Biliary Lithiasis and Subclinical Hypothyroidism: Myth or Truth?

Abstract

With an average prevalence in the general population at 4-15% and more than 20% in the elderly, Subclinical Hypothyroidism (SCH) is the most common thyroid dysfunction. The clinical and biological impact of SCH is sometimes atypical, unusual, and very challenging in current medical practice. Among these atypical manifestations of SCH, some publications have suspected a particularly promoting role in the genesis of biliary lithiasis. The purpose of this review is to clarify the relationship between this thyroid dysfunction and gallstones. The systematic review of the literature allows us to conclude that the association between biliary lithiasis and SCH is far from mere chance. Diminished bile secretion, decreased liver cholesterol metabolism, and reduced sphincter of Oddi relaxation are the mechanisms involved in the formation and accumulation of biliary stones in subjects with S CH. Thus systematic screening for SCH is highly recommended in any patient diagnosed with biliary lithiasis.