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Video

Comprehensive Otolaryngology

(A208) Assessing the Development of Hypothyroidism and Related Disorders Post-H. pylori Infection: A TriNetX analysis

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Arati Bendapudi, BS

    Medical Student
    UTMB John Sealy School of Medicine
    Celina, Texas, United States

    • Co-Author(s)

  • Delaney Shiu Clark, BS

    Medical Student
    University of Texas Medical Branch At Galveston
    Galveston, TX, United States

  • OC

    Orly M. Coblens, MD

    Associate Professor & Residency Program Director
    University of Texas Medical Branch at Galveston
    Galveston, Texas, United States

  • Sepehr Shabani, MD

    Assistant Professor
    City of Hope National Medical Center
    Duarte, California, United States

    • Senior Author(s)

  • Viran J. Ranasinghe, MD

    Assistant Professor
    Department of Otolaryngology, University of Texas Medical Branch
    Galveston, Texas, United States

Disclosure(s):
Arati Bendapudi, BS: No relevant relationships to disclose.
Delaney Shiu Clark, BS: No relevant relationships to disclose.
Orly M. Coblens, MD: No relevant relationships to disclose.
Sepehr Shabani, MD: No relevant relationships to disclose.
Viran J. Ranasinghe, MD: No relevant relationships to disclose.


Introduction: Hypothyroidism is a multifactorial condition with diverse etiologies. Recent studies have proposed a potential association between Helicobacter pylori (H. pylori) infection and the development of hypothyroidism or related autoimmune conditions, such as Hashimoto’s Thyroiditis (HT). The virulence protein CagA of H. pylori is theorized to play a role in autoimmune disease development. This study aimed to evaluate whether H. pylori infection or its treatment is linked to hypothyroidism or related conditions, such as Hashimoto's.

Methods: A retrospective analysis was conducted using the TrinetX database. Patients were categorized into H. pylori-positive and control groups, with a positive urease breath test confirming H. pylori diagnosis. Additional subgroups divided H. pylori-positive patients into those treated with proton pump inhibitors (PPIs) and those who were not. Propensity matching was used to control for age, sex, and race. Individuals with pre-existing endocrine disorders were excluded. Outcomes assessed included diagnoses of Hashimoto’s Thyroiditis or unspecified hypothyroidism, identified via ICD-10 codes.

Results: The control group showed a significantly higher risk of developing hypothyroidism compared to the H. pylori-positive group (15.4% vs 11.37%, p< 0.001). No significant difference was found when comparing the risk of developing Hashimoto's. Among H. pylori-infected patients, the PPI group (n = 4,267) had a significantly higher risk of developing unspecified hypothyroidism (9.07%) compared to the non-PPI group (7.10%), (p < 0.001).

Conclusions: This study found a lower risk of developing hypothyroidism in H. pylori-infected individuals compared to controls. This data contrasts previous literature indicating a possible link between the pathogen and development of thyroid-related autoimmune conditions. However, PPI treatment in H. pylori-positive patients was also seen to increase the risk of developing unspecified hypothyroidism. Further studies are needed to clarify the underlying mechanisms and clinical implications of these findings.