Can SIBO Cause Thyroid Autoimmunity?

Being hypothyroid or on thyroid medication has been shown to significantly enhance your risk of SIBO.  But could it be that it’s actually the SIBO that is driving the thyroid problem? Let’s discuss how SIBO may contribute to thyroid autoimmunity.

Clinicians – for a detailed write-up on the gut-thyroid connection, see www.drruscio.com/review.

  • If you need help with SIBO or thyroid autoimmunity, click here.
  • To be notified when my print book becomes available & get a free gut health eBook, click here.
  • If you are a healthcare provider looking to sharpen your clinical skills, click here.

Can SIBO Cause Thyroid Autoimmunity?

Dr. Michael Ruscio: Hi, this is Dr. Ruscio. And let’s discuss if SIBO, or small intestinal bacterial overgrowth, could actually cause thyroid autoimmunity. And just quickly, thyroid autoimmunity, also known as Hashimoto’s, is the main cause of thyroid autoimmunity in Westernized countries. So it’s definitely an important underlying factor in hypothyroidism and thyroid disease.

We’re learning more and more about the importance of the gut and how that connects to the immune system, most namely in this case, how it connects to the thyroid. And there is some preliminary evidence, most notably in the treatment of H. pylori bacterial infections in the stomach being shown to have the ability to help improve thyroid autoimmunity. So there could definitely be a connection here.

Now, other studies have shown us that one of the strongest predictors of if someone will have SIBO is if they have hypothyroid or if they are on thyroid medication. So we definitely know that hypothyroidism and SIBO tend to have some overlap. The question is, could the SIBO actually be causing the thyroid autoimmunity? And while this is speculative, I think it’s interesting and something that we could all benefit from understanding.

Some evidence has shown that intestinal bacteria actually utilize selenium. And if these bacteria overgrow, there may be an increased demand for selenium in the gut by these bacteria as they’re eating the selenium. That may cause a selenium deficiency in the host, in the person who has the SIBO. And selenium deficiencies have been documented to be one of the underlying factors that contributes to thyroid autoimmunity. This is why we see some trials showing that when people who have thyroid autoimmunity take supplemental selenium, we see an improvement in the thyroid autoimmunity.

So, again, the reason why we see SIBO and hypothyroid and thyroid autoimmunity go hand in hand may be because bacterial overgrowths are present. Those bacterial overgrowths utilize more of your selenium, creating a slight selenium deficiency. And that selenium deficiency has been shown to underlie thyroid autoimmunity.

Now, one question that comes up is, if intestinal bacteria can feed on selenium, would giving selenium cause or contribute to or exacerbate a bacterial overgrowth? Most likely not, because in the clinical trials where we give patients selenium, I have not seen any notable adverse reactions reported that would indicate that the SIBO is overgrowing, meaning gas, constipation, diarrhea, abdominal pain, what have you. So, most likely, if someone has SIBO and thyroid autoimmunity, a trial of selenium would be a safe bet for them.

So in recap, we know that thyroid autoimmunity is the main driver of hypothyroidism. We also know that thyroid autoimmunity and small intestinal bacterial overgrowth tend to go hand in hand in many cases. And what may happen and what may contribute to that in part is, overgrowth of bacteria utilizes your selenium, this utilization of selenium may create a subtle deficiency, and that may contribute to thyroid autoimmunity.

So what this means is if you have thyroid autoimmunity, you should look to your gut health as an important part of the process for improving your immune system and improving the status of your thyroid autoimmunity. Also remember that many times, the symptoms that we think are hypothyroid or coming from hypothyroid are actually coming from the gut. So the gut is a crucial part of the successful management of hypothyroidism and thyroid autoimmunity.

This is Dr. Ruscio. And I hope this information helps you get healthy and get back to your life. Thank you.


If you need help with SIBO or thyroid autoimmunity, click here.
To be notified when my print book becomes available & get a free gut health eBook, click here.
If you are a healthcare provider looking to sharpen your clinical skills, click here.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

Discussion

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30 thoughts on “Can SIBO Cause Thyroid Autoimmunity?

  1. I’ve just been diagnosed with Sibo and I have an auto immune system disorder and thyroid disease hypo. I was wondering if this could cause my constant weight gain . I’ve been gone most of my life but once I started on Synthroid and they keep upping the dose my weight is going completely out of control I’ve gained about 70 pounds over the last three years

    1. Hi Debra,
      It’s hard to say how this may pertain to you specifically, but it certainly would’nt be a bad idea to be screen for SIBO. Testing is often covered by insurance and if its not it usually cost around $200. Hope this helps! You may also want to speak with your doctor about a T4/T3 combination thyroid medication, this switch can produce a modest weight loss in some.

  2. I’ve just been diagnosed with Sibo and I have an auto immune system disorder and thyroid disease hypo. I was wondering if this could cause my constant weight gain . I’ve been gone most of my life but once I started on Synthroid and they keep upping the dose my weight is going completely out of control I’ve gained about 70 pounds over the last three years

    1. Hi Debra,
      It’s hard to say how this may pertain to you specifically, but it certainly would’nt be a bad idea to be screen for SIBO. Testing is often covered by insurance and if its not it usually cost around $200. Hope this helps! You may also want to speak with your doctor about a T4/T3 combination thyroid medication, this switch can produce a modest weight loss in some.

  3. Although I’ve not yet received results of a SIBO test I will be taking soon, and because I am hypothyroid and therefore also have autoimmune Hashimoto’s, I will probably test positive for SIBO according to what you discuss in your above article. I have recently been taking a selenium supplement after learning that a selenium deficiency could contribute to thyroid autoimmunity. However, my symptoms of gas, bloating, & diarrhea now have become much worse after using selenium. It would seem that the SIBO that probably existed in connection with my hypo/autoimmune thyroid disease is now overgrowing! And the selenium I have been taking has exacerbated these SIBO symptoms that were not nearly so pronounced before.
    I would very much appreciate your thoughts on this and whether there would be a better supplement to take as it seems that I should discontinue trying to use selenium to help my thyroid autoimmunity and concentrate on eradicating the SIBO that is, almost for certain, affecting my ability to improve my poor gut health as well as thyroid issues and symptoms (no weight gain, but medically unexplained weight loss of 25 lbs!).
    Thanks so much for your reply.

  4. Although I’ve not yet received results of a SIBO test I will be taking soon, and because I am hypothyroid and therefore also have autoimmune Hashimoto’s, I will probably test positive for SIBO according to what you discuss in your above article. I have recently been taking a selenium supplement after learning that a selenium deficiency could contribute to thyroid autoimmunity. However, my symptoms of gas, bloating, & diarrhea now have become much worse after using selenium. It would seem that the SIBO that probably existed in connection with my hypo/autoimmune thyroid disease is now overgrowing! And the selenium I have been taking has exacerbated these SIBO symptoms that were not nearly so pronounced before.
    I would very much appreciate your thoughts on this and whether there would be a better supplement to take as it seems that I should discontinue trying to use selenium to help my thyroid autoimmunity and concentrate on eradicating the SIBO that is, almost for certain, affecting my ability to improve my poor gut health as well as thyroid issues and symptoms (no weight gain, but medically unexplained weight loss of 25 lbs!).
    Thanks so much for your reply.

    1. Hi jm,
      In my opinion, its often a good idea to focus on the gut first. You could also consider other options for thyroid autoimmunity like Mg, CoQ10 and vitamin D.

  5. My name is Jennifer and I need your help! My gut issues have always been an issue and this past May 2017 they got worse (feeling sick after eating) I am seeing this regular/alternative doctor he diagnosed with SIBO (I’ve had years of IBS) and it got worse with age (food allergies, acne roseaca, psoriasis, missed menstrual cycle, and I have hypothyroidism which has gotten worse recently). My thyroid is actually not functioning well (TSH is low and T3/T4 Conversion now off). My SIBO test came back negative however, my doctor said my elevated baseline prior to ingesting of the lactulouse solution was very high (tons of gas) so it makes the test ambiguous. I definitely have all the symptoms of SIBO – weight loss, stomach pain, malabsorption and my off thyroid,. He prescriped CandidaBactrin AR an BR as he said he the herbs can be as effective as the antibiotics. My stomach feels jumpy all the time and when I eat, as my digestion feels slow. Would love to hear your thoughts on the thyroid/SIBO connection and the approach you take to treat.. Also, it is best to take a probiotic with herbs? I hear mixed thoughts starving the bacteria. I have two probiotics I use – Klaires’ Therabiotic and Prescript Assist and curious if I should be taking them while being treated for SIBO! Thank you!!

          1. Thank you! I tried this link and didn’t work. Please let me know how I can schedule a session with you. You are spot-on about SIBO causing my thyroid autoimmune issues (always had IBS) and then it got worse in April/May — then my thyroid became off and I’ve lost weight (malabsporation issues) and have acne roseaca.

  6. My name is Jennifer and I need your help! My gut issues have always been an issue and this past May 2017 they got worse (feeling sick after eating) I am seeing this regular/alternative doctor he diagnosed with SIBO (I’ve had years of IBS) and it got worse with age (food allergies, acne roseaca, psoriasis, missed menstrual cycle, and I have hypothyroidism which has gotten worse recently). My thyroid is actually not functioning well (TSH is low and T3/T4 Conversion now off). My SIBO test came back negative however, my doctor said my elevated baseline prior to ingesting of the lactulouse solution was very high (tons of gas) so it makes the test ambiguous. I definitely have all the symptoms of SIBO – weight loss, stomach pain, malabsorption and my off thyroid,. He prescriped CandidaBactrin AR an BR as he said he the herbs can be as effective as the antibiotics. My stomach feels jumpy all the time and when I eat, as my digestion feels slow. Would love to hear your thoughts on the thyroid/SIBO connection and the approach you take to treat.. Also, it is best to take a probiotic with herbs? I hear mixed thoughts starving the bacteria. I have two probiotics I use – Klaires’ Therabiotic and Prescript Assist and curious if I should be taking them while being treated for SIBO! Thank you!!

          1. Thank you! I tried this link and didn’t work. Please let me know how I can schedule a session with you. You are spot-on about SIBO causing my thyroid autoimmune issues (always had IBS) and then it got worse in April/May — then my thyroid became off and I’ve lost weight (malabsporation issues) and have acne roseaca.

  7. I’ve heard the methane type of SIBO doesn’t respond to the antibiotic. What would you suggest? I’ve always dealt with constipation. I have no bloating or abdominal pain just belching and nausea parts of the day. I also have Hashimoto’s. I’ve lost weight as well. Following low FODMAP. Breath test came back negative a few months ago but not sure it was correct. Any suggestions?

    1. Hi Chris,
      Methane SIBO can respond to antibiotics, namely Rifaximin with Neomycin. Herbal therapies also work. I would either find a good clinician or go through the protocol in my book. Hope this helps.

  8. I’ve heard the methane type of SIBO doesn’t respond to the antibiotic. What would you suggest? I’ve always dealt with constipation. I have no bloating or abdominal pain just belching and nausea parts of the day. I also have Hashimoto’s. I’ve lost weight as well. Following low FODMAP. Breath test came back negative a few months ago but not sure it was correct. Any suggestions?

    1. Hi Chris,
      Methane SIBO can respond to antibiotics, namely Rifaximin with Neomycin. Herbal therapies also work. I would either find a good clinician or go through the protocol in my book. Hope this helps.

  9. I was diagnosed with Hashimotos about 6 months ago and SIBO 2 months before that. The only time I felt like I was back to my old self was when I was on antibiotics for the SIBO and for a few weeks/ months after, then symptoms returned. My doctor won’t put me on another round of antibiotics but my SIBO is returning as well as my bad thyroid symptoms. What so I do?

  10. I was diagnosed with Hashimotos about 6 months ago and SIBO 2 months before that. The only time I felt like I was back to my old self was when I was on antibiotics for the SIBO and for a few weeks/ months after, then symptoms returned. My doctor won’t put me on another round of antibiotics but my SIBO is returning as well as my bad thyroid symptoms. What so I do?

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