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Could be a problem with thyroid (low stomach acid, b-12, hashimotos, celiac)


Lindquist

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Lindquist Contributor

Find this article i translate it from Swedish.


Many people with thyroid disease have troublesome symptoms from the stomach, and often thyroid disease begins in the gastrointestinal tract where approx. 70-80% of the body's total immune system is present. Problems in the gut can prevent absorption of nutrients that are important for thyroid function and production.

Hypothyroidism and Hashimoto's can be the basis of low stomach acid (hypochlorhydria) or lack of hydrochloric acid in the stomach (achlorhydria).

Hydrochloric acid deficiency can cause:

IBS,
acid reflux (reflux),
difficulty swallowing (dysphagia),
constipation,
bloated stomach and
cramps.
Impaired acid secretion is also linked to hyperthyroidism; according to a clinical review published on July 6, 2010, approx. 16% of all patients with hyperthyroidism lack stomach acid.

Why is stomach acid so important?
Necessary for normal digestion.
Needed for breakdown and absorption of nutrients.
Helps us sterilize food and protect us against potential pathogens.
Synthesis and release of T3 and T4
A review article published in February 2019 examined factors that cause a lack of ability to normally absorb Levothyroxine (T4). Observations showed that patients with hypothyroidism often have gut-related malabsorption, which can further affect absorption of T4. Low stomach acid can thus be one of the factors that negatively affects the conversion of T4 to T3 and increases the need for T4 in people with reduced hydrochloric acid production.

An interesting observation the authors made was that patients taking vitamin C in conjunction with Levothyroxine had increased absorption of T4.

Lack of nutrients
A study published on February 29, 2016 examined associations between autoimmune thyroid disease and other autoimmune diseases such as diabetes, alopecia and gastritis. Results showed that autoimmune thyroid disease had a strong association with gastritis. 17.5% of the participants with autoimmune diseases had anemia, 24.5% lack of vitamin B12 and 15.7% of ferritin.

Stomach enzymes cannot function optimally if hydrochloric acid levels are too low. Impaired digestion can cause, for example:

acid reflux,
constipation,
malabsorption as well
nutrient deficiencies – especially amino acids, zinc, selenium, calcium, magnesium, iron, vitamin B12 and vitamin A.
Zinc and selenium are needed, for example, for the conversion of T4 into active T3, and zinc also to form TSH. Selenium is also an important element due to its antioxidant effect against oxidative stress. Low stomach acid resulting from hypothyroidism can also lead to low iron levels. Iron is needed, for example, for the transport and utilization of T3; iron deficiency can thus reduce the production of thyroid hormones.

Lack of vitamin B12 is usually the result of damage to the digestive tract, which prevents absorption of nutrients. Absorption of vitamin B12 requires hydrochloric acid, and too little hydrochloric acid can increase the risk of vitamin B12 deficiency in people with thyroid disease who also often suffer from low stomach acid. Another risk factor is small intestinal bacterial overgrowth (SIBO) which can occur among people with Hashimoto's.

Celiac disease, gluten intolerance and reflux
People with Hashimoto's also tend to have an increased risk of other autoimmune diseases such as atrophic gastritis, vitamin B12 deficiency and celiac disease. A review article published on April 5, 2017 aimed to investigate the relationship between the gut and the thyroid gland, and the results showed that Hashimoto's thyroiditis is diagnosed more often in patients with celiac disease compared to the general population. A study published March 9, 2011 found that chronic reflux affected 30% of patients with celiac disease compared to fewer than 5% of people who had not been diagnosed with celiac disease. Furthermore, another study published on July 13, 2011 showed that over 40% of children with celiac disease suffered from esophagitis (inflammation of the esophagus) which causes acid reflux and heartburn.

In summary, then, low stomach acid can cause problems with digestion, which means that you don't properly absorb nutrients that are important for thyroid function. This malabsorption also applies to thyroid medication.

By: Sonja Miettinen

References
Castoro, C., Le Moli, R., Arpi, M. L., Tavarelli, M., Sapuppo, G., Frittitta, L., Squatrito, S., & Pellegriti, G.. (2016). Association of autoimmune thyroid diseases, chronic atrophic gastritis and gastric carcinoid: experience from a single institution. Journal of Endocrinological Investigation, 39(7), 779–784. https://doi.org/10.1007/s40618-016-0445-5

Ebert, E. & (2010). The Thyroid and the Gut. Journal of Clinical Gastroenterology, 44 (6), 402-406. doi: 10.1097/MCG.0b013e3181d6bc3e.

Lerner, A., Jeremias, P., & Matthias, T. (2017). Gut-thyroid axis and celiac disease. Endocrine connections, 6(4), R52–R58. https://doi.org/10.1530/EC-17-0021

Nachman, F., Vázquez, H., González, A., Andrenacci, P., Compagni, L., Reyes, H., Sugai, E., Moreno, M. L., Smecuol, E., Hwang, H. J., Sánchez, I. P., Mauriño, E., & Bai, J


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Scott Adams Grand Master

Do you have a link to the original article? My concern is whether or not it might be copy right protected.

Lindquist Contributor
  On 4/1/2023 at 10:59 PM, Scott Adams said:

Do you have a link to the original article? My concern is whether or not it might be copy right protected.

Expand Quote  

yes here it is on swedish Orginal text

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