Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets


ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Case Report

Recurrent Nausea and Vomiting with Weight Loss Associated with Hypothyroidism: Fact or Myth

Author(s): Jitendra Singh*, Anju Dinkar, Nilesh Kumar and Kailash Kumar

Volume 23, Issue 6, 2023

Published on: 23 January, 2023

Page: [867 - 872] Pages: 6

DOI: 10.2174/1871530323666221205110210

Price: $65


Background: Hypothyroidism is a commonly encountered endocrine disorder presenting in various clinical settings. It usually presents with classic manifestations, which are readily recognized and, therefore, easy to diagnose. However, occasionally, patients present with unusual symptoms, which becomes a challenge to diagnose. Thyroid dysfunction affects many body organs, including the gut and viscera. Studies show that intestinal motility might be affected by multiple factors, such as neuromuscular dysfunction, myopathy, or alterations in hormone receptors.

Case Presentation: Here, we present the first case of a 21-year-old female student who had complaints of recurrent nausea, vomiting, loose stool, abdominal pain, and weight loss. In the second case, a 25-year-old male student presented with recurrent nausea, vomiting, loose stool, and weight loss. Their unremarkable blood routines and gastrointestinal-specific investigations failed to ascertain the diagnosis. Later, primary hypothyroidism was established by typical biochemical abnormalities.

Conclusion: Thyroxine replacement treatment successfully resolved the presenting symptoms and normalized biochemical reports.

Keywords: Diarrhoea, nausea, vomiting, loose stool, weight loss, subclinical hypothyroidism.

Graphical Abstract
Jameson, J.L.; Mandel, S.J.; Weetman, A.P. Hypothyroidism. In: Harrison’s Principles of Internal Medicine, 20th ed; Jameson, J.L.; Kasper, D.L.; Longo, D.L.; Fauci, A.S.; Hauser, S.L.; Loscalzo, J., Eds.; McGraw Hill: New York, 2018; pp. 2698-2703.
Sweet, C.; Sharma, A.; Lipscomb, G. Recurrent nausea, vomiting and abdominal pain due to hypothyroidism. BMJ Case Rep., 2010, 2010, bcr1120092461.
Sharma, A.K.; Arya, R.; Mehta, R.; Sharma, R.; Sharma, A.K. Hypothyroidism and cardiovascular disease: factors, mechanism and future perspectives. Curr. Med. Chem., 2013, 20(35), 4411-4418.
[] [PMID: 24152286]
Almandoz, J.P.; Gharib, H. Hypothyroidism: etiology, diagnosis, and management. Med. Clin. North Am., 2012, 96(2), 203-221.
[] [PMID: 22443971]
Shafer, R.B.; Prentiss, R.A.; Bond, J.H. Gastrointestinal transit in thyroid disease. Gastroenterology, 1984, 86(5 Pt 1), 852-855.
[PMID: 6706068]
Gull, W.W. On cretinoid state supervening in adult life in women. Trans. Clin. Soc. London., 1874, 7, 180-185.
Murray, G.R. Note on the treatment of myx dema by hypodermic injections of an extract of the thyroid gland of a sheep. BMJ, 1891, 2(1606), 796-797.
[] [PMID: 20753415]
Redmond, G.P. Hypothyroidism and women’s health. Int. J. Fertil. Womens Med., 2002, 47(3), 123-127.
[PMID: 12081257]
Heinrich, T.W.; Grahm, G. Hypothyroidism presenting as psychosis. Prim. Care Companion J. Clin. Psychiatry, 2003, 5(6), 260-266.
[] [PMID: 15213796]
Gutch, M.; Kumar, S.; Bhattacharjee, A.; Agarwal, A.; Rao, S.S.; Rungta, S. Unusual manifestations associated with primary hypothyroidism: experience from a tertiary care health center. J. ASEAN Feder. Endocrine Soc., 2017, 32(1), 60-67.
[] [PMID: 33442088]
Wiersinga, W.M. Thyroid disease manager. Adult hypothyroidism. Available from:
Chaudhry, M.A.; Grazette, L.; Fong, M.W. Myxedema heart disease: a rare disease entity: case report and brief review of the literature. Curr. Hypertens. Rev., 2019, 15(1), 13-16.
[] [PMID: 30277162]
Khan, R.; Ahmed, A.; Tulpule, S.; Regeti, K.; Sen, S.; Mathew, T. Severe hypothyroidism-induced volvulus. J. Clin. Med. Res., 2015, 7(12), 995-997.
[] [PMID: 26566414]
Yaylali, O.; Kirac, S.; Yilmaz, M.; Akin, F.; Yuksel, D.; Demirkan, N.; Akdag, B. Does hypothyroidism affect gastrointestinal motility? Gastroenterol. Res. Pract., 2009, 2009, 1-7.
[] [PMID: 20224642]
Patil, A. Link between hypothyroidism and small intestinal bacterial overgrowth. Indian J. Endocrinol. Metab., 2014, 18(3), 307-309.
[] [PMID: 24944923]
Lappinga, P.J.; Abraham, S.C.; Murray, J.A.; Vetter, E.A.; Patel, R.; Wu, T.T. Small intestinal bacterial overgrowth: histopathologic features and clinical correlates in an underrecognized entity. Arch. Pathol. Lab. Med., 2010, 134(2), 264-270.
[] [PMID: 20121616]
Goldin, E.; Wengrower, D. Diarrhea in hypothyroidism. J. Clin. Gastroenterol., 1990, 12(1), 98-99.
[] [PMID: 2303691]
Ejtahed, H.S.; Angoorani, P.; Soroush, A.R.; Siadat, S.D.; Shirzad, N.; Hasani-Ranjbar, S.; Larijani, B. Our little friends with big roles: alterations of the gut microbiota in thyroid disorders. Endocr. Metab. Immune Disord. Drug Targets, 2020, 20(3), 344-350.
[] [PMID: 31566142]
Zangiabadian, M.; Mirsaeidi, M.; Pooyafar, M.H.; Goudarzi, M.; Nasiri, M.J. Associations of Yersinia Enterocolitica infection with autoimmune thyroid diseases: a systematic review and meta-analysis. Endocr. Metab. Immune Disord. Drug Targets, 2021, 21(4), 682-687.
[] [PMID: 32564766]
Dardano, A.; Monzani, F. Hypothyroidism and Endothelial Function: A Marker of Early Atherosclerosis? Recent Pat. Endocr. Metab. Immune Drug Discov., 2008, 2(2), 79-96.
Triggiani, V.; Angelo Giagulli, V.; De Pergola, G.; Licchelli, B.; Guastamacchia, E.; Iacoviello, M. Mechanisms explaining the influence of subclinical hypothyroidism on the onset and progression of chronic heart failure. Endocr. Metab. Immune Disord. Drug Targets, 2016, 16(1), 2-7.
[] [PMID: 26680772]
Obradovic, M.; Gluvic, Z.; Sudar-Milovanovic, E.; Panic, A.; Trebaljevac, J.; Bajic, V.; Zarkovic, M.; R Isenovic, E. Nitric oxide as a marker for levo-thyroxine therapy in subclinical hypothyroid patients. Curr. Vasc. Pharmacol., 2016, 14(3), 266-270.
[] [PMID: 26853795]
Jeddi, S.; Khalifi, S.; Ghanbari, M.; Ghasemi, A. Effect of fetal and neonatal hypothyroidism on glucose tolerance in middle- aged female rats. Endocr. Metab. Immune Disord. Drug Targets, 2021, 21(9), 1627-1633.
[] [PMID: 33167848]
Javed, Z.; Sathyapalan, T. Levothyroxine treatment of mild subclinical hypothyroidism: a review of potential risks and benefits. Ther. Adv. Endocrinol. Metab., 2016, 7(1), 12-23.
[] [PMID: 26885359]
Fatourechi, V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clin. Proc., 2009, 84(1), 65-71.
[] [PMID: 19121255]
Negro, R. Outcomes in pregnant patients with subclinical hypothyroidism and thyroid autoimmunity: a critical appraisal of recent randomized controlled trials. Endocr. Metab. Immune Disord. Drug Targets, 2021, 21(8), 1387-1391.
[] [PMID: 33200703]
Vidwans, A.S.; Ratzan, S.; Sanders, M.R. An unusual presentation of congenital hypothyroidism: a report of two cases. J. Pediatr. Gastroenterol. Nutr., 2000, 31(2), 198-200.
[] [PMID: 10941978]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy