title: The role of Helicobacter pylori in patients with hypothyroidism in whom could not be achieved normal thyrotropin levels despite treatment with high doses of thyroxine.
abstract: BACKGROUND
  Helicobacter pylori infection is a most frequent cause of chronic gastritis. H. pylori may decrease absorption of oral thyroxine by decreasing gastric acid secretion in the stomach. In this study, we aimed to investigate the change in thyroid function tests of the cases after H. pylori eradication who were not responding to high doses of thyroxine treatment before H. pylori eradication.
  
  
  METHODS
  Hypothyroid cases who were not responding to high doses of thyroxine among the ones presented to Endocrinology and Gastroenterohepatology Clinics of Sisli Etfal Training and Research Hospital between 2009 and 2010 were included in the study. Thyroid function tests were performed two times in all cases before and after H. pylori eradication. Duodenal, antral and corporal biopsies, and jejunal aspirates and biopsies were taken during upper gastrointestinal system endoscopies performed in all patients. Cases without intestinal pathology were included in the study.
  
  
  RESULTS
  Serum thyrotropin (TSH), free T3, and free T4 values before H. pylori eradication were 30.5 ± 28.8 IU/mL, 2.64 ± 0.56 pg/mL, and 0.92 ± 0.32 ng/mL, respectively, and after eradication were found to be 4.2 ± 10.6 IU/mL, 3.02 ± 0.61 pg/mL, and 1.3 ± 0.34 ng/mL, respectively (p values <.001, .002, and <.001, respectively). After H. pylori eradication treatment, TSH decreased in all of the cases, factitious thyrotoxicosis developed in % 21 of these cases.
  
  
  CONCLUSIONS
  In hypothyroid cases, H. pylori gastritis may be responsible for an inadequate response to the treatment. H. pylori eradication in the cases receiving high doses of thyroxine has a risk for thyrotoxicosis.
authors: Gastroenterohepatology Endocrinology Microbiology Clinics, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey. msbugdaci@gmail.com
authors: Mehmet Sait
authors: MS
authors: Bugdaci
authors: Sayid Shafi
authors: SS
authors: Zuhur
authors: Mehmet
authors: M
authors: Sokmen
authors: Buket
authors: B
authors: Toksoy
authors: Banu
authors: B
authors: Bayraktar
authors: Banu
authors: B
authors: Albayrak
authors: Yüksel
authors: Y
authors: Altuntas
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005756:Gastritis / Q000097:blood / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D013752:Tetracycline / Q000627:therapeutic use; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D014284:Triiodothyronine / Q000097:blood
chemical_list: D014284:Triiodothyronine; D008795:Metronidazole; D000658:Amoxicillin; D013972:Thyrotropin; D013752:Tetracycline; D017291:Clarithromycin; D013974:Thyroxine