P. Sundareswari1, J. Ravisankar2, G. Saravana Kumar3, K. S. Gokulnath Premchand4
BACKGROUND
Disturbances in lipid metabolism, which occur during hypothyroidism lead to the formation of gallstones. This study aims to evaluate the thyroid function pattern in patients with gallstones.
The aim of this study was to investigate the association between hypothyroidism and gallstone disease.
MATERIALS AND METHODS
200 patients admitted as inpatients for management of gallstone disease in Department of General Surgery, GRH, Madurai, between September 2014 to August 2015 were evaluated with details of cases, full history, clinical examination, symptoms and signs of hypothyroidism (loss of appetite, gaining weight, tiredness, constipation, cold intolerance, menstrual disturbances, bradycardia, presence or absence of goiter, etc.) and investigations (USG abdomen, USG neck, thyroid function test (T3, T4, TSH)). Patients are divided according to history, clinical examination, USG neck and lab estimation of T3, T4 and TSH.
1. Subclinical Hypothyroidism: Symptom free patient with TSH concentration above upper limit of normal range and T3/T4 or both decrease below normal limit.
2. Clinical Hypothyroidism: In which, there are symptoms of hypothyroidism with TSH level above the upper limit and T3/T4 or both decrease below normal limit.
3. Euthyroid Group: Where clinical and lab tests are within normal range (all these groups may present with or without goiter).
RESULTS
This study included 200 gallstone patients who were studied prospectively over a period of 1 year from September 2014 to August 2015. Among them, 18 patients had subclinical hypothyroidism and 6 patients had clinical hypothyroidism. A total of 12% of gallstone patients were diagnosed to have hypothyroidism showing that there is association of hypothyroidism with gallstone disease.
CONCLUSION
Thyroid dysfunction is more common among patients with gallstones and it maybe a risk factor for biliary stone formation. This may be attributed to the absence of the pro-relaxing effects of thyroid hormones on SO and influence of thyroid hormones on synthesis, absorption and usage of cholesterol.
