“With a little help from my friends”—the role of microbiota in thyroid hormone metabolism and enterohepatic recycling
Abstract
The gut microbiota is composed of over 1200 species of anaerobes and aerobes bacteria along with bacteriophages, viruses and fungal species. Increasing evidence indicates that the intestinal microbiota, beside digestive equilibrium, is also crucial for immunologic, hormonal and metabolic homeostasis. The intestinal microbiota interacts with distant organs by signals which may be part of the bacteria themselves or their metabolites. Dysbiosis has been observed in inflammatory or autoimmune disorders such as multiple sclerosis or type 1 diabetes as well as in obesity and type 2 diabetes. Functional thyroid disorders were associated with bacterial overgrowth and a different microbial composition. Although thyroid metabolism was apparently disregarded, the interference of microbiota on peripheral iodothyronine homeostasis is an intriguing issue. In this review we focused on the interactions of intestinal microbiota with thyroid-related micronutrients and with the metabolic steps of endogenous and exogenous iodothyronines.
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The secreted conjugated T4 is broken down by the intestinal flora and partially reabsorbed.
“The secreted conjugated T4 is then broken down by the intestinal flora and partially reabsorbed (20, 31).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [31]
Levothyroxine metabolism includes conjugation and deiodination; in the liver some levothyroxine is glucuronidated and sulfated, becoming more water-soluble, then secreted with bile into the intestine, where microbiota break it down and it is partly reabsorbed.
“The metabolism of LT4 involves conjugation and deiodination processes.22 In the liver, a portion of LT4 is conjugated by glucuronidation and sulfation, increasing its water solubility.Conjugated LT4 is secreted with bile into the intestine, 22 where it is broken down by intestinal microbiota and partially reabsorbed.23”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [23]
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Changes in gut microbiota before and after treatment in patients with primary hypothyroidism
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- Authors
- Virili, C., & Centanni, M.
- Affiliations
- Sapienza University of Rome (IT)
- Corresponding author
- Centanni, Marco
- Venue
- Molecular and Cellular Endocrinology
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 458
- Pages
- 39-43
- ISSN
- 0303-7207 (ISSN-L)
- OpenAlex
- W2583376499
- Cited by
- 105
- References
- 59
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 14 · 2023: 15 · 2022: 14 · 2021: 10 · 2020: 9 · 2019: 16 · 2018: 7 · 2017: 3
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Molecular and Cellular Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- gut microbiota, thyroid hormone metabolism, enterohepatic circulation, iodothyronines, dysbiosis, bacterial overgrowth, thyroid dysfunction, bacterial metabolites
- MeSH terms
- Gastrointestinal Microbiome, Energy Metabolism, Homeostasis, Humans, Liver, Nutritional Status, Thyroid Hormones, Thyronines
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