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Is There A Link Between IBS and Hashimoto's Disease?

Find out the interconnected relationship between your gut health and your thyroid.
Is There A Link Between IBS and Hashimoto's Disease?
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The relationship between our gut health and every other body system is becoming glaringly apparent. As more research shows just how important a healthy gut is to our overall health, we are learning that an unhealthy gut may be at the root of many chronic illnesses. And, with more people suffering from autoimmune diseases and gut disorders, there is certainly a connection worth exploring. Here, we explore if there is a link between IBS and Hashimoto’s and how these diseases can be managed together.

What is IBS?

Irritable bowel syndrome (IBS) is a common chronic health condition that targets the large intestine. Typical symptoms of IBS include:

  • Cramping
  • Bloating
  • Abdominal pain
  • Gas
  • Diarrhea
  • Constipation


Symptoms can range in severity, but only a small number of people will have severe symptoms.

We don’t fully know why people experience IBS, but numerous factors may contribute to it, including food sensitivities, mental health, and stress.

IBS is sometimes confused with inflammatory bowel disease (IBD). However, IBD is an autoimmune disorder where people can experience changes in their bowel tissue, increasing their risk for other health problems. We often use the term IBD to encompass disorders that cause chronic inflammation of the GI tract, including ulcerative colitis and Crohn’s disease. IBS neither changes your bowel tissue nor increases your risk for cancers and other diseases.


What is Hashimoto’s?

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks healthy cells in the thyroid gland. Unlike hypothyroidism, there is nothing wrong with the thyroid gland itself, but the problem lies within the immune system. Nonetheless, when the immune system continually attacks the thyroid, it leads to chronic inflammation and eventually permanent damage to thyroid-producing cells. Therefore, Hashimoto’s leads to an underactive thyroid or hypothyroidism. And in developed countries, it is the number one cause of hypothyroidism.

Like other autoimmune conditions, Hashimoto’s is thought to stem from problems in the gut. One of the theories behind many autoimmune disorders is the plausibility that tight junctions between the mucosal cells lining the intestines may allow toxins to leak into the bloodstream. Known as the leaky gut theory, this process may be why the immune system becomes overactive and starts to attack healthy cells causing health issues.


The link between IBS and Hashimoto’s disease

Many people with Hashimoto’s (and other autoimmune diseases in general) tend to have digestive symptoms and issues. Complaints such as diarrhea, gas, bloating, and abdominal cramping seem commonplace, although there is often no diagnosable cause behind these symptoms. Therefore, it is common for people to have autoimmune issues and conditions like Hashimoto’s and IBS.

To add to the complexity, about 50% of people with hypothyroidism have SIBO (small intestinal bacterial overgrowth). SIBO is where excessive amounts of bacteria accumulate in the small intestine, causing uncomfortable symptoms like bloating, gas, and diarrhea. SIBO is also common in people with IBS, and sometimes this overgrowth can be recurrent.

SIBO may be prevalent in people with hypothyroidism and IBS because both conditions may decrease intestinal motility, causing bacteria to stay in the tract and proliferate.

Despite the frequency that people can have IBS and Hashimoto’s, and even hypothyroidism, no evidence having a thyroid dysfunction or disease increases your risk for IBS and vice versa. Yet, because the thyroid plays an important role in digestive function, it seems plausible that there is a more significant relationship between the two conditions or states than pure coincidence.

More research is needed to understand why gastrointestinal symptoms and issues are common in people with thyroid issues.


How to manage IBS and Hashimoto’s together

If you are one of the many with both of these conditions, the good news is that treating one can help manage the other.

Take your thyroid medication.

People with Hashimoto’s eventually require thyroid hormone replacement medication to keep their metabolism healthy. Having optimal thyroid hormone levels can keep your intestinal motility running at a healthy pace, preventing problems like SIBO and constipation. Of course, the right dose of thyroid medication will also help the numerous other symptoms accompanying Hashimoto’s, including muscle aches, fatigue, weight gain, and cold intolerance.

Test your thyroid function regularly.

Your symptoms will tell you a lot about whether or not your thyroid hormone levels are healthy. However, it is essential to stay current with regular testing to manage your thyroid disease. A complete thyroid function test includes TSH, free T4, free T3, reverse T3, and TPO antibodies.

Eat to feed your good bacteria.

Maintaining a healthy gut microbiome is crucial, and one of the best ways we can do that is by giving the right fuel to the good bacteria in your gut. Fiber is one of the most important foods we can give good bacteria. Avoiding food that fuels harmful bacteria like sugar and unhealthy fats is also important.

Avoid food triggers.

It is common for people with either Hashimoto’s or IBS to have sensitivities to certain foods. For example, non-celiac gluten sensitivity is common in people with these conditions, so it is necessary to avoid gluten if you cannot tolerate it. Likewise, many people also have lactose intolerance, so it is helpful to avoid these foods.

Drink plenty of water

Water is the best way to flush out your system and keep your tissues hydrated. Many of us do not get this because we reach for other beverages over water. Keep a glass of water handy at all times, so you are more likely to reach for a drink when thirsty.

A note from Paloma Health

Numerous nutritional factors play a role in optimizing your thyroid function. Paloma Health allows you to work with a thyroid nutritionist in collaboration with a thyroid doctor to keep your digestive system happy and optimize your thyroid health.


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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