Hashimoto’s Thyroiditis and Autoimmune Gastritis
Open accessAbstract
The term "thyrogastric syndrome" defines the association between autoimmune thyroid disease and chronic autoimmune gastritis (CAG), and it was first described in the early 1960s. More recently, this association has been included in polyglandular autoimmune syndrome type IIIb, in which autoimmune thyroiditis represents the pivotal disorder. Hashimoto's thyroiditis (HT) is the most frequent autoimmune disease, and it has been reported to be associated with gastric disorders in 10-40% of patients while about 40% of patients with autoimmune gastritis also present HT. Some intriguing similarities have been described about the pathogenic mechanism of these two disorders, involving a complex interaction among genetic, embryological, immunologic, and environmental factors. CAG is characterized by a partial or total disappearance of parietal cells implying the impairment of both hydrochloric acid and intrinsic factor production. The clinical outcome of this gastric damage is the occurrence of a hypochlorhydric-dependent iron-deficient anemia, followed by pernicious anemia concomitant with the progression to a severe gastric atrophy. Malabsorption of levothyroxine may occur as well. We have briefly summarized in this minireview the most recent achievements on this peculiar association of diseases that, in the last years, have been increasingly diagnosed.
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Levothyroxine absorption can be limited by gastrointestinal diseases including Helicobacter pylori infection, inflammatory bowel disease, celiac disease, lactose intolerance, atrophic body gastritis, gastric bypass, biliary pancreatic diversion, and gastroparesis.
“Levothyroxine absorption can be limited by a number of diseases of the gastrointestinal (GI) tract, including: Helicobacter pylori infection, inflammatory bowel disease (IBD), celiac disease, lactose intolerance, atrophic body gastritis (ABG), gastric bypass, biliary pancreatic diversion, and gastroparesis, among others”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [17]
Non-optimal thyroxine therapy, as evidenced by TSH levels above or below the reference range, is common in hypothyroid patients.
“Even though its prevalence has not been precisely documented, non-optimal thyroxine therapy, as evidenced by TSH levels above (or below) the reference range, is common (Table 2)”
From Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report (2017) · cites this paper as [17]
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References 51 · Cited by 120
- Authors
- Cellini, M., Santaguida, M. G., Virili, C., Capriello, S., Brusca, N., Gargano, L., & Centanni, M.
- Affiliations
- Sapienza University of Rome (IT)
- Corresponding author
- Centanni, Marco
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2017-04-26
- Volume
- 8
- Pages
- 92-92
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC5405068
- OpenAlex
- W2607985302
- Cited by
- 120
- References
- 51
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 17 · 2023: 11 · 2022: 5 · 2021: 16 · 2020: 10 · 2019: 17 · 2018: 11 · 2017: 5
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Keywords
- Hashimoto's thyroiditis, autoimmune gastritis, autoimmune thyroid disease, parietal cell loss, atrophic gastritis, pernicious anemia, iron deficiency anemia, pathogenesis
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