Role of Chronic Inflammation in Developing Non-Thyroid Illness Syndrome in Symptomatic Patient with H.Pylori-Related Gastric Affection

Background: Helicobacter pylori (H. pylori) infection is a common cause of chronic gastric inflammation and has been linked to systemic effects, including thyroid dysfunction. Non-thyroid illness syndrome (NTIS) is a thyroid hormone imbalance seen in systemic illness without intrinsic thyroid disease. This study aims to evaluate the role of chronic inflammation in the development of NTIS in symptomatic patients with H. pylori-related gastric affection. Methods: This prospective study included 100 adult patients with gastrointestinal symptoms and confirmed H. pylori infection via stool antigen testing. All patients received standard triple therapy (PPI, metronidazole, and amoxicillin). Thyroid function (free T3, free T4, TSH) and inflammatory markers (CRP, ESR, ferritin, IL-6) were assessed at baseline and after 6 months. NTIS was defined by FT3 <1.8 pg/mL and/or FT4 <0.9 ng/dL and TSH <0.35 μIU/mL. Results: NTIS was observed in 5% of patients. These cases showed significantly elevated inflammatory markers compared to NTIS-negative cases: ESR first hour (23.87 ± 8.72 vs. 20.14 ± 8.51 mm/hr, P = 0.017), ESR second hour (35.37 ± 9.38 vs. 29.05 ± 9.04 mm/hr, P = 0.028), CRP (33.04 ± 2.5 vs. 27.01 ± 2.08 mg/L, P = 0.004), ferritin (251.75 ± 78.07 vs. 239.09 ± 83.34 ng/mL, P = 0.012), and IL-6 (19.33 ± 5.41 vs. 17.05 ± 4.99 pg/mL, P = 0.048). Thyroid and inflammatory markers significantly improved after 6 months of therapy. Conclusion: Chronic inflammation due to H. pylori infection may contribute to NTIS development. Early identification and eradication may prevent systemic complications.