Celiac disease detection in hypothyroid patients requiring elevated thyroid supplementation: A prospective cohort...

Area of Science:

• Endocrinology
• Gastroenterology
• Autoimmune Diseases

Background:

• Celiac disease (CD) is linked to hypothyroidism.
• Current guidelines do not universally recommend CD screening for all hypothyroid patients.
• A specific levothyroxine dosage threshold may indicate a higher risk of CD.

Purpose of the Study:

• To investigate the hypothesis that hypothyroid patients with celiac disease require higher levothyroxine doses.
• To determine a threshold daily levothyroxine dose above which CD screening is warranted.

Main Methods:

• Enrolled hypothyroid patients from endocrinology and endoscopy clinics.
• Categorized patients based on levothyroxine requirement (≥125mcg/day).
• Performed serum tissue transglutaminase (tTG) testing and endoscopy with duodenal biopsies for elevated tTG.

Main Results:

• 29% of 500 patients required ≥125mcg/day levothyroxine.
• Celiac disease was detected in 9 patients (1.8% overall).
• Patients requiring ≥125mcg/day levothyroxine showed a significantly increased risk of CD (p<0.001), with 5.6% prevalence in this subgroup.

Conclusions:

• Hypothyroid patients on elevated levothyroxine doses (≥125mcg/day) have a higher likelihood of concomitant celiac disease.
• Serologic testing for celiac disease is recommended for hypothyroid patients requiring ≥125mcg/day of levothyroxine.