Thyroid Gut Connection

Thyroid Gut Connection 

About thyroid gut connection.Over 2,000 years ago Greek physician Hippocrates, widely regarded as the father of modern medicine, apparently claimed that “all disease begins in the gut”. This certainly holds true for supporting optimal thyroid health, in particular hypothyroidism and Hashimoto’s Disease (an autoimmune thyroid condition).

It has been estimated that at least 60% of the immune system is located in our digestive system, therefore a poorly functioning gut can lead to a problematic immune system (Hrncir et al. 2008). If you have an autoimmune condition, it is widely understood that the immune system is not behaving as it should. The gut can be an important trigger in this regard (Vaarala 2002). When the intestinal membrane becomes compromised or permeable (sometimes referred to as “leaky gut”), large protein molecules can enter the bloodstream and the body can mount an immune response. These attacks can play a critical role in autoimmune conditions such as Hashimoto’s Disease (Arrieta, Bistritz, and Meddings 2006).  Elevated cortisol (our stress hormone) from chronic stress can also weaken the intestinal barrier and promote inflammation in the gut (Konturek, Brzozowski, and Konturek 2011).

About Thyroid gut connection, For proper thyroid function, it is necessary to convert T4 into the more active T3 and 20% of this happens in your digestive system, under the supervision of health gut bacteria. Research has also shown that thyroid hormones (T3 and T4) strongly influence the tight junctions in the stomach and small intestine and have been shown to protect the gut membrane from stress induced ulcer formation (Koyuncu et al. 2002). Poor gut health can also mean that we are not absorbing our nutrients effectively, including those that directly support thyroid health, like zinc, tyrosine, selenium, iodine and vitamins A and D.

The thyroid-gut connection is indeed quite powerful. Low thyroid function can lead to sub-optimal digestion, and poor gut health can also impact negatively on thyroid function, potentially triggering Hashimoto’s Disease. Both must be addressed if you are to restore the function of your thyroid.

If you suffer digestive symptoms, it is unlikely that you will be experiencing optimal thyroid function. Some common gut problems include:

  • Bloating
  • Indigestion
  • Heartburn
  • Constipation
  • Diarrhea
  • Irritable bowel syndrome
  • Gut infections
  • Intestinal permeability

So, what can you do to improve gut health and therefore support your thyroid function? You can begin restoring your digestive health using a “5R” protocol: Remove, Replace, Reinoculate, Repair and Rebalance. Ideally, you should work with a qualified Nutritional Therapist who can help you implement a “5R” protocol.


Remove all potential food triggers that may be driving an immune response, through an elimination diet (for at least 4 weeks). This will give you a chance to restore your gut integrity, without provocation from trigger foods. These foods are usually those that you crave the most(!), things like pasta, cheese and bread, but a Nutritional Therapist can help you identify them. Because of the resemblance of gluten to thyroid tissue, individuals with Hashimoto’s are recommended to remove gluten from their diets (Ch’ng, Jones, and Kingham 2007; Iuorio et al. 2007).


It is important to add back in essential aids for proper digestion and absorption of nutrients that may have been depleted over years of a poor diet, medications and a stressed-out lifestyle.

These could include:

  • Nutrients to help support the production of stomach acid. Research has found that low thyroid function can hamper the stomach’s production of its own acid (Centanni et al. 1999).
  • Nutrients to support healthy bile formation, secretion and flow.
  • Digestive enzymes to help support digestion.

It is important to work with a qualified healthcare practitioner to safely and correctly use these nutrients in the right amounts.


Restoring beneficial bacteria to reestablish a healthy microbiome is critical to supporting digestive health. This can be achieved through a good probiotic program, containing beneficial bacteria species such as lactobacillus and bifidobacteria. This can help to establish healthy levels of good bacteria needed to assist in the conversion of T4 to T3.

  • Fermented foods like sauerkraut, kimchi and pickles can also promote the growth of beneficial bacteria in the gut.
  • Also, consuming foods high in soluble fiber is important for feeding beneficial bacteria.


The gut lining can be severely compromised during periods of inflammation, stress and when exposed to allergens and toxins over time. Providing nutrients that help repair and rejuvenate the gut wall can therefore be beneficial. Eating foods rich in zinc, vitamins A, D and C and amino acids, like L-glutamine may help support repair.


This is potentially the most important step of the “5R” protocol. Rebalance refers to providing support for restorative practice in your life. Chronic digestive issues are usually the result of poor diet and lifestyle choices, such as poor sleep, lack of exercise and poor stress management. If chronic stress is not addressed, this can impact on leaky gut and potentially change the make-up of your gut microbiome. Some rebalancing techniques may include:

  • Yoga
  • Meditation
  • Breathing
  • Mindful eating
  • Improving sleep
  • Exercise

 All these help us to know about the thyroid gut connection.

Arrieta, M. C., L. Bistritz, and J. B. Meddings. 2006. “Alterations in Intestinal Permeability.” Gut 55(10):1512–20.

Centanni, M., M. Marignani, L. Gargano, V. D. Corleto, A. Casini, G. Delle Fave, M. Andreoli, and B. Annibale. 1999. “Atrophic Body Gastritis in Patients with Autoimmune Thyroid Disease: An Underdiagnosed Association.” Archives of Internal Medicine 159(15):1726–30.

Ch’ng, Chin Lye, M. Keston Jones, and Jeremy G. C. Kingham. 2007. “Celiac Disease and Autoimmune Thyroid Disease.” Clinical Medicine & Research 5(3):184–92.

Hrncir, Tomas, Renata Stepankova, Hana Kozakova, Tomas Hudcovic, and Helena Tlaskalova-Hogenova. 2008. “Gut Microbiota and Lipopolysaccharide Content of the Diet Influence Development of Regulatory T Cells: Studies in Germ-Free Mice.” BMC Immunology 9:65.

Iuorio, R., V. Mercuri, F. Barbarulo, T. D’Amico, N. Mecca, G. Bassotti, D. Pietrobono, P. Gargiulo, and A. Picarelli. 2007. “Prevalence of Celiac Disease in Patients with Autoimmune Thyroiditis.” Minerva Endocrinologica 32(4):239–43.

Konturek, Peter C., T. Brzozowski, and S. J. Konturek. 2011. “Stress and the Gut: Pathophysiology, Clinical Consequences, Diagnostic Approach and Treatment Options.” Journal of Physiology and Pharmacology : An Official Journal of the Polish Physiological Society 62(6):591–99.

Koyuncu, Ayhan, Semih Aydintu, Saval Kocak, Cengiz Aydin, Seher Demirer, Omer Topcu, and Ercument Kuterdem. 2002. “Effect of Thyroid Hormones on Stress Ulcer Formation.” ANZ Journal of Surgery 72(9):672–75.

Vaarala, Outi. 2002. “The Gut Immune System and Type 1 Diabetes.” Annals of the New York Academy of Sciences 958:39–46.


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