Helicobacter Pylori or short H pylori is one of the most common worldwide human infections. It can be found in your stomach, digestive tract, oral cavities and dental plucks and is considered as a pathogenic infection that is classified as group 1 carcinogen by the World Health Organization’s International Agency for Research on Cancer.
Besides causing many digestive disorders Helicobacter pylori is known to be one of environmental triggers of autoimmunity and leading causes of both Hashimoto’s and Grave’s diseases. H pylori can interact with HLA-DR type of genes and also cause intestinal damage that allows antigens to cross intestinal protective barriers and cause autoimmune reaction.
Multiple research studies have shown that a high percentage of people with high TPO thyroid antibodies were significantly affected by H pylori infection and a noticeable reduction of thyroid antibodies and improvement of the symptoms occur after eradication of H pylori.
Since H pylori infection with these bacteria is considered chronic it often leads to a decrease in the conversion of T4 to the active form of thyroid hormone T3. When the body is put under the stress caused by low grade inflammation and chronic health condition T3 usually gets converted to the reverse T3, This results in low levels of T3 and negative effects of reverse T3 on the thyroid receptors. The entire body gets affected by this inability to convert thyroid hormone properly.
H pylori infection is also linked to Raynaud’s syndrome, systemic autoimmunity and many other organ specific autoimmune conditions such as diabetes mellitus, lupus and multiple sclerosis. H pylori can be responsible for ulcers but can also infiltrate the epithelial tissue to cause autoimmune inflammation of the cardiovascular tissue and even cause sinusitis and Rosacea.
How Do You Get H Pylori Bacteria?
The vast majority of individuals acquire this infection during childhood. Most doctors agree that this bacteria can be easily transmitted orally and one of the most common ways is through a family member. Children can pick it up H pylori from their parents through close contact, saliva and kissing.
Other ways of transmission include:
- Poor hygiene
- Contaminated water and food
- Sexual contacts
- Contaminated endoscopic and dental equipment
- Contact with animals. Helicobacter bacteria were found in cats, dogs and some birds. For example, when children are petting animals and then put their fingers in their mouth they are at a higher risk to get H pylori.
All these factors make H pylori easy to get.
H Pylori Symptoms
Depending on the strain of H pylori it could be a cause of many digestive and non-digestive symptoms and health conditions in humans. It can change pH of your stomach, damage intestinal walls and cause many digestive symptoms and health conditions.
Digestive symptoms are the most obvious indicators for H pylori infection and include:
- Acid reflux
- Bad breath
- Chest pain
- Upper abdominal pain
- Peptic ulcers
- Gastro-intestinal bleeding
And many others.
Research has proven that some strains of H pylori can lead to stomach cancer and is the number one cause of ulcers.
H Pylori has a systemic effect on your body and the symptoms are not necessarily limited to your digestive tract only. If as a result of your digestive issues you cannot properly digest and absorb the foods that you eat, you will develop other symptoms that will affect other parts of the body outside of the digestive system and show less obvious connection to H pylori.
You may develop them even if you don’t have any digestive symptoms and this may include:
- Nutritional deficiencies
- Mood disorders
- Low energy
- Hormonal imbalances
- Heart disease
- Autoimmune thyroid conditions such as Grave’s and Hashimoto’s disease
Indirect Indicators of H Pylori In Thyroid Patients
In some people H pylori doesn’t cause any digestive symptoms at all. Furthermore, people who have H pylori may not all have the same symptoms and this makes it more difficult to diagnose.
Several recent studies have pointed out that subclinical, undiagnosed H pylori infections are far more common than otherwise thought and most people don’t even know that they have it.
One study stated that nearly 50% of the world’s population suffers from an undiagnosed H. Pylori infection. Between 20 and 50% of the population in industrial countries has this bacterial infection. In the developing countries, India and South Asia up to 80-90% of population have H pylori. More people with Hashimoto’s disease are affected by H pylori compared to general population.
Despite of such high prevalence in the general population and people with thyroid disorders doctors seldom test for H pylori even if the symptoms are present.
Instead many doctors choose to recommend OTC preparations or prescribe pharmaceuticals that are available for managing the symptoms first without addressing the root cause.
One of the examples is antacid medications. The popular over-the-counter drugs to relieve symptoms of heartburn is a multi-billion dollar industry while nobody looks into a possibility of H pylori infection and dietary factors that are responsible for this health condition most of the time.
H pylori survives the acidity of the stomach by changing the pH of the stomach and damaging the cells that produce stomach acid. Low stomach acid contributes to indigestion, nutritional deficiencies and makes you more susceptible to other pathogens. This is one of the reasons why about half of the people who have H pylori also have at least one more bacteria or infection in their digestive tract.
When H Pylori damages the intestinal lining any amount of acid that comes into contact with this area can cause pain. This may create a false impression of too much acid that causes the problem.
Indigestion also means that the transit time of the food is increased and the food sits longer in your digestive system which means constipation. If you are hypothyroid and still suffer from constipation after your thyroid treatment was optimized consider testing for H pylori infection as your next step.
Up to 40% of people with hypothyroidism suffer from persistent anemia when either B12 or iron or both are low. H pylori requires B12 vitamins for the survival in the stomach that can be a reason for low B12 levels.
Furthermore, multiple studies have suggested a potential association between unexplained iron deficiency anemia and H. pylori infection. There are two ways how H pylori can cause low iron levels that are usually not responding to iron supplementation:
- H. pylori colonisation in the gastric mucosa may impair iron uptake. The bacteria is associated with chronic gastritis that leads to achlorhydria (low HCL stomach acid) and reduced ascorbic acid secretion. This can cause a significant reduction of intestinal iron absorption.
- H. pylori can increase iron loss due to erosive gastritis and substantial internal bleeding in the damaged mucosal intestinal lining
Research data shows that in 38% of patients with unexplained low iron levels H. pylori eradication was associated with both iron deficiency anemia resolution without further need for iron supplements and stable improved iron levels after nearly two years of follow-up.
The bottom line, if you have this bug you want to get rid of it and not just manage your symptoms.
H Pylori Diagnosis and Testing
H pylori blood test for specific antibodies. High antibodies indicate that you had H pylori infection at some point of your life. According to the research studies, even if the infection was gone the antibodies can stay elevated for up to 5 years. This test doesn’t differentiate between active H pylori infection and one that you had in the past. However, if the test is positive and it correlates with your symptoms, it is considered to be a good indication for a present active H pylori infection.
Endoscopy is an invasive method of laboratory testing when a tube with a small camera is inserted into the throat and a biopsy is taken from the stomach lining. Besides H pylori this test can help to identify if some tissue is inflamed, establish damage to the intestinal lining, presence of ulcers, hernia and cancer.
H pylori breath test when you breathe into a balloon and the gases are getting analyzed on presence of H pylori. This test is the least accurate and often shows false positive or negative results.
Stool antigen testing. It is the easiest and most reliable test that indicates you have H pylori infection if it comes back positive. Another advantage is that the stool test is a comprehensive test when you get tested not only for H pylori but also for many other bacteria, infections and fungi at the same time.
Conventional Treatment For H Pylori
Conventional treatment for H pylori includes antibiotics taken for 7, 10 or 14 days and it works for many people. It is called triple therapy when two different antibiotics are given in order to eradicate H pylori. And the third component is to take an antacid medication to reduce the stomach pain and also make the antibiotics more efficient because antibiotics for H pylori don’t work too well if the stomach is too acidic.
This treatment for H pylori works for about 70-80% of people, however there is more and more cases when H pylori becomes antibiotic resistant making this treatment less effective or effective at all long term.