Autoimmune Thyroiditis With Hypothyroidism Induced By Sugar Substitutes

Autoimmune Thyroiditis With Hypothyroidism Induced By Sugar Substitutes

Many of us have heard or read about artificial sweeteners affecting the thyroid. This is a stunning example reported at the very recent American Association of Clinical Endocrinologists (AACE) 22nd Annual Scientific & Clinical Congress – Creating an Oasis of Quality of Care in the Desert, May 1-5, 2013, in Phoenix, AZ.

Abstract #1083


Issac Sachmechi, MD, FACP, FACE, Sarah Hussain, MD

Mount Sinai Services


Increase in consumption of sugar-substitutes is being observed over the last few decades. We are presenting a case of Hashimoto’s hypothyroidism induced by high intake of beverages containing sugar-substitutes, which resolved completely with the elimination of these products from diet.

Case Presentation

A 52 year old female with a history of consumption of high dose of artificial sweeteners was diagnosed with Hashimoto’s hypothyroidism in 2008. On presentation her TSH (Thyroid Stimulating Hormone) was 12.2 mIU/L (normal: 0.4 - 4.5), Free-T4 0.5 ng/dl (normal: 0.58 - 1.64) and Anti TPO Ab (Anti-Thyroid Peroxidase Antibody) 196 IU/ml (normal: <35). Treatment with Levothyroxin 0.75 mg/day normalized her TSH, which remained between 1.23 mIU/L and 2.16 mIU/L during the following 3 years. She was also ruled-out for other autoimmune disorder. Due to weight gain the patient reduced, and eventually stopped taking the sweeteners in February 2012. This was followed by unanticipated drop in her TSH to 0.005mIU/L. The TSH remained suppressed despite reduction in Levothyroxin dose to 0.5 mg and complete discontinuation of Levothyroxin was achieved with fully normal TSH and Anti-TPO antibody <20 IU/ml (normal: <35) TSI (thyroid stimulating immunoglobulin) 113% (normal less than 140%) TBII (Thyrotropin Binding Inhibiting Immunoglobulins) <6.0% (normal: <16%). She remained clinically euthyroid without any treatment during subsequent follow-up visits.


The sugar-substitutes are attributed with large number of health related side effects in animal studies, ranging from obesity to various malignancies. Nonetheless, not much is known about the human implications of these findings considering the phenomenon of excessive consumption of sugar-substitutes being relatively new. In our case it may either be a rare idiosyncratic or more generalized reaction to high intake of artificial sweeteners.

Formaldehyde, a metabolite of aspartame is reported to be associated with Type IV delayed hypersensitivity. Large control studies should be done to confirm this association.


This case emphasizes that in all patients diagnosed with Hashimoto’s Thyroiditis, intake of sugar-substitutes should be inquired. If found positive, discontinuation of intake and close follow-up of thyroid function test should be done


Image is diagram of the aspartame molecule

16 Replies

That's a very good report, considering so many complain of being overweight and use substitute sweeteners. Even Vitamins I bought from Holland and Barrett has 'sweetener' although it stated No artificial colours or flavours, etc etc. I mention it to assistant who said 'it just says flavours' I said I thought 'sweet' was a flavour.

Best keep my eyes peeled for that one. Only ever look at the soft drinks really to see if they are free of artificial sweetners, but of course it involves all foodstuffs. Thanks for the information Rod, very interesting and enlightening.

Jen x

Gosh! That's food for thought, pardon the pun.

If this were the case for everyone then Hashimoto's will increase, especially when there is lots of articles in the news stating that drinks containing high fructose corn syrup (fizzy pop) are implicated in the rise in obesity and type 2 diabetes. More people would consume the diet versions and could put their thyroids at risk.

It seems like we are all guinea pigs to the food industry.

Nowadays, I virtually never have anything fizzy, unless it is either fizzy water or pink, made from grapes and the fizz comes from the action of yeast! :-)


Definitely the best type of fizz and thanks for the post. Janet.

also bear in mind a lot of ready meals especially low calorie meals contain a lot of hidden sugars and other nasties i avoid them like the plague also sugar free mints contain surbitol which in high doses can give you an upset tum . remember too that anything artifical has been man made in a lab


Remember that desiccated thyroid goes through many "laboratory" processes. :-)

I was wondering... is it possible to get a pig thyroid gland from a butcher? Provided the animal hasn't been treated with too many growth hormones or antibiotics it could be a natural way of healing thyself.

No. It would not be allowed to knowingly let a thyroid enter the food chain.

When it does happen, last case I read was "home slaughtered" beef in the USA, it causes what is often called "hamburger thyrotoxicosis" - which is excess thyroid hormone causing hyperthyroidism symptoms.

It has been done, but not for many years:

I really do not know how you would control dosage. And I have read that eating raw thyroid, aside from any other issues, is absolutely disgusting beyond belief.

In this artificial sweetener story, do bear in mind, it is not saying that consuming equivalent sweetness as sugar or any "natural" sugar is any better for you. The best answer might well be to reduce overall sweetness of diet.


Hi Rod,

Thanks for the link above, the article is interesting and I like to understand the history behind modern developments.

I agree it would be better to reduce sugar within one's diet but it is in practically everything you buy. I've just been reading about the different synthetic thyroid medications on the thyroid uk website and even those contain sugar in the form of lactose, maize starch (corn sugar) and pregelatinised maize starch. I am a diabetic, as well as recovering from thyroid cancer and now hypothyroid, and try to limit my sugar consumption so that my blood sugars don't go overboard. Ever since taking Levothyroxine I crave sugar and I've only been taking them for nearly 3 weeks. What can I do? I need to control my blood sugar and my diabetes tablets aren't working as well as they did now I am hypothyroid.

It is, perhaps, interesting that many patent applications have been filed for levothyroxine tablets where the base is non-sugar - maybe some form of silica or cellulose.

The latest product from RLC (which company makes Nature-Throid) is Westhroid P which contains only Inulin and thyroid powder. This seems directed at avoiding as many issues as possible in one fell swoop.

Thanks for this, Rod. I'll take a look at this, it might be what I am looking for.

I've had a look at these 2 products and they are very promising, especially as they are gluten free and I believe that gluten affects my blood sugars. My blood sugars have come under control after removing all gluten/flour based products from my diet. Also, I have read that people with thyroid disorders should avoid gluten too!

Thanks for your advise. I am hoping to see a retired GP, who specialised in thyroid disorders, and now practises holistic and nutritional health and will discuss this with him.



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That helps!

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