A study was recently published which illustrates an important way in which hypothyroid may cause SIBO. Let’s discuss this study and how you can use this information to improve your gut and thyroid health.
The Thyroid-SIBO Connection
Dr. Michael Ruscio: The thyroid-SIBO connection.
Hi, this is Dr. Ruscio, and you’ve probably heard of SIBO, which causes many of the symptoms of IBS—gas, bloating, abdominal pain or distention, constipation, diarrhea, or an oscillation of the two. And there may be a thyroid tie-in to this SIBO, this small intestinal bacterial overgrowth.
Recently a study was published showing that those with subclinical hypothyroidism produced less bile. There are two things we have to discuss here then—subclinical hypothyroid and bile.
Bile is important because it’s released by your gallbladder and it helps in digestion of fats, but it also is antibacterial. It’s often not appreciated that bile is antibacterial, and it’s one of the digestive secretions that helps prevent bacterial overgrowth in the small intestine. Those with subclinical hypothyroidism secrete less bile.
So then what is subclinical hypothyroidism? Subclinical hypothyroidism is essentially where you have an elevation of TSH but normal T4 and T3 or free T4 and free T3, so thyroid hormone production is normal, but the TSH is elevated. This can be a very challenging finding because we don’t want to overtreat, necessarily, and put everyone with subclinical hypothyroidism on thyroid hormone because that can have negative impacts also, but we’re seeing that subclinical hypothyroidism can have some deleterious manifestations also.
In this case, the optimum treatment is going to need to be made on a case-by-case basis. There’s not one one-size-fits-all recommendation to be made here, but one thing that I do in the clinic to help navigate this is I put all of my SIBO patients on a digestive support supplement that contains bile to make sure that at least in our initial stages of therapy we’re covering our bases to make sure we have adequate bile in the small intestine to help both with fat absorption and with its antibacterial effects. In some cases—you may be able to say many cases—of thyroid involvement, improving the health of the gut will improve the health of the thyroid. So when you first see subclinical hypothyroidism, you may not need to have that treated, but rather treat the gut, and by fixing the gut, you may fix the thyroid.
Hopefully this concept helps. If you’re struggling with SIBO and you haven’t been using any bile, that may be helpful, and if you have not had your thyroid evaluated, that may be helpful also. There is the SIBO-thyroid connection. This is Dr. Ruscio, and I hope this helps you get healthy and get back to your life. Thanks.
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