Bulimia nervosa and thyroid issues

No items found.
No items found.

Bulimia nervosa (BN) is an eating disorder characterized by binging and purging or compensating behaviors which impacts many organs in the body, including the thyroid. Although there has not been a connection established between BN and thyroid cancer, research has shown that bulimic behaviors do impact thyroid hormone levels.

Last updated on 
In this article

What studies imply about bulimia and thyroid cancer

In 1991, researchers at the National Institutes of Mental Health (NIMH) in Bethesda, Maryland published their study on what happened to thyroid hormone levels in those with bulimia nervosa. They had tested eight bulimic women during a cycle of one week of binge eating and vomiting and seven weeks of abstinence. (1)

The research team found that the T3, T4 levels fell significantly during the time when the women did not binge. The scientists concluded that binge eating and vomiting increases the activity in the thyroid gland. 

Two years later, some of the same researchers on that Bethesda, Maryland team ran another study. This time they examined 18 people with bulimia during their binging cycle and after three weeks of abstinence. During admission, their thyroid hormone levels were in the normal range but their T3 levels were slightly lower than 28 control subjects. (2)

After three weeks of no binges, T3 and T4 had decreased significantly and thyrotropin were increased in the patients. The T3 levels correlated with intake of calories, protein, fat, and carbohydrates and were inversely correlated with weight. They hypothesized that binge-purge behavior may temporarily increase thyroid hormones and metabolic rate in those with bulimia nervosa. They also believe that when T3 decreases after abstinence, it may be because of the lower caloric consumption when not binging or it could reflect hypothalamic-pituitary dysregulation in individuals with BN.

In a 1996 study, 18 women with BN were followed during a period of active binging and vomiting and again after seven weeks of abstinence. The control group was 27 healthy women without BN.

You might be interested in

Again, during the binging phase, those with bulimia had lower T3 values than controls. During the no binging phase, they had lower levels of all thyroid hormones than controls. There were significant reductions in T3, T4, FT4 and TBG compared to the binging period. There was a positive correlation between calories consumed and TSH values, suggesting that binging may stimulate thyroid activity. (3)

None of these studies show any connection of bulimia and thyroid cancer. Polish researchers in 2017 commented in their medical journal that it’s possible for those patients with illness that doesn’t include the thyroid gland to have changes in serum thyroid hormone measurements that may indicate there is thyroid dysfunction occurring. The lab indices to be aware of are low T3, high RT4, and normal or inappropriately low T4 and TSH (thyrotropin) levels. How much thyroid function impairment there is correlates with the severity of the disease and low levels of thyroid hormones. Low levels of thyroxine predict a poor prognosis. 

To date, there’s a lot of controversy about whether this fall in thyroid hormone levels is an adaptation to what’s happening and simply a way to conserve energy, or whether it is something that requires treatment. 

Future studies may tell us more about whether there’s a connection between bulimia and thyroid cancer, but for the present, there is no knowledge of a connection.

If you need support in the treatment, and recovery from bulimia nervosa, please reach out to our team at Within today.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Alternus M, Hetherington M, Kennedy B, Licinio J, Nelson ML, Bernat AS, and Gold PW. Decrease in resting metabolic rate during abstinence from bulimic behavior. Am J Psychiatry. 1991 Aug;148(8):1071-2. https://pubmed.ncbi.nlm.nih.gov/1853959/
  2. Spalter, A. R., Gwirtsman, H. E., Demitrack, M. A., & Gold, P. W. (1993). Thyroid function in bulimia nervosa. Biological psychiatry, 33(6), 408–414. https://doi.org/10.1016/0006-3223(93)90168-d
  3. Alternus M, Hetherington M, Kennedy B, Licinio J, and Gold PW. Thyroid function in bulimia nervosa. Psychoneuroendocrinology. 1996 Apr;21(3):249-61. https://pubmed.ncbi.nlm.nih.gov/8817724/
  4. Krysiak R, Kedzia A, Kowalcze K, and Okopien B. Euthyroid sick syndrome: an important clinical problem. Wiad Lek. 2017; 70(2 pt 2):376-385. https://pubmed.ncbi.nlm.nih.gov/29059662/

FAQs

Further reading

Thumbnail image of an article

Does bulimia cause hearing loss?

Most people are familiar with the digestive system complications bulimia...
Thumbnail image of an article

Why does bulimia cause broken blood vessels?

Attempts at vomiting put extra pressure on the blood vessels of the...
Thumbnail image of an article

What is bulimia bloat?

Bulimia bloat refers to the distended belly that commonly occurs in people who...
Thumbnail image of an article

Which digestive problems does bulimia cause?

‍Bulimia nervosa (BN) affects as many as 300 women per 100,000 women between the...
Thumbnail image of an article

Why does bulimia shaking occur?

Shaking, or trembling, can sometimes occur after purging in individuals with...
Thumbnail image of an article

Can stomach ulcers develop from bulimia?

The connection between bulimia and stomach ulcers is due to stomach...
Thumbnail image of an article

Bulimia nervosa and thyroid issues

Bulimia nervosa (BN) is an eating disorder characterized by binging and...
Thumbnail image of an article

What is sialadentis, or bulimia cheeks?

Bulimia nervosa (BN) is one of the most widely-recognized eating disorders impacting...
Thumbnail image of an article

How bulimia can (permanently) affect your teeth

Bulimia nervosa (BN) is a serious psychiatric disorder that involves frequent...
Thumbnail image of an article

What are the complications of bulimia?

Bulimia nervosa (BN) can be a particularly difficult disorder to endure, both...
Thumbnail image of an article

What are bulimia teeth?

When someone purges, which happens frequently when someone has bulimia nervosa...
Thumbnail image of an article

The relationship between bulimia, skin, and acne

The dehydration and malnutrition that can occur in those with bulimia nervosa can do...
Thumbnail image of an article

Is there a relationship between bulimia, acid reflux, and GERD?

Acid reflux and gastroesophageal reflux disease (GERD) are medical conditions that...
Thumbnail image of an article

Is hair loss a symptom of bulimia nervosa?

Bulimia nervosa (BN) is an eating disorder that can lead to many medical comp...
Thumbnail image of an article

How does bulimia affect the jaw?

Bulimia nervosa (BN) is an eating disorder that affects many parts of the body, incl...
Thumbnail image of an article

How bulimia affects your period

Bulimia nervosa (BN) may cause changes in your menstrual cycle, or period. It has...
Thumbnail image of an article

How bulimia affects the upper GI and respiratory tract

Bulimia nervosa (BN) is an eating disorder that involves frequent purging...
Thumbnail image of an article

How bulimia affects your knuckles

Bulimia nervosa (BN) is a serious eating disorder, in which people engage in eating...
Thumbnail image of an article

Help for bleeding caused by bulimia

Bulimia nervosa (BN) is a serious eating disorder that can have numerous medical...
Thumbnail image of an article

Can bulimia cause cancer?

Some diseases are more likely to lead to cancer than others. For example, alcoholism...
Thumbnail image of an article

What is Russell’s sign?

Although bulimia nervosa (BN) is an insidious disease, usually characterized by...
Thumbnail image of an article

Bulimia nervosa headaches

It’s common for individuals with bulimia nervosa (BN) to experience headaches. One...