Steatorrhea in Thyrotoxicosis: Relation to Hypermotility and Excessive Dietary Fat
Abstract
Detailed studies of intestinal absorptive function were done in 10 untreated hyperthyroid patients to elucidate the mechanisms causing thyrotoxic steatorrhea. Serum calcium, serum iron, prothrombin time, jejunal biopsies, cultures of intraluminal contents, and secretin tests were normal in all patients. Vitamin B12 and D-xylose absorption were normal in 9 of 10 patients. All patients showed rapid intestinal transit. Lactose intolerance, initially present in two patients, disappeared after 131I therapy for thyrotoxicosis. On an ad libitum diet there was gross steatorrhea in six patients. The coefficient of fat absorption was only slightly abnormal in five, showing excessive dietary fat ingestion in these patients (mean fat intake, 248 g/24 hr). In two patients propranolol significantly prolonged intestinal transit time and reduced steatorrhea by 48% and 50%, respectively. The data suggest that steatorrhea in hyperthyroidism is probably caused by the combined effects of excessive dietary fat intake and intestinal hypermotility.
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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.
“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.”
From Thyroid disorders and gastrointestinal dysmotility: an old association (2024) · cites this paper as Thomas et al., 1973
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.
“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).”
From Thyroid disorders and gastrointestinal dysmotility: an old association (2024) · cites this paper as Thomas et al., 1973
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.
“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).”
From Thyroid disorders and gastrointestinal dysmotility: an old association (2024) · cites this paper as Thomas et al., 1973
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References 25 · Cited by 77
- Authors
- THOMAS, F. B., CALDWELL, J. H., & GREENBERGER, N. J.
- Affiliations
- United States Air Force (US)
- Corresponding author
- THOMAS, FRED B.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1973-05-01
- Volume
- 78
- Issue
- 5
- Pages
- 669-675
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W1989993959
- Cited by
- 77
- References
- 25
- Citations by year
- 2024: 3 · 2019: 1 · 2018: 1 · 2015: 1 · 2013: 1 · 2012: 2
- FWCI
- 4.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Digestive system and related health
- Keywords
- thyrotoxicosis, hyperthyroidism, steatorrhea, fat malabsorption, intestinal transit time, intestinal hypermotility, dietary fat intake, lactose intolerance, propranolol, 131I therapy
- MeSH terms
- Adult, Aged, Calcium, Celiac Disease, Dietary Fats, Feces, Female, Gastrointestinal Motility, Guanethidine, Humans, Hyperthyroidism, Intestinal Absorption, Iodine Isotopes, Iron, Lactose Intolerance, Male, Middle Aged, Propranolol, Prothrombin Time, Vitamin B 12, Xylose, Lipid Metabolism
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