The Gut Thyroid Connection

Your thyroid symptoms could be coming from your gut.

If you’ve been diagnosed with a thyroid condition, like Hashimoto’s disease, you may assume that symptoms such as fatigue, brain fog and poor mood, are a result of a thyroid hormone imbalance.

However, even though you have a thyroid condition, your thyroid-like symptoms may actually be coming from your gut.

A number of research studies suggest that gut conditions, like IBS, bacterial and parasitic infections, or food-related inflammation, may be the source of thyroid-like symptoms. Even more interesting, some studies have demonstrated that by treating gut conditions, thyroid symptoms improved. [1 Trusted SourcePubMedGo to source, 2 Trusted SourcePubMedGo to source, 3 Trusted SourcePubMedGo to source, 4 Trusted SourcePubMedGo to source, 5 Trusted SourcePubMedGo to source, 6 Trusted SourcePubMedGo to source, 7 Trusted SourcePubMedGo to source] Two studies even found that the need for thyroid medication decreased in some patients after gut treatment. [8 Trusted SourcePubMedGo to source, 9 Trusted SourcePubMedGo to source]

Good health starts in the gut. Let’s explore the gut-thyroid connection further.

Thyroid Symptoms or Gut Symptoms?

Symptoms like fatigue, brain fog, depression, and anxiety aren’t unique to hypothyroidism. In fact, they are also symptoms of digestive imbalances:

  • Research has found that more than 50% of IBS patients suffer from fatigue. [10 Trusted SourcePubMedGo to source] Depression and anxiety are also common.
  • 68% of patients with suspected non-celiac gluten sensitivity reported lack of well being. [11 Trusted SourcePubMedGo to source] These patients also reported tiredness (64%), headache (54%), anxiety (39%), brian fog (38%) and other symptoms.

But once you have a thyroid diagnosis, many healthcare practitioners focus exclusively on thyroid treatments for your symptoms and stop considering other options. If you’re taking thyroid medication and still suffering from thyroid symptoms, gut-focussed treatments may address the root cause of your symptoms.

Gut Treatments Improve Thyroid Health

The research clearly shows that when you treat gut conditions, thyroid health also improves, sometimes dramatically. A small study found an astounding average drop in TPO antibodies of 2,029 when patients were treated for H. pylori gut infections. [12 Trusted SourcePubMedGo to source]  Treating H. pylori has also been shown to improve TSH levels. [13 Trusted SourcePubMedGo to source, 14 Trusted SourcePubMedGo to source, 15 Trusted SourcePubMedGo to source]

Treating Blastocystis hominis (a parasitic gut infection) has been shown to reduce inflammatory markers, thyroid antibodies, and TSH levels. [16 Trusted SourcePubMedGo to source]

The Gut Thyroid Connection -

Food sensitivities can be an issue for some. One study found that lactose restriction led to significant decreases in TSH levels for thyroid patients with lactose intolerance. [17 Trusted SourcePubMedGo to source]

Another study found that a gluten-free diet improved the effects of thyroid medication for thyroid patients with atypical celiac disease. [18 Trusted SourcePubMedGo to source]

Research also shows that gut treatments improve thyroid-like symptoms, including fatigue, [19 Trusted SourcePubMedGo to source, 20, 21 Trusted SourcePubMedGo to source] mild to moderate depression, [22 Trusted SourcePubMedGo to source] and anxiety. [23]

All of this evidence suggests that if you have a thyroid diagnosis, it’s worth supporting your gut health as a means to improving your symptoms.

A Healthier Gut = Better Absorption of Thyroid Medication

Another benefit of better gut health is that it may result in better absorption of thyroid medication.

Several studies found that gut infections, food sensitivities, low stomach acid, and other gut conditions can impair absorption of standard thyroid hormone medication. [24 Trusted SourcePubMedGo to source, 25 Trusted SourcePubMedGo to source, 26 Trusted SourcePubMedGo to source, 27 Trusted SourcePubMedGo to source] In one study, 21% of patients needed to reduce their thyroid medication dose after H. pylori treatment. [28 Trusted SourcePubMedGo to source]

Probiotics are a great starting point for improving your gut health. In one study, thyroid patients who took probiotics were able to reduce their thyroid medication dosage. [29 Trusted SourcePubMedGo to source] Probiotics help with thyroid medication absorption because they improve the balance of microorganisms in your gut, reduce gut inflammation and help to heal the gut lining. [30 Trusted SourcePubMedGo to source, 31 Trusted SourcePubMedGo to source, 32 Trusted SourcePubMedGo to source, 33 Trusted SourcePubMedGo to source, 34 Trusted SourcePubMedGo to source]

Gut and Thyroid Conditions Are Linked

Even if you don’t have obvious gut symptoms, it’s important to know that gut conditions and thyroid conditions are very often found in the same patients. Here are some examples from the research:

Collectively, these studies suggest that thyroid patients should explore and address gut-related disorders.

Gut Health Tips for Thyroid Patients

If you are taking thyroid medication and still have thyroid symptoms, focusing on your gut health may help you improve your symptoms.

Gut health treatments should always begin with a whole foods, anti-inflammatory diet and probiotic supplements.

I recommend the 3-for-Balance Probiotic Protocol. Many people don’t seem to achieve balance in their microbiota with just one strain of probiotic. I have seen the best results with my patients following a protocol that includes all three probiotic categories. For many patients who have tried probiotics in the past, this approach makes all the difference.

The Gut Thyroid Connection -

Research supports this approach to taking probiotics. When mixtures of several probiotics were compared with single strains of probiotics in the treatment of IBS, the systematic reviews and meta-analyses indicated that the multi-strain probiotics were more effective than single-strain probiotics. [50 Trusted SourcePubMedGo to source, 51 Trusted SourcePubMedGo to source]

The other benefit of this approach is that it keeps you off the probiotics merry-go-round: trying out different probiotic strains and products in hopes of finding one that works. With the 3 for Balance approach, you have all of the probiotic bases covered.

For some patients, dietary improvements and probiotics will be all they need to completely eliminate thyroid-like symptoms.

Some patients may need to take additional steps, such as:

As your gut becomes healthier and your symptoms resolve, you may also absorb medication better. Lab tests and a bit of fine tuning with your health provider can help to optimize your medication dose.

If symptoms persist, consider thyroid supplements like vitamin D and selenium. A minority of patients may need alternative thyroid medication.

Case Studies

My own clinical experience parallels the research results I have shared in this article. Here are a couple of patient stories that show how treating the gut can resolve stubborn thyroid symptoms.

Don’t Let This Happen To You

Many thyroid patients suffer needlessly and spend far too much energy and money chasing thyroid treatments, with disappointing results.

Thyroid treatments will never fully work if the root cause of your symptoms is a gut imbalance. If you struggle with stubborn thyroid symptoms, despite taking thyroid medication, it’s time to take steps to improve your gut health.

➕ References
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  2. Ribichini D, Fiorini G, Repaci A, et al. Tablet and oral liquid L-thyroxine formulation in the treatment of naïve hypothyroid patients with Helicobacter pylori infection. Endocrine. 2017;57(3):394-401. doi:10.1007/s12020-016-1167-3 Trusted SourcePubMedGo to source
  3. Bugdaci MS, Zuhur SS, Sokmen M, Toksoy B, Bayraktar B, Altuntas Y. The role of Helicobacter pylori in patients with hypothyroidism in whom could not be achieved normal thyrotropin levels despite treatment with high doses of thyroxine [published correction appears in Helicobacter. 2011 Dec;16(6):482. Albayrak, Banu [corrected to Bayraktar, Banu]]. Helicobacter. 2011;16(2):124-130. doi:10.1111/j.1523-5378.2011.00830.x Trusted SourcePubMedGo to source
  4. Centanni M, Gargano L, Canettieri G, et al. Thyroxine in goiter, Helicobacter pylori infection, and chronic gastritis. N Engl J Med. 2006;354(17):1787-1795. doi:10.1056/NEJMoa043903 Trusted SourcePubMedGo to source
  5. El-Zawawy HT, Farag HF, Tolba MM, Abdalsamea HA. Improving Hashimoto’s thyroiditis by eradicating Blastocystis hominis: Relation to IL-17. Ther Adv Endocrinol Metab. 2020;11:2042018820907013. Published 2020 Feb 21. doi:10.1177/2042018820907013 Trusted SourcePubMedGo to source
  6. Asik M, Gunes F, Binnetoglu E, et al. Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014;46(2):279-284. doi:10.1007/s12020-013-0065-1 Trusted SourcePubMedGo to source
  7. Virili C, Bassotti G, Santaguida MG, et al. Atypical celiac disease as cause of increased need for thyroxine: a systematic study. J Clin Endocrinol Metab. 2012;97(3):E419-E422. doi:10.1210/jc.2011-1851 Trusted SourcePubMedGo to source
  8. Bugdaci MS, Zuhur SS, Sokmen M, Toksoy B, Bayraktar B, Altuntas Y. The role of Helicobacter pylori in patients with hypothyroidism in whom could not be achieved normal thyrotropin levels despite treatment with high doses of thyroxine [published correction appears in Helicobacter. 2011 Dec;16(6):482. Albayrak, Banu [corrected to Bayraktar, Banu]]. Helicobacter. 2011;16(2):124-130. doi:10.1111/j.1523-5378.2011.00830.x Trusted SourcePubMedGo to source
  9. Talebi S, Karimifar M, Heidari Z, Mohammadi H, Askari G. The effects of synbiotic supplementation on thyroid function and inflammation in hypothyroid patients: A randomized, double‑blind, placebo‑controlled trial. Complement Ther Med. 2020;48:102234. doi:10.1016/j.ctim.2019.102234 Trusted SourcePubMedGo to source
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  12. Bertalot G, Montresor G, Tampieri M, et al. Decrease in thyroid autoantibodies after eradication of Helicobacter pylori infection. Clin Endocrinol (Oxf). 2004;61(5):650-652. doi:10.1111/j.1365-2265.2004.02137.x Trusted SourcePubMedGo to source
  13. Ribichini D, Fiorini G, Repaci A, et al. Tablet and oral liquid L-thyroxine formulation in the treatment of naïve hypothyroid patients with Helicobacter pylori infection. Endocrine. 2017;57(3):394-401. doi:10.1007/s12020-016-1167-3 Trusted SourcePubMedGo to source
  14. Bugdaci MS, Zuhur SS, Sokmen M, Toksoy B, Bayraktar B, Altuntas Y. The role of Helicobacter pylori in patients with hypothyroidism in whom could not be achieved normal thyrotropin levels despite treatment with high doses of thyroxine [published correction appears in Helicobacter. 2011 Dec;16(6):482. Albayrak, Banu [corrected to Bayraktar, Banu]]. Helicobacter. 2011;16(2):124-130. doi:10.1111/j.1523-5378.2011.00830.x Trusted SourcePubMedGo to source
  15. Centanni M, Gargano L, Canettieri G, et al. Thyroxine in goiter, Helicobacter pylori infection, and chronic gastritis. N Engl J Med. 2006;354(17):1787-1795. doi:10.1056/NEJMoa043903 Trusted SourcePubMedGo to source
  16. El-Zawawy HT, Farag HF, Tolba MM, Abdalsamea HA. Improving Hashimoto’s thyroiditis by eradicating Blastocystis hominis: Relation to IL-17. Ther Adv Endocrinol Metab. 2020;11:2042018820907013. Published 2020 Feb 21. doi:10.1177/2042018820907013 Trusted SourcePubMedGo to source
  17. Asik M, Gunes F, Binnetoglu E, et al. Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014;46(2):279-284. doi:10.1007/s12020-013-0065-1 Trusted SourcePubMedGo to source
  18. Virili C, Bassotti G, Santaguida MG, et al. Atypical celiac disease as cause of increased need for thyroxine: a systematic study. J Clin Endocrinol Metab. 2012;97(3):E419-E422. doi:10.1210/jc.2011-1851 Trusted SourcePubMedGo to source
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  26. Asik M, Gunes F, Binnetoglu E, et al. Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014;46(2):279-284. doi:10.1007/s12020-013-0065-1 Trusted SourcePubMedGo to source
  27. Virili C, Bassotti G, Santaguida MG, et al. Atypical celiac disease as cause of increased need for thyroxine: a systematic study. J Clin Endocrinol Metab. 2012;97(3):E419-E422. doi:10.1210/jc.2011-1851 Trusted SourcePubMedGo to source
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  29. Talebi S, Karimifar M, Heidari Z, Mohammadi H, Askari G. The effects of synbiotic supplementation on thyroid function and inflammation in hypothyroid patients: A randomized, double‑blind, placebo‑controlled trial. Complement Ther Med. 2020;48:102234. doi:10.1016/j.ctim.2019.102234 Trusted SourcePubMedGo to source
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