title: Evidence of impaired carbohydrate assimilation in euthyroid patients with Hashimoto's thyroiditis.
abstract: OBJECTIVE
  Hashimoto's thyroiditis (HT) represents a wide-spread autoimmune disease. In euthyroid patients with HT, an impaired assimilation of common carbohydrates has been observed. Our objectives were to compare the frequency of (1) fructose (FM), lactose (LM) and sorbitol malassimilation (SM), (2) gastrointestinal symptoms (GS) following carbohydrate ingestion and (3) recurrent GS relevant to the participants' daily lives.
  
  
  METHODS
  We conducted a prospective case-control study of 45 ambulatory patients with HT and 38 healthy volunteers, matched with regard to age, gender and area of origin. Hydrogen breath tests with fructose, lactose, sorbitol and glucose were performed, the lactose testing additionally comprising measurements of capillary blood glucose (cBG). GS during the tests and recurrent GS concerning the participants' daily lives were assessed. A food-frequency questionnaire was administered.
  
  
  RESULTS
  FM was diagnosed in 48.9% of patients compared with 26.3% of the control group (P=0.035). In all, 42.2% of patients with HT and 21.1% of healthy controls showed LM (P=0.04). FM and/or LM was present in 73.3% of the patients and in 42.1% of healthy controls (P=0.004). GS after the ingestion of fructose (P=0.003) or lactose (P=0.025) and recurrent GS were significantly more prevalent in the case group. The consumption of free fructose, lactose or sorbitol did not differ.
  
  
  CONCLUSIONS
  Carbohydrate malassimilation and gastrointestinal complaints are frequent in euthyroid patients with HT, leading to novel clinical and pathophysiological considerations and concepts.
authors.affiliation: Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Heckl
authors.affiliation: Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Reiners
authors.affiliation: Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Buck
authors.affiliation: Department of Internal Medicine II, University of Würzburg, Würzburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schäfer
authors.affiliation: Children's Hospital, University of Würzburg, Würzburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Dick
authors.affiliation: Department of Internal Medicine II, University of Würzburg, Würzburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Scheurlen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D016022:Case-Control Studies; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D005632:Fructose / Q000032:analysis; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000378:metabolism; D005947:Glucose / Q000032:analysis; D050031:Hashimoto Disease / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007785:Lactose / Q000032:analysis; D008286:Malabsorption Syndromes / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013012:Sorbitol / Q000032:analysis; D013549:Sweetening Agents / Q000032:analysis
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D013549:Sweetening Agents; D005632:Fructose; D013012:Sorbitol; D005947:Glucose; D007785:Lactose