Thyroid disorders and gastrointestinal dysmotility: an old association
Open accessAbstract
Gastrointestinal motility symptoms may be closely related to thyroid diseases. Sometimes, such symptoms are the only thyroid disease-related clue although the degree of the symptoms may vary. The exact mechanism of action of thyroid hormones on gastrointestinal motility is not completely understood, however, a clue lies in the fact that muscle cell receptors can be directly acted upon by thyroxines. Both hypo- and hyperthyroidism can cause impairment of gastrointestinal motility, modifying structure and function of pharynx and esophagus, and regulating esophageal peristalsis through neuro-humoral interaction. In hyperthyroid patients, alterations of postprandial and basic electric rhythms have been observed at gastro-duodenal level, often resulting in slower gastric emptying. Gastric emptying may also be delayed in hypothyroidism, but an unrelated gastric mucosa-affecting chronic modification may also cause such pattern. Hyperthyroidism commonly show malabsorption and diarrhoea, while hypothyroidism frequently show constipation. In summary, it can be stated that symptoms of gastrointestinal motility dysfunction can be related to thyroid diseases, affecting any of the gastrointestinal segment. Clinically, the typical thyroid disease manifestations may be missing, borderline, or concealed because of intercurrent sicknesses. Motility-linked gastrointestinal problems may easily conceal a misdetected, underlying dysthyroidism that should be carefully analyzed. Here, we aim to elaborate on the associations between thyroid disorders and GI dysmotility and the common clinical manifestations associated with GI dysmotility.
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review summarizes associations between thyroid disorders and gastrointestinal dysmotility, covering hypo- and hyperthyroidism across the GI tract and common clinical manifestations. It concludes that GI motility symptoms can be linked to thyroid disease, but mechanisms remain incompletely understood and evidence is often conflicting.
Key findings
- Hypothyroidism is associated with delayed gastric emptying, constipation, SIBO, megacolon, and pseudo-obstruction; hyperthyroidism is commonly associated with malabsorption, diarrhoea, and increased stool frequency, though constipation has also been reported.
- SIBO was found in 54% of hypothyroidism patients by glucose breath test (Lauritano et al., 2007), and in 56% of IBS patients by positive lactose breath tests (Peralta et al., 2009).
- In hyperthyroidism, 60%–80% of thyrotoxicosis is associated with Graves’ disease; 16% of hyperthyroid patients showed histamine-resistant achlorhydria, and 33%–37% of thyrotoxicosis patients show antiparietal cell antibodies.
- Oral levothyroxine is incompletely absorbed, with only 70% of the administered dose reported to be absorbed; GI health improvement, including treating H. pylori, SIBO, lactose intolerance, or celiac disease, may improve thyroid medication absorption and lower levothyroxine requirements.
Methods
- Narrative review of published literature on thyroid disorders and GI dysmotility, including hypo- and hyperthyroidism, clinical manifestations, and therapeutic approaches.
- No primary data, systematic search strategy, or meta-analysis is described; the paper synthesizes findings from cited studies and reviews.
- Main analysis is a narrative synthesis of mechanisms, clinical associations, and treatment implications, with tables and figures summarizing GI manifestations and proposed pathways.
Limitations
- The paper states that the exact mechanism of thyroid hormone action on GI motility is not completely understood, and that knowledge about the relationship between GI and endocrine functions is very limited.
- The paper states there is a lack of definite knowledge whether hormonal disturbances in thyroid disorders directly cause GI dysmotility or whether these are autonomic nervous system-mediated secondary responses.
- Evident from the text: as a narrative review without systematic search or inclusion criteria, it reports heterogeneous and conflicting findings, such as gastric emptying being delayed, rapid, or normal in hyperthyroidism, and ghrelin levels being decreased, increased, or unaffected in hypothyroidism.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
20 of 57 cited sources checked · 9 supported · 1 flagged · accuracy not yet measured
- Premisecitation
Glycosaminoglycans such as hyaluronic acid accumulation is caused by hypothyroidism in the smooth muscles and interstitial tissues of gastrointestinal tract resulting in delayed bowel transit.
“glycosaminoglycans such as hyaluronic acid accumulation is caused by hypothyroidism in the smooth muscles and interstitial tissues of gastrointestinal tract resulting in delayed bowel transit (Maser et al., 2006).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Maser et al., 2006 source
The Functional thyroid disease section says hypothyroidism causes glycosaminoglycan accumulation and that resulting edema in gastric smooth muscle may predispose to gastric dysmotility. It also reports sluggish intestinal motility in hypothyroidism, but does not establish that glycosaminoglycan accumulation throughout gastrointestinal smooth muscle causes delayed bowel transit. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation
Bloating in IBS can be caused by SIBO.
“Bloating in IBS can be caused by SIBO.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Peralta et al., 2009 source
- Premisecitation
Reduced hollow viscera motility, including stomach, colon, esophagus, and small intestine, have been observed in myxedema which gets reversed with replacement therapy for thyroid hormone.
“Reduced hollow viscera motility, including stomach, colon, esophagus, and small intestine, have been observed in myxedema which gets reversed with replacement therapy for thyroid hormone.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Shizuma, 2016 source
Section 5.1 (page unavailable) says synthetic thyroid hormones are administered to correct hypothyroidism, but does not discuss digestive-tract motility or its reversal. Searches for myxedema and for reduced gastrointestinal motility with thyroid-hormone replacement found no passage addressing those observations in our copy. (LLM, conf=0.73)
Experimental — accuracy not yet measured
- Premisecitation
Nearly 54% of hypothyroidism patients show presence of bacterial overgrowth in the small intestine.
“Nearly 54% of hypothyroidism patients show presence of bacterial overgrowth in the small intestine (Lauritano et al., 2007).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Lauritano et al., 2007 source
- Premisecitation
Ghrelin has been associated with enhanced rate of gastric emptying.
“Ghrelin has been associated with enhanced rate of gastric emptying (Levin et al., 2006; Cheung and Wu, 2013).”
Quote in the paperNot a substantial claim1 of 2 sources checked
- Premisecitation
Increased stool frequency is found associated with hyperthyroidism.
“Increased stool frequency is found associated with hyperthyroidism (Daher et al., 2009).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Daher et al., 2009 source
- Premisecitation
Change in small GI motility is a major risk factor for SIBO development.
“Thus, change in small GI motility is a major risk factor for SIBO development (Ahmed et al., 2023).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Ahmed et al., 2023 source
- Premisecitation
Hyperthyroidism results in reduced acid secretion with histamine-resistant achlorhydria as shown by 16% of such patients.
“Hyperthyroidism results in reduced acid secretion with histamine-resistant achlorhydria as shown by 16% of such patients (Dotevall et al., 1967; De Leo et al., 2016).”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites Dotevall et al., 1967 source
- cites De Leo et al., 2016 source
The Clinical presentation and complications section discusses symptoms of excess thyroid hormone but does not address gastric acid secretion. Searches of our full-text copy for histamine-resistant achlorhydria, reduced gastric acid secretion, the 16% figure, and Dotevall found no passage supporting the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measured
- Premisecitation
A medication-related association exists between SIBO and thyroid.
“A case study highlights the medication-related association between SIBO and thyroid showing the usefulness of targeting this linkage as therapeutic opportunity although no clinical trials have been carried out to this regard (Bohinc Henderson, 2021).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Bohinc Henderson, 2021 source
The Discussion describes an association between SIBO and hypothyroidism and explains that SIBO may impair absorption of levothyroxine. The Conclusion reports improved thyroid control after switching this patient to an oral levothyroxine solution, supporting a medication-related therapeutic opportunity. The paper does not establish the citing sentence’s additional claim that no clinical trials have been conducted. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation
A significant number of thyroid disorder patients with gastric dysmotility show improvement following thyroid hormone replacement.
“A significant number of thyroid disorder patients with gastric dysmotility show improvement following thyroid hormone replacement (Canpolat et al., 2013).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Canpolat et al., 2013 source
The Abstract and Discussion report significant improvements in gastric motility measures and symptoms after L-thyroxine treatment in women with subclinical hypothyroidism. The claim extends this finding to thyroid disorder patients generally and says a significant number improved, but the study included only 20 premenopausal women with subclinical hypothyroidism and does not establish how many individuals improved. (LLM, conf=0.87)
Experimental — accuracy not yet measured
- Premisecitation
Patients with impaired stomach acid secretion require higher levothyroxine doses.
“Several studies demonstrate the requirement of higher levothyroxine doses in patients with stomach acid secretion impairment (Centanni et al., 2006; Ribichini et al., 2017).”
Quote in the paperSubstantial claim1 of 2 sources checked - Premisecitation
Altered T4 absorption owing to modified gastric physiology comes up as one of the critical reasons for increased thyroxine requirement.
“Among those, altered T4 absorption owing to modified gastric physiology comes up as one of the critical reasons (Centanni et al., 2006; Seng Yue et al., 2015).”
Quote in the paperSubstantial claim2 of 2 sources checked - Premisereasoning
Both hypo- and hyperthyroidism may cause deregulated GI motility and function.
“Both hypo- and hyperthyroidism may cause deregulated GI motility and function (Table 1).”
Quote in the paperSubstantial claim - Premisecitation
Conflicting reports have emerged regarding overt hypothyroidism-associated ghrelin concentration levels where it has been found to be either decreased, increased, or not affected.
“Conflicting reports have emerged regarding overt hypothyroidism-associated ghrelin concentration levels where it has been found to be either decreased (Altinova et al., 2006), increased (Gjedde et al., 2008), or not affected (Tanda et al., 2009).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Premisecitation
Individuals with GI motility problems commonly complain of constipation, irrespective of any changes in stool frequency or colon transit time.
“Individuals with GI motility problems commonly complain of constipation. This happens irrespective of any changes in stool frequency or colon transit time (Mearin et al., 2016).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mearin et al., 2016 source
- Interpretationreasoning
Symptoms of gastrointestinal motility dysfunction can be related to thyroid diseases, affecting any of the gastrointestinal segment.
“In summary, it can be stated that symptoms of gastrointestinal motility dysfunction can be related to thyroid diseases, affecting any of the gastrointestinal segment.”
Quote in the paperSubstantial claim - Premisecitation
In hyperthyroidism individuals, gastric emptying can be delayed, rapid or normal.
“In hyperthyroidism individuals, gastric emptying can be delayed, rapid or normal (Gunsar et al., 2003; Kisakol et al., 2003).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationreasoning
Gastrointestinal motility symptoms may be closely related to thyroid diseases.
“Gastrointestinal motility symptoms may be closely related to thyroid diseases.”
Quote in the paperSubstantial claim - Premisecitation
Gastrin concentrations in the serum is increased in hypothyroidism.
“Gastrin concentrations in the serum is increased in hypothyroidism (Sagara et al., 1983).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sagara et al., 1983 source
- Premisecitation
More than 50% of hypothyroidism patients reportedly show with the presence of SIBO.
“More than 50% of hypothyroidism patients reportedly show with the presence of SIBO (Almandoz and Gharib, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Almandoz and Gharib, 2012 source
- Premisecitation
Reduced concentrations of active ghrelin can be associated with slower rate of gastric emptying.
“On the other hand, reduced concentrations of active ghrelin can be associated with slower rate of gastric emptying (Levin et al., 2006).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Levin et al., 2006 source
- Premisecitation
Normal GI motility in healthy individuals restricts bacterial overgrowth.
“Normal GI motility in healthy individuals restricts bacterial overgrowth (Dukowicz et al., 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Dukowicz et al., 2007
- Premisenone given
In hyperthyroid patients, alterations of postprandial and basic electric rhythms have been observed at gastro-duodenal level, often resulting in slower gastric emptying.
“In hyperthyroid patients, alterations of postprandial and basic electric rhythms have been observed at gastro-duodenal level, often resulting in slower gastric emptying.”
Quote in the paperNot a substantial claim - Premisecitation
Thyroid disorders can be linked with gastrointestinal diseases or GI symptomatology.
“Thyroid disorders can be linked with gastrointestinal (GI) diseases or GI symptomatology (Kyriacou et al., 2015).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Kyriacou et al., 2015 source
- Premisenone given
GI motility dysfunction develops following reduced esophageal sphincter pressure and lowered contraction amplitude in esophageal body leading to reflux and dysphagia.
“GI motility dysfunction develops following reduced esophageal sphincter pressure and lowered contraction amplitude in esophageal body leading to reflux and dysphagia.”
Quote in the paperNot a substantial claim - Interpretationreasoning
Motility-linked gastrointestinal problems may easily conceal a misdetected, underlying dysthyroidism.
“Motility-linked gastrointestinal problems may easily conceal a misdetected, underlying dysthyroidism that should be carefully analyzed.”
Quote in the paperSubstantial claim - Premisecitation
Gastrin exerts a thyroid function-dependent influence on GI motility.
“Gastrin exerts a thyroid function-dependent influence on GI motility (Wiersinga and Touber, 1980).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wiersinga and Touber, 1980 source
- Premisecitation
Some hypothyroidism individuals may show delayed gastric emptying.
“Some hypothyroidism individuals may show delayed gastric emptying (Khraisha et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Khraisha et al., 2015
- Interpretationreasoning
Thyroid disorders prominently impair GI health including motility.
“Thyroid disorders prominently impair GI health including motility and as such evaluation of thyroid functions should be carried out in patients complaining of GI problems.”
Quote in the paperNot a substantial claim- Rests on an assumption: The thyroid gland influences GI physiology.
- Interpretationreasoning
GI health improvement (e.g., small bowel and gastric health) can lead to improved absorption of thyroid medication, thereby lowering the overall medication need in many patients to maintain euthyroidism.
“Together, it can be inferred that GI health improvement (e.g., small bowel and gastric health) can lead to improved absorption of thyroid medication thereby lowering the overall medication need in many patients to maintain euthyroidism.”
Quote in the paperSubstantial claim - Interpretationcitation
A common reason behind SIBO may be hypothyroidism.
“A common reason behind SIBO may be hypothyroidism (Lappinga et al., 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Lappinga et al., 2010 source
- Premisecitation
Seventy-six percent of hypothyroid patients show lactose intolerance.
“Seventy-six percent of hypothyroid patients show lactose intolerance, a lowered TSH was observed when such patients are provided a lactose-free diet (Asik et al., 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Asik et al., 2014 source
- Premisecitation
In humans, the jejuno-ileal tract is the main site of oral thyroxine absorption.
“In humans, the jejuno-ileal tract is the main site of oral thyroxine absorption while duodenum absorbs a few parts, but nothing has been reported to be absorbed in the large bowel unlike in the rats (Hays, 1988; Hays, 1991).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationcitation
Optimal absorption of thyroid replacement requires a proper hydrochloric acid output.
“Optimal absorption of thyroid replacement requires a proper hydrochloric acid output.”
Quote in the paperSubstantial claim - Interpretationcitation
In such patients, GI hypomotility-induced bacterial overgrowth can be the reason behind diarrhoea.
“In such patients, GI hypomotility-induced bacterial overgrowth can be the reason behind diarrhoea (Goldin and Wengrower, 1990).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Goldin and Wengrower, 1990 source
- Premisecitation
In hypothyroid patients, probiotic use lowers the required dose of levothyroxine.
“For example, use of probiotics leads to reduced levels of TSH, lower the required dose of levothyroxine, and improve hypothyroid patients’ fatigue levels who continue to show symptoms even after optimum levothyroxine therapy (Talebi et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Talebi et al., 2020 source
- Premisecitation
In individuals with atypical celiac disease, a gluten-free diet reduces the required dose of levothyroxine.
“Similarly, individuals suffering from atypical celiac disease required lesser dose of levothyroxine when provided with a gluten-free diet (Virili et al., 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Virili et al., 2012 source
- Premisecitation
In humans, no oral thyroxine absorption has been reported in the large bowel, unlike in rats.
“In humans, the jejuno-ileal tract is the main site of oral thyroxine absorption while duodenum absorbs a few parts, but nothing has been reported to be absorbed in the large bowel unlike in the rats (Hays, 1988; Hays, 1991).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
Absorption of oral thyroxine in the stomach has been ruled out based on the lag time between its appearance in plasma and its ingestion.
“Besides, absorption in the stomach has also been ruled out due to the lag time between appearance of thyroxine in the plasma and its ingestion (Hays, 1988).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hays, 1988 source
- Interpretationnone given
A close association has been found between thyroid disorders and GI motility.
“A close association has been found between thyroid disorders and GI motility.”
Quote in the paperNot a substantial claim - Interpretationcitation
In hypothyroidism patients, chronic GI symptoms can be a result of GI hypomotility-induced bacterial overgrowth.
“Thus, in hypothyroidism patients chronic GI symptoms can be a result of GI hypomotility-induced bacterial overgrowth.”
Quote in the paperSubstantial claim - Premisecitation
In hypothyroid patients who continue to show symptoms despite optimal levothyroxine therapy, probiotic use improves fatigue levels.
“For example, use of probiotics leads to reduced levels of TSH, lower the required dose of levothyroxine, and improve hypothyroid patients’ fatigue levels who continue to show symptoms even after optimum levothyroxine therapy (Talebi et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Talebi et al., 2020 source
- Premisecitation
Treatment for food sensitivities/intolerances improves malabsorption of thyroid medication.
“Malabsorption of thyroid medication has also been improved with treatment for food sensitivities/intolerances (Asik et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Asik et al., 2014 source
- Premisecitation
In hypothyroid patients with lactose intolerance, a lactose-free diet lowers TSH.
“Seventy-six percent of hypothyroid patients show lactose intolerance, a lowered TSH was observed when such patients are provided a lactose-free diet (Asik et al., 2014).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Asik et al., 2014 source
- Interpretationnone given
Thyroxine hormone replacement therapy can have a beneficial effect in patients presenting with thyroid disease-related GI motility problems.
“Nonetheless, thyroxine hormone replacement therapy can have beneficial effect in patients presenting with thyroid disease-related GI motility problems.”
Quote in the paperNot a substantial claim - Premisecitation
In hypothyroid patients, probiotic use reduces TSH levels.
“For example, use of probiotics leads to reduced levels of TSH, lower the required dose of levothyroxine, and improve hypothyroid patients’ fatigue levels who continue to show symptoms even after optimum levothyroxine therapy (Talebi et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Talebi et al., 2020 source
- Not yet classified. 1
- May combine two claims. 14
- Classified as probably not a substantial claim. 5
Not yet classified.
InterpretationSince gastric myoelectrical abnormalities are not associated with the delay in gastric emptying, the delay may be a result of dysfunction in smooth muscle in coordination with the duodenum and antrum, or pylorospasm.
“Since gastric myoelectrical abnormalities are not associated with the delay in gastric emptying, it may be a result of dysfunction in smooth muscle in coordination with the duodenum and antrum, or pylorospasm (Wang et al., 2023).”
Quote in the paperNot yet classified1 of 1 sources checked- cites Wang et al., 2023 source
Section 5.1 states that abnormal gastric slow waves are associated with delayed gastric emptying, directly contrary to the claim that myoelectrical abnormalities are not associated with it. The Introduction does identify gastric motor, pyloric, and duodenal dysfunction as possible contributors to delayed emptying, but it does not present them as alternatives established by an absence of electrical association. (LLM, conf=0.91)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationGreater GERD duration causes increased erosive esophagitis, strictures, ulceration, and Barrett's esophagus.
“Greater GERD duration causes increased erosive esophagitis, strictures, ulceration, and Barrett’s esophagus (Lin et al., 2019; Adanir et al., 2021).”
Quote in the paperNot a substantial claim2 of 2 sources checked- cites Lin et al., 2019 source
The Introduction (page unavailable) says frequent and severe reflux may result in reflux esophagitis. The section on impaired esophageal clearance (page unavailable) also links prolonged acid exposure to esophagitis and related complications. Neither passage establishes that greater duration of GERD causes more complications, or specifically identifies strictures, ulceration, and Barrett’s esophagus as outcomes of longer GERD duration. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites Adanir et al., 2021 source
The Results (Table 3) show more severe esophagitis and more Barrett’s esophagus in older than younger GERD patients. The Introduction also describes both as GERD-related complications. But the paper compares age groups, not GERD duration, and does not establish that longer disease duration causes these outcomes; it does not report increased strictures or ulceration. (LLM, conf=0.87)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationHypothyroidism has also been linked with reduced stool frequency, ischemia, paralytic ileus, vascular malformations, megacolon, volvulus, and pseudoobstruction.
“Hypothyroidism has also been linked with reduced stool frequency, ischemia, paralytic ileus, vascular malformations, megacolon, volvulus, and pseudoobstruction (Thakur et al., 2020).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Thakur et al., 2020 source
The Discussion (page not provided) links myxedema ileus due to hypothyroidism with decreased bowel movement frequency, paralytic ileus, pseudo-obstruction, acute megacolon, and pseudo-volvulus. It also mentions intestinal ischemia as a proposed contributor to reduced gut activity. It does not mention vascular malformations, and pseudo-volvulus does not establish a link with true volvulus. (LLM, conf=0.89)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationHydrogen breath tests or small bowel barium studies reveal an enhanced mouth to cecum transit time which correlates negatively with T3 concentrations in the blood.
“Hydrogen breath tests or small bowel barium studies reveal an enhanced mouth to cecum transit time which correlates negatively with T3 concentrations in the blood (Thomas et al., 1973; Tobin et al., 1989; Wegener et al., 1992; Daher et al., 2009).”
Quote in the paperNot a substantial claim1 of 3 sources checked- cites Thomas et al., 1973 source
- cites Tobin et al., 1989 source
The Results report that hydrogen breath testing found shorter orocaecal transit times in hyperthyroid patients than in controls (49 versus 85 minutes). The paper also discusses barium studies reporting rapid transit, but our copy does not report a correlation between transit time and blood T3 concentrations. If “enhanced transit time” means a longer time rather than faster transit, it does not describe this paper’s finding. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites Wegener et al., 1992 source
May combine two claims.
PremisecitationIn a patient with SIBO, optimal TSH balance was not achieved with multiple medication changes over 6 months, but symptoms resolved and euthyroidism was achieved after treatment with rifaximin for SIBO plus liquid T4.
“The patient in question could not achieve optimal TSH balance even after multiple medication changes over a 6-month duration.”
- Also stated in: § Thyroid hormone absorption is improved by GI therapies · plain
“Her symptoms could only be resolved and euthyroidism achieved when she was treated with rifaximin for SIBO besides receiving liquid T4 (Bohinc Henderson, 2021).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Bohinc Henderson, 2021 source
- Also stated in: § Thyroid hormone absorption is improved by GI therapies · plain
May combine two claims.
PremisecitationHelicobacter pylori treatment improves TSH levels and lowers the required dose of levothyroxine.
“In addition, there are studies that show improved levels of TSH upon Helicobacter pylori treatment that lower the required dose of levothyroxine (Centanni et al., 2006; Ribichini et al., 2017).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Centanni et al., 2006 source
The prospective-study passage reports that TSH fell after H. pylori eradication in 11 patients with multinodular goiter. It does not support the claimed reduction in levothyroxine dose: the median dose after eradication was slightly higher, 1.70 versus 1.56 μg/kg/day. (LLM, conf=0.92)
Experimental — accuracy not yet measured - cites Ribichini et al., 2017 source
May combine two claims.
PremisecitationWhen on similar high-fat diets, hyperthyroid patients excreted significantly excess fecal fat as compared to normal individuals, ruling out hyperphagia as the only mechanism.
“When on similar high-fat diets, hyperthyroid patients excreted significantly excess fecal fat as compared to normal individuals, ruling out hyperphagia as the only mechanism.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Thomas et al., 1973 source
May combine two claims.
PremisecitationIn some hypothyroidism individuals, secretion of acid is diminished, a finding that can be linked to gastric mucosa changes but not with the severity or duration of the hypo-functioning thyroid.
“In some hypothyroidism individuals, secretion of acid is diminished, a finding that can be linked to gastric mucosa changes but not with the severity or duration of the hypo-functioning thyroid (Dotevall et al., 1967).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dotevall et al., 1967 source
May combine two claims.
PremisereasoningBoth hypo- and hyperthyroidism can cause impairment of gastrointestinal motility, modifying structure and function of pharynx and esophagus, and regulating esophageal peristalsis through neuro-humoral interaction.
“Both hypo- and hyperthyroidism can cause impairment of gastrointestinal motility, modifying structure and function of pharynx and esophagus, and regulating esophageal peristalsis through neuro-humoral interaction.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Premisenone givenGastric emptying may also be delayed in hypothyroidism, but an unrelated gastric mucosa-affecting chronic modification may also cause such pattern.
“Gastric emptying may also be delayed in hypothyroidism, but an unrelated gastric mucosa-affecting chronic modification may also cause such pattern.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone givenGERD pathogenesis depends greatly on lower esophageal sphincter competence, gastric emptying, and esophageal clearance.
“GERD pathogenesis depends greatly on lower esophageal sphincter competence, gastric emptying, and esophageal clearance.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationExcretion of excess fecal fat is commonly observed in hyperthyroidism, which may be due to excessive fat ingestion through diet since the fat absorption coefficient is found normal in those individuals.
“Excretion of excess fecal fat is commonly observed in hyperthyroidism, which may be due to excessive fat ingestion through diet since the fat absorption coefficient is found normal in those individuals (Thomas et al., 1973).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Thomas et al., 1973 source
May combine two claims.
Premisenone givenHyperthyroidism commonly show malabsorption and diarrhoea, while hypothyroidism frequently show constipation.
“Hyperthyroidism commonly show malabsorption and diarrhoea, while hypothyroidism frequently show constipation.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationnone givenImpaired GI motility presents with features like gastritis, dysphagia, nausea/vomiting, GI bleeding, and SIBO.
“Impaired GI motility presents itself with features like gastritis, dysphagia, nausea/vomiting, GI bleeding and SIBO.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone givenThe impact of the thyroid on the GI tract may vary depending on the kind of involvement and the overall hormonal disturbance-associated effect.
“The impact of the thyroid on GI tract may vary depending on the involvement kind and the overall hormonal disturbance-associated effect (Figure 2).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationLevothyroxine is not completely absorbed orally; approximately 70% of an administered oral dose is absorbed.
“Levothyroxine is not completely absorbed orally with only 70% of the dose administered is reported to be absorbed (Hays, 1991).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hays, 1991 source
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenThyroid disorders like hypo- and hyperthyroidism deregulate hormonal balance, resulting in imbalances like autoantibody production and bile acid production, thereby leading to GI dysmotility.
“Thyroid disorders like hypo- and hyperthyroidism that deregulates its hormonal balance results in imbalances like autoantibody production and bile acid production thereby leading to GI dysmotility.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationnone givenOral thyroxine bioavailability might be impacted by gastric physiology variations, leading to increased drug need.
“However, oral thyroxine bioavailability might be impacted by gastric physiology variations, leading to increased drug need.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The exact mechanism of action of thyroid hormones on gastrointestinal motility is not completely understood.
“The exact mechanism of action of thyroid hormones on gastrointestinal motility is not completely understood”
The paper relies on this without support.
No study has been carried out regarding the association of ghrelin with gastric motility in response to a meal in subclinical hypothyroidism.
“No study has been carried out regarding the association of ghrelin with gastric motility in response to a meal in subclinical hypothyroidism (SCH).”
The paper relies on this without support.
The thyroid gland influences GI physiology.
“There is no question regarding the influence of thyroid gland on the GI physiology.”
Cites
De Leo, S., Lee, S. Y., & Braverman, L. E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00278-6 · Cited by 883 · see citing works
Hypothyroidism in Context: Where We’ve Been and Where We’re Going
Chiovato, L., Magri, F., & Carlé, A. (2019) · Advances in Therapy · doi:10.1007/s12325-019-01080-8 · Cited by 491 · see citing works
Subclinical Hypothyroidism: An Update for Primary Care Physicians
Fatourechi, V. (2009) · Mayo Clinic Proceedings · doi:10.4065/84.1.65 · Cited by 376 · see citing works
Epidemiology and prevention of clinical and subclinical hypothyroidism.
Vanderpump, M. P. J., & Tunbridge, W. M. G. (2002) · Thyroid · doi:10.1089/105072502761016458 · Cited by 347 · see citing works
Thyroxine in Goiter, <i>Helicobacter pylori</i> Infection, and Chronic Gastritis
Centanni, M., Gargano, L., Canettieri, G., Viceconti, N., Franchi, A., Fave, G. D., & Annibale, B. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa043903 · Cited by 329 · see citing works
Small intestinal bacterial overgrowth: a comprehensive review.
(2007) · PubMed Central · Cited by 321 · see citing works
Ghrelin stimulates gastric emptying and hunger in normal-weight humans
Levin, F., Edholm, T., Schmidt, P. T., Grybäck, P., Jacobsson, H., Degerblad, M., Höybye, C., Holst, J. J., Rehfeld, J. F., Hellström, P. M., et al. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-2638 · Cited by 313 · see citing works
Electrogastrography: Methodology, Validation and Applications
Yin, J., & Chen, J. D. Z. (2013) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2013.19.1.5 · Cited by 267 · see citing works
Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis
Wiersinga, W. M., Poppe, K. G., & Effraimidis, G. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00005-0 · Cited by 254 · see citing works
Hypothyroidism: etiology, diagnosis, and management
Almandoz, J. P., & Gharib, H. (2012) · Medical Clinics of North America · doi:10.1016/j.mcna.2012.01.005 · Cited by 216 · see citing works
Cho, Y., Choi, M., Jeong, J.-J., Chung, W.-C., Lee, I. S., Kim, S., Han, S.-W., Choi, K.-Y., & Chung, I. (2005) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2005.41245.x · Cited by 191 · see citing works
Gastrointestinal malabsorption of thyroxine
Virili, C., Antonelli, A., Santaguida, M. G., Benvenga, S., & Centanni, M. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00168 · Cited by 164 · see citing works
Harari, D. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.156.3.315 · Cited by 141 · see citing works
Association between hypothyroidism and small intestinal bacterial overgrowth
Lauritano, E. C., Bilotta, A. L., Gabrielli, M., Scarpellini, E., Lupascu, A., Laginestra, A., Novi, M., Sottili, S., Serricchio, M., Cammarota, G., et al. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0606 · Cited by 140 · see citing works
Localization of human thyroxine absorption
HAYS, M. T. (1991) · Thyroid · doi:10.1089/thy.1991.1.241 · Cited by 138 · see citing works
Rong, F., Dai, H., Wu, Y., Li, J., Liu, G., Chen, H., & Zhang, X. (2021) · BMC Medicine · doi:10.1186/s12916-021-02121-2 · Cited by 120 · see citing works
Atypical celiac disease as cause of increased need for thyroxine: a systematic study
Virili, C., Bassotti, G., Santaguida, M. G., Iuorio, R., Del Duca, S. C., Mercuri, V., Picarelli, A., Gargiulo, P., Gargano, L., & Centanni, M. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1851 · Cited by 114 · see citing works
Wu, J. T., & Kral, J. G. (2004) · Annals of Surgery · doi:10.1097/01.sla.0000118561.54919.61 · Cited by 111 · see citing works
Eating Disorders and Gastrointestinal Diseases
Santonicola, A., Gagliardi, M., Guarino, M. P. L., Siniscalchi, M., Ciacci, C., & Iovino, P. (2019) · Nutrients · doi:10.3390/nu11123038 · Cited by 107 · see citing works
Lappinga, P. J., Abraham, S. C., Murray, J. A., Vetter, E. A., Patel, R., & Wu, T. T. (2010) · Archives of Pathology & Laboratory Medicine · doi:10.5858/134.2.264 · Cited by 106 · see citing works
Small Intestinal Bacterial Overgrowth
Adike, A., & DiBaise, J. K. (2017) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2017.09.008 · Cited by 106 · see citing works
Consequences of dysthyroidism on the digestive tract and viscera
Daher, R., Yazbeck, T., Jaoude, J. B., & Abboud, B. (2009) · World Journal of Gastroenterology · doi:10.3748/wjg.15.2834 · Cited by 102 · see citing works
Dacha, S., Razvi, M., Massaad, J., Cai, Q., & Wehbi, M. (2015) · Gastroenterology Report · doi:10.1093/gastro/gov004 · Cited by 97 · see citing works
Hays, M. T. (1988) · Endocrine Research · doi:10.3109/07435808809032986 · Cited by 94 · see citing works
Peralta, S., Cottone, C., Doveri, T., Almasio, P. L., & Craxi, A. (2009) · World Journal of Gastroenterology · doi:10.3748/wjg.15.2628 · Cited by 88 · see citing works
Does Hypothyroidism Affect Gastrointestinal Motility?
Yaylalı, O., Kıraç, S., Yilmaz, M., Akın, F., Yüksel, D., Demirkan, N. Ç., & Akdağ, B. (2009) · Gastroenterology Research and Practice · doi:10.1155/2009/529802 · Cited by 80 · see citing works
Steatorrhea in Thyrotoxicosis: Relation to Hypermotility and Excessive Dietary Fat
THOMAS, F. B., CALDWELL, J. H., & GREENBERGER, N. J. (1973) · Annals of Internal Medicine · doi:10.7326/0003-4819-78-5-669 · Cited by 77 · see citing works
Thyroid disorders and gastrointestinal and liver dysfunction: a state of the art review
Kyriacou, A., McLaughlin, J., & Syed, A. A. (2015) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2015.07.017 · Cited by 74 · see citing works
Role of ghrelin in the pathophysiology of gastrointestinal disease
Cheung, C. K., & Wu, J. C.-Y. (2013) · Gut and Liver · doi:10.5009/gnl.2013.7.5.505 · Cited by 68 · see citing works
Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions
Desai, J., Elnaggar, M., Hanfy, A. A., & Doshi, R. P. (2020) · Clinical and Experimental Gastroenterology · doi:10.2147/ceg.s200760 · Cited by 68 · see citing works
Talebi, S., Karimifar, M., Heidari, Z., Mohammadi, H., & Askari, G. (2020) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2019.102234 · Cited by 64 · see citing works
Review article: methods of measuring gastric acid secretion
Ghosh, T., Lewis, D. I., Axon, A. T. R., et al. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04573.x · Cited by 59 · see citing works
Asik, M., Gunes, F., Binnetoglu, E., Eroglu, M., Bozkurt, N., Sen, H., Akbal, E., Bakar, C., Beyazit, Y., & Ukinc, K. (2014) · Endocrine · doi:10.1007/s12020-013-0065-1 · Cited by 58 · see citing works
Wegener, M., Wedmann, B., Langhoff, T., et al. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.75.3.745 · Cited by 57 · see citing works
Thyroxine and treatment of hypothyroidism: seven decades of experience
Mateo, R. C. I., & Hennessey, J. V. (2019) · Endocrine · doi:10.1007/s12020-019-02006-8 · Cited by 57 · see citing works
Wegener, M., Wedmann, B., Langhoff, T., Schaffstein, J., & Adamek, R. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.75.3.1517363 · Cited by 56
The genetics of Graves’ disease
Grixti, L., Lane, L. C., & Pearce, S. H. S. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09848-8 · Cited by 54 · see citing works
The economic impact of levothyroxine dose adjustments: the CONTROL HE study
Ernst, F. R., Barr, P., Elmor, R., Sandulli, W., Thevathasan, L., Sterman, A. B., Goldenberg, J., & Vora, K. (2017) · Clinical Drug Investigation · doi:10.1007/s40261-016-0462-3 · Cited by 53 · see citing works
Diagnosis and treatment of small intestinal bacterial overgrowth
Ponziani, F. R., Gerardi, V., & Gasbarrini, A. (2015) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2016.1110017 · Cited by 52 · see citing works
Esophageal motor dysfunctions in gastroesophageal reflux disease and therapeutic perspectives
Lin, S., Li, H., & Fang, X. (2019) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm19081 · Cited by 52 · see citing works
The management of adult patients with severe chronic small intestinal dysmotility
Nightingale, J. M. D., Paine, P., McLaughlin, J. T., Emmanuel, A. V., Martin, J. E., & Lal, S. (2020) · Gut · doi:10.1136/gutjnl-2020-321631 · Cited by 50 · see citing works
Concomitant thyroid disorders and inflammatory bowel disease: a literature review
Shizuma, T. (2016) · BioMed Research International · doi:10.1155/2016/5187061 · Cited by 47 · see citing works
Orocaecal transit time in health and in thyroid disease
Tobin, M. V., Fisken, R. A., Diggory, R. T., Morris, A. I., & Gilmore, I. T. (1989) · Gut · doi:10.1136/gut.30.1.26 · Cited by 45 · see citing works
Gjedde, S., Vestergaard, E. T., Gormsen, L. C., Riis, A. L. D., Rungby, J., Møller, N., Weeke, J., & Jørgensen, J. O. L. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2619 · Cited by 44 · see citing works
Gastrointestinal manifestations of endocrine disease
Maser, C. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i20.3174 · Cited by 42 · see citing works
Seng Yue, C., Benvenga, S., Scarsi, C., Loprete, L., & Ducharme, M. (2015) · Journal of Pharmacy & Pharmaceutical Sciences · doi:10.18433/j36p5m · Cited by 41 · see citing works
Relevance of pepsinogen, gastrin, and endoscopic atrophy in the diagnosis of autoimmune gastritis
Kishikawa, H., Nakamura, K., Ojiro, K., Katayama, T., Arahata, K., Takarabe, S., Sasaki, A., Miura, S., Hayashi, Y., Hoshi, H., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-07947-1 · Cited by 40 · see citing works
Eastwood, G. L., Braverman, L. E., White, E. M., & Vander Salm, T. J. (1982) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-198208000-00003 · Cited by 39 · see citing works
Effect of hypo- and hyperthyroidism on gastric myoelectrical activity
Gunsar, F., Yilmaz, S., Bor, S., Kumanlioglu, K., Çetinkalp, S., Kabalak, T., & Ozutemiz, O. A. (2003) · Digestive Diseases and Sciences · doi:10.1023/a:1022876423487 · Cited by 37 · see citing works
Wang, T. H., Angeli, T. R., Beban, G. R., et al. (2019) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00002.2019 · Cited by 37 · see citing works
Wells, I., Smith, B., & Hinton, M. (1977) · BMJ · doi:10.1136/bmj.1.6055.211-a · Cited by 35 · see citing works
Ribichini, D., Fiorini, G., Repaci, A., Castelli, V., Gatta, L., Vaira, D., & Pasquali, R. (2017) · Endocrine · doi:10.1007/s12020-016-1167-3 · Cited by 35 · see citing works
Constipation and laxative use among people living in nursing homes in 2007 and 2013
Gustafsson, M., Lämås, K., Isaksson, U., Sandman, P.-O., & Lövheim, H. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1054-x · Cited by 35 · see citing works
Serum ghrelin levels in patients with Hashimoto's thyroiditis
Altinova, A. E., Toruner, F., Karakoc, A., Yetkin, I., Ayvaz, G., Cakir, N., & Arslan, M. (2006) · Thyroid · doi:10.1089/thy.2006.16.1259 · Cited by 33 · see citing works
Yamada, M., Sekine, M., Tatsuse, T., et al. (2021) · BMC Public Health · doi:10.1186/s12889-020-10044-5 · Cited by 31 · see citing works
Celiac Disease and Autoimmune Thyroid Disease: The Two Peas in a Pod
Ashok, T., Patni, N., Fatima, M., et al. (2022) · Cureus · doi:10.7759/cureus.26243 · Cited by 31 · see citing works
Diagnostic methods for evaluation of gastric motility-A mini review
Wang, Y., Chen, J. D. Z., & Nojkov, B. (2023) · Diagnostics · doi:10.3390/diagnostics13040803 · Cited by 31 · see citing works
Aetiology, diagnosis and management of small intestinal bacterial overgrowth
Ahmed, J. F., Padam, P., & Ruban, A. (2023) · Frontline Gastroenterology · doi:10.1136/flgastro-2022-102163 · Cited by 28 · see citing works
Gastric, pancreatic, and biliary responses to meals in hyperthyroidism.
Miller, L. J., Owyang, C., Malagelada, J. ‐., et al. (1980) · Gut · doi:10.1136/gut.21.8.695 · Cited by 27 · see citing works
Relationship between gastric and thyroid function
Dotevall, G., Rohrer, V., Stefco, P., & Price, W. (1967) · The American Journal of Digestive Diseases · doi:10.1007/bf02233924 · Cited by 27 · see citing works
The hypoglycemic side of hypothyroidism
Kalra, S., Unnikrishnan, A., & Sahay, R. K. (2014) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.126517 · Cited by 26 · see citing works
Gastric parietal cell and thyroid autoantibodies in patients with atrophic glossitis
Chiang, C., Chang, J. Y., Wang, Y., et al. (2019) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2019.01.016 · Cited by 25 · see citing works
Hu, R.-T., Liu, D., & Li, B. (2020) · BMC Endocrine Disorders · doi:10.1186/s12902-020-00557-w · Cited by 25 · see citing works
Grasberger, H., Noureldin, M., Kao, T. D., Adler, J., Lee, J. M., Bishu, S., Zaatari, M. E., Kao, J. Y., & Waljee, A. K. (2018) · Scientific Reports · doi:10.1038/s41598-018-28586-5 · Cited by 24 · see citing works
Boutzios, G., Κoukoulioti, Ε., Goules, A. V., Kalliakmanis, I., Giovannopoulos, I., Vlachoyiannopoulos, P. G., Moutsopoulos, H. Μ., & Tzioufas, A. G. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.860880 · Cited by 24 · see citing works
Groener, J. B., Lehnhoff, D., Piel, D., Nawroth, P. P., Schanz, J., & Rudofsky, G. (2013) · American Journal of Case Reports · doi:10.12659/ajcr.883788 · Cited by 23 · see citing works
Effect of hyperthyroidism on antral myoelectrical activity, gastric emptying and dyspepsia in man.
Pfaffenbach, B., Adamek, R. J., Hagelmann, D., et al. (1997) · PubMed · Cited by 22 · see citing works
Tanda, M. L., Lombardi, V., Genovesi, M., Ultimieri, F., Lai, A., Gandolfo, M., Mule, I. D., Grasso, L., Bogazzi, F., Broglio, F., et al. (2009) · Journal of Endocrinological Investigation · doi:10.1007/bf03345683 · Cited by 21 · see citing works
Sheehan, M. T., & Doi, S. A. R. (2016) · Clinical Medicine & Research · doi:10.3121/cmr.2015.1297 · Cited by 21 · see citing works
Thyroid function, pernicious anemia and erythropoiesis: a two-sample Mendelian randomization study
Kjaergaard, A. D., Teumer, A., Marouli, E., Deloukas, P., Kuś, A., Sterenborg, R. B. T. M., Åsvold, B. O., Medici, M., & Ellervik, C. (2022) · Human Molecular Genetics · doi:10.1093/hmg/ddac052 · Cited by 21 · see citing works
Association pernicious anemia and autoimmune polyendocrinopathy: a retrospective study.
Zulfiqar, A., & Andrès, E. (2018) · PubMed · Cited by 20 · see citing works
A New Paradigm Shift in Gastroparesis Management
Mekaroonkamol, P., Tiankanon, K., & Rerknimitr, R. (2022) · Gut and Liver · doi:10.5009/gnl210309 · Cited by 20 · see citing works
Wiley, Z. D., Lavigne, M. E., Liu, K. M., et al. (1978) · Digestive Diseases and Sciences · doi:10.1007/bf01263100 · Cited by 19 · see citing works
An Unusual Case of Myxedema Megacolon With Features of Ischemic and Pseudomembranous Colitis
Patel, R., & Hughes, R. W. (1992) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(12)61554-7 · Cited by 19 · see citing works
The relation between gastrin, gastric acid and thyroid function disorders
Wiersinga, W. M., & Touber, J. L. (1980) · Acta Endocrinologica · doi:10.1530/acta.0.0950341 · Cited by 18 · see citing works
Kim, K.-J., Kim, B., Mok, J., Kim, C., Kang, S.-K., & Jung, C. (2015) · Endocrinology and Metabolism · doi:10.3803/enm.2015.30.3.318 · Cited by 16 · see citing works
Phytobezoar: An unusual cause of small bowel obstruction
Bouali, M., Ballati, A., Bakouri, A. E., et al. (2021) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2021.01.048 · Cited by 15 · see citing works
Yang, S., & Cho, M. J. (2021) · Frontiers in Surgery · doi:10.3389/fsurg.2021.691860 · Cited by 15 · see citing works
Endoscopic findings of gastro-esophageal reflux disease in elderly and younger age groups
Adanir, H., Baş, B., Pakoz, B., Günay, S., Camyar, H., & Ustaoglu, M. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.606205 · Cited by 15 · see citing works
Diarrhea in Hypothyroidism: Bacterial Overgrowth as a Possible Etiology
Goldin, E., & Wengrower, D. (1990) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-199002000-00025 · Cited by 14 · see citing works
(2015) · PubMed · Cited by 13 · see citing works
Canpolat, A. G., Kav, T., Sıvrı, B., & Yildiz, B. O. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1488 · Cited by 13 · see citing works
Acute colonic surgery and unrecognized hypothyroidism: A warning
Bergeron, É., Mitchell, A., Heyen, F., et al. (1997) · Diseases of the Colon & Rectum · doi:10.1007/bf02055446 · Cited by 13 · see citing works
Suboptimal Thyroid Hormone Replacement Is Associated With Worse Hospital Outcomes
Ettleson, M. D., Bianco, A. C., Wan, W., & Laiteerapong, N. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac215 · Cited by 13 · see citing works
Jonklaas, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.934003 · Cited by 12 · see citing works
Lin, H.-C., Chang, H.-M., Hung, Y., et al. (2023) · Arthritis Research & Therapy · doi:10.1186/s13075-023-02999-8 · Cited by 12 · see citing works
Huang, P., Hou, Y., Zou, Y., Ye, X., Yu, R., & Yang, S. (2021) · Frontiers in Genetics · doi:10.3389/fgene.2021.791778 · Cited by 11 · see citing works
Trastornos funcionales y motores digestivos
Mearin, F., Rey, E., & Mearin, F. (2015) · Gastroenterología y Hepatología · doi:10.1016/s0210-5705(15)30014-5 · Cited by 10 · see citing works
Bohinc Henderson, B. (2021) · International Medical Case Reports Journal · doi:10.2147/imcrj.s326481 · Cited by 10 · see citing works
Trastornos funcionales y motores digestivos
Mearin, F., Rey, E., & Balboa, A. (2016) · Gastroenterología y Hepatología · doi:10.1016/s0210-5705(16)30169-8 · Cited by 10 · see citing works
Subclinical hypothyroidism unmasked by preeclampsia and ascites
Ipadeola, A., Nkwocha, G., & Adeleye, J. O. (2013) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.119562 · Cited by 9 · see citing works
Effects of propylthiouracil on intestinal transit time and symptoms in hyperthyroid patients.
Papa, A., Cammarota, G., Tursi, A., et al. (1997) · PubMed · Cited by 8 · see citing works
Thyroid hormone alterations in trauma patients requiring massive transfusion: An observational study
Hifumi, T., Okada, I., Kiriu, N., et al. (2014) · World Journal of Emergency Medicine · doi:10.5847/wjem.j.issn.1920-8642.2014.04.005 · Cited by 8 · see citing works
Gastric emptying in subclinical hyperthyroidism.
Kısakol, G., Kayaçeti̇n, E., Sarı, O., et al. (2004) · PubMed · Cited by 7 · see citing works
Serum gastrin levels in patients with thyroid dysfunction
Sagara, K., Shimada, T., Fujiyama, S., & Sato, T. (1983) · Gastroenterologia Japonica · doi:10.1007/bf02774680 · Cited by 6 · see citing works
Gharahbaghian, L., Brosnan, D., Fox, J. C., et al. (2007) · PubMed · Cited by 6 · see citing works
Kao, P., Lin, J., Chiu, C., et al. (2004) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2003.03326.x · Cited by 6 · see citing works
Dratman, M. B., & Martin, J. V. (2020) · AIMS neuroscience · doi:10.3934/neuroscience.2020002 · Cited by 6 · see citing works
Wittekind, D. A., Kratzsch, J., Mergl, R., Baber, R., Witte, A. V., Villringer, A., & Kluge, M. (2021) · Journal of Endocrinological Investigation · doi:10.1007/s40618-021-01578-5 · Cited by 5 · see citing works
Ascites, Pleural, and Pericardial Effusion in Primary Hypothyroidism: A Rare Case Report
Santos, P. G., Marques, R. C., dos Santos, P. M., et al. (2023) · Cureus · doi:10.7759/cureus.50429 · Cited by 5 · see citing works
Kubiszewski, K., Chapman, R. W., Piazza, Y., et al. (2023) · Cureus · doi:10.7759/cureus.50799 · Cited by 5 · see citing works
Ruscio, M., Guard, G., & Mather, J. (2022) · PubMed Central · Cited by 4 · see citing works
Ulcerative colitis with autoimmune thyroid disease results in bilateral auricular ossificans：a case
Zhao, J., Liu, F., Bai, L.-S., et al. (2023) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2023.100225 · Cited by 4 · see citing works
New-Onset Hypothyroidism Manifesting As Myxedema Coma: Fighting an Old Enemy
Argueta, A. S., Doukas, S. G., & Roy, R. (2022) · Cureus · doi:10.7759/cureus.23881 · Cited by 2 · see citing works
Abdominal compartment syndrome secondary to myxedema ileus
Gupta, A., Thakur, V., & Gupta, J. (2020) · Tzu Chi Medical Journal · doi:10.4103/tcmj.tcmj_31_19 · Cited by 1 · see citing works
Myxedema ascites complicated by ischemic colitis
Riaz, S., Kudaravalli, P., Bernshteyn, M., et al. (2020) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2020.05.021 · Cited by 1 · see citing works
Gastric Emptying in Subclinical Hypothyroidism
Sar, O., Ksakol, G., Kayaçetin, E., & Kaya, A. (2005) · The Endocrinologist · doi:10.1097/01.ten.0000157888.73630.e7
Flagged first, then by citations
8 of the 115 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Pirahanchi, 2024, Physiology, thyroid stimulating hormone
- Prosapio, 2024, Physiology, gastrin
Cited by
Sorted by citations
Fang, L., & Ning, J. (2024) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2024.1465928 · Cited by 22 · see citing works
Jiang, T., Yang, X., Wu, B., Tao, R., Chen, R., Jin, L., Sun, D., & Weng, H. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1661211 · Cited by 15 · see citing works
Beyond the Thyroid: A Narrative Review of Extra-thyroidal Manifestations in Hashimoto’s Disease
Kotak, P. S., Kadam, A., Acharya, S., Kumar, S., & Varma, A. R. (2024) · Cureus · doi:10.7759/cureus.71126 · Cited by 13 · see citing works
Tang, X., Huang, Y., Jiang, T., Wu, J., Wang, K., & Wu, W. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-04387-9 · Cited by 14 · see citing works
Associations of thyroid hormones with chronic diarrhea and constipation in euthyroid individuals
Zeng, W., Wang, Y., & Zhang, L. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1395743 · Cited by 7 · see citing works
Hossen, M. S., Islam, M. M., Das, A., Ripon, M. A. R., Amin, M. T., Basher, M. A., & Rashid, M. M. O. (2025) · Health Science Reports · doi:10.1002/hsr2.70329 · Cited by 6 · see citing works
Osowiecka, K., Skrypnik, D., & Myszkowska-Ryciak, J. (2025) · Nutrients · doi:10.3390/nu17213387 · Cited by 6 · see citing works
Chang, H., Ouyang, J., Tian, M., Yang, J., Gao, J., Yang, M., Zhang, M., Yuan, H., Ya, Z., Wang, Y., et al. (2024) · BMC Gastroenterology · doi:10.1186/s12876-024-03384-8 · Cited by 5 · see citing works
Odriozola-Martínez, A., González, A., Odriozola, I., Corbi, F., & Álvarez‐Herms, J. (2025) · Nutrients · doi:10.3390/nu18010059 · Cited by 3 · see citing works
Meneghini, V., Beltrão, F. E. D. L., Golovko, G., Watson, R. K., Samreen, S., Ettleson, M. D., Benseñor, I. M., & Bianco, A. C. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf519 · Cited by 2 · see citing works
Anan, M., Kagawa, K., Okamatsu‐Ogura, Y., Yamaguchi, S., & Yano‐Nashimoto, S. (2025) · Physiology & Behavior · doi:10.1016/j.physbeh.2025.115151 · Cited by 2 · see citing works
Sex hormones and functional gastrointestinal disorders in menopausal women
Li, Z., Zheng, Y., Shen, F., & Zhou, X. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1679338 · Cited by 2 · see citing works
Low Utility of Routine Thyroid Function Testing for Bowel Symptoms: A Population-Based Assessment
Elnaiem, A. D., Hiramoto, B. A., Flanagan, R. F., Muftah, M., Shah, E. D., & Chan, W. W. (2025) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08829-4 · Cited by 2 · see citing works
Secio‐Silva, A., Evangelista-Silva, P. H., Emrich, F., Selvatici‐Tolentino, L., Ferreira, M., Silva, A. B. D. P., Gomes, B. H., da Costa, T. N. F., de Oliveira, A. G., Garcia, R. A. P., et al. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2025.1515437 · Cited by 2 · see citing works
Osowiecka, K., Skrypnik, D., & Myszkowska-Ryciak, J. (2025) · Nutrients · doi:10.3390/nu17061015 · Cited by 4 · see citing works
Chen, Q., Chen, D., Wang, X., Zheng, Y., Zhang, L., Li, Z., Wu, X., Chen, Q., Zhang, R., Chen, F., et al. (2025) · Endocrine Connections · doi:10.1530/ec-25-0066 · Cited by 3 · see citing works
Li, Y., Dong, H., Chen, W., Wang, D., & Yu, M. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-04029-0 · Cited by 1 · see citing works
Al‐Bitar, A., Al‐Masalma, D., Alkarkoukly, M., et al. (2025) · Clinical Case Reports · doi:10.1002/ccr3.71015 · Cited by 1 · see citing works
Ferreira, A. I., Souto, M. M., Capela, T. L., Arieira, C., Xavier, S. A., Rosa, B. J. F., & Cotter, J. B. (2025) · Revista Española de Enfermedades Digestivas · doi:10.17235/reed.2025.11546/2025 · Cited by 1 · see citing works
Prevalence of gastroduodenal disorders in patients with thyroid dysfunction
Дербак, М. А., Timashev, V. V., Hanych, O. T., et al. (2025) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.21.7.2025.1640 · Cited by 1 · see citing works
Risk Factors Associated with Postoperative Nausea and Vomiting After Esophagogastroduodenoscopy
Ergin, G. Y., AYTUĞ, H. E. G., & Ergin, M. (2026) · Healthcare · doi:10.3390/healthcare14101340 · Cited by 1 · see citing works
Liu, Z.-N., Wang, C., Shen, Y.-L., Shi, Y.-F., Duan, J., Dong, H.-J., Xu, Y.-B., Zheng, Y.-M., & Cui, H. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1904273 · Cited by 1 · see citing works
Exploring the Triad of Thyroid Dysfunction, Chronic Diarrhea and Anemia
Hafeez, W., Shafqat, Z., Rehman, Z., et al. (2024) · American Journal of Internal Medicine · doi:10.11648/j.ajim.20241202.12
JOÃO, B. M., MARTINHO, B. J., GUARIGLIA, L. L., et al. (2024) · doi:10.59290/978-65-6029-140-9.8
Endocrinologia e Medicina Estética - Edição I
Freitas, G. B. L. D., & Vascão, E. (2024) · doi:10.59290/978-65-6029-140-9
Upper gastrointestinal bleeding: A rare presenting sign of pediatric hypothyroidism
Aldredge, N., DiVall, S. A., & Tan, Y. T. (2024) · JEM Reports · doi:10.1016/j.jemrpt.2024.100126
Körpe, B., Köse, C., Mermi, S., et al. (2025) · Düzce Tıp Fakültesi Dergisi · doi:10.18678/dtfd.1565941
Mishchuk, V. G., Kozinchuk, H. V., Венгрович, О., Shalamai, U. P., & Salyzhyn, T. (2025) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.21.4.2025.1564
Hamdan, A. R., & Handayani, I. (2025) · Jurnal sosial dan sains · doi:10.59188/jurnalsosains.v5i8.32429
Takata, N., Kawaguchi, N., Miyagawa, M., Itou, A., Yamada, R., Takimoto, A., & Kido, T. (2025) · Japanese Journal of Radiology · doi:10.1007/s11604-025-01882-7
Hefer, S., Kelmer, E., Mazaki‐Tovi, M., Peery, D., Aharoni, K., Edry, N., & Klainbart, S. (2026) · Veterinary Record Case Reports · doi:10.1002/vrc2.70343
Mosquera, G. C. L., Lopes, K. G., Gonçalves, M. D. M., et al. (2026) · Obesity Surgery · doi:10.1007/s11695-025-08312-7
Symptom-based machine learning framework for screening hypothyroidism and hyperthyroidism
Mohammed, A., Abu-Helalah, M. A., Alshraideh, H. A., et al. (2026) · Expert Systems with Applications · doi:10.1016/j.eswa.2026.132005
Maternal thyroid-gut dynamics during pregnancy and cognitive trajectories in children
Yadav, A., Wankhede, N. L., Sangamwar, S., Taksande, B. G., Aglawe, M. M., Rahangdale, S. R., Umekar, M., & Kale, M. (2026) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2026.101254
Lepore, M., Maccioni, R., Plenzich, E., & Tufano, R. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-21811-7_20
Turek, A., Śmierciak, N., Szwajca, M., et al. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.05.040
Kılınç, Ş., & Atasoy, Z. B. K. (2026) · Journal of Health Sciences and Medicine · doi:10.32322/jhsm.1887152
Farag, M. M., Ellakany, W. I., Osman, A. A., Wael, M., Barakat, K. E., & Kandel, M. M. (2026) · European surgery. Supplement/European surgery · doi:10.1007/s10353-026-00964-8
Colon Capsule Endoscopy-Measured Colonic Transit Time Is Associated with Frailty in Older Adults
Nakaji, K., Kumamoto, M., & Nakae, Y. (2026) · Medicina · doi:10.3390/medicina62071362
Mazur, K. J., Aamery, A., Amer, M. S., et al. (2026) · Cureus · doi:10.7759/cureus.113093
Bhattacharya, J., Ghosh, C., Dasgupta, A., et al. (2026) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20262807
Lima-Moura, S. A., & da Silva‐Santos, J. E. (2026) · Journal of Muscle Research and Cell Motility · doi:10.1007/s10974-026-09739-w
Hypothyroidism’s many disguises: A clinical guide to atypical presentations
Garg, R. (2026) · Thyroid Research and Practice · doi:10.4103/trp.trp_2_26
- Authors
- Xu, G.-M., Hu, M.-X., Li, S.-Y., Ran, X., Zhang, H., & Ding, X.-F.
- Affiliations
- Jilin University (CN)
- Corresponding author
- Ding, Xiang-Fu
- ORCID
- Zhang, Hao
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2024-05-02
- Volume
- 15
- Pages
- 1389113-1389113
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC11129086
- OpenAlex
- W4396598182
- Semantic Scholar
- 3f1778aa164c675670c642f1b41851e0931288d4
- Cited by
- 43
- References
- 115
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 8
- FWCI
- 16.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Natural Science Foundation of Jilin Province
- People's Government of Jilin Province
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- thyroid dysfunction, gastrointestinal motility disorders, hyperthyroidism, hypothyroidism, gastric emptying, esophageal peristalsis, esophageal motility, constipation, diarrhea, malabsorption
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-14.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-14.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
