Published: 2021-04-28

Thyroid function and gallstone disease: is there an association?

Kharishma P. Nair, Siddartha Gowthaman S., Vinoth S., Ramanathan Manickam


Gallstone disease, amounts to a significant amount of disease burden to the medical society, more commonly encountered in the West. Various predisposing factors are associated with the development of cholelithiasis, namely age, gender, dietary food habits and haemolytic conditions, but whether or not thyroid dysfunction is a causative factor, till date, is a subject of dispute. Gallstones can be classified into cholesterol stones and pigment stones which are black or brown (with cholesterol) in colour. Thyroid hormones are said to have a direct effect on the sphincter of oddi, thereby aiding in biliary emptying. They also alter the lipid metabolism which is said to cause supersaturation of cholesterol in bile, and hence result in the formation of cholesterol stones. Several studies have tried to establish this hypothesis and have concluded with diversified results. This review article throws light into the concept of the association between thyroid dysfunction and formation of gallstones by evaluating several articles through a systematic approach in order to arrive at a better consensus.


Cholelithiasis, Hypothyroidism, Cholesterol, Sphincter of oddi

Full Text:



Jarnagin WR, Blumgart LH. Blumgart's. Surgery of the liver, biliary tract, and pancreas. In: Allen J, Chapman CW, D'Angelica MI, DeMatteo RP, Do RJ, Vauthey JN, eds. 6th ed. Philadelphia, PA: Elsevier; 2017.

Dhamnetiya D, Goel MK, Dhiman B, Pathania OP. Gallstone disease and its correlates among patients attending teaching hospital of North India. J Family Med Prim Care. 2019 Jan;8(1):189-93.

Bansal A, Akhtar M, Bansal A. A clinical study: prevalence and management of cholelithiasis. Int Surg J. 2014;1:134.

tinton LM, Shaffer EA. Epidemiology of Gallbladder Disease: Cholelithiasis and Cancer. Gut Liver. 2012;6(2):172-87.

Laukkarinen J, Sand J, Saaristo R, Salmi J, Turjanmaa V, Vehkalahti P, et al. Is bile flow reduced in patients with hypothyroidism? Surgery. 2003;133(3):288-93.

Cakir M, Kayacetin E, Toy H, Bozkurt S. Gallbladder Motor Function in Patients with Different Thyroid Hormone Status. Exp Clin Endocrinol Diabetes Off J Ger Soc Endocrinol Ger Diabetes Assoc. 2009;117:395-9.

Sood BP, Kalra N, Gupta S, Sidhu R, Gulati M, Khandelwal N, et al. Role of sonography in the diagnosis of gallbladder perforation. J Clin Ultrasound JCU. 2002;30(5):270-4.

Vassilakis JS, Nicolopoulos N. Dissolution of gallstones following thyroxine administration. A case report. Hepatogastroenterology. 1981;28(1):60-1.

Inkinen J, Sand J, Nordback I. Association between common bile duct stones and treated hypothyroidism. Hepatogastroenterology. 2000;47(34):919-21.

Bj SC, Kb N, Goutham M. Hypothyroidism as a risk factor for choledocholithiasis: A case-control study in an Indian population. Int J Surg Sci. 2019;3(4):439-44.

Manimegalai Avvai. The prevalence of undiagnosed thyroid dysfunction and diagnosed diseases of gallstones. IAIM, 2019;6(3):231-6.

Inkinen J, Sand J, Arvola P, Pörsti I, Nordback I. Direct effect of thyroxine on pig sphincter of Oddi contractility. Dig Dis Sci. 2001;46(1):182-6.

Laukkarinen J, Koobi P, Kalliovalkama J, Sand J, Mattila J, Turjanmaa V, et al. Bile flow to the duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2002;14(2):183-8.

Wang Y, Yu X, Zhao Q, Zheng S, Qing W, Miao C, et al. Thyroid dysfunction, either hyper or hypothyroidism, promotes gallstone formation by different mechanisms. J Zhejiang Univ Sci B. 2016;17(7):515-25.

Völzke H, Robinson DM, John U. Association between thyroid function and gallstone disease. World J Gastroenterol WJG. 2005;11(35):5530-4.

N et al A. The prevalence of hypothyroidism in diagnosed cases of cholelithiasis. Int J Clin Biochem Res. 2018;5(1):46–8.

Issa DAH. The prevalence of hypothyroidism in patients with gall stone disease. J Med Sci Clin Res. 2018;6(10).

Sanniyasi S, Edwin RRS, Pothuri N. Does Hypothyroidism Promote Gallstone Formation? 2018;5(11):3.

Jabini R, Hosseini SMA-R, Shirdeli M, Alabaf Yousefi A, Farzanehfar M. The Prevalence of Hypothyroidism in Patients with Biliary Sludge and Gallstones. Rev Clin Med. 2020;7(1):5-9.

Ghafoor MT, Haider SS, Iqbal S, Iqbal MN, Rehman MA, Waseem M. Frequency of hypothyroidism in patients with cholelithiasis. Experience in a teaching hospital. JSZMC 2019;10(1):1586-90.

Pradeep Ghimire MS, Frcs ED. Association of Gallstone Disease with Hypothyroidism in Western Region of Nepal. IOSR J Dental and Med Sci. 2017;16(8):40-2.

Singh AK, Kaul RK, Singh NK, Sinha SP. Prevalence of Thyroid Disorders in Patients of Gall Bladder Stones: A Prospective Study. Ann Int Med Dent Res. 2018;4(4).

Zaini HH, Zwain KM. Prevalence of hypothyroidism in patients with gallstone disease. 2010;6(10):109-17.

Sundareswari1 P, Ravisankar J, Kumar GS, Premchand KSG. Hypothyroidism, Gallstone, Thyroid Function Test. Prospect study hypothyroidism Diagn case gallstone dis. J Evi B H 2016;3(88):4819-23.

Watali YZ, Jain R, Bali RS, Mittal A. Is hypothyroidism a risk for gall stone disease? a study to assess the association. Int Surg J. 2017 Jul 24;4(8):2665-9.

Wali MI, K AP, Mukkapati K. Association of thyroid dysfunction in patients with biliary calculus: A study in tertiary care hospital. Int J Surg Sci. 2020;4(2):624-7.

Rahman DY, Hassan DY, Hussain DA, Ahmad DMN, Awan DN, Zaieem DM. Association between cholelithiasis and thyroid profile – a tertiary hospital care-based study. World J Pharm Med Res. 2018;4(12).

Yousif HH. Relationship Between Serum Levels of TSH and Cholesterol with Types of Gallstones. The Iraqi Med Postgraduate J. 2011;10(1):1-4.