health records (EHRs) from Montefiore Health System (Bronx, NY). 41,757 nonhospitalized patients with polymerase chain reaction (PCR)-confirmed COVID-19 were compared to 343,348 COVID-negative controls, all without prior thyroid disease. Follow-up spanned March 2020 to August 2024 (~4.5 years). Primary analysis used Cox regression with inverse probability weighting (IPW).
Results: Nonhospitalized COVID-19 patients showed moderately elevated risks across all thyroid outcomes vs COVID-negative controls: all thyroid disease (IPW-adjusted hazard ratio (HR) = 1.40, 95% confidence interval (CI) 1.35–1.46), hypothyroidism (HR = 1.38, 95% CI 1.31–1.46), hyperthyroidism (HR = 1.34, 95% CI 1.23–1.47), and other/unspecified thyroid disease (HR = 1.56, 95% CI 1.45–1.67), all P < .005. Kaplan-Meier curves showed gradual separation from COVID-negative controls emerging after approximately 2 years. Propensity score (PS)-matched analysis was consistent (HR = 1.42 for all thyroid disease). Compared to prepandemic historical controls, estimates were attenuated and some nonsignificant (hypothyroidism HR = 0.86, P = .003; hyperthyroidism HR = 0.88, P = .158), likely reflecting secular trends rather than a true null association, as contemporary COVID-negative vs historical controls also showed attenuated associations. Analysis restricted to patients with at least one thyroid function test confirmed findings (HR = 1.32 for all thyroid disease). Less restrictive laboratory thresholds yielded modestly higher estimates (HR = 1.52 for all thyroid disease).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in adults without pre-existing thyroid disease is associated with transient thyroid dysfunction, predominantly non-thyroidal illness syndrome (NTIS) and subclinical hypothyroidism, affecting ~14% of patients. Most cases are self-limiting over one year.

Study type: observational study
Citation: Tadisina S, Mohammed S, Asad R, et al. Prevalence and Evolution of Thyroid Dysfunction in COVID-19: A Retrospective Study. Cureus. 2025;17(9):e93542. doi:10.7759/cureus.93542 (opens in new tab)
Biomarkers: thyroid-stimulating hormone (TSH)
free thyroxine (fT4)
total triiodothyronine (TT3)
Methods: Retrospective single-center study at a tertiary care academic medical center including 615 adults with PCR-confirmed COVID-19 (March 2020–December 2023) who had thyroid function tests during infection. Patients with pre-existing thyroid disease or thyroid-affecting medications were excluded. A subgroup of 44 patients excluding those with critical illness and mechanical ventilation was also analyzed, and TFTs were followed for approximately one year.
Results: Of 615 COVID-19 patients, 84 (13.6%) had thyroid dysfunction. The most prevalent abnormalities were NTIS (n=39, 46.4%) and subclinical hypothyroidism (n=37, 44%), followed by overt hyperthyroidism (n=6, 7.1%) and overt hypothyroidism (n=2, 2.3%). In the refined subgroup of 44 patients (excluding critical illness and mechanical ventilation), subclinical hypothyroidism was the most common (61.3%), followed by NTIS (32%). Patients with and without thyroid dysfunction did not differ significantly in age (p=0.478), BMI (p=0.140), mortality (p=0.496), ICU admission (p=0.373), or hospital stay duration (p=0.258). Mechanical ventilation was significantly more common in the thyroid dysfunction group (32.1% vs 0%, p<0.001). On one-year follow-up, most abnormalities were transient: among subclinical hypothyroidism patients with repeat testing, 26% became euthyroid, 15% remained subclinical, and only 7% progressed to overt hypothyroidism. Among NTIS patients retested, 21% became euthyroid and one developed overt hyperthyroidism from a toxic nodule.

SARS-CoV-2 infection in COVID-19 patients is associated with ~13% thyroid dysfunction. Higher viral load independently predicts low thyroid-stimulating hormone (TSH), suggestive of thyroiditis, while free thyroxine (fT4) is unaffected. Elevated C-reactive protein (CRP) predicts low free triiodothyronine (fT3). Low fT3 portends adverse outcomes.

Study type: observational study
Citation: Lui DTW, Lee CH, Chow WS, et al. Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19. J Clin Endocrinol Metab. 2021;106(2):e926-e935. doi:10.1210/clinem/dgaa813 (opens in new tab)
Biomarkers: thyroid-stimulating hormone (TSH)serum
free thyroxine (fT4)serum
free triiodothyronine (fT3)serum
fT3/fT4 ratioserum
anti-thyroid peroxidase antibody (anti-TPO)serum
anti-thyroglobulin antibody (anti-Tg)serum
anti-TSH receptor antibody (anti-TSHR)serum
C-reactive protein (CRP)serum
erythrocyte sedimentation rate (ESR)blood
SARS-CoV-2 PCR cycle threshold (Ct) valuenasopharyngeal swab/deep throat saliva
Methods: 191 consecutive adult COVID-19 patients without known thyroid disorders admitted to Queen Mary Hospital, Hong Kong (Jul–Aug 2020) were prospectively recruited. Serum TSH, fT4, fT3, and anti-thyroid antibodies were measured on admission by immunoassay. SARS-CoV-2 Ct values from RT-PCR were obtained on the same day as a surrogate for viral load.
Results: Among 191 patients (mean age 53.5 ± 17.2 years, 51.8% male; 84.3% mild, 12.6% moderate, 3.1% severe COVID-19), 13.1% had abnormal thyroid function. Two distinct patterns emerged: 11 patients (5.8%) had subnormal TSH with high-normal fT4 and fT3/fT4 ratios mostly <0.3, consistent with thyroiditis (most anti-thyroid antibody negative); 12 patients (6.7%) had low fT3, consistent with non-thyroidal illness syndrome (NTIS). On multivariate analysis, lower Ct value (higher viral load) was independently associated with subnormal TSH (p=0.030), while elevated CRP was independently associated with low fT3 (p=0.007). fT3 decreased significantly with increasing COVID-19 severity (mild 4.18, moderate 3.83, severe 3.68 pmol/L; p=0.032). ESR was independently inversely associated with fT3/fT4 ratio (β = −0.310, p<0.001), supporting inflammation-driven reduced deiodinase activity. Patients with low fT3 had significantly worse outcomes: clinical deterioration (50.0% vs 5.0%, p<0.001), dexamethasone/oxygen requirement (41.7% vs 7.5%, p=0.003), and prolonged hospitalization ≥14 days (41.7% vs 12.7%, p=0.018). Subnormal TSH was not associated with adverse outcomes. fT4 did not differ across disease severity (p=0.642).

6 more moderate-relevance findings in the full report

Low relevance

Kept for the record. Something important does not line up on your side, or the evidence is still thin.

Thyroid Hormones and Antibodies

Linked to benefit

Research in Hashimoto's thyroiditis patients shows that selenium supplementation (200 µg/day) may significantly lower TPO antibody levels, the same marker you mentioned was elevated at your last blood test, and could also improve mood. This could be a contributor worth discussing with your doctor, especially given that the evidence suggests a greater response in people with higher baseline TPO antibody titers.

Dietary gluten in patients with autoimmune thyroid disease (ATD) is associated with a 10-fold higher prevalence of coeliac disease (CD) compared to the general population. The association is strongest for Hashimoto's thyroiditis, and all affected patients were subclinical, suggesting shared autoimmune susceptibility.

Study type: observational study
Citation: Valentino R, Savastano S, Tommaselli AP, et al. Prevalence of coeliac disease in patients with thyroid autoimmunity. Horm Res. 1999;51(3):124-7. doi:10.1159/000023344 (opens in new tab)
Biomarkers: endomysial antibodies (EmA)serum
thyroid antiperoxidase antibodies (TPO)serum
thyroglobulin antibodies (AbTG)serum
thyroid-stimulating hormone (TSH)serum
Methods: 150 adult outpatients (136 female, 14 male; ages 13–48) with newly diagnosed autoimmune thyroid disease were prospectively enrolled from June 1995 to June 1997. Diagnoses included 58 Hashimoto's thyroiditis, 18 Graves' disease, and 74 multinodular euthyroid goitre. Sera were screened for IgA class endomysial antibodies (EmA) by indirect immunofluorescence using human umbilical cord substrate; EmA-positive subjects underwent jejunal biopsy via upper GI endoscopy.
Results: IgA class endomysial antibodies (EmA) were detected in 5 of 150 (3.3%) ATD patients. All 5 underwent jejunal biopsy confirming total or subtotal villous atrophy consistent with CD. This prevalence of 1:30 was approximately 10-fold higher than the estimated general population rate of 1:300 (prior literature; p < 0.01 by Fisher's exact test). Four of the 5 EmA-positive patients had Hashimoto's thyroiditis and 1 had Graves' disease; none of the 74 patients with multinodular euthyroid goitre tested positive, suggesting the association is stronger for Hashimoto's thyroiditis. Notably, none of the 5 patients had past or present gastrointestinal symptoms suggestive of CD, indicating entirely subclinical disease. All had elevated thyroid antiperoxidase antibody (TPO) and thyroglobulin antibody (AbTG) titres.

Gut microbiota dysbiosis in euthyroid Hashimoto's thyroiditis (HT) patients is associated with elevated Firmicutes/Bacteroidetes ratio, increased Blautia and Eubacterium hallii group, and decreased Bacteroides and Faecalibacterium. Altered genera correlate with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab) levels.

Study type: observational study
Citation: Zhao F, Feng J, Li J, et al. Alterations of the Gut Microbiota in Hashimoto's Thyroiditis Patients. Thyroid. 2018;28(2):175-186. doi:10.1089/thy.2017.0395 (opens in new tab)
Biomarkers: thyroid peroxidase antibody (TPO-Ab)serum
thyroglobulin antibody (TG-Ab)serum
thyroid-stimulating hormone (TSH)serum
free thyroxine (FT4)serum
free triiodothyronine (FT3)serum
Firmicutes/Bacteroidetes ratiofecal
Blautia relative abundancefecal
Bacteroides relative abundancefecal
Faecalibacterium relative abundancefecal
Prevotella_9 relative abundancefecal
Roseburia relative abundancefecal
Eubacterium_hallii_group relative abundancefecal
Methods: Cross-sectional study with an exploration cohort of 28 euthyroid HT patients and 16 age-, sex-, and BMI-matched healthy controls, plus a validation cohort of 22 HT patients and 11 controls, all of Han Chinese nationality from northeastern China. Fecal microbiota were characterized using 16S rRNA gene sequencing (V3-V4 region) on Illumina HiSeq2500. Strict exclusion criteria included recent antibiotic or probiotic use, other autoimmune diseases, and GI surgery.
Results: Alpha diversity was similar between HT and control groups (P > 0.05), but community structure differed significantly (ANOSIM R = 0.7154, P < 0.001 at phylum level). At the phylum level, Firmicutes were increased and Bacteroidetes decreased in HT patients (Q < 0.05), with a significantly elevated F/B ratio (9.53 ± 3.21 vs 3.18 ± 0.82, P < 0.05) independent of age and BMI. At the genus level, 11 genera differed significantly (Mann-Whitney U-test, Q < 0.05): Blautia, Roseburia, Ruminococcus torques group, Romboutsia, Dorea, Fusicatenibacter, and Eubacterium hallii group were increased in HT, while Faecalibacterium, Bacteroides, Prevotella 9, and Lachnoclostridium were decreased. Spearman correlation analysis showed 24 of 27 LEfSe-identified genera were significantly correlated with TPO-Ab or TG-Ab (P < 0.05). HT-enriched genera were positively correlated with autoantibodies, while control-enriched genera showed inverse correlations. A 10-genus biomarker panel selected by LDA scores achieved AUC of 0.91 in the exploration cohort (n = 44) and AUC of 0.88 in the independent validation cohort (n = 33), confirming the discriminatory potential of the gut microbiota signature for HT diagnosis.

3 more low-relevance findings in the full report

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