Thyroid Thursday Episode 45: Hypothyroidism and Reflux
Many people with Hypothyroidism have gastroesophageal reflux commonly referred to as reflux. Is there a link? Absolutely.
Remember thyroid hormone impacts every cell in the body either directly or indirectly. It’s thought that acid reflux may actually be an early indicator of Hypothyroidism. The science of this is not definitive but it is believed that low cellular levels of T3 are associated with reflux via a number of mechanisms.
- Cellular Hypothyroidism (reduced T3 in peripheral tissues) can reduce motility of the esophagus and GI tract. Lack of T3 in the esophageal and GI tissues can cause accumulation of glycosaminoglycan’s (especially hyaluronic acid) which reduces esophageal and GI motility. The same mechanism may also cause changes in tone of the lower esophageal sphincter allowing stomach acid to escape up into the esophagus. Decreased esophageal motility can cause Dysphagia (difficulty swallowing). Relaxation of the lower esophageal sphincter allows gastric acid to move backwards out of the stomach and up into the esophagus causing the symptoms and damage associated with reflux.
- The thyroid gland also produces a substance called motilin. Motilin is a hormone that stimulates GI motility via stimulation of the migrating motor complex. When there is glandular disease/dysfunction not only can thyroid hormone production be compromised but thyroid motilin production can be compromised as well. It is thought that thyroid gland removal, destruction via radiation or medication, or destruction via autoimmune attack can reduce motilin production leading to reduced motility. Slow GI motility leads to bacterial overgrowth in the GI tract which can increase GI gasses leading to reflux.
- Thyroid hormone, specifically T3 is needed to support parietal cell growth which are the cells that produce hydrochloric acid (stomach acid). Without sufficient T3 getting into these cells you can’t produce sufficient stomach acid. The amount of stomach acid produced impacts how tight the lower esophageal sphincter closes.
Low stomach acid, slowed GI motility and dysfunction of the lower esophageal sphincter all contribute to stomach acid backing up into the esophagus causing the damage and symptoms associated with reflux.
If you have reflux, gas, bloating, pressure, or constipation, by working with your functional medicine practitioner you can reduce reflux, improve stomach acid
production, and improve GI motility.
