Gut and Thyroid, Thyroid and Gut

A couple of abstracts of possible interest. The second I have posted before, but there have been many thousands of posts and new members since last time.

World J Gastroenterol. 2009 Jun 21; 15(23): 2834–2838.

Published online 2009 Jun 21. doi: 10.3748/wjg.15.2834

PMCID: PMC2699000

Consequences of dysthyroidism on the digestive tract and viscera

Ronald Daher, Thierry Yazbeck, Joe Bou Jaoude, and Bassam Abboud


Thyroid hormones define basal metabolism throughout the body, particularly in the intestine and viscera. Gastrointestinal manifestations of dysthyroidism are numerous and involve all portions of the tract. Thyroid hormone action on motility has been widely studied, but more complex pathophysiologic mechanisms have been indicated by some studies although these are not fully understood. Both thyroid hormone excess and deficiency can have similar digestive manifestations, such as diarrhea, although the mechanism is different in each situation. The liver is the most affected organ in both hypo- and hyperthyroidism. Specific digestive diseases may be associated with autoimmune thyroid processes, such as Hashimoto’s thyroiditis and Grave’s disease. Among them, celiac sprue and primary biliary cirrhosis are the most frequent although a clear common mechanism has never been proven. Overall, thyroid-related digestive manifestations were described decades ago but studies are still needed in order to confirm old concepts or elucidate undiscovered mechanisms. All practitioners must be aware of digestive symptoms due to dysthyroidism in order to avoid misdiagnosis of rare but potentially lethal situations.

Keywords: Hypothyroidism, Hyperthyroidism, Gastrointestinal motility, Intestine, Liver, Viscera

Full paper available here:

Klin Med (Mosk). 2006;84(2):71-4.

[Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism].

[Article in Russian]

Savina LV, Semenikhina TM, Korochanskaia NV, Klitinskaia IS, Iakovenko MS.


The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.

PMID: 16613012 [PubMed - indexed for MEDLINE]

Abstract only available here:

7 Replies

  • Many thanks for the posting. Very interesting. I have both a hiatus hernia (have had for some years) and acid reflux. I have had IBS for year too. My doctor accepts those but refuses to believe I am hypothyroid...I have 'fibromyalgia' according to him.

  • Rod, the good thing about posting to the brainfogged and forgetful is that repeat posts seem new and fresh :-D

    My gut issues are pretty settled now that I'm optimally medicated. I suffered a lot of heartburn, painful indigestion and acid reflux which caused vomiting in the 2 years before I was treated. Didn't see a GP so I'm not laying that on anyone.

  • Thanks for posting Rod.

    Very interesting. I had a hiatus hernia diagnosed after suffering for many years with so called "IBS". I never did believe that the HH accounted for my symptoms which were often quite severe.

    Now optimally medicated, I have no digestive or bowel issues.


  • I find this fascinating, since it is the area of most concern (and research) for me, but all I ever get out of these 'studies' is a sense of frustration. To me they just scream chicken & egg a new way. What is ACTUALLY causing what here? And no-one really seems to know.

    I have to confess I find it hard to believe a thyroid just randomly decides to become faulty. Even if you are genetically hard-wired for that, it still needs an environmental trigger. This is especially true if your thyroid condition is an autoimmune issue. Given that scenario, this HAS to be a gut issue, and when it's a gut issue it HAS to be something external affecting the gut. So what is it? The Western diet, that attack of thread worms you got when you were eight, your aluminium saucepan, what???

    It's like hypothyroidism and obesity. Do we have hypothyroidism because we are obese or did we get obese because we have hypothyroidism? If it IS a gut issue first then have we all been architects of our own disaster, albeit unwittingly?

    When we think gluten-free diets help is that because a) they are fashionable, b) some people do have non-coeliac gluten sensitivity or c) we've just stopped overeating/eating crap and it helps?

    There are no clear answers to any of his. At all. Despite thyroid problems being incredibly common, and getting more common (which should tell us something - but what?), no-one seems to be breaking new ground or getting a firm line of progression here. For me personally, this means I have a cluster-f**k of symptoms and diseases which any fool can see are related but I have no good line of cause and effect. Without that line of cause and effect, how do I cure it, or even repair it, or stop it worsening, if that's the best I can aspire to? It's an exercise in frustration.

  • These things are multi-factorial, of course.

    There is a clear statistical link between fluoridated water and hypothyroidism. That is not the same as a clear causal link, because there might be a chain of causation, one of which is influenced by fluoride. It is also clear that many hypothyroid folk, myself included, are better on a gf diet. One theory I have seen put forward is that gluten is a similar structure to thyroid hormone, and confuses the immune system. I have seen no research, or even any evidence regarding similar structures.

    Of all the possible causes of my problems, the only ones I can realistically influence are diet and lifestyle. I can do nothing about historical use of prescription or OTC meds, about the fact I may have lived in an area with fluoridated water in the past, or lived in a city with poor air quality, eaten rubbish etc etc etc. All I can hope is that my current drive to eat clean and clean up my home is helpful.

    I am currently investigating gut health/coffee enemas/cyanobacteria and also histamine intolerance(I reacted violently to kefir, even though I am OK on milk). I'll report back if I find anything really useful!

  • Hi Ruthi. You are absolutely right about it being multi-factorial; that's one of the biggest problems - so many correlations but no clear line of cause and effect.

    I'm afraid I can't believe in the fluoride connection. One, because it's a 'cause du jour' and two, because it's in water naturally in some places and, to my knowledge, those regions don't have higher incidences of thyroid problems.

    I do find it difficult to warm to any of the current toxin based environmental arguments. They always seem to come from half a**ed 'science' and can often be traced back to some barking 'alternative' site or author. I think if you lived next to a nuclear reactor or you worked in a lead factory those things would be legitimate, but I can't embrace microwaves, saucepans and toothpaste as likely culprits. They're too incremental and too selective. It would have to be a very intelligent water supply that only took out every second woman. What are the other women doing? Only drinking beer made in a different county?

    But gluten does seem like a more viable villain in the piece, at least if you have autoimmune issues. Gluten became a more interesting option to me when I learned that all humans actually find gluten toxic, it's just that most of us have adapted to deal with it. It didn't seem too unlikely to me that some people might struggle, especially given the wheat based modern diet. And I'd be very interested to hear how you get on with your histamine intolerance research. I suffer from urticaria and apparently that's related to histamine allergy so there's maybe something more to that one. Do let me know what you find out.

  • Natural fluoride and artificially added fluoride won't be the same - different contaminants even if its the same chemically. Levo is supposed to be the same as natural T4, but it sure as heck doesn't behave the same in my body!

    Spent some time reading up about histamine today. It looks as if it requires a fairly draconian elimination diet - sigh! I think I will do that when hubby is away abroad next time. I suspect it will end up like the gluten thing, where I had all the indications of 'silent' coeliac, but no positive test results. Here I have fewer signs, just lifelong headaches, IBS itchyness and a rather dramatic reaction to kefir! But no rhinitis, no lung problems. What I don't have is obvious skin reactions, except to sunshine. I guess I could consider taking an anti-histamine for a while to see if I feel better.

    As a believer in homoeopathy I am no stranger to pinning faith in something 'unproven'. But I do find a lot of the 'whackier' medical theories worrying. I don't really buy the 'there's no money in it for big pharma' argument that much. I think big pharma would find a way to make money if they could prove something worked! They've been quick enough to jump on the marijuana bandwagon!!!

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