The Association of Helicobacter pylori Infection with Hashimoto's Thyroiditis

  • Rokhsareh Aghili Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
  • Faria Jafarzadeh Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
  • Raheb Ghorbani Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Semnan, Iran.
  • Mohammad Ebrahim Khamseh Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
  • Maryam Alsadat Salami Department of Endocrinology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mojtaba Malek Mail Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Autoimmune thyroid disease, Hashimoto thyroiditis, Helicobacter pylori


Autoimmune thyroid diseases (ATD) are multifactorial conditions that result from genetic predisposition in combination with environmental risk factors. Helicobacter pylori infection as an environmental risk factor has been proposed to imitate the antigenic components of the thyroid cell membrane and may play a leading role in the onset of the autoimmune diseases, such as Hashimoto thyroiditis. The aim of this study was to investigate the association between Helicobacter pylori (HP) infection and Hashimoto's thyroiditis (HT). The participants in this case-control study included 43 patients affected by Hashimoto's thyroiditis, and 40 healthy individuals without history of autoimmune disease as the control group. Anti HP IgG and anti-TPO antibodies were determined using ELISA method. Results were considered positive when the IgG anti-HP value was higher than 30 IU/ml and the anti-TPO autoantibody value was higher than 75 IU/ml. The mean TSH level was 18.3±16.8 IU/ml for patients and 2.8±1.2 IU/ml for the control group (P<0.001). 46.5% of the patient group and 10.8% of the control group were infected with HP. The association between HP and Hashimoto's thyroiditis was statistically significant (Odds Ratio=7.2, 95%, Confidence Interval: 2.0- 28.8, P<0.001). The findings show that, there is an association between HP and Hashimoto's thyroiditis. To establish a definite correlation between them, more detailed studies with a more specialized examination and precise consideration regarding species of HP, genetic polymorphism of the host and investigation of environmental factors are needed.


El-Eshmawy MM, El-Hawary AK, Abdel Gawad SS, El- Baiomy AA. Helicobacter pylori infection might be responsible for the interconnection between type 1 diabetes and autoimmune thyroiditis. Diabetol Metab Syndr 2011;3(1):28.

Fountoulakis S, Tsatsoulis A. On the pathogenesis of autoimmune thyroid disease: a unifying hypothesis. Clin Endocrinol (Oxf) 2004;60(4):397-409.

Bassi V, Santinelli C, Iengo A, Romano C. Identification of a correlation between Helicobacter pylori infection and Graves' disease. Helicobacter 2010;15(6):558-62.

Feldman M, Peterson WL. Helicobacter pylori and peptic ulcer disease. West J Med 1993;159(5):555-9.

Bassendine MF. Primary Biliary Cirrhosis. In: Dooley JS, Lok ASF, Burroughs AK, Heathcote EJ. Sherlock’s Diseases of Liver and Biliary System. 12th ed. Oxford: Blackwell Publishers; 2002, P. 293.

Gasbarrini A, Serricchio M, Tondi P, Gasbarrini G, Pola P. Association of Helicobacter pylori infection with primary Raynaud phenomenon. Lancet 1996;348(9032): 966-7.

Gasbarrini A, De Luca A, Fiore G, Gambrielli M, Franceschi F, Ojetti V, Torre ES, Gasbarrini G, Pola P, Giacovazzo M. Beneficial effects of Helicobacter pylori eradication on migraine. Hepatogastroenterology 1998;45(21):765-70.

Pasceri V, Cammarota G, Patti G, Cuoco L, Gasbarrini A, Grillo RL, Fedeli G, Gasbarrini G, Maseri A. Association of virulent Helicobacter pylori strains with ischemic heart disease. Circulation 1998;97(17):1675-9.

Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D, Camm AJ, Northfield TC. Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J 1994;71(5):437-9.

Eskandarian R, Malek M, Mousavi SH, Babaei M. Association of Helicobacter pylori infection with cardiac syndrome X. Singapore Med J 2006;47(8):704-6.

de Luis DA, Varela C, de La Calle H, Canton R, de Argila CM, San Roman AL, Boixeda D. Helicobacter pylori infection is markedly increased in patients with autoimmune atrophic thyroiditis. J Clin Gastroenterol 1998;26(4):259-63.

Oshowo A, Gillam D, Botha A, Tunio M, Holton J, Boulos P, Hobsley M. Helicobacter pylori: the mouth, stomach, and gut axis. Ann Periodontol 1998;3(1):276-80.

Arao T, Morimoto I, Kakinuma A, Ishida O, Zeki K, Tanaka Y, Ishikawa N, Ito K, Eto S. Thyrocyte proliferation by cellular adhesion to infiltrating lymphocytes through the intercellular adhesion molecule- 1/lymphocyte function-associated antigen-1 pathway in Graves' disease. J Clin Endocrinol Metab 2000;85(1):382-9.

Larizza D, Calcaterra V, Martinetti M, Negrini R, De Silvestri A, Cisternino M, Iannone AM, Solcia E. Helicobacter pylori infection and autoimmune thyroid disease in young patients: the disadvantage of carrying the human leukocyte antigen-DRB1*0301 allele. J Clin Endocrinol Metab 2006;91(1):176-9.

Bertalot G, Montresor G, Tampieri M, Spasiano A, Pedroni M, Milanesi B, Favret M, Manca N, Negrini R. Decrease in thyroid autoantibodies after eradication of Helicobacter pylori infection. Clin Endocrinol (Oxf) 2004;61(5):650-2.

Tomasi PA, Dore MP, Fanciulli G, Sanciu F, Realdi G, Delitala G. Is there anything to the reported association between Helicobacter pylori infection and autoimmune thyroiditis? Dig Dis Sci 2005;50(2):385-8.

Franceschi F, Satta MA, Mentella MC, Penland R, Candelli M, Grillo RL, Leo D, Fini L, Nista EC, Cazzato IA, Lupascu A, Pola P, Pontecorvi A, Gasbarrini G, Genta RM, Gasbarrini A. Helicobacter pylori infection in patients with Hashimoto's thyroiditis. Helicobacter 2004;9(4):369.

Figura N, Di Cairano G, Lore F, Guarino E, Gragnoli A, Cataldo D, Giannace R, Vaira D, Bianciardi L, Kristodhullu S, Lenzi C, Torricelli V, Orlandini G, Gennari C. The infection by Helicobacter pylori strains expressing CagA is highly prevalent in women with autoimmune thyroid disorders. J Physiol Pharmacol 1999;50(5):817-26.

Sterzl I, Hrda P, Potuznikova B, Matucha P, Hana V, Zamrazil V. Autoimmune thyroiditis and Helicobacter pylori--is there a connection? Neuro Endocrinol Lett 2006;27 Suppl 1:41-5.

Bures J, Kopácová M, Koupil I, Vorísek V, Rejchrt S, Beránek M, Seifert B, Pozler O, Zivný P, Douda T, Kolesárová M, Pintér M, Palicka V, Holcík J. European Society for Primary Care Gastroenterology. Epidemiology of Helicobacter pylori infection in the Czech Republic. Helicobacter 2006;11(1):56-65.

Valle JD. Peptic ulcer disease and related disorders. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo L, editor. Harrison’s principles of internal medicine. 18th ed. New york: McGraw Hill; 2012;P. 2442.

Venturi S, Venturi M. Iodide, thyroid and stomach carcinogenesis: evolutionary story of a primitive antioxidant? Eur J Endocrinol 1999;140(4):371-2.

How to Cite
Aghili R, Jafarzadeh F, Ghorbani R, Khamseh ME, Salami MA, Malek M. The Association of Helicobacter pylori Infection with Hashimoto’s Thyroiditis. Acta Med Iran. 51(5):293-296.