We haven’t yet finished with the possible consequences of having an insufficient thyroid function for the digestive tract, underlining that not a single patient can present all the symptoms at once – only one symptom should be enough to make us suspicious!

We have already covered in detail the topic of constipation. However, concerning the slowing of the oesophageal transit and gastric emptying, one must also be aware of their possible consequences: dysphagia and pyrosis (more often called “heartburn”) if the oesophagus has slowed down; dyspepsia, nausea and vomiting if stomach emptying is too slow.

You can also see a significant decrease in the production of digestive juices: less gastric juices, which decrease the secretion of hydrochloric acid in the stomach; less pancreatic juices, which decrease the secretion of digestive enzymes – this is related to the exocrine function of the pancreas as opposed to the production of insulin from its endocrine function.

As a reminder, these links are supported by recognised medical literature, namely articles published in leading scientific journals, available on my website www.gmouton.com under the heading: ‘Conferences” –“ Functional Hormonology” – “Thyroid”.

Let’s now examine the consequences of hypothyroidism on the weight of a patient. Now, all together, you say “weight gain and obesity”… and you would very often be right, but not always, far from it. Indeed, many hypothyroid patients are a normal weight and you can even encounter weight loss or a difficulty recovering any lost pounds.  This is explained by a lack of appetite as a direct link between the blood level of T3 (the active thyroid hormone) and that of ghrelin (the orexigenic peptide secreted by the stomach). Laziness of peristalsis, the wavelike contractions that move food through the digestive tract, doesn’t help either. To this must be added the important role of thyroid hormones on metabolism, in particular on bone growth and muscle development.  These anabolic hormones are essential for growth, except in case of excess when they become catabolic (wasting caused by hyperthyroidism).

Their anabolic action plays a major part in bone metabolism: it was fully understood from the First World War that bone fractures are more difficult to heal in people suffering thyroid insufficiency. We often speak of the risk of osteoporosis risk in cases of overdose of thyroid hormones (which doesn’t necessarily mean a low TSH!). We don't talk enough about the increased fracture risk in hypothyroid patients. It is however a serious risk as reputable scientific articles can attest (see website). 

Let’s now take a look at the many harmful effects of hypothyroidism on the skin, with a significant increase in dry skin, a symptom that is so typical that I often state the following: “any patient suffering from very dry skin – which includes eczema and psoriasis – must be considered hypothyroid until proven otherwise”.  That speaks volumes! Childhood eczema or “cradle cap” is also to be included.

The list goes on concerning the potential consequences of autoimmune thyroiditis on the skin: melasma (brown spots on the face), vitiligo (white patches on the whole body), Sjögren's syndrome (loss of tears, dry mucous membranes), premenstrual acne, and hirsutism (excess hair). Do not miss the frequent link with chronic urticaria (I have identified many cases), with the more serious lichen sclerosus, lichen planus, acne rosacea, acne vulgaris, bullous dermatoses, the numerous connective tissue disorders with an impact on the skin, and even with leprosy…